Cargando…
Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis
The response of patients with inflammatory bowel disease (IBD) to fecal microbial transplantation (FMT) has been inconsistent possibly due to variable engraftment of donor microbiota. This failure to engraft has resulted in the use of several different strategies to attempt optimization of the recip...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957789/ https://www.ncbi.nlm.nih.gov/pubmed/33804464 http://dx.doi.org/10.3390/jcm10050959 |
_version_ | 1783664730200604672 |
---|---|
author | Mocanu, Valentin Rajaruban, Sabitha Dang, Jerry Kung, Janice Y. Deehan, Edward C. Madsen, Karen L. |
author_facet | Mocanu, Valentin Rajaruban, Sabitha Dang, Jerry Kung, Janice Y. Deehan, Edward C. Madsen, Karen L. |
author_sort | Mocanu, Valentin |
collection | PubMed |
description | The response of patients with inflammatory bowel disease (IBD) to fecal microbial transplantation (FMT) has been inconsistent possibly due to variable engraftment of donor microbiota. This failure to engraft has resulted in the use of several different strategies to attempt optimization of the recipient microbiota following FMT. The purpose of our study was to evaluate the effects of two distinct microbial strategies—antibiotic pre-treatment and repeated FMT dosing—on IBD outcomes. A systematic literature review was designed and implemented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A medical librarian conducted comprehensive searches in MEDLINE, Embase, Scopus, Web of Science Core Collection, and Cochrane Library on 25 November 2019 and updated on 29 January 2021. Primary outcomes of interest included comparing relapse and remission rates in patients with IBD for a single FMT dose, repeated FMT dosages, and antibiotic pre-treatment groups. Twenty-eight articles (six randomized trials, 20 cohort trials, two case series) containing 976 patients were identified. Meta-analysis revealed that both repeated FMT and antibiotic pre-treatment strategies demonstrated improvements in pooled response and remission rates. These clinical improvements were associated with increases in fecal microbiota richness and α-diversity, as well as the enrichment of several short-chain fatty acid (SCFA)-producing anaerobes including Bifidobacterium, Roseburia, Lachnospiraceae, Prevotella, Ruminococcus, and Clostridium related species. |
format | Online Article Text |
id | pubmed-7957789 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79577892021-03-16 Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis Mocanu, Valentin Rajaruban, Sabitha Dang, Jerry Kung, Janice Y. Deehan, Edward C. Madsen, Karen L. J Clin Med Review The response of patients with inflammatory bowel disease (IBD) to fecal microbial transplantation (FMT) has been inconsistent possibly due to variable engraftment of donor microbiota. This failure to engraft has resulted in the use of several different strategies to attempt optimization of the recipient microbiota following FMT. The purpose of our study was to evaluate the effects of two distinct microbial strategies—antibiotic pre-treatment and repeated FMT dosing—on IBD outcomes. A systematic literature review was designed and implemented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A medical librarian conducted comprehensive searches in MEDLINE, Embase, Scopus, Web of Science Core Collection, and Cochrane Library on 25 November 2019 and updated on 29 January 2021. Primary outcomes of interest included comparing relapse and remission rates in patients with IBD for a single FMT dose, repeated FMT dosages, and antibiotic pre-treatment groups. Twenty-eight articles (six randomized trials, 20 cohort trials, two case series) containing 976 patients were identified. Meta-analysis revealed that both repeated FMT and antibiotic pre-treatment strategies demonstrated improvements in pooled response and remission rates. These clinical improvements were associated with increases in fecal microbiota richness and α-diversity, as well as the enrichment of several short-chain fatty acid (SCFA)-producing anaerobes including Bifidobacterium, Roseburia, Lachnospiraceae, Prevotella, Ruminococcus, and Clostridium related species. MDPI 2021-03-01 /pmc/articles/PMC7957789/ /pubmed/33804464 http://dx.doi.org/10.3390/jcm10050959 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Mocanu, Valentin Rajaruban, Sabitha Dang, Jerry Kung, Janice Y. Deehan, Edward C. Madsen, Karen L. Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title | Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title_full | Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title_fullStr | Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title_full_unstemmed | Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title_short | Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis |
title_sort | repeated fecal microbial transplantations and antibiotic pre-treatment are linked to improved clinical response and remission in inflammatory bowel disease: a systematic review and pooled proportion meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957789/ https://www.ncbi.nlm.nih.gov/pubmed/33804464 http://dx.doi.org/10.3390/jcm10050959 |
work_keys_str_mv | AT mocanuvalentin repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis AT rajarubansabitha repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis AT dangjerry repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis AT kungjanicey repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis AT deehanedwardc repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis AT madsenkarenl repeatedfecalmicrobialtransplantationsandantibioticpretreatmentarelinkedtoimprovedclinicalresponseandremissionininflammatoryboweldiseaseasystematicreviewandpooledproportionmetaanalysis |