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A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis
BACKGROUND: Manipulation of the pouch microbiota via fecal microbiota transplant (FMT) has been theorized to be a promising therapeutic approach for pouchitis. The goal of this systematic review was to summarize the available, high-quality data on the efficacy and safety of FMT for acute and chronic...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9802227/ https://www.ncbi.nlm.nih.gov/pubmed/36777294 http://dx.doi.org/10.1093/crocol/otaa034 |
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author | Kayal, Maia Lambin, Thomas Pinotti, Rachel Dubinsky, Marla C Grinspan, Ari |
author_facet | Kayal, Maia Lambin, Thomas Pinotti, Rachel Dubinsky, Marla C Grinspan, Ari |
author_sort | Kayal, Maia |
collection | PubMed |
description | BACKGROUND: Manipulation of the pouch microbiota via fecal microbiota transplant (FMT) has been theorized to be a promising therapeutic approach for pouchitis. The goal of this systematic review was to summarize the available, high-quality data on the efficacy and safety of FMT for acute and chronic pouchitis. METHODS: A systematic electronic literature search was conducted on Embase, MEDLINE, Scopus, and Cochrane CENTRAL. Randomized controlled trials and observational studies that assessed the efficacy and safety of FMT for the treatment of acute and/or chronic pouchitis in patients with ulcerative colitis who underwent total proctocolectomy with ileal pouch-anal anastomosis were included. RESULTS: Four studies involving the use of FMT for chronic pouchitis were considered eligible for data extraction. No study involving the use of FMT for the management of acute pouchitis was identified. In 1 study, 3/5 (75%) patients achieved sustained clinical remission at 3 months. In the remaining 3 studies, 2/8, 1/11, and 1/5 patients achieved clinical response defined as a decrease in pouchitis disease activity index at least 3. Stool donor engraftment as determined by 16s rRNA gene sequencing occurred only in those patients with clinical response. CONCLUSIONS: The 4 studies that met inclusion criteria for this systematic review indicate FMT is safe in chronic pouchitis, however largely not efficacious. These data are limited by study heterogeneity. Additional studies are required to guide the use of FMT in patients with acute and chronic pouchitis. |
format | Online Article Text |
id | pubmed-9802227 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-98022272023-02-10 A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis Kayal, Maia Lambin, Thomas Pinotti, Rachel Dubinsky, Marla C Grinspan, Ari Crohns Colitis 360 Observations and Research BACKGROUND: Manipulation of the pouch microbiota via fecal microbiota transplant (FMT) has been theorized to be a promising therapeutic approach for pouchitis. The goal of this systematic review was to summarize the available, high-quality data on the efficacy and safety of FMT for acute and chronic pouchitis. METHODS: A systematic electronic literature search was conducted on Embase, MEDLINE, Scopus, and Cochrane CENTRAL. Randomized controlled trials and observational studies that assessed the efficacy and safety of FMT for the treatment of acute and/or chronic pouchitis in patients with ulcerative colitis who underwent total proctocolectomy with ileal pouch-anal anastomosis were included. RESULTS: Four studies involving the use of FMT for chronic pouchitis were considered eligible for data extraction. No study involving the use of FMT for the management of acute pouchitis was identified. In 1 study, 3/5 (75%) patients achieved sustained clinical remission at 3 months. In the remaining 3 studies, 2/8, 1/11, and 1/5 patients achieved clinical response defined as a decrease in pouchitis disease activity index at least 3. Stool donor engraftment as determined by 16s rRNA gene sequencing occurred only in those patients with clinical response. CONCLUSIONS: The 4 studies that met inclusion criteria for this systematic review indicate FMT is safe in chronic pouchitis, however largely not efficacious. These data are limited by study heterogeneity. Additional studies are required to guide the use of FMT in patients with acute and chronic pouchitis. Oxford University Press 2020-05-12 /pmc/articles/PMC9802227/ /pubmed/36777294 http://dx.doi.org/10.1093/crocol/otaa034 Text en © 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Observations and Research Kayal, Maia Lambin, Thomas Pinotti, Rachel Dubinsky, Marla C Grinspan, Ari A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title | A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title_full | A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title_fullStr | A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title_full_unstemmed | A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title_short | A Systematic Review of Fecal Microbiota Transplant for the Management of Pouchitis |
title_sort | systematic review of fecal microbiota transplant for the management of pouchitis |
topic | Observations and Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9802227/ https://www.ncbi.nlm.nih.gov/pubmed/36777294 http://dx.doi.org/10.1093/crocol/otaa034 |
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