Lahoud Chloe, Habib Toni, Kalta Daniel, Dimachkie Reem, El Sayegh Suzanne, Deeb Liliane
Department of Internal Medicine, Staten Island University Hospital, Northwell Health, 475 Seaview Avenue, Staten Island, New York, NY 10305, USA.
Division of Gastroenterology and Hepatology, Staten Island University Hospital, Northwell Health, 475 Seaview Avenue, Staten Island, New York, NY 10305, USA.
J Clin Med. 2025 Jul 25;14(15):5260. doi: 10.3390/jcm14155260.
: Inflammatory bowel disease (IBD) is characterized by chronic relapsing and remitting inflammation of the gastrointestinal tract. Fecal microbiota transplantation (FMT) has emerged as an FDA-approved treatment for recurrent infections (CDIs), with promising potential in patients with IBD. This manuscript aimed to provide a comprehensive and updated review of the available literature on fecal microbiota transplantation, its clinical use in IBD in general, as well as in patients with IBD and CDI. : An extensive literature search was performed from October 2024 to March 2025. All publications available within PubMed, Medline, Embase, Google Scholar, and Cochrane databases were reviewed. All original articles, case reports, review articles, systematic reviews, and meta-analyses were included. Qualitative and quantitative data were both extracted. : Intestinal microbiota is an integral part of the human body, and dysbiosis (an imbalance in the gut's microbial community) has been linked with several pathologies. Dysbiosis in IBD is marked by reduced beneficial bacteria and increased pro-inflammatory pathogens, contributing to mucosal damage and immune dysregulation. FMT has emerged as a solution to dysbiosis, with the first case recorded in 1917. FMT has been successful in treating patients with CDI. The diagnostic value of the gut microbiome is currently being explored as a possible therapeutic approach to IBD. Several studies have assessed FMT in patients with IBD and CDI with promising results in both ulcerative colitis (UC) and Crohn's disease (CD) but varying efficacy based on administration routes, donor selection, and processing methods. In the context of recurrent CDI in patients with IBD, FMT demonstrates a high cure rate and potential benefit in concurrently improving IBD activity. However, risks such as IBD flare-ups post-FMT remain a concern. : FMT holds promising potential in the management of CDI in patients with IBD. By restoring microbial diversity and correcting dysbiosis, FMT offers a novel, microbiota-targeted alternative to conventional therapies. While data support its efficacy in improving disease remission, variability in outcomes underscores the need for standardized protocols and additional large-scale, controlled studies. Continued research efforts into donor selection, treatment regimens, and long-term safety will be critical to optimizing FMT's role in IBD and CDI care as well as improving patient outcomes.
炎症性肠病(IBD)的特征是胃肠道的慢性复发和缓解性炎症。粪便微生物群移植(FMT)已成为美国食品药品监督管理局(FDA)批准的复发性感染(CDI)治疗方法,在IBD患者中具有广阔的应用前景。本手稿旨在对粪便微生物群移植的现有文献进行全面更新的综述,包括其在IBD总体上以及IBD合并CDI患者中的临床应用。:2024年10月至2025年3月进行了广泛的文献检索。对PubMed、Medline、Embase、谷歌学术和Cochrane数据库中所有可用的出版物进行了综述。纳入了所有原创文章、病例报告、综述文章、系统评价和荟萃分析。提取了定性和定量数据。:肠道微生物群是人体不可或缺的一部分,微生物群失调(肠道微生物群落失衡)与多种疾病有关。IBD中的微生物群失调表现为有益细菌减少和促炎病原体增加,导致黏膜损伤和免疫失调。FMT已成为解决微生物群失调的一种方法,首例病例记录于1917年。FMT已成功用于治疗CDI患者。目前正在探索肠道微生物组的诊断价值,作为IBD的一种可能治疗方法。多项研究评估了IBD合并CDI患者的FMT,在溃疡性结肠炎(UC)和克罗恩病(CD)中均取得了有希望的结果,但疗效因给药途径、供体选择和处理方法而异。在IBD患者复发性CDI的背景下,FMT显示出高治愈率,并在同时改善IBD活动方面具有潜在益处。然而,FMT后IBD发作等风险仍然令人担忧。:FMT在IBD患者的CDI管理中具有广阔的应用前景。通过恢复微生物多样性和纠正微生物群失调,FMT为传统疗法提供了一种新的、以微生物群为靶点的替代方法。虽然数据支持其在改善疾病缓解方面的疗效,但结果的变异性强调了标准化方案和更多大规模对照研究的必要性。对供体选择、治疗方案和长期安全性的持续研究努力对于优化FMT在IBD和CDI治疗中的作用以及改善患者预后至关重要。
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