Abstract
ABSTRACT The intestinal microbiome has been identified as a key modifier for a variety of health conditions. Fecal Microbiota Transplantation (FMT) has emerged as a fast, safe, and effective means by which to modify the intestinal microbiome and potentially treat a variety of health conditions. Despite extensive research of FMT for CDI, there is a lack of clarity informed by systematic synthesis of data regarding the safety and efficacy of FMT for other health conditions. This systematic review used PRISMA guidelines and was prospectively registered with PROSPERO (CRD42018104243). In March 2020, a search of MEDLINE, EMBASE, and PsycINFO was conducted. We identified 26 eligible studies. A meta-analysis of FMT for active Ulcerative Colitis (UC) showed that FMT significantly improved rates of clinical remission (OR = 3.634, 95% CI = 1.940 to 6.808, I2 = 0%, p < .001), clinical response (OR = 2.634, 95% CI = 1.441 to 4.815, I2 = 33%, p = .002) and endoscopic remission (OR = 4.431, 95% CI = 1.901 to 10.324, I2 = 0%, p = .001). With respect to Irritable Bowel Syndrome, a meta-analysis showed no significant change in symptoms following FMT (p = .739). Hepatic disorders, metabolic syndrome, and antibiotic-resistant organisms were conditions with emerging data on FMT. Serious adverse events (AE) were more often reported in control group participants (n = 43) compared with FMT group participants (n = 26). There were similar rates of mild to moderate AE in both groups. Preliminary data suggest that FMT is a potentially safe, well-tolerated and efficacious treatment for certain conditions other than CDI, with evidence for active UC being the most compelling.
Highlights
The intestinal microbiome has emerged as a modifiable target for treating a variety of health conditions thought to be associated with dysregu lated microbiome profiles.[1]
For the purposes of this review, Fecal Microbiota Transplantation (FMT) was defined as any process by which a fecal microbiota suspension was trans ferred from the gastrointestinal tract of a healthy individual into another person with the aim of treating a health condition.35 ● Comparator: Studies were included if they uti lized a control group. ● Outcomes: When reporting on efficacy, this review used primary outcome measures as described by each study
Eight studies investigated the use of FMT for Inflammatory Bowel Disease (IBD), six for functional gut disor ders, four for hepatic disorders, three for metabolic syndrome, two for antibiotic-resistant organisms, and one each for “pouchitis,” obesity without meta bolic syndrome, and Human Immunodeficiency Virus (HIV)
Summary
The intestinal microbiome has emerged as a modifiable target for treating a variety of health conditions thought to be associated with dysregu lated microbiome profiles.[1]. The intestinal micro biome is believed to have a key role in modifying immunity, inflammation, and – by extension – a plethora of health conditions.[2–4]. There is substantial research interest[5] into interventions that might target the gut microbiome to improve chronic diseases, including diet, supplementary prebiotics, probiotics, antibiotics, short-chain fatty acids, and Fecal Microbiota Transplantation (FMT).[6,7]. FMT is a technique in which gut bacteria are transferred from a healthy donor to a patient, with the goal of introducing or restoring a stable microbial community in the gut. FMT has been established as an effective means of rapidly modify ing the intestinal microbiota and may e1854640-2.
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