Systematic Review with Meta-Analysis: Fecal Microbiota Transplantation for Severe or Fulminant Clostridioides difficile

Tixier, Emily; Verheyen, Elijah; Luo, Yuying; Grinspan, Lauren Tal; Du, Charles; Ungaro, Ryan C.; Walsh, Samantha; Grinspan, Ari

doi:10.1007/s10620-021-06908-4

Cited by 22 publications

(18 citation statements)

References 48 publications

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“…Recently, there has been increasing interest on FMT, which consists of transplanting an autologous or donor stool through colonoscopy, oral capsules or enteral feeding tube to restore a healthy microbiota. FMT has for example been proposed as an alternative treatment for severe or recurrent Clostridium difficile colitis [ 109 , 110 ]. In the ICU, there are case reports in septic patients with multiple organ failures and suspected dysbiosis highlighting successful FMT in these patients [ 111 , 112 ].…”

Section: Intestinal Dysbiosis In Critically Ill Patients: Pathophysio...mentioning

confidence: 99%

The central and biodynamic role of gut microbiota in critically ill patients

et al. 2022

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Gut microbiota plays an essential role in health and disease. It is constantly evolving and in permanent communication with its host. The gut microbiota is increasingly seen as an organ, and its failure, reflected by dysbiosis, is seen as an organ failure associated with poor outcomes. Critically ill patients may have an altered gut microbiota, namely dysbiosis, with a severe reduction in “health-promoting” commensal intestinal bacteria (such as Firmicutes or Bacteroidetes) and an increase in potentially pathogenic bacteria (e.g. Proteobacteria). Many factors that occur in critically ill patients favour dysbiosis, such as medications or changes in nutrition patterns. Dysbiosis leads to several important effects, including changes in gut integrity and in the production of metabolites such as short-chain fatty acids and trimethylamine N-oxide. There is increasing evidence that gut microbiota and its alteration interact with other organs, highlighting the concept of the gut–organ axis. Thus, dysbiosis will affect other organs and could have an impact on the progression of critical diseases. Current knowledge is only a small part of what remains to be discovered. The precise role and contribution of the gut microbiota and its interactions with various organs is an intense and challenging research area that offers exciting opportunities for disease prevention, management and therapy, particularly in critical care where multi-organ failure is often the focus. This narrative review provides an overview of the normal composition of the gut microbiota, its functions, the mechanisms leading to dysbiosis, its consequences in an intensive care setting, and highlights the concept of the gut–organ axis.

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Section: Intestinal Dysbiosis In Critically Ill Patients: Pathophysio...mentioning

confidence: 99%

The central and biodynamic role of gut microbiota in critically ill patients

et al. 2022

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“…Another relevant disease deeply correlated with gut dysbiosis is Clostridioides difficile Infection (CDI), caused by opportunistic bacteria responsible for infectious colitis in hospitalized patients [ 19 ]. Considering that CDI occurs in patients with disrupted gut microbiota, it seems easy to hypothesize that healthy gut microbiota can prevent Clostridioides difficile colonization [ 20 ]; in fact, the fecal microbiota transplant can contrast the infection restoring a functional microbiota, as recently documented by a systematic study [ 21 ]. Microbiota composition in cancer biology has been increasingly accepted as an environmental factor favoring colorectal cancer (CRC) development.…”

Section: Link Between Dysbiosis and Pathologiesmentioning

confidence: 99%

Microbiota, Bacterial Carbonic Anhydrases, and Modulators of Their Activity: Links to Human Diseases?

Amedei

Capasso

Nannini

et al. 2021

Mediators of Inflammation

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The involvement of the human microbiome is crucial for different host functions such as protection, metabolism, reproduction, and especially immunity. However, both endogenous and exogenous factors can affect the balance of the microbiota, creating a state of dysbiosis, which can start various gastrointestinal or systemic diseases. The challenge of future medicine is to remodel the intestinal microbiota to bring it back to healthy equilibrium (eubiosis) and, thus, counteract its negative role in the diseases’ onset. The shaping of the microbiota is currently practiced in different ways ranging from diet (or use of prebiotics, probiotics, and synbiotics) to phage therapy and antibiotics, including microbiota fecal transplantation. Furthermore, because microbiota modulation is a capillary process, and because many microbiota bacteria (both beneficial and pathogenic) have carbonic anhydrases (specifically the four classes α, β, γ, and ι), we believe that the use of CA inhibitors and activators can open up new therapeutic strategies for many diseases associated with microbial dysbiosis, such as the various gastrointestinal disorders and the same colorectal cancer.

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“…infection (CDI), with response rates around 90% in several independent trials [17]. Even in a recent meta-analysis of FMT in severe and fulminant CDI (including 16 studies representing 676 patients) cure rates of 61.3% were reported [18]. Of interest in that context multiple repeated procedures achieved higher cure rates compared to single FMT (100% versus 75%, p = 0.01).…”

Section: Targeting the Gut Microbiome In Gastroenterologymentioning

confidence: 99%

Microbiota in Health and Disease—Potential Clinical Applications

et al. 2021

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Within the last two decades tremendous efforts in biomedicine have been undertaken to understand the interplay of commensal bacteria living in and on our human body with our own human physiology. It became clear that (1) a high diversity especially of the microbial communities in the gut are important to preserve health and that (2) certain bacteria via nutrition-microbe-host metabolic axes are beneficially affecting various functions of the host, including metabolic control, energy balance and immune function. While a large set of evidence indicate a special role for small chain fatty acids (SCFA) in that context, recently also metabolites of amino acids (e.g., tryptophan and arginine) moved into scientific attention. Of interest, microbiome alterations are not only important in nutrition associated diseases like obesity and diabetes, but also in many chronic inflammatory, oncological and neurological abnormalities. From a clinician’s point of view, it should be mentioned, that the microbiome is not only interesting to develop novel therapies, but also as a modifiable factor to improve efficiency of modern pharmaceutics, e.g., immune-therapeutics in oncology. However, so far, most data rely on animal experiments or human association studies, whereas controlled clinical intervention studies are spare. Hence, the translation of the knowledge of the last decades into clinical routine will be the challenge of microbiome based biomedical research for the next years. This review aims to provide examples for future clinical applications in various entities and to suggest bacterial species and/or microbial effector molecules as potential targets for intervention studies.

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Systematic Review with Meta-Analysis: Fecal Microbiota Transplantation for Severe or Fulminant Clostridioides difficile

Cited by 22 publications

References 48 publications

The central and biodynamic role of gut microbiota in critically ill patients

The central and biodynamic role of gut microbiota in critically ill patients

Microbiota, Bacterial Carbonic Anhydrases, and Modulators of Their Activity: Links to Human Diseases?

Microbiota in Health and Disease—Potential Clinical Applications

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