Protocol for Fecal Microbiota Transplantation in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.
Protocol for Fecal Microbiota Transplantation in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.
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DOI：
10.1155/2018/8941340
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发表时间：
2018
影响因子：
--
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Fang H;Fu L;Wang J
粪便微生物群移植（FMT）是一种新兴的炎症性肠病（IBD）治疗方法。供体的选择、粪便细菌的分离、FMT的频率、输注方式、长期安全性和有效性仍不确定。 进一步研究FMT治疗IBD的有效性、安全性及治疗方案。 在2018年2月之前进行了系统综述和荟萃分析。临床缓解被确定为主要结局。 共有596名儿童和成人IBD患者入组，459名患者接受FMT治疗。28.8%（132/459）的患者在随访期间获得临床缓解。53%（241/459）的患者达到临床缓解。溃疡性结肠炎（UC）的合并估计临床缓解率为21%（95% CI：8%-37%）和30%（95% CI：11%-52%）克罗恩病（CD），均存在异质性风险; 10%（95% CI：0%-43%）;成人UC为26%（95% CI：10%-48%）;儿童CD为45%（95% CI：24%-66%）;成人CD为22%（95% CI：3%-52%）。队列研究的Meta分析显示，中重度IBD患者通过FMT获得的缓解率高于轻中度患者（P=0.037）。给药途径对FMT治疗UC和CD的疗效无影响。根据现有的证据，冷冻粪便FMT治疗UC的临床缓解率有高于新鲜粪便的趋势，而新鲜粪便和冷冻粪便FMT治疗CD的临床缓解率无显著差异。FMT的最佳供体粪便仍不确定。RCT的荟萃分析显示，FMT治疗UC的临床缓解率显著高于安慰剂（28% vs 9%，P=0.0003）。 FMT对儿童和成人IBD都是一种有效和安全的治疗方法;新鲜或冷冻供体粪便、给药途径和抗生素预处理对FMT治疗IBD的疗效没有影响。FMT可能是IBD的一种潜在的补救治疗，甚至是最初的标准化治疗。然而，关于长期安全性和有效性的数据很少，需要进一步验证。
Fecal microbiota transplantation (FMT) is an emerging treatment approach for inflammatory bowel disease (IBD). The donor selection, the separation of fecal bacteria, the frequency of FMT, the way of infusion, the long-term safety, and efficacy are still uncertain. To further study the efficacy and safety and protocol of FMT for IBD. A systematic review and meta-analysis were conducted until February, 2018. Clinical remission was established as the primary outcome. A total of 596 paediatric and adult IBD patients were enrolled, and 459 patients received FMT therapy. 28.8% (132/459) patients achieved clinical remission during follow-up. 53% (241/459) patients achieved clinical response. The pooled estimated clinical remission for ulcerative colitis (UC) was 21% (95% CI: 8%-37%) and 30% (95% CI: 11%-52%) for Crohn's disease (CD), both with a risk of heterogeneity; 10% (95% CI: 0%-43%) for paediatric UC; 26% (95% CI: 10%-48%) for adult UC; 45% for paediatric CD (95% CI: 24%-66%); 22% (95% CI: 3%-52%) for adult CD. Meta-analysis of cohort studies showed that moderate-severe IBD patients could achieve more significant remission from FMT than mild-moderate patients (P=0.037). Delivery route has no impact on the efficacy of FMT in UC and CD. Based on current available evidence, a trend was observed towards higher clinical remission rate of frozen stool FMT than that of fresh stool for UC, while there was no significant difference between fresh and frozen FMT for CD. The optimal donor stool for FMT is still uncertain. Meta-analysis of RCTs showed that FMT treatment achieved significantly higher clinical remission rate than placebo for UC (28% versus 9%, P=0.0003). FMT is an effective and safe therapy for both paediatric and adult IBD; fresh or frozen donor stool, delivery route, and antibiotic pretreatment or not have no impact on the efficacy of FMT in IBD. FMT might be a potential rescue therapy and even an initial standardized therapy for IBD. However, few data exist on long-term safety and efficacy and further validation is needed.
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影响因子：
7.4
作者：
Cui B;Li P;Xu L;Zhao Y;Wang H;Peng Z;Xu H;Xiang J;He Z;Zhang T;Nie Y;Wu K;Fan D;Ji G;Zhang F
通讯作者：
Zhang F
影响因子：
3
作者：
Furlan, Andrea D.;Pennick, Victoria;van Tulder, Maurits
通讯作者：
van Tulder, Maurits
影响因子：
14.2
作者：
Debast, S. B.;Bauer, M. P.;Kuijper, E. J.
通讯作者：
Kuijper, E. J.
影响因子：
9.8
作者：
Angelberger, Sieglinde;Reinisch, Walter;Erry, David B.
通讯作者：
Erry, David B.
DOI：
10.1126/science.aad9948
发表时间：
2016-05-27
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Chu H;Khosravi A;Kusumawardhani IP;Kwon AH;Vasconcelos AC;Cunha LD;Mayer AE;Shen Y;Wu WL;Kambal A;Targan SR;Xavier RJ;Ernst PB;Green DR;McGovern DP;Virgin HW;Mazmanian SK
通讯作者：
Mazmanian SK