INTESTINE Vol.20 No.4(2-7)


特集名 潰瘍性大腸炎─明日から使える内科治療のコツと最新情報
題名 治療 (7) Fecal microbiota transplantation
発刊年月 2016年 07月
著者 西田 淳史 滋賀医科大学消化器内科
著者 安藤 朗 滋賀医科大学消化器内科
【 要旨 】 近年の腸内細菌の研究や,HMP(Human Microbiome Project),iHMP (integrative Human Microbiome Project)やMetaHIT(Metagenomics of the Human Intestinal Tract)といった大規模なコンソーシアムによるメタゲノム計画によって,腸内細菌は単にわれわれの腸内に生息しているだけでなく,免疫応答や代謝などの生理機能に対して大きな影響を及ぼしていることがわかってきた.近年,腸内細菌叢をターゲットとした治療としてfecal microbiota transplantation(FMT)が登場し,現在さまざまな疾患に対してその有効性が検証されている.とくにその検討が進んでいるのが再発性のClostridium difficile infection(CDI)に対するFMTの効果であり,治療選択肢の一つとして認識されてきている.それに続き,炎症性腸疾患(inflammatory bowel disease),なかでも潰瘍性大腸炎(ulcerative colitis;UC)に対するFMTの効果についての検討が進んでいる.
Theme Tips and up-to-date of the medical therapy for ulcerative colitis
Title Fecal Microbiota Transplantation
Author Atsushi Nishida Department of Gastroenterology, Shiga University of Medical Science
Author Akira Andoh Department of Gastroenterology, Shiga University of Medical Science
[ Summary ] Through the large-scale work of consortiumdriven "metagenomic projects, such as the Human Microbiome Project, integrative Human Microbiome Project, and Metagenomics of the Human Intestinal Tract, it has been revealed that the commensal microorganisms are not simple "passengers" in our bodies, and instead have important roles in our physiology, including immune responses and metabolism. Approaches to modify the gastrointestinal microbiota, such as probiotics, prebiotics, and fecal microbiota transplantation (FMT), have attracted considerable attention for the treatment of gastrointestina diseases with "dysbiosis." FMT has been used successfully in the management of Clostridium difficile infection (CDI). Based on these results, clinical trials have been conducted to examine whether FMT could be used as a treatment for inflammatory bowel disease (IBD). However, the available evidence is limited and poor. Well-designed randomized controlled trials are required to evaluate the effect of FMT on IBD.
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