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BMC Gastroenterology:粪便微生物群移植对小肠细菌过度生长患者的临床疗效

2021-02-06 MedSci原创 MedSci原创

小肠细菌过度生长(SIBO)是由小肠中细菌的过度生长引起的,主要的胃肠道症状包括肠胃气胀,消化不良和腹泻。SIBO是门诊中常见的疾病,特别是在肠易激综合征(I

      小肠细菌过度生长(SIBO)是由小肠中细菌的过度生长引起的,主要的胃肠道症状包括肠胃气胀,消化不良和腹泻。SIBO是门诊中常见的疾病,特别是在肠易激综合征(IBS)患者中。最近,许多研究已经证实,SIBO与肠易激综合征,肝硬化和小肠肿瘤相关。SIBO患者常常用抗生素(利福昔明,诺氟沙星,甲硝唑,甲氧苄啶-磺胺甲恶唑等)进行治疗,除此之外,益生菌可用于帮助恢复肠道微生物生态系统。将粪便微生物菌群移植(FMT)应用于胃肠道疾病已经引起了医学研究者的越来越多的关注。多年来,FMT已被用作治疗艰难梭菌感染(CDI)以及其他复发性或难治性胃肠道疾病的有效方法。

 

 

      本项FMT治疗SIBO的实验为期6个月,是一项随机,双盲,安慰剂对照研究。研究人员将患者分为两组,并连续4周让其每周口服一次口服FMT胶囊或安慰剂胶囊。入组前两个月没有患者接受抗生素治疗。所有受试者每周接受十六次胶囊治疗,持续四个星期。研究人员记录并收集他们的胃肠道症状基线信息,并在1、3和6个月时进行随访。此外,进行了乳果糖氢呼气试验(LHBT)和CT扫描,并在基线和6个月时在FMT和安慰剂组中分析了患者和供体的粪便微生物群多样性。

 

 

      结果最后显示与安慰剂组相比,FMT治疗后SIBO患者的胃肠道症状明显改善。FMT组的肠道菌群多样性有明显增加,而安慰剂组则没有。通过乳果糖氢呼气试验证实患者呼出气体中的H 2浓度在40、60、80、100和120分钟时显着增加,但CH 4浓度没有升高。此外,研究人员还发现FMT治疗后的H 2浓度较FMT组的基线水平降低,但安慰剂组未降低。

 

      这项研究表明,将FMT用于SIBO患者可以缓解胃肠道症状,表明FMT可能是SIBO的一种有前途的新颖治疗方案。

 

 

 

原始出处:

Fenghua Xu. Et al. Clinical efficacy of fecal microbiota transplantation for patients with small intestinal bacterial overgrowth: a randomized, placebo-controlled clinic study. BMC Gastroenterology.2021.

 

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[GetPortalCommentsPageByObjectIdResponse(id=2065265, encodeId=edd5206526538, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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 18 16:02:55 CST 2021, time=2021-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1907209, encodeId=d998190e209e4, content=<a href='/topic/show?id=acc02289e40' target=_blank style='color:#2F92EE;'>#临床疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22897, encryptionId=acc02289e40, topicName=临床疗效)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8346212, createdName=respect, createdTime=Sun Jul 25 23:02:55 CST 2021, time=2021-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975051, encodeId=c41c19e5051eb, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Nov 30 09:02:55 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825247, encodeId=9d0e182524e98, content=<a href='/topic/show?id=702a5065860' target=_blank style='color:#2F92EE;'>#微生物#</a>, beContent=null, objectType=article, channel=null, level=null, 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style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Apr 01 02:02:55 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756380, encodeId=f23c1e56380b4, content=<a href='/topic/show?id=7202e63153b' target=_blank style='color:#2F92EE;'>#粪便微生物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76315, encryptionId=7202e63153b, topicName=粪便微生物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def837117498, createdName=pps20031, createdTime=Fri Feb 19 20:02:55 CST 2021, time=2021-02-19, status=1, ipAttribution=), 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createdName=Homburg, createdTime=Mon Feb 08 11:02:55 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505178, encodeId=ee7515051e89e, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Feb 08 11:02:55 CST 2021, time=2021-02-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2065265, encodeId=edd5206526538, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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 18 16:02:55 CST 2021, time=2021-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1907209, encodeId=d998190e209e4, content=<a href='/topic/show?id=acc02289e40' target=_blank style='color:#2F92EE;'>#临床疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22897, encryptionId=acc02289e40, topicName=临床疗效)], attachment=null, authenticateStatus=null, createdAvatar=, 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style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Apr 01 02:02:55 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756380, encodeId=f23c1e56380b4, content=<a href='/topic/show?id=7202e63153b' target=_blank style='color:#2F92EE;'>#粪便微生物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76315, encryptionId=7202e63153b, topicName=粪便微生物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def837117498, createdName=pps20031, createdTime=Fri Feb 19 20:02:55 CST 2021, time=2021-02-19, status=1, ipAttribution=), 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createdName=Homburg, createdTime=Mon Feb 08 11:02:55 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505178, encodeId=ee7515051e89e, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Feb 08 11:02:55 CST 2021, time=2021-02-08, status=1, ipAttribution=)]
    2021-06-17 许安
  6. 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  7. 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  9. 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    2021-02-08 Homburg
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重症度和暴发性艰难梭菌感染与高死亡率有关。尽管已证明粪便微生物菌群移植对于复发性艰难梭菌感染有效,但关于严重或难治性艰难梭菌感染,粪便微生物菌群移植的效用数据很少。因此,本项研究比较了重症或暴发性艰难梭菌感染的危重患者的抗生素和粪便微生物群移植与单独使用抗生素的结果。

Gut:亚太胃肠病学会和亚太消化内镜学会粪便微生物移植共识

专家组认为,在对不同疾病的治疗前景进行评估之前,FMT需要优化。这一结论为未来FMT研究和实践打下基础

GUT:粪菌移植可以阻止新发1型糖尿病的进展

1型糖尿病(T1D)是一种自身免疫性疾病,其特征在于进行性β细胞破坏。

Gastroenterology:粪菌群移植可减轻以肠腹胀为主的肠易激综合征患者的症状

肠易激综合症(IBS)是与肠功能异常有关的功能性胃肠疾病。有报道,粪便微生物菌群移植(FMT)在治疗以腹胀为症状的肠易激患者中有希望,因此,本项研究旨在研究了该治疗的疗效。

Dig Dis Sci:高危感染艰难梭菌老年人应该进行粪便微生物菌群移植减少疾病复发

粪便菌群移植(FMT)对复发性艰难梭菌(Clostridioides difficile)感染(CDI)的治疗非常有效的办法。

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