Gastroenterology:无菌粪便滤液同样能治疗艰难梭菌感染吗?

2016-11-20 MedSci MedSci原创

粪便菌群移植(FMT)是复发性艰难梭菌感染(CDI)的一个非常有效的治疗方案。研究目的是,调查无菌粪便滤液(含细菌碎片、蛋白质、抗菌化合物、代谢产物和寡核苷酸/ DNA)而不是完整的微生物,对CDI的治疗是否有效。 我们进行了一项病例系列研究,观察粪便滤液转移(FFT)对5例症状性慢性复发性CDI患者的疗效。患者随访6个月到33个月。FFT前、后1周和6周采集患者的粪便标本,比较捐赠者和患者

粪便菌群移植(FMT)是复发性艰难梭菌感染(CDI)的一个非常有效的治疗方案。研究目的是,调查无菌粪便滤液(含细菌碎片、蛋白质、抗菌化合物、代谢产物和寡核苷酸/ DNA)而不是完整的微生物,对CDI的治疗是否有效。

我们进行了一项病例系列研究,观察粪便滤液转移(FFT)对5例症状性慢性复发性CDI患者的疗效。患者随访6个月到33个月。FFT前、后1周和6周采集患者的粪便标本,比较捐赠者和患者的微生物、病毒和蛋白质等。

所有5例患者的大便习惯均恢复正常,CDI症状的消除最短时间为6个月。选择性FFT滤液的蛋白质组分析没有发现与疗效相关的明显候选蛋白质。16S rRNA基因测序显示了细菌DNA的多样性。滤液病毒样颗粒分析发现,CDI症状的减少与复杂的噬菌体有关。受者粪便样品的细菌和病毒的系统发育分析显示了FFT后微生物和病毒群落结构的纵向变化。

5例CDI患者的初步调查显示,供体粪便提取的无菌滤液,而不是粪便菌群,足以恢复患者的正常大便习惯和消除症状。这一发现表明,细菌成分、代谢产物或噬菌体介导FMT的许多疗效。


梅斯医学小编:这个研究令人糊涂了,对于艰难梭菌感染,是肠道微生物菌群起作用,还是正常粪便中“有益成分”?实在令人费解。记得以前中医中有采用人或动物粪便入药的,被反中医人士骂死!因为用最污染的粪便入药,实在有污人格!后来肠道微生物的重要作用被证实,中医人士开始反驳,你看现代科学证实了中医的作用了!!结果又被打脸。因为中医中入药的粪便,可能早已没有活的肠道微生物”了。但是,这一篇研究又令人蒙了。看来传统中医采用粪便治疗,还真有一定的科学道理了。

不管科学争议如何,总之在不断争鸣中得到发展和认识提高。

原始出处:


Stephan J. Ott,et al.Efficacy of Sterile Fecal Filtrate Transfer for Treating Patients With Clostridium difficile Infection.Gastroenterology.Articles in Press

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    2017-05-25 许安
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    2016-11-22 Homburg
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