臨床婦人科産科77巻7号

2023年07月発行

今月の臨床 細菌叢から読み解く女性と子どものヘルスケア 総論

細菌叢に着目した治療の現状

著者： 石川大¹

所属機関： ¹順天堂大学医学部消化器内科学講座

ページ範囲：P.664 - P.671

●2022年11月，米国，オーストラリアにおいてClostridioides difficile感染症に対する腸内細菌叢移植療法（FMT）が薬事承認を受け，実装化が開始された．

●潰瘍性大腸炎に対してのFMT臨床研究が多く行われ，本邦においては2023年1月に先進医療Bとして承認された．

●dysbiosis関連疾患に対してのFMTの適応拡大は進み，マイクロバイオーム創薬につながっていく．

参考文献

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4）Frank DN, et al : Disease phenotype and genotype are associated with shifts in intestinal-associated microbiota in inflammatory bowel diseases. Inflamm Bowel Dis 17 : 179-184, 2011

5）Moayyedi P, et al : Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology 149 : 102-109.e6, 2015

6）Rossen NG, et al : Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology 149 : 110-118.e4, 2015

7）Paramsothy S, et al : Multidonor intensive faecal microbiota transplantation for active ulcerative colitis : a randomised placebo-controlled trial. Lancet 389 : 1218-1228, 2017

8）Costello SP, et al : Effect of fecal microbiota transplantation on 8-week remission in patients with ulcerative colitis : a randomized clinical trial. JAMA 321 : 156-164, 2019

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10） Zhou HY, et al : Comparative of the effectiveness and safety of biological agents, tofacitinib, and fecal microbiota transplantation in ulcerative colitis : systematic review and network meta-analysis. Immunol Invest 50 : 323-337, 2021

11）Ishikawa D, et al : Changes in intestinal microbiota following combination therapy with fecal microbial transplantation and antibiotics for ulcerative colitis. Inflamm Bowel Dis 23 : 116-125, 2017

12）Ishikawa D, et al : The microbial composition of Bacteroidetes species in ulcerative colitis is effectively improved by combination therapy with fecal microbiota transplantation and antibiotics. Inflamm Bowel Dis 24 : 2590-2598, 2018

13）Okahara K, et al : Matching between donors and ulcerative colitis patients is important for long-term maintenance after fecal microbiota transplantation. J Clin Med 9 : 1650, 2020

14）Baruch EN, et al : Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients. Science 371 : 602-609, 2021

15）Wang Y, et al : Fecal microbiota transplantation for refractory immune checkpoint inhibitor-associated colitis. Nat Med 24 : 1804-1808, 2018

16）Papathoma E, et al : Cesarean section delivery and development of food allergy and atopic dermatitis in early childhood. Pediatr Allergy Immunol 27 : 419-424, 2016

17）Korpela K, et al : Maternal fecal microbiota transplantation in Cesarean-born infants rapidly restores normal gut microbial development : a proof-of-concept study. Cell 183 : 324-334.e5, 2020