Efficacy and safety of fecal microbiota transplantation for treatment of ulcerative colitis: A post-consensus systematic review and meta-analysis.

BACKGROUND: Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation (FMT) as a therapy for ulcerative colitis (UC). However, the treatment processes and outcomes of these studies vary. AIM: To evaluate the efficacy and safety of FMT for treating UC by conducting a systematic meta-analysis. METHODS: The inclusion criteria involved reports of adult patients with UC treated with FMT, while studies that did not report clinical outcomes or that included patients with infection were excluded. Clinical remission (CR) and endoscopic remission (ER) were the primary and secondary outcomes, respectively. RESULTS: We included nine studies retrieved from five electronic databases. The FMT group had better CR than the control group [relative risk (RR) = 1.53; 95% confidence interval (CI): 1.19-1.94; P < 0.0008]. ER was statistically significantly different between the two groups (RR = 2.80; 95%CI: 1.93-4.05; P < 0.00001). Adverse events did not differ significantly between the two groups. CONCLUSION: FMT demonstrates favorable performance and safety; however, well-designed randomized clinical trials are still needed before the widespread use of FMT can be recommended. Furthermore, standardizing the FMT process is urgently needed for improved safety and efficacy.

[Expression of human beta-defensin 2 and tumor necrosis factor-A in colonic mucosae of ulcerative colitis and diarrhea-predominant irritable bowel syndrome].

OBJECTIVE: To detect the expression of human beta-defensin 2 (HBD-2) and tumor necrosis factor-alpha (TNF-alpha) in the colonic mucosae of ulcerative colitis (UC) patients and diarrhea-predominant irritable bowel syndrome (IBS-D) patients and to evaluate the roles of HBD-2 and TNF-alpha in the pathogenesis and the relationship between them. METHODS: Immunohistochemistry was conducted on the biopsy samples of colonic mucosa from 30 UC patients, 20 IBS-D patients, and 10 normal persons to measure the expression of HBD-2 and TNF-alpha. RESULTS: The expression levels of HBD-2 and TNF-alpha in the colonic mucosa of UC were both significantly higher than those in the colonic mucosa of IBS-D (z = -4.856, z = -3. 987, all P < 0.01) and in the normal colonic mucosa (z = -3.611, z = -3. 248, all P < 0.01). But no significant differences were found between the colonic mucosa of IBS-D and the normal colonic mucosa in the intensity of the expressions of HBD-2 and TNF-alpha (z = -0.373, z = -0.032, all P > 0.05). There were no significant differences in the intensity of the expressions of HBD-2 and TNF-alpha in colonic mucosa of among the mild, moderate, and severe UC (chi2 = 1.190, P > 0.05, chi2 = 1.672, P > 0. 05). CONCLUSION: The expressions of HBD-2 and TNF-at are significantly increased in UC, but are not correlated with IBS-D and the severity of clinical symptoms of UC patients.