Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

Borody, Thomas J.; Fischer, Monika; Mitchell, Scott; Campbell, John

doi:10.1586/17474124.2015.1086267

Cited by 37 publications

(26 citation statements)

References 79 publications

(94 reference statements)

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“…Nevertheless, the ability of specific commensals and probiotics to beneficially influence epithelial transport and barrier properties indicates that reversing dysbiosis may be of value in chronic diarrhea. 103,104 Dynamic changes in the diet, microbiome, bacterial metabolism, intestinal mucosa, and the immune system could all have protean effects on the gastrointestinal tract. 105 …”

Section: Secretory or Osmotic Diarrheamentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extra-epithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented.

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Section: Secretory or Osmotic Diarrheamentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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“…In our study, the efficacy of FMT in refractory CDI was comparable to that achieved in recurrent CDI (primary cure rate: 84.6% and 91.7%, p = 0.6). Nevertheless, the adequate time to perform FMT in recurrent CDI remains to be determined as different gastrointestinal societies have different opinions (6,14,18,22). American guidelines recommend FMT for the treatment of a third episode of CDI after failure of a pulsed/tapered vancomycin regimen (6,14,17).…”

Section: Discussionmentioning

confidence: 99%

“…American guidelines recommend FMT for the treatment of a third episode of CDI after failure of a pulsed/tapered vancomycin regimen (6,14,17). On the other hand, European guidelines recommend the use of FMT for a second episode of CDI (6,18,22).…”

Section: Discussionmentioning

confidence: 99%

Fecal microbiota transplantation in refractory or recurrent Clostridium difficile infection: a real-life experience in a non-academic center

et al. 2018

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Author's contributionAna Ponte: design of the study, analysis and interpretation of the data and references and drafting of the article.Rolando Pinho: design of the study, analysis and interpretation of the data and references, drafting of the article and critical revision of the article for important intellectual content.Margarida Mota: design of the study, analysis and interpretation of the data.Nuno Vieira and Rosa Oliveira: design of the study.Joana Silva, Jaime Rodrigues, Mafalda Sousa and Isabel Sousa: analysis and interpretation of the data and references.João Carvalho: final approval of the article. ABSTRACTAim: this study aimed to describe the efficacy and safety of fecal microbiota transplantation (FMT) for the treatment of refractory and recurrent Clostridium difficile infection (CDI).Methods: this was an observational study of patients with refractory or recurrent CDI treated with FMT between June 2014 and January 2017. Primary and secondary outcomes were the resolution of diarrhea without CDI recurrence within two months after one or more FMT. A descriptive analysis was performed.Results: thirty-four FMT were performed in 28 patients, 88.2% (n = 30) using an upper route with a gastroscopy and 11.8% (n = 4) with colonoscopy; 50% (n = 17) of FMT were due to recurrent CDI and 50% (n = 17) were due to refractory CDI. The overall cure rate of upper FMT was 87.5% (21/24) and 100% (4/4) when colonoscopy was performed. A cure was achieved after one FMT in 88% (22/25) of cases and after two or more FMT in 8% (2/25) of cases, resulting in an overall cure rate of 96% (24/25). No severe adverse events were reported. Conclusion:FMT constitutes an effective and safe approach for the management of refractory and recurrent CDI, with an overall cure rate of 96% and no reported severe adverse events.

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“…Notably, FMT was more successful for treating patients with UC rather than CD, 85 again likely due to the heterogeneity of CD. However, FMT for IBD is much less effective than for C. difficile infections, 88 which may be because of a collection of different risk factors in disease development, and in the differences of donor microbiota 89 , 90 . The primary reason might be the difference between one causative bacteria ( C. difficile ) compared with an unknown cause and contributing microorganisms for IBD.…”

Section: The Local Effects Of Gut Microbiota On Ibdmentioning

confidence: 99%

Bugging inflammation: role of the gut microbiota

Shen

Wong

2016

Clin & Trans Imm

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The advent of vaccination and improved hygiene have eliminated many of the deadly infectious pathogens in developed nations. However, the incidences of inflammatory diseases, such as inflammatory bowel disease, asthma, obesity and diabetes are increasing dramatically. Research in the recent decades revealed that it is indeed the lack of early childhood microbial exposure, increase use of antibiotics, as well as increase consumption of processed foods high in carbohydrates and fats, and lacking fibre, which wreak havoc on the proper development of immunity and predispose the host to elevated inflammatory conditions. Although largely unexplored and under-appreciated until recent years, these factors impact significantly on the composition of the gut microbiota (a collection of microorganisms that live within the host mucosal tissue) and inadvertently play intricate and pivotal roles in modulating an appropriate host immune response. The suggestion that shifts in the composition of host microbiota is a risk factor for inflammatory disease raises an exciting opportunity whereby the microbiota may also present as a potential modifiable component or therapeutic target for inflammatory diseases. This review provides insights into the interactions between the microbiota and the immune system, how these affect disease phenotypes, and explore current and emerging therapies that target the gut microbiota as potential treatment for inflammatory diseases.

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Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

Cited by 37 publications

References 79 publications

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Fecal microbiota transplantation in refractory or recurrent Clostridium difficile infection: a real-life experience in a non-academic center

Bugging inflammation: role of the gut microbiota

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