Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2015; 21(1): 102-111
Published online Jan 7, 2015. doi: 10.3748/wjg.v21.i1.102
Fecal microbiota transplantation broadening its application beyond intestinal disorders
Meng-Que Xu, Hai-Long Cao, Wei-Qiang Wang, Shan Wang, Xiao-Cang Cao, Fang Yan, Bang-Mao Wang
Meng-Que Xu, Hai-Long Cao, Wei-Qiang Wang, Shan Wang, Xiao-Cang Cao, Fang Yan, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
Fang Yan, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232-0696, United States
Author contributions: Xu MQ, Cao HL, Wang S, Cao XC and Wang BM designed the review; Xu MQ and Cao HL analyzed the data; Xu MQ, Cao HL, Wang S and Cao XC wrote the paper; Xu MQ, Cao HL, Yan F and Wang WQ revised the manuscript.
Supported by Grants (No. 81470796 to Yan F, No. 81070283 to Wang BM and No. 81300272 to Cao HL) from the National Natural Science Foundation of China, a grant (No. 20121202110018 to Wang BM) from the Research Fund for the Doctoral Program of Higher Education of China, and a grant (No. 13JCQNJC10600 to Cao HL) from Tianjin Research Program of Application Foundation and Advanced Technology of China
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hai-Long Cao, MD, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, 154 Anshan Rd, Heping District, Tianjin 300052, China. cao_hailong@163.com
Telephone: +86-22-60362608 Fax: +86-22-27813550
Received: July 28, 2014
Peer-review started: July 29, 2014
First decision: August 15, 2014
Revised: August 30, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: January 7, 2015
Abstract

Intestinal dysbiosis is now known to be a complication in a myriad of diseases. Fecal microbiota transplantation (FMT), as a microbiota-target therapy, is arguably very effective for curing Clostridium difficile infection and has good outcomes in other intestinal diseases. New insights have raised an interest in FMT for the management of extra-intestinal disorders associated with gut microbiota. This review shows that it is an exciting time in the burgeoning science of FMT application in previously unexpected areas, including metabolic diseases, neuropsychiatric disorders, autoimmune diseases, allergic disorders, and tumors. A randomized controlled trial was conducted on FMT in metabolic syndrome by infusing microbiota from lean donors or from self-collected feces, with the resultant findings showing that the lean donor feces group displayed increased insulin sensitivity, along with increased levels of butyrate-producing intestinal microbiota. Case reports of FMT have also shown favorable outcomes in Parkinson’s disease, multiple sclerosis, myoclonus dystonia, chronic fatigue syndrome, and idiopathic thrombocytopenic purpura. FMT is a promising approach in the manipulation of the intestinal microbiota and has potential applications in a variety of extra-intestinal conditions associated with intestinal dysbiosis.

Keywords: Fecal microbiota transplantation, Intestinal microbiota, Dysbiosis, Extra-intestinal disorders, Therapy

Core tip: Fecal microbiota transplantation (FMT) achieved a successful cure rate in recurrent Clostridium difficile infection. Although there is a deficiency of randomized controlled trials, the present review reveals that FMT could be a promising rescue therapy in extra-intestinal disorders associated with gut microbiota, including metabolic diseases, neuropsychiatric disorders, autoimmune diseases, allergic disorders, and tumors.