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Immunological mechanisms of fecal microbiota transplantation in recurrent Clostridioides difficile infection
Fecal microbiota transplantation (FMT) is a successful method for treating recurrent Clostridioides difficile ( C. difficile ) infection (rCDI) with around 90% efficacy. Due to the relative simplicity of this approach, it is being widely used and currently, thousands of patients have been treated wi...
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Published in: | World journal of gastroenterology : WJG 2022-09, Vol.28 (33), p.4762-4772 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Fecal microbiota transplantation (FMT) is a successful method for treating recurrent
Clostridioides difficile
(
C. difficile
) infection (rCDI) with around 90% efficacy. Due to the relative simplicity of this approach, it is being widely used and currently, thousands of patients have been treated with FMT worldwide. Nonetheless, the mechanisms underlying its effects are just beginning to be understood. Data indicate that FMT effectiveness is due to a combination of microbiological direct mechanisms against
C. difficile
, but also through indirect mechanisms including the production of microbiota-derived metabolites as secondary bile acids and short chain fatty acids. Moreover, the modulation of the strong inflammatory response triggered by
C. difficile
after FMT seems to rely on a pivotal role of regulatory T cells, which would be responsible for the reduction of several cells and soluble inflammatory mediators, ensuing normalization of the intestinal mucosal immune system. In this minireview, we analyze recent advances in these immunological aspects associated with the efficacy of FMT. |
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ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v28.i33.4762 |