O.Yu. KARPUKHIN, E.R. KHASANOV, B.Sh. BIKBOV

Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

Karpuknin O.Yu. — D. Med. Sc., Professor of the Department of Surgical Diseases No. 1, tel. (843) 269-00-53, e-mail: oleg_karpukhin@mail.ru

Khasanov E.R. — student of Pediatric Faculty, tel. (937) 528-02-59, e-mail: khasael95@gmail.com

Bikbov B.Sh. — student of Pediatric Faculty, tel. (953) 495-99-63, e-mail: bulat1994bikbov@gmail.com

The article presents an overview of the Russian and foreign literature devoted to the fecal microbiota transplantation method, assessment of its efficacy and safety in the treatment of various diseases. Clinical resolution of the pathological process after application of this method was observed in a number of diseases of the gastrointestinal tract. Efficacy of the method in patients with Crohn’s disease was shown in 60.5 % of clinical observations, pseudomembranous colitis — 90 % and irritable bowel syndrome — 100 %. Moreover, the effectiveness of the method was also found in metabolic syndrome, chronic constipation, and obesity. Additionally, the neurological improvement was observed in Parkinson’s disease, multiple sclerosis and autism. The total number of complications after transplantation of fecal microbiota was 28.5 %. Most often, they manifested as dyspeptic disorders (nausea, vomiting, diarrhea). Mortality associated with the use of microbiota transplantation did not exceed 0.01 %, and was caused by aspiration the donor material by vomiting reflex in the case of microbiota introduction per os.

Transplantation of fecal microbiota is an effective and safe method for treatment the diseases with the violation of the intestinal microbiota in their pathogenesis. In the future, the method can been considered as an alternative to some traditional methods of treatment, but this requires a comprehensive study with multifaceted clinical research.

Key words: fecal microbiota transplantation, indications, procedure, complications.

References

1. Vasiliev A.N., Goryachev D.V., Gavrishina E.V. et al. Transplantation of fecal microbiota: possible therapeutic approaches and legal regulation issues. Biopreparations. Peer-reviewed scientific and practical journal, 2015, vol. 2, no.54, pp. 15-23. (in Russ.).
2. Zhang F., Luo W., Shi Y. et al. Should we standardize the 1700-year-old fecal microbiota transplantation? The American journal of Gastroenterology, 2012, no. 107, p. 1755.
3. Eiseman B., Silen W., Bascom G.S. et al. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery, 1958, no.44, p. 854.
4. Manichanh C., Borruel N., Casellas F., et al. The gut microbiota in IBD. Nature Reviews Gastroenterology and Hepatology, 2012, no.9, pp. 599-608.
5. Colman R.J, Rubin D.T. Fecal microbiota transplantation as therapy for inflammatory bowel disease: A systematic review and meta-analysis. Journal of Crohn’s and Colitis, 2014, vol. 8, no.12, pp. 69-81.
6. Bartlett J.G., Chang T.W., Gurwith M. et al. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. New England Journal of Medicine, 1978, no.298, pp. 531-534.
7. Van Nood E., Vrieze A., Nieuwdorp M.et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. New England Journal of Medicine, 2013, no. 368, pp. 407-415.
8. Crouzet L., Gaultier E., Del’Homme C. et al. The hypersensitivity to the colonic distension of IBS patients. Neurogastroenterology and Motility, 2013, no. 25, pp. 272-282.
9. Andrews P., Borody T.J., Shortis N.P. et al. Bacteriotherapy for chronic constipation — a long term follow-up. Gastroenterology, 1995, no. 108, issue 4, p. 563.
10. Smits L.P., Bouter K.E., de Vos W.M. et al. Therapeutic potential of fecal microbiota transplantation. Gastroenterology, 2013, no. 145, issue 5, pp. 946-953.
11. Ogden C.L., Carroll M.D., Kit B.K. et al. Prevalence of obesity among adults: United States, 2011-2012. National Center for Health Statistics, 2013, no. 131, pp. 1-8.
12. Melnichenko G.A., Romantsova T.I. Obesity: epidemiology, classification, pathogenesis, clinical symptomatology and diagnosis. Obesity. Moscow, Medical News Agency, 2004, pp. 407-428. (in Russ.).
13. Greenblum S., Turnbaugh P.J., Borenstein E. Metagenomic systems biology of the human gut microbiome reveals topological shifts associated with obesity and inflammatory bowel disease. Proceedings of the National Academy of Science of the United States of America, 2012, no.109, pp. 594-599.
14. Armougom F., Henry M., Vialettes B. et al. Monitoring bacterial community of human gut microbiota reveals an increase in Lactobacillus in obese patients and Methanogens in anorexic patients. Public Library of Science ONE, 2009, vol.4, no.9, doi: 10.1371 / journal.pone.0007125.
15. Teixeira T.F., Collado M.C., Ferreira C.L. Et al. Potential mechanisms for the emerging link between obesity and increased intestinal permeability. Nutrition Research, 2012, no.32, issue 9, pp. 637-647.
16. Druzhinin P.V., Novikov A.F., Aleshin S.V. Syndrome «X» — metabolic syndrome (high-risk condition). Guidelines. Moscow, 2005, pp. 13-18. (in Russ.).
17. Bäckhed F., Ding H., Wang T. et al. The gut microbiota as an environmental factor that regulates fat storage. Proceedings of the National Academy of Sciences of the United States of America, 2004, vol. 101, no.44, pp.15718-15723.
18. Vrieze A., Van Nood E., Holleman F. et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology, 2012, vol.143, 4, pp.913-916.
19. Ueki A., Otsuka M. Life style risks of Parkinson’s disease: association between decreased water intake and constipation. Journal of Neurology, 2004, no.251, pp. 18-23.
20. Ananthaswamy A. Faecal transplant eases symptoms of Parkinson’s disease. New Science, 2011, no. 209, p. 8-9.
21. Borody T. J., Leis S. M., Campbell J. et al. Fecal microbiota transplantation (FMT) in multiple sclerosis (MS) [abstract]. The American journal of Gastroenterology, 2011, no.106, pp. 352.
22. Finegold S.M., Molitoris D., Song Y. et al. Gastrointestinal microflora studies in late-onset autism. Clinical Infectious Diseases, 2002, no.35, pp. 6-16.
23. Aroniadis O.C., Brandt L.J. Fecal microbiota transplantation: past, present and future. Current opinion in Gastroenterology, 2013, no.29, pp. 79-84.
24. Chicherin I.Yu., Pogorelsky I.P., Lundovskikh I.A. Transplantation of fecal microbiota. Journal of Infectology, 2013, vol.5, no.2, pp. 82-88. (in Russ.).
25. Gough E.K., Shaikh H., Manges A.R. Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clinical infectious diseases, 2011, no.53, pp.994-1002.
26. Manichanh C., Reeder J., Gibert P. et al. Reshaping the gut microbiome with bacterial transplantation and antibiotic intake. Genome research, 2010, no.20, pp. 1411-1419.
27. Hamilton M.J., Weingarden A.R., Sadowsky M.J. Et al. Standardized preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection. The American journal of Gastroenterology, 2012, no.107, pp. 761-767.
28. Feltman R. «You can earn $ 13,000 a year selling your poop» [Electronic resource]. The Washington Post. USA, Washington. 29, January 2015. Code of access: https://www.washingtonpost.com/news/speaking-of-science/wp/2015/01/29/you-can-earn-13000-a-year-selling-your -poop /? Utm_term = .476ac1881130.
29. Shelygin Yu.A., Golovenko O.V., Golovenko A.O. et al. Transplantation of fecal microbiota — perspectives of use in intestinal diseases (review of literature). Koloproctology, 2015, vol.4, no.54, pp. 65-73. (in Russ.).
30. Brandt L.J., Aroniadis O.C., Mellow M. et al. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. The American journal of Gastroenterology, 2012, no 107, pp. 1079-1087.
31. Shriner E.V., Kurilovich S.A., Osipenko M.F. Transplantation of intestinal microbiota: therapeutic potential in diseases of the digestive system. Russian Journal of Gastroenterology, Hepatology and Coloproctology, 2014, no.5, pp.63-67. (in Russ.).
32. Brandt L.J., Aroniadis O.C. An overview of fecal microbiota transplantation: techniques, indications, and outcomes. Gastrointestinal Endoscopy, 2013, no.78, pp. 240-249.
33. Shi Y., Dong Y., Huang W., et al. Fecal Microbiota Transplantation for Ulcerative Colitis: A Systematic Review and Meta-Analysis. Public Library of Science ONE, vol.11, no.6, doi: 10.1371 / journal.pone.0157259.
34. Brandt L.J., Reddy S.S. Fecal microbiota transplantation for recurrent Clostridium difficile infection. Journal of clinical Gastroenterology, 2011, no.45, p. 159.
35. Brandt L.J., Borody T.J., Campbell J. Endoscopic fecal microbiota transplantation: «first-line» treatment for severe clostridium difficile infection? Journal of the clinical Gastroenterology, 2011, no.45, pp. 655-657.
36. Wang S., Xu M., Wang W. et al. Systematic Review: Adverse Events of Fecal Microbiota Transplantation. Public Library of Science ONE, 2016, vol.11, no.8, doi: 10.1371 / journal.pone.0161174.