Gaps in knowledge and future directions for the use of faecal microbiota transplant in the treatment of inflammatory bowel disease. (November 2019)

• Record Type: Journal Article
• Authors: Yalchin, Mehmet; Segal, Jonathan P.; Mullish, Benjamin H.; Quraishi, Mohammed Nabil; Iqbal, Tariq H.; Marchesi, Julian R.; Hart, Ailsa L.
• Is Part Of: Therapeutic advances in gastroenterology. Volume 12(2019)
• Publication Date: 2019-11
• Subjects: faecal microbiota transplantation -- inflammatory bowel disease -- microbiota; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Liver -- Diseases -- Treatment -- Periodicals; Pharmacology -- Periodicals; Gastroenterology -- Periodicals; Gastrointestinal Diseases -- therapy -- Periodicals; Liver Diseases -- therapy -- Periodicals; Pharmacology -- Periodicals; Gastroentérologie -- Périodiques; Appareil digestif -- Maladies -- Traitement -- Périodiques; Tractus gastro-intestinal -- Maladies -- Traitement -- Périodiques; Hépatologie -- Périodiques; Foie -- Maladies -- Périodiques; Pharmacologie -- Périodiques; 616.3005
• DOI: 10.1177/1756284819891038
• Languages: English
• ISSNs: 1756-283X

Abstract

Faecal microbiota transplant (FMT) has now been established into clinical guidelines for the treatment of recurrent and refractory Clostridioides difficile infection (CDI). Its therapeutic application in inflammatory bowel disease (IBD) is currently at an early stage. To date, there have been four randomized controlled trials for FMT in IBD and a multitude of observational studies. However, significant gaps in our knowledge regarding optimum methods for FMT preparation, technical aspects and logistics of its administration, as well as mechanistic underpinnings, still remain. In this article, we aim to highlight these gaps by reviewing evidence and making key recommendations on the direction of future studies in this field. In addition, we provide an overview of the current evidence of potential mechanisms of FMT in treating IBD.