title: Fecal microbial transplant for the treatment of pediatric inflammatory bowel disease.
abstract: The role of fecal microbial transplant (FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrentClostridium difficileinfection (RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease (IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhood-onset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.
authors.affiliation: Alice Yuxin Wang, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada.
authors.forename: Alice Yuxin
authors.initials: AY
authors.lastname: Wang
authors.affiliation: Alice Yuxin Wang, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada.
authors.forename: Jelena
authors.initials: J
authors.lastname: Popov
authors.affiliation: Alice Yuxin Wang, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Pai
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D003424:Crohn Disease / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D000069467:Fecal Microbiota Transplantation / Q000009:adverse effects / Q000266:history; D000069196:Gastrointestinal Microbiome; D041981:Gastrointestinal Tract / Q000382:microbiology*; D007722:Health Knowledge, Attitudes, Practice; D049673:History, 20th Century; D049690:History, Ancient; D006801:Humans; D007223:Infant; D010342:Patient Acceptance of Health Care; D016896:Treatment Outcome; D055815:Young Adult
keywords: Crohn’s disease; Fecal microbial transplant; Inflammatory bowel disease; Microbiome; Microbiota; Pediatric; Ulcerative colitis