From stool transplants to next-generation microbiota therapeutics.

From stool transplants to next-generation microbiota therapeutics.
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DOI:
10.1053/j.gastro.2014.01.004
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发表时间:
2014-05
期刊:
影响因子:
29.4
通讯作者:
Khoruts A
Khoruts A
中科院分区:
医学1区
文献类型:
--
作者:
Petrof EO;Khoruts A

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由新的强毒菌株推动的艰难梭菌感染流行导致粪便微生物移植(FMT)的使用增加。即使是在多次抗生素疗程失败后最绝望的情况下,该手术也有效。该方法认识到微生物群是正常人体生理学不可或缺的一部分,而 FMT 中使用的微生物群代表了一种新的治疗方法。微生物群的组成失衡和活性改变与许多疾病有关。因此,人们越来越有兴趣将 FMT 应用于非 C 人群。艰难梭菌适应症。然而,只有基于机制理解并应用最新的微生物生态学原理,系统地开发微生物疗法,这才有可能成功。我们讨论了开发这种新治疗类别的两条途径:从供体粪便中分离的整个微生物群落和体外生长的特定粪便微生物的集合。
The epidemic of Clostridium difficile infection fueled by new virulent strains of the organism has led to increased use of fecal microbiota transplantation (FMT). The procedure is effective for even the most desperate cases, after failure of multiple courses of antibiotics. The approach recognizes microbiota to be integral to normal human physiology, and microbiota being used in FMT represents a new class of therapeutics. Imbalance in the composition and altered activity of the microbiota are associated with many diseases. Consequently, there is growing interest in applying FMT to non-C. difficile indications. However, this may succeed only if microbiota therapeutics are developed systematically, based on mechanistic understanding, and applying updo-date principles of microbial ecology. We discuss two pathways in development of this new therapeutic class: whole microbial communities separated from donor stool and an assembly of specific fecal microorganisms grown in vitro.
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