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粪便微生物群移植治疗炎症性肠病的现状

The current landscape of fecal microbiota transplantation in treating inflammatory bowel disease.

作者信息

Bi Yajun, Cheng Bomin, Zou Biao, Liu Shengxuan, Cui Zhenze

机构信息

Department of Pediatrics, Dalian Women and Children's Medical Group, Dalian, China.

Graduate School, Dalian Medical University, Dalian, China.

出版信息

Transl Gastroenterol Hepatol. 2025 Jun 11;10:55. doi: 10.21037/tgh-24-138. eCollection 2025.


DOI:10.21037/tgh-24-138
PMID:40755720
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12314702/
Abstract

Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a chronic, immune-mediated disorder that impacts the intestinal tract. The gut microbiota, a diverse community of microorganisms, plays a pivotal role in the initiation, development, and progression of IBD by modulating inflammation, and immune responses, and maintaining gut homeostasis. Dysbiosis, or an imbalance in the gut microbiota, is frequently observed in IBD patients and is believed to contribute to the pathogenesis of the disease by disrupting the mucosal immune system. Fecal microbiota transplantation (FMT) involves transferring feces from a healthy donor (HD) into a recipient and has emerged as a promising therapeutic approach for IBD. The primary goal of FMT is to restore microbial balance in the recipient's gut, improving both microbiota composition and immune function. Numerous preclinical and clinical studies have demonstrated varying degrees of success in alleviating IBD symptoms through FMT. The benefits of FMT include modulation of gut bacteria abundance, restoration of microbial diversity, and enhancement of immune system regulation, all of which contribute to reducing IBD-related inflammation. This review presents a comprehensive analysis of animal studies and clinical trials exploring using FMT as a treatment for IBD. Understanding the underlying mechanisms of FMT in IBD is crucial for designing effective therapeutic strategies and optimizing its clinical impact.

摘要

炎症性肠病(IBD)包括溃疡性结肠炎(UC)和克罗恩病(CD),是一种影响肠道的慢性免疫介导性疾病。肠道微生物群是一个多样化的微生物群落,通过调节炎症、免疫反应和维持肠道稳态,在IBD的发生、发展和进展中发挥关键作用。在IBD患者中经常观察到肠道微生物群失调,即肠道微生物群失衡,据信这是通过破坏黏膜免疫系统导致该疾病发病机制的原因。粪便微生物群移植(FMT)是将健康供体(HD)的粪便转移到受体体内,已成为一种有前景的IBD治疗方法。FMT的主要目标是恢复受体肠道中的微生物平衡,改善微生物群组成和免疫功能。大量临床前和临床研究表明,通过FMT缓解IBD症状取得了不同程度的成功。FMT的益处包括调节肠道细菌丰度、恢复微生物多样性以及增强免疫系统调节,所有这些都有助于减轻与IBD相关的炎症。本综述对探索将FMT用作IBD治疗方法的动物研究和临床试验进行了全面分析。了解FMT在IBD中的潜在机制对于设计有效的治疗策略和优化其临床效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d925/12314702/918397f6dec3/tgh-10-24-138-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d925/12314702/104b852f5f3d/tgh-10-24-138-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d925/12314702/918397f6dec3/tgh-10-24-138-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d925/12314702/104b852f5f3d/tgh-10-24-138-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d925/12314702/918397f6dec3/tgh-10-24-138-f2.jpg

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The current landscape of fecal microbiota transplantation in treating inflammatory bowel disease.

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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Integrated Safety and Efficacy Analyses of Phase 3 Trials of a Microbiome Therapeutic for Recurrent CDI.

Infect Dis Ther. 2024-10

[2]
Navigating the complexities of drug development for inflammatory bowel disease.

Nat Rev Drug Discov. 2024-7

[3]
Novel approaches in IBD therapy: targeting the gut microbiota-bile acid axis.

Gut Microbes. 2024

[4]
Faecal Transplantation for Ulcerative Colitis From Diet Conditioned Donors Followed by Dietary Intervention Results in Favourable Gut Microbial Profile Compared to Faecal Transplantation Alone.

J Crohns Colitis. 2024-10-15

[5]
The management of patients with inflammatory bowel disease-associated spondyloarthritis: Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) and Italian Society of Rheumatology (SIR) recommendations based on a pseudo-Delphi consensus.

Autoimmun Rev. 2024-5

[6]
and served as key components of fecal microbiota transplantation to alleviate colitis.

Am J Physiol Gastrointest Liver Physiol. 2024-5-1

[7]
Long- and short-term effects of fecal microbiota transplantation on antibiotic resistance genes: results from a randomized placebo-controlled trial.

Gut Microbes. 2024

[8]
Updates on the management of inflammatory bowel disease from periconception to pregnancy and lactation.

Lancet. 2024-3-30

[9]
Protective effects of fecal microbiota transplantation against ischemic stroke and other neurological disorders: an update.

Front Immunol. 2024

[10]
Metabolic network of the gut microbiota in inflammatory bowel disease.

Inflamm Regen. 2024-3-5

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