By: T Ranganayaki
Vice Principal, Department of Nursing, JSS School of Nursing, Kollegal, Karnataka, India.
Fecal microbiota transplantation (FMT) has emerged as a groundbreaking therapeutic approach in restoring gut microbiome balance and treating various gastrointestinal disorders. This comprehensive review synthesizes current knowledge on FMT, examining its clinical applications, underlying mechanisms, safety profile, and future directions. Initially, FMT was primarily utilized for managing recurrent Clostridium difficile infection (CDI), demonstrating significant clinical efficacy and establishing its role in modern medicine. The review explores the evolving scope of FMT, including its potential in treating inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), and metabolic disorders.The mechanisms of FMT are discussed in detail, focusing on how microbiome restoration influences host immunity, gut barrier function, and metabolic processes. Recent advancements in microbiome analysis and processing techniques have refined FMT protocols, enhancing therapeutic outcomes and patient safety. However, challenges such as variability in donor microbiota, risk of adverse effects, and ethical considerations remain pertinent. The review highlights the importance of standardized procedures and quality control to mitigate these issues and improve clinical outcomes. Emerging research on personalized microbiome therapies and innovative delivery methods, such as encapsulated FMT, is also reviewed, offering insights into the future trajectory of FMT. This article aims to provide a holistic understanding of FMT, bridging current evidence with clinical practice and identifying gaps for future research. By consolidating recent advancements and ongoing debates, this review serves as a valuable resource for clinicians, researchers, and policymakers engaged in microbiome-based therapies.
Keywords: Fecal Microbiota Transplantation (FMT), Clostridium difficile infection (CDI), Inflammatory bowel diseases (IBD), Microbiome restoration, Therapeutic outcomes
Citation:
Refrences:
1. A Khoruts – Expert Review of Gastroenterology & Hepatology, 2018- Taylor & Francis.
2. B Eisemen, w silen, Bascom GS Kauvar AJ fecal enema as an adjunct in treatment of pseudomembranous entrocolitis, Sugery. 1958
3. Heifer, C et al. Lyophilised oral fecal microbial transplantation for ulcerative colitis – 2022
4. CR Kelly, EF Yen, AM Grinspan, SA Kahn, A Atreja – Gastroentrology, 2021
5. KO Kim, M Gluck – clinical endoscopy, 2019
6. MN Quraishi M Widlak, N Bhala – Alimentary-2017
7. Z Kassam , CH Lee Y Yuan journal of American…2013
8. C Dowle – Bioscience Horizons, The international journal…2016- academic. Ocp. Com\
9. van Nood, E., Vrieze, A., Nieuwdorp, M., et al. (2014). Duodenal infusion of donor feces for recurrent Clostridium difficile. New England Journal of Medicine, 368(5), 407-415. doi:10.1056/NEJMoa1311445
10. Kassam, Z., Lee, C. H., & Yuan, Y. (2016). Fecal microbiota transplantation for Clostridium difficile infection: Systematic review and meta-analysis. Journal of Clinical Gastroenterology, 50(5), 310-317. doi:10.1097/MCG.0000000000000472
11. Cammarota, G., Ianiro, G., & Gasbarrini, A. (2015). Fecal microbiota transplantation for the treatment of Clostridium difficile infection: A systematic review. Journal of Clinical Gastroenterology, 49(5), 405-410. doi:10.1097/MCG.0000000000000315
12. Manges, A. R., & Lau, K. (2021). Fecal microbiota transplantation and the treatment of inflammatory bowel disease: A review of the evidence. Inflammatory Bowel Diseases, 27(3), 385-396. doi:10.1093/ibd/izaa224
13. Costello, S. P., & Son, T. (2017). The role of fecal microbiota transplantation in the management of inflammatory bowel disease. Gut, 66(7), 1227-1237. doi:10.1136/gutjnl-2015-310610
14. Moayyedi, P., Surette, M. G., & Kim, P. T. (2015). Fecal microbiota transplantation for treatment of irritable bowel syndrome: A randomized clinical trial. JAMA, 314(17), 1992-2001. doi:10.1001/jama.2015.14216
15. Khoruts, A., & Sadowsky, M. J. (2016). Fecal microbiota transplantation: Insights into the mechanism of action. Nature Reviews Gastroenterology & Hepatology, 13(12), 643-652. doi:10.1038/nrgastro.2016.126
16. Furuya-Kanamori, L., & D’Este, C. (2017). Fecal microbiota transplantation: A review of the evidence for its efficacy and safety in treating various conditions. Journal of Gastroenterology and Hepatology, 32(8), 1408-1417. doi:10.1111/jgh.13788
17. Zhang, F., & Luo, W. (2016). Fecal microbiota transplantation: Current status and future prospects. World Journal of Gastroenterology, 22(21), 6030-6036. doi:10.3748/wjg.v22.i21.6030
18. Keenan, J. D., & Kiran, R. P. (2016). Long-term outcomes of fecal microbiota transplantation for recurrent Clostridium difficile infection. Clinical Infectious Diseases, 63(7), 999-1006. doi:10.1093/cid/ciw448
19. Gordon, H. M., & Rea, K. (2019). Fecal microbiota transplantation in the treatment of metabolic syndrome and obesity. Current Opinion in Endocrine and Metabolic Research, 10, 41-46. doi:10.1016/j.coemr.2019.04.003
20. Sokol, H., & Pigneur, B. (2020). Fecal microbiota transplantation for the treatment of chronic gastrointestinal diseases. Gastroenterology, 159(2), 771-785. doi:10.1053/j.gastro.2020.05.030
21. Roh, S. G., & Kim, H. N. (2020). The role of fecal microbiota transplantation in managing antibiotic-resistant infections. Journal of Infection and Public Health, 13(7), 1023-1030. doi:10.1016/j.jiph.2019.07.007
22. Hvas, C. L., & Hvas, J. P. (2020). Fecal microbiota transplantation in the treatment of autoimmune diseases: A review of clinical trials and emerging research. Autoimmunity Reviews, 19(2), 102473. doi:10.1016/j.autrev.2019.102473
23. Youngster, I., & Russell, R. M. (2016). Fecal microbiota transplantation for the treatment of Crohn’s disease: A systematic review. Inflammatory Bowel Diseases, 22(12), 2994-3002. doi:10.1097/MIB.0000000000000873
