Systematic review: faecal microbiota transplantation therapy for digestive and nondigestive disorders in adults and children

Sha, Sumei; Liang, Jie; Chen, M.; Xu, Bing; Liang, Cong; Wei, Ning; Wu, Kaichun

doi:10.1111/apt.12699

Cited by 120 publications

(128 citation statements)

References 99 publications

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“…In this study, 83.3% were cured with only one administration, these results being similar to those reported in the literature (13). However, a patient required three FMTs to resolve diarrhea, which highlights the fact that some patients will require more than just one procedure to achieve remission.…”

supporting

confidence: 89%

Fecal microbiota transplantation - something more than merely a therapeutic curiosity

Ferre‐Aracil¹,

Aguilera²,

Santiago³

et al. 2015

Rev Esp Enferm Dig

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Intestinal microbiota likely represents the most complex organ in our body. It is estimated to include approximately 10 14 independent living organisms comprising bacteria, archaea, fungi, and acellular forms such as viruses. In a healthy adult microbiota accounts for approximately one kilogram in weight, and plays a role in multiple homeostatic and physiological functions. These include energy and intermediary metabolism, normal immune responses, and even appropriate bowel development and nervous system functioning. Several bacterial patterns (so-called "enterotypes") exist that have been associated with appropriate, healthy intestinal functioning. The therapeutic manipulation of intestinal microbiota may seem innovative. However, early (rudimentary) examples date back to remote times such as ancient Imperial China, and have been documented across time and geography ever since.As stated, we have increasingly more evidence available suggesting a key role of intestinal microbiota in human health and disease. Hence, its manipulation, and more specifically fecal microbiota transplantation (FMT), is currently becoming increasingly interesting because of its proven effectiveness and the myriad of possibilities it offers (1). Some of these possibilities are now fairly well established whereas others remain under study.The primary indication of FMT is Clostridium difficile infection. Many clinical series have been reported in major publications (2,3). Recently, Rossen and colleagues performed a systematic review of FMT cases thus far reported (4). After reviewing 33 series of cases and two clinical trials, they corroborated the procedure's high efficacy rate, with resolution of diarrhea by C. difficile in up to 90% of patients. All studies reviewed showed efficacy above 50%, even in immunosuppressed or elderly individuals, or in patients with severe conditions; furthermore, no differences in results were seen according to fecal infusion route (using colonoscopy or a nasojejunal feeding tube). Three clinical trials have been reported thus far on FMT for recurrent C. difficile colitis. The first one, of poor methodological quality, showed a symptom resolution rate of 81% (5). The second study, on a sample of 20 patients, compared several infusion routes with no control group, and found a cure rate of 70%, no differences being observed according to administration approach (6). The third study, with no control group and using capsules for FMT administration, found a success rate of 70% with a single dose, and up to 90% after a second dose (7). In the setting of refractory C. difficile colitis fewer -though highly successful-reports and no clinical trials are available. Notably, in the light of available evidence the procedure seems very safe. But for anecdotal evidence, no adverse effects have been reported, to which thorough donor assessment surely contributes. From all the above, the procedure's effectiveness in this setting is beyond doubt, which is reflected by the inclusion of FMT in the therapeutic guidelines issued ...

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supporting

confidence: 89%

Fecal microbiota transplantation - something more than merely a therapeutic curiosity

Ferre‐Aracil¹,

Aguilera²,

Santiago³

et al. 2015

Rev Esp Enferm Dig

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“…125 Another review found similar results, with 78% of patients, both pediatric and adult, achieving remission. 126 However, these studies only included data from case reports or series, which are not controlled and subject to publication bias. A more recent systematic review which included a randomized trial for FMT in IBD noted less promising results, with 45% of patients achieving remission (22% of patients with UC, 60.5% of patients with CD).…”

Section: Systematic Reviews Of Fmt In Ibdmentioning

confidence: 99%

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

2017

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Inflammatory bowel disease (IBD) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. Although the etiology of IBD is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of IBD. Manipulation of the gut microbiota, therefore, may represent a target for IBD therapy. Fecal microbiota transplantation (FMT), where fecal microbiota from a healthy donor is transplanted into a patient's GI tract, is already a successful therapy for Clostridium difficile infection. FMT is currently being explored as a potential therapy for IBD as well. In this review, the associations between the gut microbiota and IBD and the emerging data on FMT for IBD will be discussed.

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“…Given the success of FMT in this one area, and given the appeal and curiosity exhibited by providers and the lay public, it is not surprising, that consideration of FMT for other conditions associated with disturbances of the microbiome is under active discussion (14).…”

mentioning

confidence: 99%

Fecal microbiota transplantation in children: a brief review

Hourigan

Oliva-Hemker

2016

Pediatr Res

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There has been a growing interest in fecal microbiota transplantation (FMT) over recent years, in part due to the increasing prevalence of Clostridium difficile infection (CDI) and expanding association of intestinal dysbiosis with a wide range of human diseases. Many adult studies have shown that FMT is an effective treatment for recurrent CDI and may possibly have applications in other illnesses such as inflammatory bowel disease (IBD); however, there is a paucity of data available in children who may differ from adults for many reasons including having a dynamic developing microbiome compared to adults who have a relatively stable microbiome. Here, we review published studies looking at FMT in children, for CDI and IBD, and discuss special considerations needed when conducting FMT in children.

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Systematic review: faecal microbiota transplantation therapy for digestive and nondigestive disorders in adults and children

Abstract: SUMMARY BackgroundThere has been growing interest in the use of faecal microbiota transplantation (FMT) for the treatment of gastrointestinal and nongastrointestinal diseases.

Cited by 120 publications

References 99 publications

Fecal microbiota transplantation - something more than merely a therapeutic curiosity

Fecal microbiota transplantation - something more than merely a therapeutic curiosity

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

Fecal microbiota transplantation in children: a brief review

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