Effects of Microbiota on Human Health

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DOI :10.26650/B/LS34CH11CH22/2024.011.006   IUP :10.26650/B/LS34CH11CH22/2024.011.006    Full Text (PDF)

The Use of Fecal Microbiota Transplantation in Pediatric Patients

Tuğçe Göksu Yılmaz, Elif Türkmen

Intestinal microbiota plays an important role in many metabolic, systemic and immunologic events. In this context, dysbiosis is recognized to be effective in the pathogenesis of many gastrointestinal and non-GI diseases. Fecal microbiota transplantation (FMT) is the process of transferring stool from a donor with a healthy microbiota into the GI tract of a sick individual, thus replacing the impaired microbiota with a healthy flora. It is important to establish appropriate indications and to thoroughly examine donors so that transplantation does not create a new disease state in the recipient. FMT application in the pediatric age group includes differences from adults. Recurrent Clostridium difficile infection is an FDA-approved treatment method and is the most common indication for FMT. In addition, it is an effective and safe treatment modality that is increasingly being used in many diseases primarily inflammatory bowel diseases caused by dysbiosis in both adult and pediatric populations.


Keywords: Fecal microbiota transplantation, microbiome, intestinal flora
DOI :10.26650/B/LS34CH11CH22/2024.011.006   IUP :10.26650/B/LS34CH11CH22/2024.011.006    Full Text (PDF)

Fekal Mi̇krobi̇yota Transplantasyonunun Çocuk Hastalarda Kullanımı

Tuğçe Göksu Yılmaz, Elif Türkmen

İntestinal mikrobiyota; metabolik, sistemik ve immünolojik birçok olayda önemli rol oynar. Bu bağlamda disbiyozisin; hem gastrointestinal sistem (GİS) ile ilgili hem de GİS dışı birçok hastalığın patogenezinde etkili olduğu kabul edilmektedir. Fekal mikrobiyota transplantasyonu (FMT); sağlıklı mikrobiyotaya sahip bir donörden alınan gaitanın, hasta bireyin GİS’ine transfer edilmesi işlemidir; böylece bozulmuş olan mikrobiyota sağlıklı bir flora ile değiştirilmiş olur. Transplantasyonun alıcıda yeni bir hastalık hali yaratmaması adına uygun endikasyonların konulması ve donörlerin ayrıntılı şekilde incelenmesi önem arz etmektedir. Pediatrik yaş grubunda FMT uygulaması erişkinlerden farklılıklar içermektedir. Tekrarlayan Clostridium difficile enfeksiyonu, FDA onaylı bir tedavi yöntemi olup, FMT’nin en sık yapıldığı endikasyondur. Buna ek olarak hem erişkin hem pediatrik popülasyonda, başta inflamatuvar bağırsak hastalığı olmak üzere disbiyozisin neden olduğu birçok hastalıkta, kullanımı giderek yaygınlaşan, etkin ve güvenli bir tedavi yöntemidir.


Keywords: Fekal mikrobiyota transplantasyonu, mikrobiyom, intestinal flora

References

  • Anderson, J. L., Edney, R. J., & Whelan, K. (2012). Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease. Aliment Pharmacol Ther, 36(6), 503-516. doi:10.1111/j.1365-2036.2012.05220.x google scholar
  • Bennet, J. D., & Brinkman, M. (1989). Treatment of ulcerative colitis by implantation of normal colonic flora. Lancet, 1(8630), 164. doi:10.1016/s0140-6736(89)91183-5 google scholar
  • Cammarota, G., laniro, G., Tilg, H., RajiliC-Stojanovic, M., Kump, P., Satokari, R., . . . Gasbarrini, A. (2017). European consensus conference on faecal microbiota transplantation in clinical practice. Gut, 66(4), 569580. doi:10.1136/gutjnl-2016-313017 google scholar
  • Choi, H. H., & Cho, Y. S. (2016). Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives. Clin Endosc, 49(3), 257-265. doi:10.5946/ce.2015.117 google scholar
  • Claesson, M. J., Cusack, S., O’Sullivan, O., Greene-Diniz, R., de Weerd, H., Flannery, E., . . . O’Toole, P. W. (2011). Composition, variability, and temporal stability of the intestinal microbiota of the elderly. Proc Natl Acad Sci U S A, 108 Suppl 1(Suppl 1), 4586-4591. doi:10.1073/pnas.1000097107 google scholar
  • Colman, R. J., & Rubin, D. T. (2014). Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis, 8(12), 1569-1581. doi:10.1016/j.croh-ns.2014.08.006 google scholar
  • Cui, B., Feng, Q., Wang, H., Wang, M., Peng, Z., Li, P., . . . Zhang, F. (2015). Fecal microbiota transplantation through mid-gut for refractory Crohn’s disease: safety, feasibility, and efficacy trial results. J Gastroenterol Hepatol, 30(1), 51-58. doi:10.1111/jgh.12727 google scholar
  • Dominguez-Bello, M. G., Costello, E. K., Contreras, M., Magris, M., Hidalgo, G., Fierer, N., & Knight, R. (2010). Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci U S A, 107(26), 11971-11975. doi:10.1073/pnas.1002601107 google scholar
  • Drekonja, D., Reich, J., Gezahegn, S., Greer, N., Shaukat, A., MacDonald, R., . . . Wilt, T. J. (2015). Fecal Mic-robiota Transplantation for Clostridium difficile Infection: A Systematic Review. Ann Intern Med, 162(9), 630-638. doi:10.7326/m14-2693 google scholar
  • Duncan, S. H., Lobley, G. E., Holtrop, G., Ince, J., Johnstone, A. M., Louis, P., & Flint, H. J. (2008). Human colonic microbiota associated with diet, obesity and weight loss. Int J Obes (Lond), 32(11), 1720-1724. doi:10.1038/ijo.2008.155 google scholar
  • Eiseman, B., Silen, W., Bascom, G. S., & Kauvar, A. J. (1958). Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery, 44(5), 854-859. google scholar
  • Evrensel, A., & Ceylan, M. E. (2016). Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders. Clin Psychopharmacol Neurosci, 14(3), 231-237. doi:10.9758/cpn.2016.14.3.231 google scholar
  • Gough, E., Shaikh, H., & Manges, A. R. (2011). Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clin Infect Dis, 53(10), 994-1002. doi:10.1093/ cid/cir632 google scholar
  • Goyal, A., Yeh, A., Bush, B. R., Firek, B. A., Siebold, L. M., Rogers, M. B., . . . Morowitz, M. J. (2018). Safety, Clinical Response, and Microbiome Findings Following Fecal Microbiota Transplant in Children With Inflammatory Bowel Disease. Inflamm Bowel Dis, 24(2), 410-421. doi:10.1093/ibd/izx035 google scholar
  • Koren, O., Spor, A., Felin, J., Fâk, F., Stombaugh, J., Tremaroli, V., . . . Bâckhed, F. (2011). Human oral, gut, and plaque microbiota in patients with atherosclerosis. Proc Natl Acad Sci U S A, 108 Suppl 1(Suppl 1), 4592-4598. doi:10.1073/pnas.1011383107 google scholar
  • Lee, C. H., Steiner, T., Petrof, E. O., Smieja, M., Roscoe, D., Nematallah, A., . . . Kim, P. T. (2016). Frozen vs Fresh Fecal Microbiota Transplantation and Clinical Resolution of Diarrhea in Patients With Recur-rent Clostridium difficile Infection: A Randomized Clinical Trial. Jama, 315(2), 142-149. doi:10.1001/ jama.2015.18098 google scholar
  • Lee, H. J., Choi, J. K., Ryu, H. S., Choi, C. H., Kang, E. H., Park, K. S., . . . Hong, K. S. (2017). Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders. J Neurogastroenterol Motil, 23(1), 9-19. doi:10.5056/jnm16124 google scholar
  • Leong, K. S. W., Jayasinghe, T. N., Wilson, B. C., Derraik, J. G. B., Albert, B. B., Chiavaroli, V., . . . Cutfield, W. S. (2020). Effects of Fecal Microbiome Transfer in Adolescents With Obesity: The Gut Bugs Randomized Controlled Trial. JAMA Netw Open, 3(12), e2030415. doi:10.1001/jamanetworkopen.2020.30415 google scholar
  • Li, N., Tian, H., Ma, C., Ding, C., Ge, X., Gu, L., . . . Zhou, Y. (2017). [Efficacy analysis of fecal microbiota transplantation in the treatment of 406 cases with gastrointestinal disorders]. Zhonghua Wei Chang Wai Ke Za Zhi, 20(1), 40-46. google scholar
  • Moayyedi, P., Surette, M. G., Kim, P. T., Libertucci, J., Wolfe, M., Onischi, C., . . . Lee, C. H. (2015). Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial. Gastroenterology, 149(1), 102-109.e106. doi:10.1053/j.gastro.2015.04.001 google scholar
  • Paramsothy, S., Kamm, M. A., Kaakoush, N. O., Walsh, A. J., van den Bogaerde, J., Samuel, D., . . . Borody, T. J. (2017). Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial. Lancet, 389(10075), 1218-1228. doi:10.1016/s0140-6736(17)30182-4 google scholar
  • Penders, J., Thijs, C., Vink, C., Stelma, F. F., Snijders, B., Kummeling, I., . . . Stobberingh, E. E. (2006). Fac-tors influencing the composition of the intestinal microbiota in early infancy. Pediatrics, 118(2), 511-521. doi:10.1542/peds.2005-2824 google scholar
  • Sha, S., Liang, J., Chen, M., Xu, B., Liang, C., Wei, N., & Wu, K. (2014). Systematic review: faecal microbiota transplantation therapy for digestive and nondigestive disorders in adults and children. Aliment Pharmacol Ther, 39(10), 1003-1032. doi:10.1111/apt.12699 google scholar
  • Shimizu, H., Arai, K., Abe, J., Nakabayashi, K., Yoshioka, T., Hosoi, K., & Kuroda, M. (2016). Repeated fe-cal microbiota transplantation in a child with ulcerative colitis. Pediatr Int, 58(8), 781-785. doi:10.1111/ ped.12967 google scholar
  • Tang, G., Yin, W., & Liu, W. (2017). Is frozen fecal microbiota transplantation as effective as fresh fecal micro-biota transplantation in patients with recurrent or refractory Clostridium difficile infection: A meta-analysis? Diagn Microbiol Infect Dis, 88(4), 322-329. doi:10.1016/j.diagmicrobio.2017.05.007 google scholar
  • Toubon, G., Butel, M. J., Roze, J. C., Nicolis, I., Delannoy, J., Zaros, C., . . . Charles, M. A. (2023). Early Life Factors Influencing Children Gut Microbiota at 3.5 Years from Two French Birth Cohorts. Microorganisms, 11(6). doi:10.3390/microorganisms11061390 google scholar
  • Uygun, A., Ozturk, K., Demirci, H., Oger, C., Avci, I. Y., Turker, T., & Gulsen, M. (2017). Fecal microbiota transplantation is a rescue treatment modality for refractory ulcerative colitis. Medicine (Baltimore), 96(16), e6479. doi:10.1097/md.0000000000006479 google scholar
  • Whitman, W. B., Coleman, D. C., & Wiebe, W. J. (1998). Prokaryotes: the unseen majority. Proc Natl Acad Sci U S A, 95(12), 6578-6583. doi:10.1073/pnas.95.12.6578 google scholar
  • Youngster, I., Sauk, J., Pindar, C., Wilson, R. G., Kaplan, J. L., Smith, M. B., . . . Hohmann, E. L. (2014). Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open-label, controlled pilot study. Clin Infect Dis, 58(11), 1515-1522. doi:10.1093/ cid/ciu135 google scholar


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