Fecal Microbiota Transplantation: Past, Present and Future
https://doi.org/10.23934/2223-9022-2019-8-2-160-165
Abstract
In this review, we have summarized the latest evidence, indications, and methods of fecal microbiota transplantation (FMT), and analyzed the prospects and therapeutic potentials of this procedure. In recent years, FMT has attracted great interest, especially due to the global Clostridium difficile infection (CDI). FMT is now recommended as alternative therapy for recurrent CDI when standard treatment with antibiotics fails. It involves putting suspended biomaterial with intestinal microorganisms of a healthy donor into the intestine of a patient. Although the exact mechanism of action is not entirely clear, it is believed to restore the composition and function of the intestinal microbiota in diseased patients. The efficacy varies depending on the route of administration, quality and volume of donor biomaterial, and treatment before the procedure.
About the Authors
N. V. Yevdokimova
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Natalya Vitalyevna Yevdokimova - Cand. Biol. Sci., Senior Researher of the Laboratory of Clinical Microbiology.
3 Bolshaya Sukharevskaya Square, Moscow 129090
T. V. Chyornenkaya
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Tatyana Vitalyevna Chyornenkaya - Cand. Med. Sci., Head of the Laboratory of Clinical Microbiology.
3 Bolshaya Sukharevskaya Square, Moscow 129090
References
1. Colman R.J., Rubin D.T. Fecal microbiota transplantation as therapy for inflammatory bowel disease: A systematic review and meta-analysis. J Crohns Colitis. 2014; 8(12): 1569-1581. PMID: 25223604. PMCID. DOI: 10.1016/j.crohns.2014.08.006.
2. Smits L.P., Bouter K.E., de Vos W.M., et al. Therapeutic potential of fecal microbiota transplantation. Gastroenterology. 2013; 145(5): 946-953. PMID: 24018052. DOI: 10.1053/j.gastro.2013.08.058
3. Lessa F.C., Mu Y., Bamberg W.M., et al. Burden of Clostridium difficile infection in the United States. Engl J Med. 2015; 372(9): 825-834. PMID: 25714160. DOI: 10.1056/NEJMoa1408913.
4. Rubin T.A., Gessert C.E., Aas J., Bakken J.S. Fecal microbiome transplantation for recurrent Clostridium difficile infection: report on a case series. Anaerobe. 2013; (19): 22-26. PMID: 23182843. DOI: 10.1016/j.anaerobe.2012.11.004.
5. Van Nood E., Vrieze A., Nieuwdorp M., et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013; 368(5): 407-415. PMID: 23323867. DOI: 10.1056/NEJMoa1205037.
6. Khoruts A., Dicksved J., Jansson J.K., Sadowsky M.J. Changes in the composition of the human fecal microbiome after bacteriotherapy for recurrent Clostridium difficile-associated diarrhea. J Clin Gastroenterol. 2010; 44(5): 354-360. PMID: 20048681. DOI: 10.1097/MCG.0b013e3181c87e02.
7. Song Y., Garg S., Girotra M., et al. Microbiota dynamics in patients treated with fecal microbiota transplantation for recurrent Clostridium difficile infection. PLoS One. 2013; 8 (11): e81330. PMID: 24303043. DOI: 10.1371/journal.pone.0081330.
8. Jalanka J., Mattila E., Jouhten H., et al. Long-term effects on luminal and mucosal microbiota and commonly acquired taxa in faecal microbiota transplantation for recurrent Clostridium difficile infection. BMC Med. 2016; 14(1): 155. PMID: 27724956. DOI: 10.1186/s12916-016-0698-z.
9. Loo V.G., Poirier L., Miller M.A., et al. A predominantly clonal multiinstitutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med. 2005; 353(23): 2442-2449. PMID: 16322602. DOI: 10.1056/NEJMoa051639.
10. Louie T.J., Miller M.A., Mullane K.M., et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011; 364(5): 422-431. PMID: 21288078. DOI: 10.1056/NEJMoa0910812.
11. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. Available at: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf (Accessed 28 May 2019).
12. Johnson S. Recurrent Clostridium difficile infection: a review of risk factors, treatments, and outcomes. J Infect. 2009; 58(6): 403-410. PMID: 19394704. DOI: 10.1016/j.jinf.2009.03.010.
13. Surawicz C.M., Mcfarland L.V., Greenberg R.N., et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000; 31(4): 1012-1017. PMID: 11049785. DOI: 10.1086/318130.
14. McFarland L.V., Elmer G.W., Surawicz C.M. Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease. Am J Gastroenterol. 2002; 97(7): 1769-1775. PMID: 12135033. DOI: 10.1111/j.1572-0241.2002.05839.x.
15. Cornely O.A., Miller M.A., Louie T.J., et al. Treatment of first recurrence of Clostridium difficile infection: fidaxomicin versus vancomycin. Clin Infect Dis. 2012; 55 Suppl 2: S154-161. PMID: 22752865. DOI: 10.1093/cid/cis462.
16. Gerding D.N., Muto C.A., Owens R.C. Measures to control and prevent Clostridium difficile infection. Clin Infect Dis. 2008; 46(Suppl 1): S43-49. PMID: 1817722. DOI: 10.1086/521861.
17. Wilson K.H. The microecology of Clostridium difficile. Clin Infect Dis. 1993; 16(Suppl 4): S214-218. PMID: 8324122.
18. Cammarota G., Ianiro G., Gasbarrini A. Fecal microbiota transplantation for the treatment of Clostridium difficile infection: a systematic review. J Clin Gastroenterol. 2014; 48(8):693-702. PMID: 24440934. DOI: 10.1097/MCG.0000000000000046.
19. Guidance for Industry: Enforcement Policy Regarding Investigational New Drug Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium Difficile Infection Not Responsive to Standard Therapies. US Government DoHaHS, Food and Drug, Administration, Center for Biologics Evaluation and Research. Jul 2013. Available at: http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatorylnformation/Guidances/Vaccines/ucm361379.htm (Accessed 28 May 2019).
20. Cammarota G., Ianiro G., Tilg H., et al. European consensus conference on faecal microbiota transplantation in clinical practice. Gut. 2017; 66(4): 569-580. PMID: 28087657. DOI: 10.1136/gutjnl-2016-313017.
21. Cammarota G., Masucci L., Ianiro G., et al. Randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent Clostridium difficile infection. Aliment Pharmacol Ther. 2015; 41(9): 835-843. PMID: 2572880. DOI: 10.1111/apt.13144.
22. Lee C.H., Steiner T., Petrof E.O., et al. Frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent Clostridium difficile infection: a randomized clinical trial. JAMA. 2016; 315(2): 142-149. PMID: 26757463. DOI: 10.1001/jama.2015.18098.
23. Cammarota G., Ianiro G., Magalini S., et al. Decrease in surgery for Clostridium difficile infection after starting a program to transplant fecal microbiota. Ann Intern Med. 2015; 163(6): 487-488. PMID: 26370022. DOI: 10.7326/L15-5139.
24. Fischer M., Sipe B.W., Rogers N.A., et al. Faecal microbiota transplantation plus selected use of vancomycin for severe-complicated Clostridium difficile infection: description of a protocol with high success rate. Aliment Pharmacol Ther. 2015; 42(4): 470-476. PMID: 26096320. DOI: 10.1111/apt.13290.
25. Weingarden A.R., Hamilton M.J., Sadowsky M.J., Khoruts A. Resolution of severe Clostridium difficile infection following sequential fecal microbiota transplantation. J Clin Gastroenterol. 2013; 47(8): 735-737. PMID: 23632358. DOI: 10.1097/MCG.0b013e31829004ae.
26. Satokari R., Mattila E., Kainulainen V., Arkkila P.E. Simple faecal preparation and efficacy of frozen inoculum in faecal microbiota transplantation for recurrent Clostridium difficileinfection—an observational cohort study. Aliment Pharmacol Ther. 2015; 41(1): 46-53. PMID: 25355279. DOI: 10.1111/apt.13009.
27. Browne H.P., Forster S.C., Anonye B.O., et al. Culturing of ‘unculturable’ human microbiota reveals novel taxa and extensive sporulation. Nature. 2016; 533(7604): 543-546. MID: 27144353. DOI: 10.1038/nature17645.
28. Drekonja D., Reich J., Gezahegn S., et al. Fecal microbiota transplantation for Clostridium difficile infection: a systematic review. Ann Intern Med. 2015; 162(9): 630-638. PMID: 25938992. DOI: 10.7326/M14-2693.
29. Frank J., Hogenauer C., Grochenig H.P., et al. Safety of fecal microbiota transplantation in patients with chronic colitis and immunosuppressive treatment [abstract]. J Crohns Colitis. 2015; 9: S245.
30. Baxter M., Ahmad T., Colville A., Sheridan R. Fatal aspiration pneumonia as a complication of fecal microbiota transplant. Clin Infect Dis. 2015; 61(1): 136-137. PMID: 25805303. DOI: 10.1093/cid/civ247.
31. Fischer M., Kao D., Mehta S.R., et al. Predictors of early failure after fecal microbiota transplantation for the therapy of Clostridium difficile infection: a multicenter study. Am J Gastroenterol. 2016; 111(7): 10241031. PMID: 27185076. DOI: 10.1038/ajg.2016.180.
32. Moayyedi P., Surette M.G., Kim P.T., et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterol. 2015; 149(1): 102-109. PMID: 25857665. DOI: 10.1053/j.gastro.2015.04.001.
33. Holvoet T., Joossens M., Wang J., et al. Assessment of faecal microbial transfer inirritable bowel syndrome with severe bloating. Gut. 2017; 66(5): 980-982. PMID: 27511198. DOI: 10.1136/gutjnl-2016-312513.
34. Kakihana K., Fujioka Y., Suda W., et al. Fecal microbiota transplantation for patients with steroid-resistant/dependent acute graft-versus-host disease of the gut. Blood. 2016; 128(16): 2083-2088. PMID: 27461930. DOI: 10.1182/blood-2016-05-717652.
Review
For citations:
Yevdokimova N.V., Chyornenkaya T.V. Fecal Microbiota Transplantation: Past, Present and Future. Russian Sklifosovsky Journal "Emergency Medical Care". 2019;8(2):160-165. https://doi.org/10.23934/2223-9022-2019-8-2-160-165
Views:
1213
Email this article 