糞便微生物移植の現状と未来
強毒変異株の出現を契機に，難治性の再発性クロストリジウム・ディフィシル感染症（recurrent Clostridium difficile infection：rCDI）が欧米で猛威をふるっている．2013年にオランダのグループがrCDIを対象とした糞便微生物移植（fecal microbiota transplantation：FMT）の臨床試験で画期的な有効性を証明したことで，FMTに注目が集まることとなった．rCDI以外に，炎症性腸疾患，過敏性腸症候群（irritable bowel syndrome：IBS）をはじめとしたさまざまな消化管疾患や肝疾患・精神神経系疾患等も含めた多くの疾...
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| Published in | 日本内科学会雑誌 Vol. 107; no. 10; pp. 2176 - 2182 |
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| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.10.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.107.2176 |
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| Abstract | 強毒変異株の出現を契機に，難治性の再発性クロストリジウム・ディフィシル感染症（recurrent Clostridium difficile infection：rCDI）が欧米で猛威をふるっている．2013年にオランダのグループがrCDIを対象とした糞便微生物移植（fecal microbiota transplantation：FMT）の臨床試験で画期的な有効性を証明したことで，FMTに注目が集まることとなった．rCDI以外に，炎症性腸疾患，過敏性腸症候群（irritable bowel syndrome：IBS）をはじめとしたさまざまな消化管疾患や肝疾患・精神神経系疾患等も含めた多くの疾患においても，FMTの有用性を探る試みが続けられている．本稿では，rCDIにおけるFMTの成功から5年が経過し，研究の進展に伴って徐々に概念が変化しつつあるFMTの歴史と現状を解説し，将来を見据えたFMTの位置付けについて議論してみたい． |
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| AbstractList | 強毒変異株の出現を契機に，難治性の再発性クロストリジウム・ディフィシル感染症（recurrent Clostridium difficile infection：rCDI）が欧米で猛威をふるっている．2013年にオランダのグループがrCDIを対象とした糞便微生物移植（fecal microbiota transplantation：FMT）の臨床試験で画期的な有効性を証明したことで，FMTに注目が集まることとなった．rCDI以外に，炎症性腸疾患，過敏性腸症候群（irritable bowel syndrome：IBS）をはじめとしたさまざまな消化管疾患や肝疾患・精神神経系疾患等も含めた多くの疾患においても，FMTの有用性を探る試みが続けられている．本稿では，rCDIにおけるFMTの成功から5年が経過し，研究の進展に伴って徐々に概念が変化しつつあるFMTの歴史と現状を解説し，将来を見据えたFMTの位置付けについて議論してみたい． |
| Author | 金井, 隆典 水野, 慎大 |
| Author_xml | – sequence: 1 fullname: 水野, 慎大 organization: 慶應義塾大学内科学（消化器） – sequence: 1 fullname: 金井, 隆典 organization: 慶應義塾大学内科学（消化器） |
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| Copyright | 2018 一般社団法人 日本内科学会 |
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| References | 8) Maldonado-Gómez MX, et al: Stable engraftment of Bifidobacterium longum AH1206 in the human gut depends on individualized features of the resident microbiome. Cell Host Microbe 20: 515-526, 2016. 10) Ott SJ, et al: Efficacy of sterile fecal filtrate transfer for treating patients with Clostridium difficile infection. Gastroenterology 152: 799-811, 2017. 2) Beck DA, et al: Coprophagia in an elderly man: a case report and review of the literature. Int J Psychiatry Med 35: 417-427, 2005. 1) van Nood E, et al: Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 368: 407-415, 2013. 7) Ridaura VK, et al: Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 341: 1241214, 2013. 4) Mizuno S, et al: Bifidobacterium-rich fecal donor may be a positive predictor for successful fecal microbiota transplantation in patients with irritable bowel syndrome. Digestion 96: 29-38, 2017. 6) Johnsen PH, et al: Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. Lancet Gastroenterol Hepatol 3: 17-24, 2018. 5) Paramsothy S, et al: Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial. Lancet 389: 1218-1228, 2017. 3) Kao D, et al: Effect of oral capsule- vs colonoscopy-delivered fecal microbiota transplantation on recurrent Clostridium difficile infection: a randomized clinical trial. JAMA 318: 1985-1993, 2017. 9) Li SS, et al: Durable coexistence of donor and recipient strains after fecal microbiota transplantation. Science 352: 586-589, 2016. |
| References_xml | – reference: 5) Paramsothy S, et al: Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial. Lancet 389: 1218-1228, 2017. – reference: 1) van Nood E, et al: Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 368: 407-415, 2013. – reference: 4) Mizuno S, et al: Bifidobacterium-rich fecal donor may be a positive predictor for successful fecal microbiota transplantation in patients with irritable bowel syndrome. Digestion 96: 29-38, 2017. – reference: 9) Li SS, et al: Durable coexistence of donor and recipient strains after fecal microbiota transplantation. Science 352: 586-589, 2016. – reference: 6) Johnsen PH, et al: Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. Lancet Gastroenterol Hepatol 3: 17-24, 2018. – reference: 8) Maldonado-Gómez MX, et al: Stable engraftment of Bifidobacterium longum AH1206 in the human gut depends on individualized features of the resident microbiome. Cell Host Microbe 20: 515-526, 2016. – reference: 7) Ridaura VK, et al: Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 341: 1241214, 2013. – reference: 3) Kao D, et al: Effect of oral capsule- vs colonoscopy-delivered fecal microbiota transplantation on recurrent Clostridium difficile infection: a randomized clinical trial. JAMA 318: 1985-1993, 2017. – reference: 2) Beck DA, et al: Coprophagia in an elderly man: a case report and review of the literature. Int J Psychiatry Med 35: 417-427, 2005. – reference: 10) Ott SJ, et al: Efficacy of sterile fecal filtrate transfer for treating patients with Clostridium difficile infection. Gastroenterology 152: 799-811, 2017. |
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| Snippet | 強毒変異株の出現を契機に，難治性の再発性クロストリジウム・ディフィシル感染症（recurrent Clostridium difficile infection：rCDI）が欧米で猛威をふるっている．2013... |
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| SubjectTerms | dysbiosis クロストリジウム・ディフィシル感染症 糞便微生物移植 |
| Title | 糞便微生物移植の現状と未来 |
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