粪便菌群移植对抗艰难梭菌感染和其他肠道疾病

K. Moelling, F. Broecker
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引用次数: 15

摘要

我们分析了一例通过粪便微生物群移植(FMT)治愈的复发性艰难梭菌感染(rCDI)患者的粪便细菌和病毒群落。“z丰富患者”立即治愈,并在5年多的时间里没有症状。fmt后4.5年,供体相似的细菌组成显示供体微生物群以拟杆菌门和厚壁菌门细菌为主,可持续植入。有益菌种prausnitzii Faecalibacterium和Akkermansia municiphila出现,而与疾病相关的变形菌减少。由于临床症状的迅速改善,微生物群的稳定所需的时间比预期的要长,这表明需要对患者进行更持久的观察。该病毒组主要由尾状病毒噬菌体组成,但令人惊讶的是,它也含有与小球藻巨型病毒相关的序列,这种病毒通常会感染不存在于人类肠道中的绿藻。FMT对rCDI非常有效,目前正在将其应用范围扩大到其他疾病,包括炎症性肠病(IBD)。在这里,我们讨论了FMT治疗rCDI和其他适应症的前景和挑战,包括对噬菌体的关注。
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Fecal microbiota transplantation to fight Clostridium difficile infections and other intestinal diseases
ABSTRACT We have analyzed fecal bacterial and viral communities of a patient with recurrent C. difficile infection (rCDI) who was cured by fecal microbiota transplantation (FMT). The “Zürich Patient” experienced immediate cure and has remained free of symptoms for now over 5 y. Donor-similar bacterial compositions after 4.5 y post-FMT demonstrated sustainable engraftment of donor microbiota predominated by Bacteroidetes and Firmicutes bacteria. Appearance of beneficial species Faecalibacterium prausnitzii and Akkermansia municiphila was detected while disease-related Proteobacteria decreased. Stabilization of the microbiota took longer than expected from the rapidly improving clinical symptoms, suggesting the need for longer-lasting patient observation. The virome was mainly composed of Caudovirales bacteriophages but surprisingly also contained sequences related to a Chlorella giant virus that normally infects green algae not known to inhabitate the human intestine. FMT is highly effective against rCDI and is presently broadening its application to other conditions including inflammatory bowel disease (IBD). Here, we discuss the prospects and challenges of FMT against rCDI and other indications including a focus on bacteriophages.
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Phagebiotics in treatment and prophylaxis of healthcare-associated infections. Testing a proposed paradigm shift in analysis of phage DNA packaging Fecal microbiota transplantation to fight Clostridium difficile infections and other intestinal diseases Félix Hubert d'Herelle (1873–1949): History of a scientific mind My scientific life
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