Das gastrointestinale Mikrobiom beeinflusst physiologische Funktionen und ist bei
einer Vielzahl von Erkrankungen verändert. Bei Patienten mit entzündlichen Darmerkrankungen
zeigen Bakterien, Pilze, Bakteriophagen und Archaeen krankheitstypische Muster, die
mit Störungen im Metabolom einhergehen. Der fäkale Mikrobiomtransfer (FMT) ist die
einschneidendste Methode zur Therapie einer Dysbiose.
Abstract
The gastrointestinal microbiome influences physiological functions and is altered
in a variety of diseases. The causality of “dysbiosis” in the pathogenesis is not
always proven; association studies are often involved. Patients with IBD, bacteria,
fungi, bacteriophages, and archaea show disease-typical patterns associated with metabolome
disturbances. Fecal microbiome transfer (FMT) for treating various diseases is the
subject of numerous clinical studies. Currently, recurrent Clostridioides difficile
infection (rCDI) is the only confirmed indication recommended in medical guidelines.
In Germany, the FMT is subject to the Medicines Act and may only be carried out as
part of individual healing attempts or clinical studies. For patient safety, repeated
donor screening, ideally with the construction of a chair bench, is necessary. This
significantly limits the nationwide availability of the FMT in Germany. Microbiota-based
therapeutics prepared from the stool of tested donors have recently been approved
by the US Food and Drug Administration (FDA) for the prevention of rCDI. More microbiome-based
medicines can be expected in the future.
Schlüsselwörter
Mikrobiota - Mikrobiotatransplantation - fäkal - LBP - Clostridioides-difficile-Infektion
Keywords
microbiota - microbiota-transplantation - fecal - live-biotherapeutic-product - clostridioides-difficile-infection
