Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials

Wang, Mancai; Xie, Xiaofeng; Zhao, Sumei; Ma, Xiao‐Jun; Wang, Zheyuan; Zhang, Youcheng

doi:10.3389/fimmu.2023.1136343

Cited by 10 publications

(6 citation statements)

References 88 publications

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“…Specifically, we speculate that higher levels of fecal organic acids in NC-IBS patients may indicate a greater likelihood of success for therapeutic interventions targeting the microbiome. In addition to the low-FODMAP diet, which has significant limitations in long-term sustainability, this subset of IBS patients may represent the population most likely to derive substantial benefits from treatments such as antibiotics (e.g., as rifaximin), interventions involving probiotics or live biotherapeutics (e.g., Blautia hydrogenotrophica , 50 , and fecal microbiota transplantation (FMT), the efficacy of which in IBS is controversial 51 . Concerning FMT, we can postulate that in IBS patients where the colonic microbial ecosystem is a major contributor to symptoms (as we hypothesized here, particularly in FC-H patients), FMT may offer the most significant and potentially enduring advantages.…”

Section: Discussionmentioning

confidence: 99%

Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Gargari,

Mantegazza,

Taverniti

et al. 2023

Gut Microbes

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The gut microbiota is believed to be a critical factor in the pathogenesis of IBS, and its metabolic byproducts, such as short-chain fatty acids (SCFAs), are known to influence gut function and host health. Despite this, the precise role of SCFAs in IBS remains a topic of debate. In this study, we examined the bacterial community structure by 16S rRNA gene profiling and SCFA levels by UPLC-MS/MS in fecal samples from healthy controls (HC; n = 100) and non-constipated patients (IBS-D and IBS-M; NC-IBS; n = 240) enrolled in 19 hospitals in Italy. Our findings suggest a significant difference between the fecal microbiomes of NC-IBS patients and HC subjects, with HC exhibiting higher intra-sample biodiversity. Furthermore, we were able to classify non-constipated patients into two distinct subgroups based on their fecal SCFA levels (fecal catabotype “high” and “low”), each characterized by unique taxonomic bacterial signatures. Our results suggest that the fecal catabotype with higher SCFA levels may represent a distinct clinical phenotype of IBS that could have implications for its diagnosis and treatment. This study provides a new perspective on the intricate relationship between the gut microbiome and bowel symptoms in IBS, underscoring the importance of personalized strategies for its management.

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Section: Discussionmentioning

confidence: 99%

Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Gargari,

Mantegazza,

Taverniti

et al. 2023

Gut Microbes

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“…Outcomes . The primary outcome measures of this review will be the efficiency rate and the Symptoms Severity Score [ 30 ]. The clinical efficiency rate was defined as the degree of relief of IBS symptoms, which are assessed through the Symptoms Severity Score.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of different courses of acupuncture for diarrhea irritable bowel syndrome: A protocol for systematic review and meta-analysis

Tian,

Li,

Zhao

et al. 2023

PLoS ONE

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Irritable Bowel Syndrome (IBS) is the most common functional gastrointestinal disorder. As one of the most common subtypes of IBS, IBS-D can impair the patients’ quality of life (QOL) and decreased work productivity. Acupuncture may be a potential treatment for patients with IBS-D. However, the treatment course of acupuncture was diverse. It is unclear what is the optimal acupuncture treatment courses for acupuncture. The efficacy and safety of different courses of acupuncture for IBS-D have not been systematically evaluated yet. The purpose of this study is to evaluate effectiveness of Acupuncture of different courses in the treatment of IBS-D and provide sufficient evidence for clinical recommendations for IBS-D. We will follow the Preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) guidelines to design the protocol of a systematic review and meta-analysis. This systematic review is registered in PROSPERO (CRD42023418846). We will include randomized controlled trials (RCTs) in which the efficacy of Acupuncture is compared with a placebo, sham acupuncture or Pinaverium bromide in the treatment of IBS-D with no language restrictions. The outcomes of interest will be efficiency rate and the Symptoms Severity Score. RCTs will be searched in the electronic database and Clinical Trials Registry Platform from inception to April 2023. Two independent reviewers will independently select studies, extract data from the included studies, and assess the risk of bias using the Cochrane tool. We will choose a random or fixed-effects model based on the heterogeneity index. We will use the relative risk and mean difference to estimate data with 95% CI. A stratified meta-analysis was conducted to evaluate the effect of different treatment courses of Acupuncture: 2weeks, 4weeks(or 1 months), 6 weeks, and 8 weeks. If there is significant clinical and methodological heterogeneity, we will look for the reason for heterogeneity and perform a subgroup analysis. According to the Grading of Recommendations Assessment, Development and Evaluation (GRADE), we will evaluate the evidence quality and provide the recommendation’s strength.

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“…Each modality can improve the composition of the gut microbiota effectively and has been widely used in digestive diseases other than cancer. 82,83 Endoscopic transplantation is the most direct way to accurately transplant larger amounts of intestinal bacteria into the implicated bowel segment with potentially greater clinical efficacy, especially in recurrent Clostridium difficile infection (CDI), 84,85 IBS, 85 and IBD. 86,87 However, endoscopic operations are more invasive and intolerable.…”

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

Modulation of gut microbiota: a novel approach to enhancing the effects of immune checkpoint inhibitors

Huang,

Gong,

Zhou

2023

Ther Adv Med Oncol

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Although immune checkpoint inhibitors (ICIs) have greatly improved the prognosis of some cancer patients, the majority still fail to respond adequately, and the available biomarkers cannot reliably predict drug efficacy. The gut microbiota has received widespread attention among the various intrinsic and extrinsic factors contributing to drug resistance. As an essential regulator of physiological function, the impact of gut microbiota on host immunity and response to cancer therapy is increasingly recognized. Several studies have demonstrated significant differences in gut microbiota between responders and nonresponders. The gut microbiota associated with better clinical outcomes is called ‘favorable gut microbiota’. Significantly, interventions can alter the gut microbiota. By shifting the gut microbiota to the ‘favorable’ one through various modifications, preclinical and clinical studies have yielded more pronounced responses and better clinical outcomes when combined with ICIs treatment, providing novel approaches to improve the efficacy of cancer immunotherapy. These findings may be attributed to the effects of gut microbiota and its metabolites on the immune microenvironment and the systemic immune system, but the underlying mechanisms remain to be discovered. In this review, we summarize the clinical evidence that the gut microbiota is strongly associated with the outcomes of ICI treatment and describe the gut microbiota characteristics associated with better clinical outcomes. We then expand on the current prevalent modalities of gut microbiota regulation, provide a comprehensive overview of preclinical and clinical research advances in improving the therapeutic efficacy and prognosis of ICIs by modulating gut microbiota, and suggest fundamental questions we need to address and potential directions for future research expansion.

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Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials

Cited by 10 publications

References 88 publications

Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Efficacy of different courses of acupuncture for diarrhea irritable bowel syndrome: A protocol for systematic review and meta-analysis

Modulation of gut microbiota: a novel approach to enhancing the effects of immune checkpoint inhibitors

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