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《粪菌移植治疗帕金森病患者的安全性和可行性:一项自身对照的供体-FMT 初步研究方案》

Safety and feasibility of faecal microbiota transplantation for patients with Parkinson's disease: a protocol for a self-controlled interventional donor-FMT pilot study.

机构信息

Department of Medical Microbiology, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands

Department of Medical Microbiology, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

BMJ Open. 2023 Oct 5;13(10):e071766. doi: 10.1136/bmjopen-2023-071766.


DOI:10.1136/bmjopen-2023-071766
PMID:37798034
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10565159/
Abstract

INTRODUCTION: Experimental studies suggest a role of gut microbiota in the pathophysiology of Parkinson's disease (PD) via the gut-brain axis. The gut microbiota can also influence the metabolism of levodopa, which is the mainstay of treatment of PD. Therefore, modifying the gut microbiota by faecal microbiota transplantation (FMT) could be a supportive treatment strategy. METHODS AND ANALYSIS: We have developed a study protocol for a single-centre, prospective, self-controlled, interventional, safety and feasibility donor-FMT pilot study with randomisation and double-blinded allocation of donor faeces. The primary objectives are feasibility and safety of FMT in patients with PD. Secondary objectives include exploring whether FMT leads to alterations in motor complications (fluctuations and dyskinesias) and PD motor and non-motor symptoms (including constipation), determining alterations in gut microbiota composition, assessing donor-recipient microbiota similarities and their association with PD symptoms and motor complications, evaluating the ease of the study protocol and examining FMT-related adverse events in patients with PD. The study population will consist of 16 patients with idiopathic PD that use levodopa and experience motor complications. They will receive FMT with faeces from one of two selected healthy human donors. FMT will be administered via a gastroscope into the duodenum, after treatment with oral vancomycin, bowel lavage and domperidone. There will be seven follow-up moments during 12 months. ETHICS AND DISSEMINATION: This study was approved by the Medical Ethical Committee Leiden Den Haag Delft (ref. P20.087). Study results will be disseminated through publication in peer-reviewed journals and international conferences. TRIAL REGISTRATION NUMBER: International Clinical Trial Registry Platform: NL9438.

摘要

简介:实验研究表明,通过肠-脑轴,肠道微生物群在帕金森病 (PD) 的病理生理学中起作用。肠道微生物群也可以影响左旋多巴的代谢,左旋多巴是 PD 治疗的主要方法。因此,通过粪便微生物群移植 (FMT) 来改变肠道微生物群可能是一种支持性的治疗策略。

方法和分析:我们已经制定了一项关于单中心、前瞻性、自我对照、干预性、安全性和可行性供体-FMT 先导研究的研究方案,该方案采用随机化和供体粪便的双盲分配。主要目标是评估 FMT 在 PD 患者中的可行性和安全性。次要目标包括探索 FMT 是否导致运动并发症(波动和运动障碍)和 PD 运动和非运动症状(包括便秘)的改变,确定肠道微生物群组成的变化,评估供体-受者微生物群的相似性及其与 PD 症状和运动并发症的关联,评估研究方案的容易程度,并检查 PD 患者的 FMT 相关不良事件。研究人群将包括 16 名使用左旋多巴且出现运动并发症的特发性 PD 患者。他们将接受来自两名选定健康人类供体之一的粪便 FMT。FMT 将通过胃镜进入十二指肠进行,在口服万古霉素、肠道灌洗和多潘立酮治疗后进行。在 12 个月内将有七个随访时刻。

伦理和传播:这项研究得到了莱顿德黑兰代尔夫特医学伦理委员会 (P20.087) 的批准。研究结果将通过发表在同行评议期刊和国际会议上进行传播。

试验注册编号:国际临床试验注册平台:NL9438。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bf1/10565159/ab5a53021882/bmjopen-2023-071766f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bf1/10565159/ab5a53021882/bmjopen-2023-071766f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bf1/10565159/ab5a53021882/bmjopen-2023-071766f01.jpg

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[1]
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引用本文的文献

[1]
The microbiota-gut-brain axis and central nervous system diseases: from mechanisms of pathogenesis to therapeutic strategies.

Front Microbiol. 2025-6-13

[2]
Short-chain fatty acids mediate enteric and central nervous system homeostasis in Parkinson's disease: Innovative therapies and their translation.

Neural Regen Res. 2026-3-1

[3]
The Gut-Brain Axis in Parkinson disease: Emerging Concepts and Therapeutic Implications.

Mov Disord Clin Pract. 2025-3-13

[4]
Young rat microbiota extracts strongly inhibit fibrillation of α-synuclein and protect neuroblastoma cells and zebrafish against α-synuclein toxicity.

Mol Cells. 2025-1

[5]
The interplay between gut microbiota and the brain-gut axis in Parkinson's disease treatment.

Front Neurol. 2024-5-29

[6]
Buty and the beast: the complex role of butyrate in Parkinson's disease.

Front Pharmacol. 2024-4-17

[7]
The Gut Microbiota in Parkinson Disease: Interactions with Drugs and Potential for Therapeutic Applications.

CNS Drugs. 2024-5

[8]
Targeting the Gut-Brain Axis with Fecal Microbiota Transplantation: Considerations on a Potential Novel Treatment for Parkinson's Disease.

Mov Disord Clin Pract. 2022-12-7

[9]
Therapeutic Perspectives for Microbiota Transplantation in Digestive Diseases and Neoplasia-A Literature Review.

Pathogens. 2023-5-26

本文引用的文献

[1]
Targeting the Gut-Brain Axis with Fecal Microbiota Transplantation: Considerations on a Potential Novel Treatment for Parkinson's Disease.

Mov Disord Clin Pract. 2022-12-7

[2]
Fecal microbiota transplantation in Parkinson's disease-A randomized repeat-dose, placebo-controlled clinical pilot study.

Front Neurol. 2023-3-2

[3]
Fecal Microbiota Transplantation for Severe or Fulminant Infection: Systematic Review and Meta-analysis.

J Can Assoc Gastroenterol. 2021-7-23

[4]
European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults.

Clin Microbiol Infect. 2021-12

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Fecal microbiota transplant as a potential treatment for Parkinson's disease - A case series.

Clin Neurol Neurosurg. 2021-8

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Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults.

Clin Infect Dis. 2021-9-7

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Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation.

Microb Cell Fact. 2021-5-13

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Gastrointestinal Dysfunction in Parkinson's Disease.

J Clin Med. 2021-1-31

[9]
Faecal microbiota transplantation for recurrent infection: An updated systematic review and meta-analysis.

EClinicalMedicine. 2020-11-23

[10]
Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020.

Aliment Pharmacol Ther. 2021-1

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