Safety and efficacy of fecal microbiota transplantation for autoimmune diseases and autoinflammatory diseases: A systematic review and meta-analysis

Abstract

ObjectiveTo evaluate the safety and efficacy of fecal microbiota transplantation for autoimmune diseases and autoinflammatory diseases.MethodsRelevant literature was retrieved from the PubMed database, Embase database, Cochrane Library database, etc. The search period is from the establishment of the database to January 2022. The outcomes include clinical symptoms, improvement in biochemistry, improvement in intestinal microbiota, improvement in the immune system, and adverse events. Literature screening and data extraction were independently carried out by two researchers according to the inclusion and exclusion criteria, and RevMan 5.3 software was used for statistics and analysis.ResultsOverall, a total of 14 randomized controlled trials (RCTs) involving six types of autoimmune diseases were included. The results showed the following. 1) Type 1 diabetes mellitus (T1DM): compared with the autologous fecal microbiota transplantation (FMT) group (control group), the fasting plasma C peptide in the allogenic FMT group at 12 months was lower. 2) Systemic sclerosis: at week 4, compared with one of two placebo controls, three patients in the experimental group reported a major improvement in fecal incontinence. 3) Ulcerative colitis, pediatric ulcerative colitis, and Crohn’s disease: FMT may increase clinical remission, clinical response, and endoscopic remission for patients with ulcerative colitis and increase clinical remission for patients with Crohn’s disease. 4) Psoriatic arthritis: there was no difference in the ratio of ACR20 between the two groups.ConclusionBased on current evidence, the application of FMT in the treatment of autoimmune diseases is effective and relatively safe, and it is expected to be used as a method to induce remission of active autoimmune diseases.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021235055, identifier CRD42021235055.

Autoimmune diseases and gut microbiota: a bibliometric and visual analysis from 2004 to 2022

“…For psoriasis, FMT is one of the most effective modalities [ 84 ], as well as one of the treatment modalities for AIH [ 88 , 90 ]. It is also effective against systemic sclerosis and T1D [ 92 ]. FMT can be optimized as a tailored dietary intervention pair, facilitating a pathway for precise engineering of the gut microbiome using the diet in ADs [ 93 ].…”

“…FMT can be optimized as a tailored dietary intervention pair, facilitating a pathway for precise engineering of the gut microbiome using the diet in ADs [ 93 ]. It can be seen that FMT is effective and relatively safe in the treatment of ADs and is expected to be used as a method to induce remission of active ADs [ 92 ]. Thus, from Fig.…”

Nurturing by nutrition: On the future of gut microbiota management strategies for autoimmune disease

“…The call for a personalized gut microbiota intervention at older age is illustrated by the results that are being obtained using fecal microbiota transplantation. A recent meta-analysis clearly demonstrated the potential of FMT for autoimmune disorders, like Type-1 diabetes and inflammatory bowel disease ( 32 ). However, although FMT provides a patient with a completely new gut microbial ecosystem, it’s efficacy seems still to be determined by baseline characteristics of the patient.…”

A Taxonomy-Agnostic Approach to Targeted Microbiome Therapeutics—Leveraging Principles of Systems Biology

“…FMT is among the oldest approaches to microbiome therapeutics; essentially, the goal is to directly change the recipient’s gut microbial composition by means of administration of fecal matter (or purified fecal microbiota) from a presumably healthy donor to resolve a state of dysbiosis [ 66 ]. FMT has proved to be highly effective so far in only one specific condition: Clostridiodes difficile (formerly Clostridium difficile ) diarrhea [ 66 ], but it is also showing promise in treating other disorders related to dysbiosis, including IBD, certain autoimmune disorders, Alzheimer’s and Parkinson’s diseases [ 67 , 68 , 69 ], autoimmune diseases [ 70 ], type 2 diabetes [ 71 ], and many others [ 66 , 72 , 73 ].…”