Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives
This article has been
cited by other articles in PMC.
Abstract
Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.
Keywords: Fecal microbiota transplantation, Clostridium difficile infection, Colitis, ulcerative, Crohn disease, Irritable bowel syndrome
INTRODUCTION
The gut microbiota provides an intestinal biological barrier against pathogens and has a pivotal role in the maintenance of intestinal homeostasis and modulation of the host immune system [1]. The specific changes in the composition of gut microbiota, termed dysbiosis, have been associated not only with many gastrointestinal (GI) diseases but also with metabolic diseases, autoimmune diseases, allergic disorders, and neuropsychiatric disorders [2]. Restoring a healthy microbial community is therefore a promising therapeutic strategy for diseases related with gut dysbiosis [3]. Fecal microbiota transplantation (FMT), also called stool/fecal transplantation or fecal bacteriotherapy, is the infusion or engraftment of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease [4]. The concept of FMT for treatment of human GI disease was described approximately 1,700 years ago by a Chinese medical scientist named Ge Hong [5]. At that time, he orally administered human fecal suspension to treat patients who had food poisoning or severe diarrhea. Borody et al. [4] and Brandt et al. [6] noted that FMT may have been first used in veterinary medicine by the Italian anatomist Fabricius Aquapendente in the 17th century. It was first reported in the English language by Eiseman et al. [7], who used fecal enemas to treat pseudomembranous colitis in 1958. Recently, FMT is becoming interesting with its effectiveness in treating refractory and recurrent Clostridium difficile infection (CDI) and the possibilities for treating other diverse conditions [8]. We review the efficacy of FMT used in treating a variety of diseases and preclinical conditions. In addition, we describe the methodology, criteria for donor selection and screening, and safety data.
Loading ...