The use of fecal microbiota transplantation in gastrointestinal diseases

master's thesis

• Title (croatian): Primjena transplantacije fekalne mikrobiote u gastrointestinalnim bolestima
• Author: Jannat Monosi Ali
• Mentor: Mihaela Perić (mentor)
• Committee member: Mihaela Perić (predsjednik povjerenstva)
• Committee member: Fran Borovečki (član povjerenstva)
• Committee member: Nino Sinčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-01-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Fecal microbiota transplantation (FMT) is a treatment modality that involves the process of transplanting fecal matter obtained from a selected donor to a recipient in order to restore the microbial homeostasis in the intestine. Although the utilization of fecal matter to treat diseased individuals can be traced to the 4th century, China, it was not until the end of the 20th century that Western countries began to study the potential role of FMT. Since then, there has been a growing interest in the scientific community to understand the composition and the function of the human microbiota. In addition, there has also been a great deal of interest in how to manipulate the microbiota and to understand the relationship between various disease conditions and the perturbated microbial community.
In contrast to antibiotics and immunomodulators, FMT seems to be an excellent therapy option for several gastrointestinal diseases, as it is a restorative treatment modality and not destructive or suppressive. The mechanism of action of FMT is not fully understood, however, its effectiveness is thought to be attributable to the recovery of the microbiota from dysbiosis to eubiosis. To date, the only formally approved indication for FMT is Clostridioides difficile infection (CDI), in addition, the reported efficacy rates have been very high. The findings on employing FMT for treating inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are not as straightforward, possibly due to the limited large-scale RCTs, the heterogenous nature of the disease, the various phenotypic presentations and the still unknown factors associated to the transplanted microbiota. Nevertheless, FMT seems to have a role in both IBD and IBS management and could be incorporated as an adjunctive therapy to combat not only dysbiosis and related pathology but also the additional pathogenetic mechanisms that usually underlie these multifactorial-related conditions.

Abstract (croatian)

Transplantacija fekalne mikrobiote (FMT) je modalitet liječenja koji uključuje proces transplantacije fekalne tvari dobivene od odabranog darivatelja kako bi se povratila homeostaza crijevne mikrobiote primatelja. Iako se korištenje fekalne tvari za liječenje oboljelih osoba može pratiti od 4. stoljeća u Kini, zapadne zemlje su tek krajem 20. stoljeća počele proučavati potencijalnu ulogu FMT-a. Od tada, u znanstvenoj zajednici raste interes za razumijevanje sastava i funkcije ljudske mikrobiote, kao i poremećaja u ljudskim mikrobnim zajednicama povezanih s raznim bolestima.
Za razliku od antibiotika i imunomodulatora, čini se da je FMT izvrsna terapijska opcija za nekoliko gastrointestinalnih bolesti, budući da predstavlja obnavljajući modalitet liječenja, a ne destruktivan ili supresivan. Mehanizam djelovanja FMT-a nije u potpunosti razjašnjen, međutim, njegova se učinkovitost pripisuje obnavljanju mikrobiote iz stanja disbioze u stanje eubioze. Do danas, jedina službeno odobrena indikacija za FMT je infekcija bakterijom Clostridioides difficile (CDI) s vrlo visokim stopama učinkovitosti. Nalazi o korištenju FMT-a za liječenje upalne bolesti crijeva (IBD) i sindroma iritabilnog crijeva (IBS) nisu tako jednostavni, vjerojatno zbog ograničenih randomiziranih i kontroliranih ispitivanja velikih razmjera, heterogene prirode bolesti, njenih različitih fenotipskih prikaza kao i još uvijek nepoznatih čimbenika povezanih s transplantiranom mikrobiotom. Ipak, čini se da bi FMT mogla imati ulogu i u liječenju IBD-a i IBS-a te bi se mogala koristiti i kao pomoćna terapija u borbi ne samo s disbiozom i srodnom patologijom nego i s dodatnim patogenetskim mehanizmima koji obično leže u osnovi ovih multifaktorskih stanja.

• Keywords: Clostridioides difficile infection; Crohn’s disease; dysbiosis; fecal microbiota transplantation; inflammatory bowel disease; irritable bowel syndrome; microbiota; ulcerative colitis
• Keywords (croatian): Infekcija Clostridioides difficile; Crohnova bolest; disbioza; transplantacija fekalne mikrobiotedisbioza; upalna bolest crijeva; sindrom iritabilnog crijeva; mikrobiota; ulcerozni kolitis
• Language: english
• URN:NBN: urn:nbn:hr:105:159138
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-12-15 12:31:32