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Fecal microbiota transplantation as novel therapy in gastroenterology:A systematic review

World Journal of gastroenterology 2015年第17期21卷 5359-5371页

作者： Noortje g Rossen John K Mac Donald Elisabeth M de Vries geert R D'Haens Willem M de Vos erwin g zoetendal Cyriel Y Ponsioen Department of gastroenterology and Hepatology Academic Medical Center Amsterdam1105 AZ AmsterdamThe Netherlands Division of gastroenterology Robarts Clinical trialsRobarts Research Institutethe University of Western OntarioLondonCanada and Amsterdamthe NetherlandsOntario N6A 5K8Canada Departments of Bacteriology and Immunology and Veterinary Biosciences University of HelsinkiFI-00014 HelsinkiFinland Laboratory of Microbiology Wageningen University6703 HA Wageningenthe Netherlands

AIM:To study the clinical efficacy and safety of Fecal microbiota transplantation(FMT).We systematically reviewed FMT used as clinical ***:We searched MEDLINE,EMBASE,the Cochrane Library and Conference proceedings from inception to July,*** effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category,on an intention-to-treat ***:We included 45 studies;34 on Clostridium difficile-infection(CDI),7 on inflammatory bowel disease,1 on metabolic syndrome,1 on constipation,1 on pouchitis and 1 on irritable bowel syndrome(IBS).In CDI 90% resolution of diarrhea in 33 case series(n = 867) was reported,and 94% resolution of diarrhea after repeated FMT in a randomized controlled trial(RCT)(n = 16).In ulcerative colitis(UC) remission rates of 0% to 68% were found(n = 106).In Crohn's disease(CD)(n = 6),no benefit was *** IBS,70% improvement of symptoms was found(n = 13).100% Reversal of symptoms was observed in constipation(n = 3).In pouchitis,none of the patients(n = 8) achieved *** RCT showed significant improvement of insulin sensitivity in metabolic syndrome(n = 10).Serious adverse events were ***:FMT is highly effective in CDI,and holds promise in *** for CD,chronic constipation,pouchitis and IBS data are too limited to draw *** increases insulin sensitivity in metabolic syndrome.

关键词： Fecal microbiota transplantation Microbiota Clostridium difficile infection Inflammatory boweldisease Metabolic syndrome

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Effect of fiber supplementation on the microbiota in critically ill patients

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World Journal of gastrointestinal Pathophysiology 2011年第6期2卷 138-145页

作者： Stephen JD O'Keefe Junhai Ou James P DeLany Scott Curry erwin zoetendal H Rex gaskins Scott gunn Division of gastroenterology Department of MedicineUniversity of PittsburghPittsburghPA 15213United States Division of Endocrinology Department of MedicineUniversity of PittsburghPittsburghPA 15261United States Division of Infectious Disease Department of MedicineUniversity of PittsburghPittsburghPA 15261United States Laboratory of Microbiology Wageningen UniversityWageningen 6703HBThe Netherlands Department of Animal Sciences and Pathobiology Division of Nutritional SciencesInstitute for Genomic BiologyUniversity of Illinois at Urbana-ChampaignUrbanaIL 61801United States Division of Critical Care Medicine Department of MedicineUniversity of PittsburghPittsburghPA 15261United States

AIM:To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and ***:Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were *** study was divided into 2 parts:first,short-term (3-9 d)clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid(SCFA)concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid;second,4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR)of microbial 16S rRNA genes and Human Intestinal Tract Chip(HITChip)microarray *** all patients were receiving antibiotics(10/13)and acid suppressants(11/13)at some stage during the ***:In group 1,tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence(P=0.008 and Pgroup 2 before supplementation,fecal microbiota mass and their metabolites,SCFA,were dramatically lower in patients compared to healthy *** qPCR and HITChip analyses we calculated that there was a 97%reduction in the predominant potential butyrate producers and starch *** 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA(acetate 28.4±4.1μmol/g to 42.5±3.1μmol/g dry weight,P=0.01;propionate 1.6±0.5 vs 6.22±1.1,P=0.006 and butyrate 2.5±0.6 vs 5.9±1.1,P=0.04)and microbial counts of specific butyrate producers,with resolution of diarrhea in 3 of 4 ***:Conventional management of critically ill patie

关键词： Critical illness Acute pancreatitis Microbiota Enteral nutrition Fiber

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