Therapeutic manipulation of the microbiota: past, present, and considerations for the future.
Therapeutic manipulation of the microbiota: past, present, and considerations for the future.
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DOI：
10.1016/j.cmi.2016.09.001
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Young VB
中科院分区：
文献类型：
--
作者：
Young VB
随着越来越多地认识到土著微生物群在各种疾病状态中的潜在作用，对操纵微生物群以获得治疗效果产生了伴随的兴趣。用于治疗疾病的微生物群操纵的最成功的例子是在细菌病原体艰难梭菌的复发性感染的情况下。本综述将提供微生物群移植发展的历史观点，并回顾其在复发性C。艰难感染最近的工作指出了以粪便移植形式恢复微生物群的潜在机制。这包括在人类和动物研究中与成功粪便移植相关的微生物研究，以及关注细菌胆汁酸代谢作为介导对病原体的定植抗性的机制。将讨论微生物群操纵对其他疾病如炎症性肠病和代谢紊乱的潜在用途。本文将总结治疗复发性C.艰难梭菌感染可能不一定转化为使用粪便移植或其他方法来改变微生物组以治疗其他疾病。从使用粪便移植作为治疗方式的结果的审查中可以得出的一个关键结论是，在确定微生物群操纵是否代表一种新的治疗方法之前，有必要了解微生物群在特定疾病发病机制中的确切作用。
With the growing appreciation of the potential role of the indigenous microbiota in a variety of disease states there has been a concomitant interest in manipulating the microbiome for therapeutic effect. The most successful example of microbiota manipulation for the treatment of a disease is in the setting of recurrent infection with the bacterial pathogen Clostridium difficile. This review will provide historic perspectives on the development of microbiota transplantation and review the evidence for its use in recurrent C. difficile infection. Recent work has pointed to potential mechanisms by which microbiota restoration in the form of fecal transplantation has been efficacious. This includes studies of the microorganisms that are associated with successful fecal transplantation in human and animal studies and the focus on bacterial bile acid metabolism as a mechanism that mediates colonization resistance against the pathogen. The potential use of microbiota manipulation for other diseases such as the inflammatory bowel diseases and metabolic disorders will be discussed. The case will be made that the lessons learned from treatment of recurrent C. difficile infection may not necessarily translate to the use of fecal transplantation or other methods to alter the microbiome for the treatment of other diseases. A key conclusion that can be drawn from the review of the results of the use of fecal transplantation as a therapeutic modality is that understanding of the precise role of the microbiota in the pathogenesis of a specific disease is necessary prior to determining if microbiota manipulation represents a novel treatment therapy.
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作者：
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通讯作者：
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