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Clin Gastroenterol H:炎症性肠病影响粪便菌群移植结局?

2016-10-08 xing.T MedSci原创

基于对272例患者的分析,无论有无免疫抑制治疗,相比于不伴有IBD的患者,在伴有IBD患者中粪便菌群移植清除CDI复发的效果稍差。超过25%的伴有IBD的患者在粪便菌群移植之后出现炎症表现,淋巴细胞性结肠炎不影响粪便菌群移植的结局,只有一小部分患者进行粪便菌群移植后需要药物治疗。

相当一部分患者感染复发性艰难梭菌(CDI)同时伴有炎症性肠病(IBD),粪便菌群移植可以打破CDI复发周期,并且无需进行结肠功能评估就可以实施。近日,消化病领域权威杂志《Clinical Gastroenterology and Hepatology》发表了一篇研究文章,旨在评估在有或无IBD的患者进行结肠镜粪便菌群移植的疗效,并且明确在这个操作过程中能否发现IBD患者。

研究者收集了从2008年到2015年期间因CDI复发在明尼苏达大学住院的272例接受粪便菌群移植的患者的临床数据和结肠镜检查结果。患者至少有2次自发性CDI复发,在粪便菌群移植中,研究者随机从患者右结肠粘膜活检来鉴别结肠炎淋巴细胞或胶原细胞,并在粪便菌群移植2个月后确定CDI清除的成败。

接受粪便菌群移植的患者,15%患者伴有IBD,2.6%的患者在粪便菌群移植过程中发现有IBD,在IBD患者中单次结肠镜FMT可以清除74.4%患者的CDI,而在不伴有IBD的患者中,粪便菌群移植可以清除92.1%患者的CDI(P=0018)。无论有无免疫抑制治疗,患者对粪便菌群移植有类似的反应。超过1/4(25.6%)的IBD患者在进行粪便菌群移植之后有明显的临床炎症表现,在内镜结肠黏膜正常的患者有7.4%出现淋巴细胞性结肠炎;这些患者中仅有3例患者(20%)在清除CDI后需要额外治疗结肠炎。

基于对272例患者的分析,无论有无免疫抑制治疗,相比于不伴有IBD的患者,在伴有IBD患者中粪便菌群移植清除CDI复发的效果稍差。超过25%的伴有IBD的患者在粪便菌群移植之后出现炎症表现,淋巴细胞性结肠炎不影响粪便菌群移植的结局,只有一小部分患者进行粪便菌群移植后需要药物治疗。

原始出处:

Alexander Khoruts,et al. Inflammatory Bowel Disease Affects the Outcome of Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection. clinical
gastroenterology and hepatology 2016. 

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    2024-01-10 ms1000001795047619 来自广东省

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    2017-03-29 许安
  4. [GetPortalCommentsPageByObjectIdResponse(id=2180488, encodeId=f60d21804886f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=835e9128109, createdName=ms1000001795047619, createdTime=Wed Jan 10 13:38:43 CST 2024, time=2024-01-10, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2064015, encodeId=06c520640151a, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 10 01:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071680, encodeId=b41f20e168030, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Mar 29 09:44:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710939, encodeId=97651e1093917, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Jan 24 00:44:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1803293, encodeId=116c180329335, content=<a href='/topic/show?id=e503e52136a' target=_blank style='color:#2F92EE;'>#移植结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75213, encryptionId=e503e52136a, topicName=移植结局)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Mon May 29 10:44:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145886, encodeId=e7f7145886f7, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:21:49 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466781, encodeId=d9791466e8108, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468124, encodeId=ecee14681248f, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547025, encodeId=acee154e02523, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142600, encodeId=034614260015, content=高端大气上档次!, beContent=null, objectType=article, channel=null, level=null, likeNumber=3, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sun Oct 09 12:49:08 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2017-01-24 hb2008ye
  5. [GetPortalCommentsPageByObjectIdResponse(id=2180488, encodeId=f60d21804886f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=835e9128109, createdName=ms1000001795047619, createdTime=Wed Jan 10 13:38:43 CST 2024, time=2024-01-10, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2064015, encodeId=06c520640151a, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 10 01:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071680, encodeId=b41f20e168030, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Mar 29 09:44:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710939, encodeId=97651e1093917, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:21:49 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466781, encodeId=d9791466e8108, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468124, encodeId=ecee14681248f, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547025, encodeId=acee154e02523, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142600, encodeId=034614260015, content=高端大气上档次!, beContent=null, objectType=article, channel=null, level=null, likeNumber=3, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sun Oct 09 12:49:08 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2180488, encodeId=f60d21804886f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=835e9128109, createdName=ms1000001795047619, createdTime=Wed Jan 10 13:38:43 CST 2024, time=2024-01-10, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2064015, encodeId=06c520640151a, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 10 01:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), 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createdTime=Tue Jan 24 00:44:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1803293, encodeId=116c180329335, content=<a href='/topic/show?id=e503e52136a' target=_blank style='color:#2F92EE;'>#移植结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75213, encryptionId=e503e52136a, topicName=移植结局)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Mon May 29 10:44:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145886, encodeId=e7f7145886f7, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:21:49 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466781, encodeId=d9791466e8108, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468124, encodeId=ecee14681248f, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547025, encodeId=acee154e02523, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Mon Oct 10 12:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142600, encodeId=034614260015, content=高端大气上档次!, beContent=null, objectType=article, channel=null, level=null, likeNumber=3, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sun Oct 09 12:49:08 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2180488, encodeId=f60d21804886f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=835e9128109, createdName=ms1000001795047619, createdTime=Wed Jan 10 13:38:43 CST 2024, time=2024-01-10, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2064015, encodeId=06c520640151a, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 10 01:44:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), 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  8. 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  9. 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  10. 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    2016-10-09 meiliwuxian

    高端大气上档次!

    0

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背景:粪便菌群移植(FMT)是一种可以重建肠道菌群的疗法;将健康人粪便中的功能菌群,通过一定方式移植到患者肠道内,进而对患者的肠道菌群失衡进行调节,重建具正常功能的肠道微生态系统。 难治性或复发性艰难梭菌感染(CDI)的一个重要原因是抗生素的滥用导致肠道菌群紊乱;现有的研究已经表明,FMT治疗这类CDI是安全和有效的。 但是在FMT实际进行过程中还存在实践障碍;早些时候,我们初步报道了

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一项新的研究有助认识在进行粪便菌群移植(fecal microbiota transplant, FMT)后病人肠道微生物组会发生什么。来自德国海德堡欧洲分子生物学实验室(EMBL)的研究人员及其同事们在每名代谢综合征病人接受FMT后对这些病人肠道中的细菌菌株DNA进行测序,发现供者细菌菌株在受者肠道中持续存在高达3个月。研究人员也研究了FMT的供者-受者相容性。相关研究结果发表在2016年

粪便菌群移植的前世今生

粪便菌群移植(FMT)—顾名思义,就是将健康人粪便中的功能菌群,移植到患者胃肠道内,重建具有正常功能的肠道菌群,实现肠道及肠道外疾病的治疗。在国际合作组对此词进行统一之前,少数情况下被译为“粪便移植”、“粪菌治疗”和“肠菌移植”或“肠微生态移植”。 迄今,全世界已有数千例患者接受FMT治疗,这种新型疗法的迅速崛起使越来越多的患者受益。然而,FMT受到日受关注的同时,也给美国食品和药品管理

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