Fecal Microbiota Transplantation for Recurrent <i>Clostridium difficile</i> Infection and Other Conditions in Children

Davidovics, Zev; Michail, Sonia; Nicholson, Maribeth R; Kociolek, Larry K.; Pai, Nikhil; Hansen, Richard; Schwerd, Tobias; Maspons, Aldo; Shamir, Raanan; Szajewska, Hania; Thapar, Nikhil; Meij, Tim de; Mosca, Alexis; Vandenplas, Yvan; Kahn, Stacy A.; Kellermayer, Richárd

doi:10.1097/mpg.0000000000002205

Cited by 99 publications

(65 citation statements)

References 155 publications

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“…It should be noticed that the diversity of probiotic intervention employed by the different studies may result in confounding, which is important because lots of publications have proved that different species of probiotics may promote opposing effects in human beings [67]. However, complex existing data including doses, durations, pharmaceutical formulations, and combination of treatment differed in each study are difficult to reconcile.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review with Meta-Analysis: The Effects of Probiotics in Nonalcoholic Fatty Liver Disease

Xiao

Lin

Shen

et al. 2019

Gastroenterology Research and Practice

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Background and Aims Probiotics was considered as a potential therapy for nonalcoholic fatty liver disease (NAFLD) without approval and comprehensive assessment in recent years, which call for a meta-analysis. Methods We performed electronic and manual searches including English and Chinese databases published before April 2019, with the use of mesh term and free text of “nonalcoholic fatty liver disease” and “probiotics.” Clinical trials evaluating the efficacy of probiotic therapy in NAFLD patients were included according to the eligibility criteria. With the use of random effects models, clinical outcomes were presented as weighted mean difference (WMD) with 95% confidence interval (CI), while heterogeneity and meta-regression were also assessed. Results 28 clinical trials enrolling 1555 criterion proven NAFLD patients with the use of probiotics from 4 to 28 weeks were included. Overall, probiotic therapy had beneficial effects on body mass index (WMD: -1.46, 95% CI: [-2.44, -0.48]), alanine aminotransferase (WMD: -13.40, 95% CI: [-17.03, -9.77]), aspartate transaminase (WMD: -13.54, 95% CI: [-17.86, -9.22]), gamma-glutamyl transpeptidase (WMD: -9.88, 95% CI: [-17.77, -1.99]), insulin (WMD: -1.32, 95% CI: [-2.43, -0.21]), homeostasis model assessment-insulin resistance (WMD: -0.42, 95% CI: [-0.73, -0.12]), and total cholesterol (WMD: -15.38, 95% CI: [-26.50, -4.25]), but not in fasting blood sugar, lipid profiles, or tumor necrosis factor-alpha. Conclusion The systematic review and meta-analysis support that probiotics are superior to placebo in NAFLD patients and could be utilized as a common complementary therapeutic approach.

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Section: Discussionmentioning

confidence: 99%

Systematic Review with Meta-Analysis: The Effects of Probiotics in Nonalcoholic Fatty Liver Disease

Xiao

Lin

Shen

et al. 2019

Gastroenterology Research and Practice

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“…In addition, further work is needed to understand the dose and duration of therapy needed to maximize the therapeutic effect of FMT while optimizing patient tolerance and compliance [77]. In the case of UC, one ongoing study ( NCT03006809) aims to compare the various stool doses and routes of FMT administration.…”

Section: Discussionmentioning

confidence: 99%

Impact of Fecal Microbiota Transplantation on Obesity and Metabolic Syndrome—A Systematic Review

et al. 2019

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Fecal microbiota transplantation (FMT) is a gut microbial-modulation strategy that has been investigated for the treatment of a variety of human diseases, including obesity-associated metabolic disorders. This study appraises current literature and provides an overview of the effectiveness and limitations of FMT as a potential therapeutic strategy for obesity and metabolic syndrome (MS). Five electronic databases and two gray literature sources were searched up to 10 December 2018. All interventional and observational studies that contained information on the relevant population (adult patients with obesity and MS), intervention (receiving allogeneic FMT) and outcomes (metabolic parameters) were eligible. From 1096 unique citations, three randomized placebo-controlled studies (76 patients with obesity and MS, body mass index = 34.8 ± 4.1 kg/m2, fasting plasma glucose = 5.8 ± 0.7 mmol/L) were included for review. Studies reported mixed results with regards to improvement in metabolic parameters. Two studies reported improved peripheral insulin sensitivity (rate of glucose disappearance, RD) at 6 weeks in patients receiving donor FMT versus patients receiving the placebo control. In addition, one study observed lower HbA1c levels in FMT patients at 6 weeks. No differences in fasting plasma glucose, hepatic insulin sensitivity, body mass index (BMI), or cholesterol markers were observed between two groups across all included studies. While promising, the influence of FMT on long-term clinical endpoints needs to be further explored. Future studies are also required to better understand the mechanisms through which changes in gut microbial ecology and engraftment of microbiota affect metabolic outcomes for patients with obesity and MS. In addition, further research is needed to better define the optimal fecal microbial preparation, dosing, and method of delivery.

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“…Regardless, in light of these findings and the unique potential, we encourage FFT safety and feasibility testing in preterm infants using a rigid safety paradigm. Donor and stool should be subject to an extensive screening procedure, equivalent to existing pediatric FMT procedures 46 , and bacteria removed using validated techniques 20 . Furthermore, the data indicates the use of a prophylactic approach with early neonatal treatment, and favors the use of oro-gastric administration route.…”

Section: Discussionmentioning

confidence: 99%

Fecal filtrate transfer protects against necrotizing enterocolitis in preterm pigs

Brunse

Deng

Pan

et al. 2020

Preprint

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9Background and aims. Necrotizing enterocolitis (NEC) is an acute and life-threatening 2 0 3 1 Results. Oro-gastric FFT eliminated NEC, which was confirmed by microscopy, whereas FMT did 3 2 not perform better than control. Moreover, FFT but not FMT reduced intestinal permeability, 3 3 whereas FMT animals had reduced body weight increase and intestinal growth. Oro-gastric FFT 3 4increased viral diversity and reduced Proteobacteria abundance in ileal mucosa relative to control. 5Global gene expression of host mucosa responded to FMT but not FFT with increased and 3 6 decreased bacterial and viral defense mechanisms, respectively. 7Conclusions. As preterm infants are extremely vulnerable, rational therapies need incontestable 3 8 safety profiles. Here we show in a clinically relevant animal model that FFT, as opposed to FMT, 3 9

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Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children

Cited by 99 publications

References 155 publications

Systematic Review with Meta-Analysis: The Effects of Probiotics in Nonalcoholic Fatty Liver Disease

Systematic Review with Meta-Analysis: The Effects of Probiotics in Nonalcoholic Fatty Liver Disease

Impact of Fecal Microbiota Transplantation on Obesity and Metabolic Syndrome—A Systematic Review

Fecal filtrate transfer protects against necrotizing enterocolitis in preterm pigs

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