Fecal microbiota transplantation improves metabolic syndrome parameters: systematic review with meta-analysis based on randomized clinical trials

Proença, Igor Mendonça; Allegretti, Jessica R.; Bernardo, Wanderley Marques; Moura, Diogo Turiani Hourneaux de; Neto, Alberto M. Ponte; Matsubayashi, Carolina O.; Flor, Marcelo Mochate; Kotinda, Ana Paula Samy Tanaka; Moura, Eduardo Guimarães Hourneaux de

doi:10.1016/j.nutres.2020.06.018

Cited by 60 publications

(36 citation statements)

References 32 publications

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“…However, with regard to causality, no strong evidence of obesity‐associated changes in gut bacteria composition constituting a cause or a consequence of obesity in humans exists. Interventions modulating the gut bacterial composition in overweight/obese subjects have shown some beneficial metabolic effects (primarily, short‐lasting improvements in insulin resistance), but, as shown in a recent meta‐analysis investigating the effect of faecal microbiota transplantation as a gut microbial‐modulation strategy in obese individuals, no effects on BMI have been shown in any clinical studies 188 . Nevertheless, several studies suggest that gut microbiota and its products may affect the secretion of gut hormones with established effects on hunger and satiety sensations in humans, for example, GLP‐1 and PYY, 189,190 but the pathophysiological implications and therapeutic potential of these interactions remain obscure.…”

Section: Pathophysiology Of Obesity In Humansmentioning

confidence: 99%

An overview of obesity mechanisms in humans: Endocrine regulation of food intake, eating behaviour and common determinants of body weight

Theilade

Christensen

Vilsbøll

et al. 2021

Diabetes Obesity Metabolism

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Obesity is one of the biggest health challenges of the 21st century, already affecting close to 700 million people worldwide, debilitating and shortening lives and costing billions of pounds in healthcare costs and loss of workability. Body weight homeostasis relies on complex biological mechanisms and the development of obesity occurs on a background of genetic susceptibility and an environment promoting increased caloric intake and reduced physical activity. The pathophysiology of common obesity links neuro‐endocrine and metabolic disturbances with behavioural changes, genetics, epigenetics and cultural habits. Also, specific causes of obesity exist, including monogenetic diseases and iatrogenic causes. In this review, we provide an overview of obesity mechanisms in humans with a focus on energy homeostasis, endocrine regulation of food intake and eating behavior, as well as the most common specific causes of obesity.

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Section: Pathophysiology Of Obesity In Humansmentioning

confidence: 99%

An overview of obesity mechanisms in humans: Endocrine regulation of food intake, eating behaviour and common determinants of body weight

Theilade

Christensen

Vilsbøll

et al. 2021

Diabetes Obesity Metabolism

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show abstract

“…Bibliographies of review articles and meta-analyses were searched to identify additional studies. 9,[25][26][27] The detailed search strategy is outlined in Supplementary Table 2.…”

Section: Search Strategymentioning

confidence: 99%

Systematic review with meta-analysis: encapsulated faecal microbiota transplantation – evidence for clinical efficacy

Cold

Baunwall

Dahlerup

et al. 2021

Therap Adv Gastroenterol

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Background: Faecal microbiota transplantation (FMT) is an effective treatment of recurrent Clostridioides difficile infection (rCDI) and is being applied experimentally in other diseases. Encapsulated administration may be equivalent in efficacy to delivery through other routes. Methods: A systematic review was undertaken of studies using encapsulated FMT up to 26 October 2020. Data on indication, clinical outcomes, safety, treatment protocol and capsule preparation were collected and reported. Pooled rates of clinical efficacy in rCDI were calculated using random-effects meta-analysis. The impact of single variables on clinical efficacy was evaluated using univariate meta-regression. Results: A total of 35 studies reporting the treatment of 960 patients with encapsulated FMT for eight different indications met the inclusion criteria. Most studies ( n = 18, 51%) and patients ( n = 755, 79%) were from studies on rCDI. Cure rates after single and multiple courses of treatments with encapsulated FMT in rCDI were 85% (95% CI: 82%-88%) and 93% (95% CI: 88%-96%) respectively. The treatment outcome was not significantly affected by dose, number of delivered capsules, anaerobic/aerobic processing, single/multi-donor treatment, lyophilisation, or any other single factor in the production or delivery of encapsulated FMT. Promising but non-comparable results from the treatment of ulcerative colitis and multidrug-resistant organisms were reported. Conclusions: Encapsulated FMT is an effective and safe treatment of rCDI, with cure rates comparable to FMT delivered through other routes. The treatment is effective despite variations in donor screening, preparation and treatment protocol. For other indications, the role of FMT capsules is still not sufficiently examined, although some studies show promising results. Plain Language Summary Transfer of faecal material through capsules in the treatment of various diseases. Evidence for clinical efficacy The bacteria and other microorganisms of the gut is different in patient with various diseases in comparison with healthy subjects. Therefore, ways to change the microorganisms of the gut in a beneficial direction has been the subject of various research projects within recent years. Faecal microbiota transplantation often referred as FMT is a method of transferring microorganisms from healthy donors to patients with various diseases and is seen as one way to change the microbial community of the gut in a beneficial direction. Faecal microbiota transplantation can be performed in different ways such as through endoscopy, enemas or capsules. The transfer through capsules is preferred by the patients and has advantages since it can be administered long-term and can be delivered to the patients in their home. In this paper, we evaluated all accessible research reporting treatment with encapsulated faecal microbiota transplantation in the treatment of various diseases. We report the following major findings: -Treatment with capsules is safe when guidelines for screening donors and testing faecal material is followed. -The treatment is highly effective in the treatment of recurrent C. difficile infection, a disease with high mortality often caused by repeated antibiotic treatments. The treatment was effective in 596 of 723 patients following one course of capsule treatment. -Faecal microbiota transplantation delivered through capsules is as effective as treatment delivered through other routes in the treatment of C. difficile infection. -The treatment is effective in the treatment of C. difficile infection across studies and countries, despite great differences in the ways the capsules were prepared and delivered. -Increasing the amount of faecal material used in the production did not affect the efficacy of the treatment. -There are promising results in the treatment of other diseases such as liver disease, inflammatory bowel disease and the treatment of multi-drug resistant bacteria.

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“…Results of research on prebiotics have suggested favourable outcomes in metabolic disorders: decreased fasting glucose (fGlc), improved insulin sensitivity and lipid profile, reduced inflammation including neuroinflammation; however, when investigated as isolated therapies, prebiotics did not impact outcomes' measures of depression or anxiety [43][44][45][46][47]. Interestingly, there appears to be some evidence for the treatment of psychiatric and metabolic disorders through fecal microbiota transplantation (FMT); additionally, FMT did have the potential to reduce small intestinal permeability in patients with NAFLD [48][49][50]. Another clinical intervention involving microbiota is the use of postbiotics (metabiotics).…”

Section: Microbiota Interventionsmentioning

confidence: 99%

Probiotics as a Treatment for “Metabolic Depression”? A Rationale for Future Studies

Gawlik-Kotelnicka

Strzelecki

2021

Pharmaceuticals

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Depression and metabolic diseases often coexist, having several features in common, e.g., chronic low-grade inflammation and intestinal dysbiosis. Different microbiota interventions have been proposed to be used as a treatment for these disorders. In the paper, we review the efficacy of probiotics in depressive disorders, obesity, metabolic syndrome and its liver equivalent based on the published experimental studies, clinical trials and meta-analyses. Probiotics seem to be effective in reducing depressive symptoms when administered in addition to antidepressants. Additionally, probiotics intake may ameliorate some of the clinical components of metabolic diseases. However, standardized methodology regarding probiotics use in clinical trials has not been established yet. In this narrative review, we discuss current knowledge on the recently used methodology with its strengths and limitations and propose criteria that may be implemented to create a new study of the effectiveness of probiotics in depressive disorders comorbid with metabolic abnormalities. We put across our choice on type of study population, probiotics genus, strains, dosages and formulations, intervention period, as well as primary and secondary outcome measures.

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Fecal microbiota transplantation improves metabolic syndrome parameters: systematic review with meta-analysis based on randomized clinical trials

Cited by 60 publications

References 32 publications

An overview of obesity mechanisms in humans: Endocrine regulation of food intake, eating behaviour and common determinants of body weight

An overview of obesity mechanisms in humans: Endocrine regulation of food intake, eating behaviour and common determinants of body weight

Systematic review with meta-analysis: encapsulated faecal microbiota transplantation – evidence for clinical efficacy

Probiotics as a Treatment for “Metabolic Depression”? A Rationale for Future Studies

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