Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis.
Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis.
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DOI：
10.1016/j.crohns.2014.08.006
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发表时间：
2014-12
影响因子：
8
通讯作者：
Rubin, David T.
中科院分区：
文献类型：
--
作者：
Colman, Ruben J.;Rubin, David T.
关键词：
粪便微生物群移植（FMT）作为炎症性肠病（IBD）的一种新的治疗选择已经引起了人们的兴趣。虽然自2012年以来，将FMT描述为IBD治疗方法的出版物增加了一倍以上，但调查FMT治疗效果的研究却很少。我们进行了一项系统回顾和荟萃分析，以评估FMT治疗IBD患者的疗效。在2014年5月之前进行了系统的文献检索。纳入标准要求FMT作为主要治疗剂。临床缓解（CR）和/或粘膜愈合被定义为主要结局。如果研究没有报告临床结果或包括感染患者，则排除研究。共纳入18项研究（9项队列研究、8项病例研究和1项随机对照试验）。122例患者被描述(79例溃疡性结肠炎（UC）；39例克罗恩病（CD）；4 IBD（未分类）。总体而言，45%（54/119）的患者在随访期间达到CR。在队列研究中，达到CR的合并患者比例为36.2% (95% CI 17.4%-60.4%)，异质性风险中等（Cochran’s Q， P=0.011; I2 = 37%）。亚组分析显示UC的临床缓解汇总估计为22% (95% CI 10.4%-40.8%) (Cochran’s Q， P=0.37; I2 =0%)， CD的临床缓解汇总估计为60.5% (95% CI 28.4%-85.6%) （Cochran’s Q， P=0.05; I2 = 37%）。6项研究进行了微生物群分析。这一分析表明，FMT是一种安全的治疗IBD的方法，但疗效不一。需要更多的随机对照试验，并应调查FMT给药频率、供体选择和微生物组分析标准化。
Fecal microbiota transplantation (FMT) has gained interest as a novel treatment option for inflammatory bowel diseases (IBD). While publications describing FMT as therapy for IBD have more than doubled since 2012, research that investigates FMT treatment efficacy has been scarce. We conducted a systematic review and meta-analysis to evaluate the efficacy of FMT as treatment for patients with IBD. A systematic literature search was performed through May 2014. Inclusion criteria required FMT as primary therapeutic agent. Clinical remission (CR) and/or mucosal healing were defined as primary outcomes. Studies were excluded if they did not report clinical outcomes or included patients with infections. Eighteen studies (9 cohort studies, 8 case studies and 1 randomized controlled trial) were included in the analysis. 122 patients were described (79 ulcerative colitis (UC); 39 Crohn's disease (CD); 4 IBD unclassified). Overall, 45% (54/119) of patients achieved CR during follow up. Among cohort studies, the pooled proportion of patients that achieved CR was 36.2% (95% CI 17.4%-60.4%), with a moderate risk of heterogeneity (Cochran's Q, P=0.011; I2 = 37%). Subgroup analyses demonstrated a pooled estimate of clinical remission of 22% (95% CI 10.4%-40.8%) for UC (Cochran's Q, P=0.37; I2 =0%) and 60.5% (95% CI 28.4%-85.6%) for CD (Cochran's Q, P=0.05; I2 = 37%). Six studies performed microbiota analysis. This analysis suggests that FMT is a safe, but variably efficacious treatment for IBD. More randomized controlled trials are needed and should investigate frequency of FMT administration, donor selection and standardization of microbiome analysis.
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影响因子：
24.5
作者：
Kruis, W;Fric, P;Schulze, J
通讯作者：
Schulze, J
影响因子：
2.9
作者：
Grehan, Martin J.;Borody, Thomas Julius;Wettstein, Antony
通讯作者：
Wettstein, Antony
影响因子：
9.8
作者：
Angelberger, Sieglinde;Reinisch, Walter;Erry, David B.
通讯作者：
Erry, David B.
影响因子：
4.9
作者：
Kump, Patrizia K.;Groechenig, Hans-Peter;Hoegenauer, Christoph
通讯作者：
Hoegenauer, Christoph
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N