[Faecal microbiota transplantation: indications in perspective]

Area of Science:

• Gastroenterology and Microbiology
• Microbiome Therapeutics

Background:

• Recurrent Clostridium difficile infection (CDI) has limited treatment options.
• Faecal microbiota transplantation (FMT) is established for recurrent CDI with high cure rates.
• The efficacy of FMT for other gastrointestinal and systemic conditions is under investigation.

Purpose of the Study:

• To review the current indications and emerging applications of FMT.
• To summarize the effectiveness of FMT in ulcerative colitis and metabolic syndrome.
• To highlight areas for future research in FMT.

Main Methods:

• Review of existing literature on FMT.
• Analysis of clinical trial data for FMT in various conditions.
• Identification of patient subgroups and donor characteristics.

Main Results:

• FMT achieves high cure rates (around 85%) for recurrent CDI.
• FMT shows significant clinical and endoscopic improvement in ulcerative colitis patients (24-30%) compared to placebo.
• FMT may improve insulin sensitivity in metabolic syndrome but does not affect weight or BMI.
• FMT is being explored for Crohn's disease, irritable bowel syndrome, graft-versus-host-disease, and multidrug-resistant organism carriage.

Conclusions:

• FMT is a definitive treatment for recurrent CDI.
• FMT demonstrates promise for ulcerative colitis and metabolic syndrome.
• Further randomized controlled trials are needed to establish FMT efficacy for other emerging indications.