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探索粪便微生物群移植对认知功能的影响:临床试验综述

Exploring the effects of faecal microbiota transplantation on cognitive function: A review of clinical trials.

作者信息

Alaeddin Sara, Chatterjee Anushka, Roberts Tara L, Steiner-Lim Genevieve Z, Jensen Slade O, Gyengesi Erika, Muench Gerald, Ho Vincent

机构信息

School of Medicine, Western Sydney University, Penrith NSW, 2751, Australia.

Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.

出版信息

Brain Behav Immun Health. 2025 Jul 4;48:101049. doi: 10.1016/j.bbih.2025.101049. eCollection 2025 Oct.

Abstract

Faecal Microbiota Transplantation (FMT) is a widely used microbiota-modulation technique to treat recurrent infections (rCDI). Rodent studies and clinical trials on probiotic interventions indicate that alterations in microbiota composition may impact cognitive function. To explore whether FMT influences cognitive function in humans, we conducted a systematic search and narrative synthesis and identified 14 studies examining its effects on cognition. A variety of cohort studies, single-arm trials, case reports and randomised, placebo-controlled trials have been conducted on different neurological patient cohorts, including those with Hepatic Encephalopathy, Parkinson's Disease, dementia, and Mild Cognitive Impairment. FMT has been shown to have a significant impact on cognitive function in these populations, accompanied by alterations in microbial composition and blood markers. Interestingly, success was influenced by the route of FMT administration, indicating greater efficacy of rectal cf. oral administration on microbiome composition and cognitive improvements. However, no clinical trials have yet examined the effects of FMT on cognitively healthy individuals. FMT appears to have potential as a therapeutic strategy for cognitive impairment, though further research with larger sample sizes is needed to explore its effects in both impaired and cognitively healthy populations.

摘要

粪便微生物群移植(FMT)是一种广泛应用的微生物群调节技术,用于治疗复发性感染(rCDI)。对益生菌干预的啮齿动物研究和临床试验表明,微生物群组成的改变可能会影响认知功能。为了探究FMT是否会影响人类的认知功能,我们进行了系统的检索和叙述性综合分析,并确定了14项研究其对认知影响的研究。针对不同的神经疾病患者队列,包括肝性脑病、帕金森病、痴呆和轻度认知障碍患者,开展了各种队列研究、单臂试验、病例报告以及随机安慰剂对照试验。结果表明,FMT对这些人群的认知功能有显著影响,同时伴随着微生物组成和血液标志物的改变。有趣的是,FMT的成功受给药途径的影响,这表明直肠给药相较于口服给药,在微生物群组成和认知改善方面具有更高的疗效。然而,尚无临床试验研究FMT对认知健康个体的影响。尽管需要进一步开展更大样本量的研究,以探索FMT在认知受损和认知健康人群中的作用,但FMT似乎有潜力成为一种治疗认知障碍的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7c4/12273246/91f04ed302f8/ga1.jpg

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