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中华移植杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 42 -48. doi: 10.3877/cma.j.issn.1674-3903.2018.01.010

所属专题: 文献

综述

粪菌移植的临床应用
陈卫1, 杨涛1, 刘玮丽1,()   
  1. 1. 310000 杭州,浙江大学医学院附属邵逸夫医院消化内科
  • 收稿日期:2017-11-27 出版日期:2018-02-25
  • 通信作者: 刘玮丽

The clinical application of fecal microbiota transplantation

Wei Chen1, Tao Yang1, Weili Liu1,()   

  1. 1. Department of Gastroenterology, Sir Run Run Shaw Hospital affiliated to Zhejiang University, Hangzhou 310000, China
  • Received:2017-11-27 Published:2018-02-25
  • Corresponding author: Weili Liu
  • About author:
    Corresponding author: Liu Weili, Email:
引用本文:

陈卫, 杨涛, 刘玮丽. 粪菌移植的临床应用[J]. 中华移植杂志(电子版), 2018, 12(01): 42-48.

Wei Chen, Tao Yang, Weili Liu. The clinical application of fecal microbiota transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2018, 12(01): 42-48.

粪菌移植是指将健康人群粪便中分离得到的功能菌群移植到患者胃肠道,通过重建患者肠道菌群来实现对疾病的治疗。近年来,随着对肠道微生态与人类疾病关系认识的不断深入以及宏基因组测序等实验技术的发展,粪菌移植技术被越来越多地应用于临床治疗。本文就近年来粪菌移植的临床应用热点进行综述。

Fecal microbiota transplantation (FMT) consists of the infusion of feces from a healthy donor to the gastrointestinal tract of a recipient patient, in order to treat a specific disease associated with alteration of gut microbiota. In recent years, along with the growing knowledge of the relationship between the intestinal microecology and human health, and the development of the experimental technology such as macro genome sequencing, FMT is more and more used in clinical treatment. This review will discuss the application of FMT in the treatment of human disease.

1
Sirisinha S. The potential impact of gut microbiota on your health: Current status and future challenges[J]. Asian Pac J Allergy Immunol, 2016, 34(4):249-264.
2
Blaser M, Bork P, Fraser C, et al. The microbiome explored: recent insights and future challenges[J]. Nat Rev Microbiol, 2013, 11(3):213-217.
3
Round JL, Mazmanian SK. The gut microbiota shapes intestinal immune responses during health and disease[J]. Nat Rev Immunol, 2009, 9(5):313-323.
4
张发明,李潘,崔伯塔,等. 粪菌移植:老故事与新未来[J]. 医学争鸣,2015, (1):17-22.
5
Zhang F, Luo W, Shi Y, et al. Should we standardize the 1,700-year-old fecal microbiota transplantation?[J]. Am J Gastroentero, 2012, 107(11):1755-1756.
6
Eiseman B, Silen W, Bascom GS, et al. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis[J]. Surgery, 1958, 44(5):854-859.
7
Blum HE. The human microbiome[J]. Adv Med Sci, 2017, 62(2):414-420.
8
Cammarota G, Ianiro G, Bibbò S, et al. Gut microbiota modulation: probiotics, antibiotics or fecal microbiota transplantation?[J]. Intern Emerg Med, 2014, 9(4):365-373.
9
van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile[J]. N Engl J Med, 2013, 368(5):407-415.
10
Bajaj JS, Kassam Z, Fagan A, et al. Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial[J]. Hepatology, 2017, 66(6):1727-1738.
11
Paramsothy S, Kamm MA, Kaakoush NO, et al. Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial[J]. Lancet, 2017, 389(10075):1218-1228.
12
Turnbaugh PJ, Ley RE, Mahowald MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest[J]. Nature, 2006, 444(7122):1027-1031.
13
Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections[J]. Am J Gastroenterol, 2013, 108(4):478-498; quiz 99.
14
Köpke M, Straub M, Dürre P. Clostridium difficile is an autotrophic bacterial pathogen[J]. PloS one, 2013, 8(4):e62157.
15
Bakken JS, Borody T, Brandt LJ, et al. Treating Clostridium difficile infection with fecal microbiota transplantation[J]. Clin gastroenterol hepatol, 2011, 9(12):1044-1049.
16
Khoruts A, Sadowsky MJ. Understanding the mechanisms of faecal microbiota transplantation[J]. Nat Rev Gastroenterol Hepatol, 2016, 13(9):508-516.
17
Cammarota G, Ianiro G, Tilg H, et al. European consensus conference on faecal microbiota transplantation in clinical practice[J]. Gut, 2017, 66(4):569-580.
18
Sartor RB, Wu GD. Roles for intestinal bacteria, viruses, and fungi in pathogenesis of inflammatory bowel diseases and therapeutic approaches[J]. Gastroenterology, 2017, 152(2):327-339. e4.
19
Moayyedi P, Surette MG, Kim PT, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial[J]. Gastroenterology, 2015, 149(1):102-109. e6.
20
Rossen NG, Fuentes S, Van Der Spek MJ, et al. Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis[J]. Gastroenterology, 2015, 149(1):110-118.e4.
21
Grinspan AM, Kelly CR. Fecal microbiota transplantation for ulcerative colitis: not just yet[J]. Gastroenterology, 2015, 149(1):15-18.
22
Cui B, Feng Q, Wang H, et al. Fecal microbiota transplantation through mid-gut for refractory Crohn′s disease: safety, feasibility, and efficacy trial results[J]. J Gastroenterol Hepatol, 2015, 30(1):51-58.
23
Gordon H, Harbord M. A patient with severe Crohn′s colitis responds to faecal microbiota transplantation[J]. J Crohns Colitis, 2014, 8(3):256-257.
24
Kao D, Hotte N, Gillevet PM, et al. Fecal microbiota transplantation inducing remission in Crohn′s colitis and the associated changes in fecal microbial profile[J]. J Clin Gastroenterol, 2014, 48(7):625-628.
25
Zhang FM, Wang HG, Wang M, et al. Fecal microbiota transplantation for severe enterocolonic fistulizing Crohn′s disease[J]. World J Gastroenterol, 2013, 19(41):213-216.
26
Surrenti E, Rath DM, Pemberton JH, et al. Audit of constipation in a tertiary referral gastroenterology practice[J]. Am J Gastroenterol, 1995, 90(9):1471-1475.
27
Li N, Jiang J, Feng X, et al. Long-term follow-up of the Jinling procedure for combined slow-transit constipation and obstructive defecation[J]. Dis Colon Rectum, 2013, 56(1):103-112.
28
Khalif IL, Quigley EM, Konovitch EA, et al. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation[J]. Dig Liver Dis, 2005, 37(11):838-849.
29
Stecher B, Chaffron S, Kappeli R, et al. Like will to like: abundances of closely related species can predict susceptibility to intestinal colonization by pathogenic and commensal bacteria[J]. PLoS Pathog, 2010, 6(1):1-15.
30
Zoppi G, Cinquetti M, Luciano A, et al. The intestinal ecosystem in chronic functional constipation[J]. Acta Paediatr, 2007, 87(8):836-841.
31
Tian H, Ding C, Gong J, et al. Treatment of slow transit constipation with fecal microbiota transplantation: A pilot study[J]. J Clin Gastroenterol, 2016, 50(10):865-870.
32
Tian H, Ge X, Nie Y, et al. Fecal microbiota transplantation in patients with slow-transit constipation: A randomized, clinical trial[J]. PloS one, 2017, 12(2):e0171308.
33
Tandon P, Madsen K, Kao D. Fecal microbiota transplantation for hepatic encephalopathy - ready for prime time?[J]. Hepatology, 2017, 66(6):1713-1715.
34
Bajaj JS. The role of microbiota in hepatic encephalopathy[J]. Gut microbes, 2014, 5(3):397-403.
35
Kao D, Roach B, Park H, et al. Fecal microbiota transplantation in the management of hepatic encephalopathy[J]. Hepatology, 2016, 63(1):339-340.
36
Bajaj JS, Kassam Z, Fagan A, et al. Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial[J]. Hepatology, 2017, 66(6):1727-1738.
37
Cowie BC, Carville KS, Maclachlan JH. Mortality due to viral hepatitis in the Global Burden of Disease Study 2010: new evidence of an urgent global public health priority demanding action[J]. Antivir Ther, 2013, 18(8):953-954.
38
Yang HI, Lu SN, Liaw Y, et al. Hepatitis B e antigen and the risk of hepatocellular carcinoma[J]. N Engl J Med, 2002, 347(3):168-174.
39
Terrault NA, Bzowej N, Chang K, et al. AASLD guidelines for treatment of chronic hepatitis B[J]. Hepatology, 2016, 63(1):261-283.
40
Chou H, Chien W, Wu L, et al. Age-related immune clearance of hepatitis B virus infection requires the establishment of gut microbiota[J]. Proc Natl Acad Sci U S A, 2015, 112(7):2175-2180.
41
Knolle P, Uhrig A, Protzer U, et al. Interleukin-10 expression is autoregulated at the transcriptional level in human and murine kupffer cells[J]. Hepatology, 1998, 27(1):93-99.
42
Huang L, Wohlleber D, Reisinger F, et al. Intrahepatic myeloid-cell aggregates enable local proliferation of CD8 T cells and successful immunotherapy against chronic viral liver infection[J]. Nat Immunol, 2013, 14(6):574-583.
43
Ling Z, Liu X, Cheng Y, et al. Decreased diversity of the oral microbiota of patients with hepatitis B virus-induced chronic liver disease: A pilot project[J]. Sci Rep, 2015, 5:17098.
44
Ren YD, Ye ZS, Yang LZ, et al. Fecal microbiota transplantation induces hepatitis B virus e-antigen (HBeAg) clearance in patients with positive HBeAg after long-term antiviral therapy[J]. Hepatology, 2017, 65(5):1765-1768.
45
Ley RE, Turnbaugh PJ, Klein S, et al. Human gut microbes associated with obesity[J]. Nature, 2006, 444(7122):1022-1023.
46
Bäckhed F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage[J]. Proc Natl Acad Sci U S A, 2004, 101(44):15718-15723.
47
Vrieze A, Van Nood E, Holleman F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[J]. Gastroenterology, 2012, 143(4):913-916. e7.
48
Brandl K, Schnabl B. Intestinal microbiota and nonalcoholic steatohepatitis[J]. Curr Opin Gastroenterol, 2017, 33(3):128-133.
49
Haque TR, Barritt AS 4th. Intestinal microbiota in liver disease[J]. Best Pract Res Clin Gastroenterol, 2016, 30(1):133-142.
50
Haslam DB. Nonalcoholic steatohepatitis and the intestinal microbiota[J]. Hepatology, 2017, 65(2):401-403.
51
Zhou D, Pan Q, Shen F, et al. Total fecal microbiota transplantation alleviates high-fat diet-induced steatohepatitis in mice via beneficial regulation of gut microbiota[J]. Sci Rep, 2017, 7(1):1529.
52
Mcelhanon BO, Mccracken C, Karpen S, et al. Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis[J]. Pediatrics, 2014, 133(5):872-883.
53
Li Q, Han Y, Dy ABC, et al. The gut microbiota and autism spectrum disorders[J]. Front Cell Neurosci, 2017, 11:120.
54
Kang DW, Adams JB, Gregory AC, et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study[J]. Microbiome, 2017, 5(1):10.
55
Couriel DR, Caldera H, Champlin RE, et al. Acute graft-versus-host disease: Pathophysiology, clinical manifestations, and management[J]. Cancer, 2004, 101(9):1936-1946.
56
Blazar BR, Murphy WJ, Abedi M. Advances in graft-versus-host disease biology and therapy[J]. Nat Rev Immunol, 2012, 12(6):443-458.
57
Heidegger S, van den Brink MR, Haas T, et al. The role of pattern-recognition receptors in graft-versus-host disease and graft-versus-leukemia after allogeneic stem cell transplantation[J]. Front Immunol, 2014, 5:337.
58
Yoshioka K, Kakihana K, Doki N, et al. Gut microbiota and acute graft-versus-host disease[J]. Pharmacol Res, 2017, 122:90-95.
59
Deeg HJ. How I treat refractory acute GVHD[J]. Blood, 2007, 109(10):4119-4126.
60
Kakihana K, Fujioka Y, Suda W, et al. Fecal microbiota transplantation for patients with steroid-resistant acute graft-versus-host disease of the gut[J]. Blood, 2016, 128(16):2083-2088.
61
Spindelboeck W, Schulz E, Uhl B, et al. Repeated fecal microbiota transplantations attenuate diarrhea and lead to sustained changes in the fecal microbiota in acute, refractory gastrointestinal graft-versus-host-disease[J]. Haematologica, 2017, 102(5):e210.
62
Borody TJ, Leis S, Campbell J. Fecal microbiota transplantation (FMT) in multiple sclerosis (MS)[J]. Am J Gastroenterol, 2011, 106:S352.
63
Malnick SD, Oppenheim A, Melzer E. Immune thrombocytopenia caused by fecal microbial transplantation in a patient with severe recurrent clostridium difficile Infection[J]. J Clin Gastroenterol, 2015, 49(10):888-889.
64
WHO, FAO. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria[R]. Argentina, 2001.
65
Dinleyici EC, Eren M, Ozen M, et al. Effectiveness and safety of Saccharomyces boulardii for acute infectious diarrhea[J]. Expert Opin Biol Ther, 2012, 12(4):395-410.
66
Grehan MJ, Borody TJ, Leis SM, et al. Durable alteration of the colonic microbiota by the administration of donor fecal flora[J]. J Clin Gastroenterol, 2010, 44(8):551-561.
67
Tannock GW, Munro K, Harmsen HJ, et al. Analysis of the fecal microflora of human subjects consuming a probiotic product containing lactobacillus rhamnosus DR20[J]. Appl Environ Microbiol, 2000, 66(6):2578-2588.
68
Tyakht AV, Alexeev DG, Popenko AS, et al. Rural and urban microbiota: To be or not to be?[J]. Gut Microbes, 2014, 5(3):351-356.
69
Kelly CR, Ihunnah C, Fischer M, et al. Fecal microbiota transplant for treatment of clostridium difficile infection in immunocompromised patients[J]. Am J Gastroenterol, 2014, 109(7):1065-1071.
70
Safety of fecal microbiota transplantation in patients with chronic colitis and immunosuppressive treatement[J]. J Crohns Colitis, 2015, 9(Suppl 1):S245-S246.
71
Solari PR, Fairchild PG, Noa LJ, et al. Tempered enthusiasm for fecal transplant[J]. Clin Infect Dis, 2014, 59(2):319.
72
Kump PK, Krause R, Steininger C, et al. Recommendations for the use of faecal microbiota transplantation " stool transplantation" :consensus of the Austrian Society of Gastroenterology and Hepatology (OGGH) in cooperation with the Austrian Society of Infectious Diseases and Tropical Medicine[J]. Z Gastroenterol, 2014, 52(12):1485-1492.
73
Sokol H, Galperine T, Kapel N, et al. Faecal microbiota transplantation in recurrent Clostridium difficile infection: Recommendations from the French Group of Faecal microbiota Transplantation[J]. Dig Liver Dis, 2016, 48(3):242-247.
74
Tandon P, Madsen K, Kao D. Fecal microbiota transplantation for hepatic encephalopathy: Ready for prime time?[J]. Hepatology, 2017, 66(6):1713-1715.
75
Millan B, Laffin M, Madsen K. Fecal microbiota transplantation: beyond Clostridium difficile[J]. Curr Infect Dis Rep, 2017, 19(9):31.
76
Smits LP, Bouter KE, De Vos WM, et al. Therapeutic potential of fecal microbiota transplantation[J]. Gastroenterology, 2013, 145(5):946-953.
77
Smith M, Kassam Z, Edelstein C, et al. OpenBiome remains open to serve the medical community[J]. Nat Biotechnol, 2014, 32(9):867.
78
何植,张发明. 中华粪菌库的原则、方案和风险管理[J]. 胃肠病学,2017, 22(4):193-198.
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