潰瘍性大腸炎における様々な糞便微生物移植の有効性:体系的レビューとネットワークメタ解析
Julia Chapon1, Julien Scanzi1,2, Harry Sokol3,4,5
1Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.
Therapeutic advances in gastroenterology
|August 28, 2025
まとめ
下部胃腸 (GI) と経口カプセル便微生物移植 (FMT) の組み合わせは,潰瘍性大腸炎 (UC) の寛解を誘発するのに最も効果的です. 潜在的に有害な影響があるため,自律的なFMTは避けるべきです.
科学分野:
- 胃腸内科
- 微生物学
- 臨床医学
背景:
- 潰瘍性大腸炎 (UC) は慢性炎症性腸疾患である.
- 糞便の微生物移植 (FMT) はUC治療において有望である.
- UCの最適のFMT方式は未決定のままである.
研究 の 目的:
- UC患者の臨床寛解を誘導する際の,異なるFMTの有効性を比較する.
- UC治療のための最も効果的なFMT投与方法を特定する.
主な方法:
- ランダム化制御試験の体系的レビューとネットワーク分析
- FMTを受けているUCの成人の患者も含む.
- 主要エンドポイントは,6~12週間の臨床寛解でした.
主要な成果:
- 口服用カプセル,下部胃腸FMT,および併用療法がプラセボよりも効果的でした.
- 下部消化器官FMTと経口カプセルの組み合わせは,最も高い寛解率を示した (SUCRA=0. 93).
- プラセボ (SUCRA=0. 12) よりも自律的なFMTの効果は低かった.
結論:
- 下部消化管と口服カプセルによるFMTは,UCの寛解に最も効果的であるとみられる.
- オトログのFMTは有害な効果があるため,試験では避けるべきです.
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