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Erschienen in: Current Gastroenterology Reports 3/2017

01.03.2017 | Pediatric Gastroenterology (S Orenstein, Section Editor)

Donor Considerations in Fecal Microbiota Transplantation

verfasst von: Danielle Barnes, K. T. Park

Erschienen in: Current Gastroenterology Reports | Ausgabe 3/2017

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Abstract

Purpose of Review

Tremendous acceleration has been made in understanding the gut microbiota in the past decade and, with it, further understanding of the pathologic role of dysbiosis and the use of fecal microbiota transplantation (FMT) as therapy. FMT has been studied in many disease states including the most common indication of Clostridium difficile infection (CDI), though many questions regarding stool donor selection remain.

Recent Findings

Though traditionally, one donor has provided stool for one patient, research is underway to explore many donor selection considerations from the use of pooled donor stool to selection of a high diversity donor. It is well-known that dietary intake shapes the gut microbiota and the potential implications of this on FMT donor selection are being explored.

Summary

Though further high-quality research is needed, optimizing the fecal microbiota inoculum holds great promise.
Literatur
1.
Zurück zum Zitat NIH HMP Working Group et al. The NIH Human Microbiome Project. Genome Res. 2009;19:2317–23.CrossRef NIH HMP Working Group et al. The NIH Human Microbiome Project. Genome Res. 2009;19:2317–23.CrossRef
2.
Zurück zum Zitat Jost L. Partitioning diversity into independent alpha and beta components. Ecology. 2007;88:2427–39.CrossRefPubMed Jost L. Partitioning diversity into independent alpha and beta components. Ecology. 2007;88:2427–39.CrossRefPubMed
3.
Zurück zum Zitat Bakken JS et al. Treating Clostridium difficile infection with fecal microbiota transplantation. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2011;9:1044–9. Bakken JS et al. Treating Clostridium difficile infection with fecal microbiota transplantation. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2011;9:1044–9.
4.
Zurück zum Zitat Kelly CR et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent Clostridium difficile infection: a randomized trial. Ann Intern Med. 2016. doi:10.7326/M16-0271. Kelly CR et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent Clostridium difficile infection: a randomized trial. Ann Intern Med. 2016. doi:10.​7326/​M16-0271.
5.
Zurück zum Zitat •• Lee CH 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;315:142–9. This study represents the largest randomized clinical trial of FMT to date.CrossRefPubMed •• Lee CH 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;315:142–9. This study represents the largest randomized clinical trial of FMT to date.CrossRefPubMed
6.
Zurück zum Zitat •• van Nood E et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013;368:407–15. This study was the first randomized clinical trial of FMT. Prior to this time, the data on FMT was comprised of observational studies.CrossRefPubMed •• van Nood E et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013;368:407–15. This study was the first randomized clinical trial of FMT. Prior to this time, the data on FMT was comprised of observational studies.CrossRefPubMed
7.
8.
Zurück zum Zitat Youngster I et al. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA. 2014;312:1772–8.CrossRefPubMed Youngster I et al. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA. 2014;312:1772–8.CrossRefPubMed
9.
Zurück zum Zitat Bluemel S, Williams B, Knight R, Schnabl B. Precision medicine in alcoholic and non-alcoholic fatty liver disease via modulating the gut microbiota. Am J Physiol Gastrointest Liver Physiol. 2016. doi:10.1152/ajpgi.00245.2016.PubMed Bluemel S, Williams B, Knight R, Schnabl B. Precision medicine in alcoholic and non-alcoholic fatty liver disease via modulating the gut microbiota. Am J Physiol Gastrointest Liver Physiol. 2016. doi:10.​1152/​ajpgi.​00245.​2016.PubMed
10.
Zurück zum Zitat Agilli M, Ilga U. A methodological approach to fecal microbial transplant via nasogastric tube for active pediatric ulcerative colitis. J Pediatr Gastroenterol Nutr. 2015;60:e36.CrossRefPubMed Agilli M, Ilga U. A methodological approach to fecal microbial transplant via nasogastric tube for active pediatric ulcerative colitis. J Pediatr Gastroenterol Nutr. 2015;60:e36.CrossRefPubMed
11.
Zurück zum Zitat Kronman MP et al. Fecal microbiota transplantation via nasogastric tube for recurrent clostridium difficile infection in pediatric patients. J Pediatr Gastroenterol Nutr. 2015;60:23–6.CrossRefPubMed Kronman MP et al. Fecal microbiota transplantation via nasogastric tube for recurrent clostridium difficile infection in pediatric patients. J Pediatr Gastroenterol Nutr. 2015;60:23–6.CrossRefPubMed
12.
Zurück zum Zitat Wonderlick JS, D’Agostino R. Fecal microbiota transplantation via fluoroscopy-guided nasojejunal catheter placement: indications, technique, and the role of radiology. Abdom Radiol (N Y). 2016;41:2020–5.CrossRef Wonderlick JS, D’Agostino R. Fecal microbiota transplantation via fluoroscopy-guided nasojejunal catheter placement: indications, technique, and the role of radiology. Abdom Radiol (N Y). 2016;41:2020–5.CrossRef
13.
Zurück zum Zitat Allegretti JR, Korzenik JR, Hamilton MJ. Fecal microbiota transplantation via colonoscopy for recurrent C. difficile infection. J Vis Exp (JoVE). 2014. doi:10.3791/52154. Allegretti JR, Korzenik JR, Hamilton MJ. Fecal microbiota transplantation via colonoscopy for recurrent C. difficile infection. J Vis Exp (JoVE). 2014. doi:10.​3791/​52154.
14.
Zurück zum Zitat Eiseman B, Silen W, Bascom GS, Kauvar AJ. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery. 1958;44:854–9.PubMed Eiseman B, Silen W, Bascom GS, Kauvar AJ. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery. 1958;44:854–9.PubMed
16.
Zurück zum Zitat Moayyedi P, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149, 102–109.e6. Moayyedi P, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149, 102–109.e6.
17.
Zurück zum Zitat Vrieze A, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012;143:913–916.e7. Vrieze A, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012;143:913–916.e7.
18.
Zurück zum Zitat • Bousvaros A, Wang K, Rustgi A, Vender R, Relman D. Current consensus guidance on donor screening and stool testing for FMT; 2013. This guidance is used as the primary reference for pre-donation screening for potential donors. • Bousvaros A, Wang K, Rustgi A, Vender R, Relman D. Current consensus guidance on donor screening and stool testing for FMT; 2013. This guidance is used as the primary reference for pre-donation screening for potential donors.
19.
Zurück zum Zitat Orenstein R et al. Safety and durability of RBX2660 (microbiota suspension) for recurrent Clostridium difficile infection: results of the PUNCH CD study. Clin Infect Dis Off Publ Infect Dis Soc Am. 2016;62:596–602.CrossRef Orenstein R et al. Safety and durability of RBX2660 (microbiota suspension) for recurrent Clostridium difficile infection: results of the PUNCH CD study. Clin Infect Dis Off Publ Infect Dis Soc Am. 2016;62:596–602.CrossRef
20.
Zurück zum Zitat Paramsothy S et al. Donor recruitment for fecal microbiota transplantation. Inflamm Bowel Dis. 2015;21:1600–6.CrossRefPubMed Paramsothy S et al. Donor recruitment for fecal microbiota transplantation. Inflamm Bowel Dis. 2015;21:1600–6.CrossRefPubMed
21.
Zurück zum Zitat O’Donnell MM et al. Preparation of a standardised faecal slurry for ex-vivo microbiota studies which reduces inter-individual donor bias. J Microbiol Methods. 2016;129:109–16.CrossRefPubMed O’Donnell MM et al. Preparation of a standardised faecal slurry for ex-vivo microbiota studies which reduces inter-individual donor bias. J Microbiol Methods. 2016;129:109–16.CrossRefPubMed
22.
Zurück zum Zitat Sonnenburg JL, Bäckhed F. Diet-microbiota interactions as moderators of human metabolism. Nature. 2016;535:56–64.CrossRefPubMed Sonnenburg JL, Bäckhed F. Diet-microbiota interactions as moderators of human metabolism. Nature. 2016;535:56–64.CrossRefPubMed
23.
Zurück zum Zitat De Filippo C et al. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci U S A. 2010;107:14691–6.CrossRefPubMedPubMedCentral De Filippo C et al. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci U S A. 2010;107:14691–6.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Ferrocino I et al. Fecal microbiota in healthy subjects following omnivore, vegetarian and vegan diets: culturable populations and rRNA DGGE profiling. PLoS ONE. 2015;10, e0128669.CrossRefPubMedPubMedCentral Ferrocino I et al. Fecal microbiota in healthy subjects following omnivore, vegetarian and vegan diets: culturable populations and rRNA DGGE profiling. PLoS ONE. 2015;10, e0128669.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Estaki M et al. Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions. Microbiome. 2016;4:42.CrossRefPubMedPubMedCentral Estaki M et al. Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions. Microbiome. 2016;4:42.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022–3.CrossRefPubMed Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022–3.CrossRefPubMed
Metadaten
Titel
Donor Considerations in Fecal Microbiota Transplantation
verfasst von
Danielle Barnes
K. T. Park
Publikationsdatum
01.03.2017
Verlag
Springer US
Erschienen in
Current Gastroenterology Reports / Ausgabe 3/2017
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-017-0548-y

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