Science:如何对粪便菌群移植进行监管?

2017-12-17 佚名 “细胞”微信号

来自美国马里兰大学的一小群研究人员在Science期刊上发表了一篇标题为“Improving regulation of microbiota transplants”的政策论坛论文,概述了当前对粪便菌群移植(fecal microbiota transplant, FMT)的监管状态。在这篇论文中,他们描述这种移植的性质,为何和如何使用它,以及政府试图监管它的方法。

来自美国马里兰大学的一小群研究人员在Science期刊上发表了一篇标题为“Improving regulation of microbiota transplants”的政策论坛论文,概述了当前对粪便菌群移植(fecal microbiota transplant, FMT)的监管状态。在这篇论文中,他们描述这种移植的性质,为何和如何使用它,以及政府试图监管它的方法。

粪便菌群移植(FMT)指的是将来自一个人(即供者)的粪便样品转移到另一个人(即受者)的体内以便希望改善受者的肠道生物群落。FMT既能够像灌肠剂那样简单地将粪便样品注射到肛门中,也可通过插入一根管子,将粪便样品更深地注射到体内。随着人们在接受一轮抗菌剂注射来消灭不需要的感染之后寻求替换必需的肠道细菌,FMT变得越来越普遍。

在某些情形下,FMT成为让一个人恢复健康的唯一手段---比如,遭受艰难梭菌感染(Clostridium difficile infection, CDI)的患者没有其他的治疗选择。CDI是在一轮抗生素治疗清除了天然的肠道生物群落之后通常会发生的肠道感染,如果不及时治疗,它可能是致命的。不幸的是,正如这些研究人员在这篇论文中注意到的是,寻求这种治疗的患者能够遇到意想不到的障碍---如今FMT受到美国药品食品管理局(FDA)等机构的监管,这是因为捐赠的粪便样品当前被放置在粪便库中,而这些粪便库像血库那样必须遵守旨在保证公众安全的规则。

但是,这些研究人员问道,粪便样品应当像血液样品那样加以处理?一些人认为它们应当像组织样品那样加以处理,这将会增加新的监管。还有一些人建议仅作为另一种药物对它们进行监管。他们指出,最终的结果是这整个行业并没有得到很好的界定,这对需要这种治疗的患者或担心迄今为止仍不知道的副作用的监管机构来说并不是最佳的。更严峻的问题是获得粪便样品的简易性---比如,患者可能仅选择来自其亲属的一袋粪便。而且如果监管成为障碍的话,并不难以看到一些患者会自行进行处理,这实际上可能会伤害他们自己。

原始出处:

Hoffmann D,et al.,Improving regulation of microbiota transplants.Science. 2017 Dec 15;358(6369):1390-1391.

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    2017-12-19 wwzzly
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    2017-12-19 jichang
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    2017-12-19 Homburg
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    2017-12-17 林3301

    学习了解多的知识

    0

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    2017-12-17 天涯183

    非常好的文章.学习了

    0

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    2017-12-17 131****1460

    学习了受益匪浅

    0

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