BACKGROUND Fecal microbial transplantation(FMT)is a promising new method for treating active ulcerative colitis(UC),but knowledge regarding FMT for quiescent UC is scarce.AIM To investigate FMT for the maintenance of ...BACKGROUND Fecal microbial transplantation(FMT)is a promising new method for treating active ulcerative colitis(UC),but knowledge regarding FMT for quiescent UC is scarce.AIM To investigate FMT for the maintenance of remission in UC patients.METHODS Forty-eight UC patients were randomized to receive a single-dose FMT or autologous transplant via colonoscopy.The primary endpoint was set to the maintenance of remission,a fecal calprotectin level below 200μg/g,and a clinical Mayo score below three throughout the 12-mo follow-up.As secondary endpoints,we recorded the patient’s quality of life,fecal calprotectin,blood chemistry,and endoscopic findings at 12 mo.RESULTS The main endpoint was achieved by 13 out of 24(54%)patients in the FMT group and by 10 out of 24(41%)patients in the placebo group(log-rank test,P=0.660).Four months after FMT,the quality-of-life scores decreased in the FMT group compared to the placebo group(P=0.017).In addition,the disease-specific quality of life measure was higher in the placebo group than in the FMT group at the same time point(P=0.003).There were no differences in blood chemistry,fecal calprotectin,or endoscopic findings among the study groups at 12 mo.The adverse events were infrequent,mild,and distributed equally between the groups.CONCLUSION There were no differences in the number of relapses between the study groups at the 12-mo follow-up.Thus,our results do not support the use of a single-dose FMT for the maintenance of remission in UC.展开更多
Research suggests that inflammation is important in the pathophysiology of mental disorders.In addition,a growing body of evidence has led to the concept of the microbiota-gut-brain axis.To understand the potential in...Research suggests that inflammation is important in the pathophysiology of mental disorders.In addition,a growing body of evidence has led to the concept of the microbiota-gut-brain axis.To understand the potential interactions,we begin by exploring the liaison between the immune system and mental disorders,then we describe the evidence that the microbiota impact the immune response in the developing brain.Next,we review the literature that has documented microbiome alterations in major mental disorders.We end with a summary of therapeutic applications,ranging from psycho-biotics to immunomodulatory drugs that could affect the microbiotagut-brain axis,and potential treatments to alleviate the adverse effects of antipsycho tics.We conclude that there is promising evidence to support the position that the microbiota plays an important role in the immunological pathophysiology of mental disorders with an emphasis on psychotic disorders and mood disorders.However,more research is needed to elucidate the mechanisms.展开更多
基金Academy of Finland(Reetta Satokari),No.323156Sigrid Juselius Foundation+2 种基金University of Helsinki(A Three-year Grant)The Competitive State Research Financing(Perttu Lahtinen),No.200230042The Ella and Georg Ehrnrooth Foundation(Perttu Arkkila)
文摘BACKGROUND Fecal microbial transplantation(FMT)is a promising new method for treating active ulcerative colitis(UC),but knowledge regarding FMT for quiescent UC is scarce.AIM To investigate FMT for the maintenance of remission in UC patients.METHODS Forty-eight UC patients were randomized to receive a single-dose FMT or autologous transplant via colonoscopy.The primary endpoint was set to the maintenance of remission,a fecal calprotectin level below 200μg/g,and a clinical Mayo score below three throughout the 12-mo follow-up.As secondary endpoints,we recorded the patient’s quality of life,fecal calprotectin,blood chemistry,and endoscopic findings at 12 mo.RESULTS The main endpoint was achieved by 13 out of 24(54%)patients in the FMT group and by 10 out of 24(41%)patients in the placebo group(log-rank test,P=0.660).Four months after FMT,the quality-of-life scores decreased in the FMT group compared to the placebo group(P=0.017).In addition,the disease-specific quality of life measure was higher in the placebo group than in the FMT group at the same time point(P=0.003).There were no differences in blood chemistry,fecal calprotectin,or endoscopic findings among the study groups at 12 mo.The adverse events were infrequent,mild,and distributed equally between the groups.CONCLUSION There were no differences in the number of relapses between the study groups at the 12-mo follow-up.Thus,our results do not support the use of a single-dose FMT for the maintenance of remission in UC.
基金supported by the National Natural Science Foundation of China (81871056)。
文摘Research suggests that inflammation is important in the pathophysiology of mental disorders.In addition,a growing body of evidence has led to the concept of the microbiota-gut-brain axis.To understand the potential interactions,we begin by exploring the liaison between the immune system and mental disorders,then we describe the evidence that the microbiota impact the immune response in the developing brain.Next,we review the literature that has documented microbiome alterations in major mental disorders.We end with a summary of therapeutic applications,ranging from psycho-biotics to immunomodulatory drugs that could affect the microbiotagut-brain axis,and potential treatments to alleviate the adverse effects of antipsycho tics.We conclude that there is promising evidence to support the position that the microbiota plays an important role in the immunological pathophysiology of mental disorders with an emphasis on psychotic disorders and mood disorders.However,more research is needed to elucidate the mechanisms.
