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粪菌移植治疗帕金森病的疗效与安全性:一项系统评价

Efficacy and safety of fecal microbiota transplantation in the management of parkinson's disease: a systematic review.

作者信息

Nabil Yehia, Helal Mohamed Mohsen, Qutob Israa Ahmed, Dawoud Ali I Abbas, Allam Salma, Haddad Roaa, Manasrah Ghaida Majid, AlEdani Esraa M, Sleibi Wadi, Faris Ayhan, Hassan Amr K, Nandwana Varsha

机构信息

Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA.

出版信息

BMC Neurol. 2025 Jul 17;25(1):291. doi: 10.1186/s12883-025-04105-8.

Abstract

BACKGROUND

Parkinson's disease (PD) involves progressive neurodegeneration with motor and non-motor symptoms. Gut microbiota alterations are implicated in PD pathogenesis, leading to interest in fecal microbiota transplantation (FMT) as a therapeutic option. This systematic review assesses the efficacy and safety of FMT in managing PD symptoms.

METHODS

We conducted a comprehensive search across PubMed, Scopus, Web of Science, and Cochrane Central Controlled trials databases. Studies were screened based on predetermined inclusion criteria, focusing on randomized controlled trials (RCTs) involving FMT in PD patients. Two reviewers independently performed the data extraction and quality assessment. Key outcomes included improvements in motor and non-motor symptoms, quality of life, and adverse effects.

RESULTS

Five RCTs involving 157 patients met the inclusion criteria. Some studies reported improvements in motor and non-motor symptoms, particularly with colonic FMT, while others found no significant benefit. One trial observed motor function worsening. FMT was generally well-tolerated, with mild and transient gastrointestinal side effects.

CONCLUSION

FMT may relieve PD symptoms, but findings are inconsistent. Larger trials with standardized protocols are needed to determine its long-term efficacy and safety.

摘要

背景

帕金森病(PD)涉及伴有运动和非运动症状的进行性神经退行性变。肠道微生物群改变与PD发病机制有关,这引发了人们对粪便微生物群移植(FMT)作为一种治疗选择的兴趣。本系统评价评估了FMT在管理PD症状方面的疗效和安全性。

方法

我们在PubMed、Scopus、科学网和Cochrane中心对照试验数据库中进行了全面检索。根据预先确定的纳入标准对研究进行筛选,重点关注涉及PD患者FMT的随机对照试验(RCT)。两名 reviewers 独立进行数据提取和质量评估。主要结局包括运动和非运动症状的改善、生活质量以及不良反应。

结果

五项涉及157例患者的RCT符合纳入标准。一些研究报告了运动和非运动症状的改善,特别是结肠FMT,但其他研究未发现显著益处。一项试验观察到运动功能恶化。FMT总体耐受性良好,有轻度和短暂的胃肠道副作用。

结论

FMT可能缓解PD症状,但结果不一致。需要进行更大规模的标准化方案试验来确定其长期疗效和安全性。

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