FECAL MICROBIOTA TRANSPLANTATION IN ADULTS AS A MODERN FORM OF PAST “COPROTHERAPY”: HOPE OR HYPE?
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The influence of intestinal microbiota on the human health and disease is of great importance. Fecal microbiota transplantation (FMT) defined as the transfer of the stool-derived microbiota of the distal gastrointestinal (GI) tract from a healthy donor to a patient with a disease attributable to intestinal dysbiosis is, in addition to the use of probiotics, prebiotics, synbiotics and eubiotics, one of the methods to restore eubiosis. Thorough medical history and physical examination followed by a set of blood and stool laboratory tests should be performed in a potential stool donor. Stool-derived microbiota may be administered through the upper and/or lower GI tract. FMT is believed to be a well-tolerated and, in general, safe procedure. The emergence of stool banks of frozen feces-derived material containing intestinal microbiota and the availability of convenient oral capsules with selected components of feces would definitely facilitate the use of this method in both research and the clinics. An inflammation caused by Clostridium difficile is the most often indication for FMT. Other conditions include inflammatory bowel disease, irritable bowel syndrome or the eradication of multi-drug resistant microorganisms. However, the list of potential indications rapidly increases. Further randomized double-blind studies in humans are needed to confirm a real benefit-risk ratio and clinical value of FMT, especially in extraintestinal disorders like obesity, diabetes mellitus, metabolic syndrome, fatty liver disease, hepatic encephalopathy, allergy, autism, depression or dementia.
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