超越随机粪便微生物移植：用于使失调微生物群正常化以治疗炎症性肠病的下一代个性化方法。

Beyond Random Fecal Microbial Transplants: Next Generation Personalized Approaches to Normalize Dysbiotic Microbiota for Treating IBD.

作者信息

Sartor R Balfour

机构信息

Department of Medicine, Center for Gastrointestinal Biology and Disease, University of North Carolina - Chapel Hill, Chapel Hill, NC 27517, USA; Department of Microbiology & Immunology, Center for Gastrointestinal Biology and Disease, University of North Carolina - Chapel Hill, Chapel Hill, NC 27517, USA.

出版信息

Gastroenterol Clin North Am. 2025 Jun;54(2):333-350. doi: 10.1016/j.gtc.2024.11.002. Epub 2024 Dec 4.

DOI:10.1016/j.gtc.2024.11.002

PMID:40348491

Abstract

This review and commentary outline the strong rationale for normalizing the abnormal microbiota of patients with ulcerative colitis, Crohn's disease, and pouchitis and focus on strategies to improve current variable outcomes of fecal microbial transplant (FMT) in ulcerative colitis. Applying lessons from successful FMT therapy of recurrent Clostridioides difficile and insights from basic scientific understanding of host/microbial interactions provide strategies to enhance clinical outcomes in IBD. We outline promising approaches to develop novel-defined consortia of live biotherapeutic products and combination treatments to improve current results and to optimize and personalize treatment approaches in individual patients and disease subsets.

摘要

本综述与评论概述了使溃疡性结肠炎、克罗恩病和袋炎患者的异常微生物群正常化的有力理由，并着重探讨改善目前溃疡性结肠炎粪便微生物移植（FMT）可变结果的策略。借鉴复发性艰难梭菌感染FMT治疗的成功经验以及对宿主/微生物相互作用的基础科学理解所获得的见解，可提供改善炎症性肠病临床结果的策略。我们概述了开发新型明确的活生物治疗产品组合以及联合治疗的有前景的方法，以改善当前的治疗效果，并在个体患者和疾病亚组中优化和个性化治疗方法。