Fecal microbiota transplantation – past, present, and future

Česká verzia

Authors: Stebel R.; Vojtilová L.; Husa P.
Authors place of work: Klinika infekčních chorob LF MU a FN Brno
Published in the journal: Gastroent Hepatol 2020; 74(1): 54-61
Category: Clinical and Experimental Gastroenterology: Review Article
doi: https://doi.org/10.14735/amgh201954

Summary

Distortions in intestinal microbial ecosystems are important pathogenetic factors of numerous diseases. The role of alterations in intestinal microbiota in the pathogenesis of recurrent clostridium colitis is well known. A fecal transfer from a healthy donor can restore natural homeostasis in intestinal microbiota and thus disrupt a „vicious circle“ of chronic relapsing clostridium infection. In the future, it should be possible to perform peroral fecal microbiota transplantations using enterosolvent tablets or commercially produced fecal derivatives. This administration route minimises the risk of adverse complications, which are rarely observed when fecal suspensions are administered via a nasoenteral probe, endoscopy, or by rectal clysma. In the past few years, intestinal microbiota transplantation has been used for the treatment of other diseases, the pathogenesis of which is probably associated with intestinal dysbiosis. In this respect, the most discussed issues are idiopathic intestinal inflammations, irritable bowel syndrome, liver encephalopathy and recently, „civilisation diseases“ such as diabetes mellitus type 2, multiple sclerosis, Parkinson’s disease, and metabolic syndrome. The fecal bacteriotherapy effect is observed also during the eradication of multi-resistant bacterial strains that colonise patients’ intestines. At present, fecal bacteriotherapy for recurrent clostridium colitis, as a proved medical method, is an accepted and world-wide recommended therapy. As for other diseases, this method is still in the experimental stage. Conclusive results of randomised control trials are expected.

Conflict of Interest: The authors declare that the article/ manuscript complies with ethical standards, patient anonymity has been respected, and they state that they have no financial, advisory or other com mercial interests in relation to the subject matter.

Publication Ethics: This article/ manuscript has not been published or is cur rently be ing submitted for another review. The authors agree to publish their name and e-mail in the published article/ manuscript.

Dedication: Supported by MZ ČR – RVO (FNBr, 65269705).

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio medical papers.

Keywords:

dysbiosis – Clostridioides difficile – fecal microbiota transplantation – microbial drug resistance – intestinal microbiome – pseudomembranous colitis

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