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©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Oct 28, 2014; 20(40): 14805-14820
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14805
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14805
Table 1 Possible microbial pathogens associated with inflammatory bowel disease
Mycobacterium avium subspecies paratuberculosis[19,126,127] |
Adherent-invasive Escherichia coli[18,44,45,128] |
Clostridium difficile[107,129,130] |
Candida albicans[21,49] |
Helicobacter sp.[131-133] |
Campylobacter sp., such as Campylobacter jejuni and Campylobacter concisus[134-136] |
Salmonella sp.[135] |
Klebsiella sp.[137] |
Yersinia sp.[138] |
Listeria sp.[139] |
Fusobacterium sp.[140] |
Methanosphaera stadtmanae[141] |
Bacteroides fragilis[142] |
Norovirus[143] |
Table 2 Main case series and reports of fecal microbiota transplantation in inflammatory bowel disease treatment
Ref. | IBD type (n) | Stoolmaterial | Volumeinfusion | Infusion route | Frequency | Donor relationship | Characteristics of outcomes |
Bennet et al[34], 1989 | UC (1) | NR | NR | Enema | 1 | NR | Documents remission for 6 mo and cease medications |
Borody et al[144], 1989 | UC (1) | NR | NR | Enema | NR | NR | Documented remission for 3 mo and cease medications. |
Borody et al[35], 2003 | UC (6) | Fresh | 200-300 g/200-300 mL | Enema | 6 | Related or unrelated | Documented remission from 1 to 13 yr and cease medications |
Hamilton et al[112], 2012 | UC combinedwith CDI (4) | Fresh orfrozen | 220-240 mL | Colonoscopy | 1 | Related or unrelated | Colitis activity was improved, and CDI was cured |
Zainah et al[145], 2012 | UC combined with CDI (1) | Fresh | 300 mL | Colonoscopy | 1 | Related | Documented symptom-free for 8 mo without CDI recurrence |
Borody et al[146], 2012 | UC (3) | Fresh | NR | Repeated rectal infusions | Daily infusion for 2 to 6.5 mo | Related or unrelated | Documented improvement from 1 to 36 mo |
Patel et al[147], 2013 | UC combined with CDI (3) | Fresh | 18-397 g/180-600 mL | Colonoscopy | 1 | Related or unrelated | Symptoms such as diarrhea improved or resolved 3 mo after FMT |
Angelberger et al[105], 2013 | UC (5) | Fresh | 17-25 g/250 mL +6-12 g/100 mL | Nasojejunal tube + enema | 3 | Unrelated | None of cases achieved remission, but only one case was response to FMT by week 12; two cases deteriorated 4 wk after FMT |
Kump et al[148], 2013 | UC (6) | Fresh | 300-500 mL | Colonoscopy | 1 | Unrelated | Documented improvement, but no remission within 2 wk after FMT |
De Leon et al[110], 2013 | UC combined with CDI (1) | Fresh | 600 mL | Colonoscopy | 1 | Related | UC relapse 9 d after FMT |
Kunde et al[108], 2013 | UC (10) | Fresh | 165 ml | Enema | 5 | Related | 78% and 67% subjects achieved clinical response within 1 wk and 1 mo after FMT, respectively |
Borody et al[144], 1989 | CD (1) | NR | NR | Enema | NR | NR | Symptoms-free and receiving no medications 4 mo after FMT |
Grehan et al[118], 2010 | CD (1) | Fresh | 200-400 mL | Colonoscopy + enema | 1 + 9 | NR | CD related improvement was not reported |
Hamilton et al[112], 2012 | CD combined with CDI (6) | Fresh orfrozen | 220-240 mL | Colonoscopy | 1 or 2 | Related or unrelated | Two cases accepted the second FMT due to CDI recurrence, but the efficacy of FMT on CD was not reported |
Patel et al[147], 2013 | CD combined with CDI (2) | Fresh | 18-397 g/180-600 mL | ColonoscopyUpper endoscopy | 2 | Related or unrelated | CDI recurred in 1 case after the first FMT by colonoscopy, and a second FMT was performed by upper endoscopy; but the efficacy of FMT on CD was not reported |
Gordon et al[109], 2013 | CD (1) | Fresh | NR | NR | NR | Related | Response to FMT for 6 mo and then relapsed |
Quera et al[149], 2013 | CD combined with CDI (1) | NR | NR | Colonscopy | NR | NR | Transient bacteremia occurred 24 h after FMTDocumented symptom-free 5 mo after FMT and CDI disappeared |
Zhang et al[36], 2013 | CD (1) | Fresh | 150 mL | Gastroscope | 1 | Related | Documented clinical remission for more than 9 mo |
Table 3 Donor selection for fecal microbiota transplantation
Absolute exclusion criteria[32,104,124] |
Failed to provide informed consent |
Systematic and local microbial infections (e.g., pathogenic bacteria, virus, ova and parasites) |
Current communicable diseases |
Malignancy and chemotherapeutics administration |
Chronic gastrointestinal disorders |
Peptic ulcer diseases |
Gastroesophageal reflux disease |
GI polyposis |
Inflammatory bowel disease |
Irritable bowel syndrome |
Chronic constipation |
Traveler’s diarrhea |
Current GI symptoms |
Antibiotics administration |
Immunosuppressive agents and biological agents |
Other medications impact on the gut microbiota (e.g., proton pump inhibitor, prokinetic agents, steroids, aspirin, probiotics, etc.) |
High-risk lifestyles (e.g., intravenous drug abuse, risk sexual behaviors, etc.) |
Relative exclusion criteria[32,104,124] |
Age < 18 and > 70 yr |
History of major GI surgery |
Metabolic syndrome |
Diabetes mellitus |
Abnormal body mass index (< or > 18-25 kg/m2) |
Systemic autoimmune disease |
Atopic diseases(e.g., asthma and eczema) |
Chronic pain syndromes (e.g., chronic fatigue syndrome and fibromyalgia) |
Neuropsychiatric diseases |
Table 4 Donor screening for fecal microbiota transplantation
Common and entail serologic screening items[32,124] |
Blood routine |
Blood biochemistry |
Human immunodeficiency virus-1 and -2 |
Hepatitis A, B and C virus |
Syphilis |
Helicobacter pylori |
Human T lymphotropic virus |
Cytomegalovirus |
Epstein-barr virus |
Common and entail stool screening items[32,124] |
Stool routine |
Clostridium difficile toxin A/B |
Salmonella sp. |
Shigella sp. |
Campylobacter sp. |
Escherichia coli O157 |
Staphylococcus aureus |
Yersinia |
Helicobacter pylori |
Vibrio parahaemolyticus and Vibrio cholerae |
Candida albicans |
Rotavirus |
Cryptosporidium |
Giardia |
Cyclospora |
Isospora |
Ova and parasites |
- Citation: Wang ZK, Yang YS, Chen Y, Yuan J, Sun G, Peng LH. Intestinal microbiota pathogenesis and fecal microbiota transplantation for inflammatory bowel disease. World J Gastroenterol 2014; 20(40): 14805-14820
- URL: https://www.wjgnet.com/1007-9327/full/v20/i40/14805.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i40.14805