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Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model
Published on: April 6, 2022
Fecal microbiota transplantation in childhood: past, present, and future
Xu Gu1, Zhao-Hong Chen2, Shu-Cheng Zhang3
1Department of Pediatrics, Shengjing Hospital of China Medical University, 36 Sanhao Street Heping District, Shenyang, 110004, China.
Insights
Fecal microbiota transplantation (FMT) in children is evolving, with recent studies updating knowledge on its mechanisms, delivery, and safety for various pediatric conditions. Further clinical trials are needed to standardize FMT protocols for children.
Area of Science:
- Microbiology
- Pediatric Gastroenterology
- Immunology
Background:
- Fecal microbiota transplantation (FMT) is recognized for treating pediatric diseases.
- Current understanding of FMT's application in children requires updating.
- Key concepts related to pediatric FMT need re-evaluation.
Purpose of the Study:
- To review and synthesize recent advancements in fecal microbiota transplantation for pediatric diseases.
- To provide an updated overview of FMT mechanisms, methodology, indications, and safety in children.
Main Methods:
- Comprehensive literature search of MEDLINE, EMBASE, and Cochrane databases.
- Keywords used: "Fecal microbiota transplantation OR Fecal microbiota transfer".
- Inclusion of articles published within the last five years, supplemented by manual reference list searches.
Main Results:
- Reviewed studies covered FMT mechanisms (28), sample preparation (9), delivery (23), and safety (26).
- Key indications explored include Clostridium difficile infection (CDI/rCDI), non-alcoholic fatty liver disease (NAFLD), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), diabetes, functional constipation (FC), and autism spectrum disorder (ASD).
- Recent literature provides updated insights into the application of FMT in pediatric populations.
Conclusions:
- FMT concepts in pediatric diseases have been significantly updated regarding mechanisms, methodology, indications, and safety.
- The need for evidence-based clinical trials to address challenges in pediatric FMT dosage, duration, and treatment endpoints is highlighted.
- Standardized protocols are essential for advancing FMT in pediatric care.
Background:
Fecal microbiota transplantation (FMT) has been well described in the treatment of pediatric diseases; however, the latest updates regarding its use in children are unclear and the concepts involved need to be revisited.
Data Sources:
We performed advanced searches in the MEDLINE, EMBASE, and Cochrane databases using the keywords "Fecal microbiota transplantation OR Fecal microbiota transfer" in the [Title/Abstract] to identify relevant articles published in English within the last five years. To identify additional studies, reference lists of review articles and included studies were manually searched. Retrieved manuscripts (case reports, reviews, and abstracts) were assessed by the authors.
Results:
Among the articles, studies were based on the mechanism (n = 28), sample preparation (n = 9), delivery approaches (n = 23), safety (n = 26), and indications (n = 67), including Clostridium difficile infection (CDI) and recurrent C. difficile infection (rCDI; n = 21), non-alcoholic fatty liver disease (NAFLD; n = 10), irritable bowel syndrome (IBS; n = 5), inflammatory bowel disease (IBD; n = 15), diabetes (n = 5), functional constipation (FC; n = 4), and autism spectrum disorder (ASD; n = 7).
Conclusions:
Concepts of FMT in pediatric diseases have been updated with respect to underlying mechanisms, methodology, indications, and safety. Evidence-based clinical trials for the use of FMT in pediatric diseases should be introduced to resolve the challenges of dosage, duration, initiation, and the end point of treatment.
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