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Fecal microbial transplant for inflammatory bowel disease.
Curr Opin Clin Nutr Metab Care. 2020 Jun 28 [Online ahead of print]CO

Abstract

PURPOSE OF REVIEW

The purpose of this brief review is to investigate the current utility of fecal microbial transplantation (FMT) to ameliorate dysbiosis contributing to inflammatory bowel disease pathogenesis.

RECENT FINDINGS

Increasing data from randomized, controlled trials support a role for multiple FMT administrations in the induction of remission and even as a maintenance therapy in mild-to-moderate Ulcerative Colitis. Small series and one small randomized controlled trial among patients with Crohn's Disease and with pouchitis continue to produce conflicting clinical results and microbial profile data on the host and donor levels. It is not clear whether patients with Crohn's disease are more susceptible to disease flare after FMT. Novel FMT delivery systems, including oral, and early-intensity colonoscopic devices, are under investigation.

SUMMARY

The allure of minimizing the risks and cost of long-term immunosuppression via modulation of patient microbiota remains enticing, and the most recent randomized controlled data in ulcerative colitis reveals acceptable clinical remission rates. However, prior to wide adoption of FMT within the inflammatory bowel disease treatment armamentarium, large clinical trials identifying biomarkers of treatment success, ensuring safety across all indications, and cultivating optimized donor and host selection are needed.

Authors+Show Affiliations

Department of Internal Medicine.Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, California, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618725

Citation

Claytor, Jennifer D., and Najwa El-Nachef. "Fecal Microbial Transplant for Inflammatory Bowel Disease." Current Opinion in Clinical Nutrition and Metabolic Care, 2020.
Claytor JD, El-Nachef N. Fecal microbial transplant for inflammatory bowel disease. Curr Opin Clin Nutr Metab Care. 2020.
Claytor, J. D., & El-Nachef, N. (2020). Fecal microbial transplant for inflammatory bowel disease. Current Opinion in Clinical Nutrition and Metabolic Care. https://doi.org/10.1097/MCO.0000000000000676
Claytor JD, El-Nachef N. Fecal Microbial Transplant for Inflammatory Bowel Disease. Curr Opin Clin Nutr Metab Care. 2020 Jun 28; PubMed PMID: 32618725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fecal microbial transplant for inflammatory bowel disease. AU - Claytor,Jennifer D, AU - El-Nachef,Najwa, Y1 - 2020/06/28/ PY - 2020/7/4/entrez JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care N2 - PURPOSE OF REVIEW: The purpose of this brief review is to investigate the current utility of fecal microbial transplantation (FMT) to ameliorate dysbiosis contributing to inflammatory bowel disease pathogenesis. RECENT FINDINGS: Increasing data from randomized, controlled trials support a role for multiple FMT administrations in the induction of remission and even as a maintenance therapy in mild-to-moderate Ulcerative Colitis. Small series and one small randomized controlled trial among patients with Crohn's Disease and with pouchitis continue to produce conflicting clinical results and microbial profile data on the host and donor levels. It is not clear whether patients with Crohn's disease are more susceptible to disease flare after FMT. Novel FMT delivery systems, including oral, and early-intensity colonoscopic devices, are under investigation. SUMMARY: The allure of minimizing the risks and cost of long-term immunosuppression via modulation of patient microbiota remains enticing, and the most recent randomized controlled data in ulcerative colitis reveals acceptable clinical remission rates. However, prior to wide adoption of FMT within the inflammatory bowel disease treatment armamentarium, large clinical trials identifying biomarkers of treatment success, ensuring safety across all indications, and cultivating optimized donor and host selection are needed. SN - 1473-6519 UR - https://www.unboundmedicine.com/medline/citation/32618725/Fecal_microbial_transplant_for_inflammatory_bowel_disease L2 - https://doi.org/10.1097/MCO.0000000000000676 DB - PRIME DP - Unbound Medicine ER -
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