医学
溃疡性结肠炎
结肠炎
胃肠病学
内科学
炎症性肠病
巨细胞病毒
不利影响
更昔洛韦
钙蛋白酶
耐火材料(行星科学)
免疫学
疾病
人巨细胞病毒
病毒
病毒性疾病
疱疹病毒科
物理
天体生物学
作者
Katarzyna Karolewska-Bochenek,Izabella Łazowska-Przeorek,Paweł Grzesiowski,Marcin Dziekiewicz,Łukasz Dembiński,Piotr Albrecht,Andrzej Radzikowski,Aleksandra Banaszkiewicz
摘要
Introduction Cytomegalovirus (CMV) infection in patients with inflammatory bowel disease (IBD) is reactivated by the use of immunosuppressive drugs. CMV infection may produce IBD flares refractory to standard therapy. Objective The aim of our study was to assess the efficacy and safety of faecal microbiota transplantation (FMT) for the treatment of CMV colitis in patients with ulcerative colitis (UC) flare. Material and methods A total of 8 children, with mild to severe UC, positive for CMV PCR in colonic biopsies, received 50-100 ml FMT by nasogastric tube on 5 consecutive days in each of 2 weeks. During the study, the subjects were treated with 5ASA and FMT. Immunosuppressant therapy was withdrawn, when CMV colitis was diagnosed by positive DNA PCR in colonic tissues. The clinical response was defined as a decrease of Paediatric UC Activity Index by ≥20 points. Results At the 6th week of the study, negative colonic CMV DNA PCR was measured after 10 infusions in 7/8 patients. For one boy, 20 infusions were administered to assess CMV elimination from colonic biopsies. A clinical response was observed in 3/8 patients, with clinical remission in 3/8 patients. Faecal calprotectin decreased significantly in 3 patients. CRP normalized in 2 patients after 6 weeks. No serious adverse effects were observed during and after infusions. Conclusions FMT seems to be an effective and safe treatment option for CMV colitis in children with UC. This is the first study to demonstrate the application of FMT as a new therapeutic option for CMV colitis.
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