Sanzone Jenna, Life Mason, Reiss Devan, May Daniel, Hartley Brianna, Spiddle Patrick, Al-Kirwi Joseph, Grigoryan Tigran, Costin Joshua
Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA.
Cureus. 2024 Jun 12;16(6):e62265. doi: 10.7759/cureus.62265. eCollection 2024 Jun.
Fecal microbiota transplantation (FMT) is the administration of fecal bacteria from a healthy donor into the intestinal tract of a recipient in order to directly change the recipient's gut microbial composition and confer a health benefit. The relationship between the gut microbiome and the central nervous system, termed the gut-brain axis, has been a frequent topic of gut microbiome studies. Commensal gut bacteria communicate with the central nervous system through various hormones, cytokines, and neural pathways. Therefore, influencing the gut microbiome via FMT may have the potential in treating symptoms of neurodegenerative conditions. This study aims to identify current uses of FMT in treating neurodegenerative diseases and highlight areas of future investigation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, a literature search was conducted of peer-reviewed sources on September 27, 2022, from Embase, MEDLINE, Web of Science, and Cochrane Central. Search terms were utilized that were related to the application of FMT and neurodegenerative disorders and limited those human studies, those that were published in English, and those that were published between 2017 and 2022. The initial search yielded 450 unique articles, and after the assessment of the title and abstract for inclusion and exclusion criteria, six articles were identified for full-text review. Studies that focused on either Parkinson's disease (PD) or multiple sclerosis (MS) demonstrated improvements in both motor symptoms and non-motor symptoms. FMT was also shown to provide significant relief of constipation and general gastrointestinal (GI) symptoms in all conditions studied. The studies related to MS showed the most mixed results with regard to symptomatic improvement. The data on the use of FMT as a treatment for neurodegenerative disorders is limited; however, studies have shown not only improvement in GI symptoms but also improvement in the cognitive symptoms of PD and dementia. The data on FMT as a treatment to improve the motor symptoms of PD is both more complete and more compelling than the data on the motor symptoms of MS. The studies that were reviewed showed no major adverse effects of FMT and generally promising results. There is a strong case to be made for larger, more well-controlled studies to be done on FMT and its potential use as a treatment not only for GI symptoms but for the motor and cognitive symptoms of neurodegenerative diseases.
粪便微生物群移植（FMT）是将来自健康供体的粪便细菌导入受体的肠道，以直接改变受体的肠道微生物组成并带来健康益处。肠道微生物群与中枢神经系统之间的关系，即肠-脑轴，一直是肠道微生物群研究的热门话题。共生肠道细菌通过各种激素、细胞因子和神经通路与中枢神经系统进行交流。因此，通过FMT影响肠道微生物群可能具有治疗神经退行性疾病症状的潜力。本研究旨在确定FMT在治疗神经退行性疾病中的当前用途，并突出未来的研究领域。按照系统评价和荟萃分析的首选报告项目（PRISMA）框架，于2022年9月27日在Embase、MEDLINE、科学网和考科蓝中央对照试验注册库中对同行评审来源进行了文献检索。使用了与FMT应用和神经退行性疾病相关的检索词，并将检索范围限定为人类研究、英文发表的研究以及2017年至2022年发表的研究。初步检索产生了450篇独特的文章，在根据纳入和排除标准对标题和摘要进行评估后，确定了6篇文章进行全文审查。专注于帕金森病（PD）或多发性硬化症（MS）的研究表明，运动症状和非运动症状均有改善。在所有研究的病症中，FMT还显示出能显著缓解便秘和一般胃肠道（GI）症状。与MS相关的研究在症状改善方面结果最为参差不齐。关于使用FMT治疗神经退行性疾病的数据有限；然而，研究表明，FMT不仅能改善胃肠道症状，还能改善PD和痴呆症的认知症状。与MS运动症状的数据相比，关于FMT作为改善PD运动症状的治疗方法的数据更完整、更有说服力。所审查的研究表明，FMT没有重大不良反应，总体结果令人鼓舞。有充分理由开展规模更大、控制更严格的研究，以研究FMT及其作为不仅治疗胃肠道症状，而且治疗神经退行性疾病的运动和认知症状的潜在用途。
