Singh Arshdeep, Midha Vandana, Chauhan Nar Singh, Sood Ajit
Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
Indian J Gastroenterol. 2024 Feb;43(1):129-144. doi: 10.1007/s12664-023-01516-8. Epub 2024 Feb 9.
Fecal microbiota transplantation (FMT) has emerged as a promising therapeutic modality within the domain of inflammatory bowel disease (IBD). While FMT has secured approval and demonstrated efficacy in addressing recurrent and refractory Clostridioides difficile infection, its application in IBD remains an area of active exploration and research. The current status of FMT in IBD reflects a nuanced landscape, with ongoing investigations delving into its effectiveness, safety and optimal implementation. Early-stage clinical trials and observational studies have provided insights into the potential of FMT to modulate the dysbiotic gut microbiota associated with IBD, aiming to mitigate inflammation and promote mucosal healing. However, considerable complexities persist, including variations in donor selection, treatment protocols and outcome assessments. Challenges in standardizing FMT protocols for IBD treatment are compounded by the dynamic nature of the gut microbiome and the heterogeneity of IBD itself. Despite these challenges, enthusiasm for FMT in IBD emanates from its capacity to address gut microbial dysbiosis, signifying a paradigm shift towards more comprehensive approaches in IBD management. As ongoing research progresses, an enhanced understanding of FMT's role in IBD therapy is anticipated. This article synthesizes the current status of FMT in IBD, elucidating the attendant challenges and aspiring towards the refinement of its application for improved patient outcomes.
粪便微生物群移植(FMT)已成为炎症性肠病(IBD)领域一种有前景的治疗方式。虽然FMT已获批并在治疗复发性和难治性艰难梭菌感染方面显示出疗效,但其在IBD中的应用仍是一个积极探索和研究的领域。FMT在IBD中的现状反映出一个微妙的局面,正在进行的调查深入研究其有效性、安全性和最佳实施方式。早期临床试验和观察性研究已对FMT调节与IBD相关的肠道微生物群失调的潜力提供了见解,旨在减轻炎症并促进黏膜愈合。然而,相当多的复杂性依然存在,包括供体选择、治疗方案和结果评估的差异。肠道微生物组的动态性质和IBD本身的异质性使IBD治疗的FMT方案标准化面临的挑战更加复杂。尽管存在这些挑战,但FMT在IBD中的应用前景源于其解决肠道微生物群失调的能力,这标志着IBD管理向更全面方法的范式转变。随着正在进行的研究不断推进,预计对FMT在IBD治疗中作用的理解将得到增强。本文综合了FMT在IBD中的现状,阐明了随之而来的挑战,并期望优化其应用以改善患者预后。
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