What is it about?
Inflammatory bowel diseases, such as ulcerative colitis and Crohn disease, cause chronic inflammation of the gut. Their exact cause is unknown, but an abnormal immune reaction to the bacteria living in the intestine (the microbiota) plays a key role. Current treatments act on the immune system and work for many patients, but failures and side effects are common. Faecal microbiota transplantation (FMT) - transferring stool from a healthy donor to restore a normal gut microbiota - is highly effective for recurrent Clostridioides difficile infection and is being explored in IBD. We reviewed the clinical studies of FMT in IBD patients without C. difficile infection, discussing patient selection and preparation, donor characteristics, transplantation procedures, clinical outcomes, safety and changes in the microbiota after treatment.
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Why is it important?
FMT offers a new, potentially complementary strategy to conventional immunosuppressive therapies for IBD. This review summarizes what is known, highlights the heterogeneity of available studies and the need for well-designed trials to define which patients benefit, which procedure works best and how durable the effect is.
Perspectives
Our experience with faecal microbiota transplantation for C. difficile infection in Trieste made us curious about its potential beyond infections. Writing this review with gastroenterologists and colleagues from Genoa and Sheffield helped us understand both the promise and the many open questions of microbiota-based therapies.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: Role of fecal microbiota transplantation in inflammatory bowel disease, Journal of Digestive Diseases, May 2018, Wiley,
DOI: 10.1111/1751-2980.12603.
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