Fecal microbiota transplantation: past, present and future
– Source: Current Opinion in Gastroenterology, Oct 4, 2012
By Olga C Aroniadis, MD, Lawrence J Brandt, MD
[Note: Drs. Aroniadis and Brandt specialize in the study of fecal transplantion at Montefiore Medical Center. They review emerging science demonstrating that a healthy balance of intestinal flora is the foundation of cellular immunity and energy metabolism; its disruption plays a role in many disorders including IBS and ME/CFS (per Drs. Peterson, Cheney, Myhill, de Meirleir, Enlander, etc.); and plan controlled studies of microbiota transplantation in hopes of opening new horizons in healing.]
Purpose of review: Fecal microbiota transplantation (FMT) re-establishes a balanced intestinal flora with resultant cure of recurrent Clostridium difficile infection (RCDI).
FMT has also been used to treat other gastrointestinal (GI) diseases including:
• Inflammatory bowel disease (IBD),
• Irritable bowel syndrome (IBS),
• Chronic constipation
• And a variety of non-GI disorders.
The purpose of this review is to discuss the intestinal microbiota and FMT treatment of GI and non-GI diseases.
Recent findings: It is known that an imbalanced intestinal microbiota predisposes to CDI, IBD and IBS.
The complex role of intestinal microbiota to maintain health, however, is a newer concept that is being increasingly studied.
The microbiome plays an important role in cellular immunity and energy metabolism and has been implicated in the pathogenesis of:
• Non-GI autoimmune diseases,
• Chronic fatigue syndrome [ME/CFS],
• And even some neuropsychiatric disorders.
Summary: FMT is a highly effective cure for RCDI, but increased knowledge of the intestinal microbiota in health maintenance, as well as controlled trials of FMT in a wide range of disorders are needed before FMT can be accepted and applied clinically.
Source: Current Opinion in Gastroenterology, Oct 4, 2012. PMID:23041678, by Aroniadis OC, Brandt LJ. Division of Gastroenterology, Montefiore Medical Center, Bronx, New York, USA. [Lbrandt@montefiore.org]