肝移植术后肠道菌群失调的研究进展
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摘要
近年来,随着分子生物学技术的飞速发展,肠道微生物作为一个"器官"受到越来越广泛的关注。肠道微生物与机体免疫系统相互作用,共同维持机体的免疫稳态。肠道菌群失调可能是肝移植术后发生感染、排斥反应等并发症的重要原因。通过选择性去污、缺血预处理、益生菌和粪便菌群移植等手段干预肠道微生物可在一定程度上改善肝移植受者预后。
Recently,intestinal flora,as an organ,is being paid much more attention accompanied with rapid development of molecular biotechnology. Intestinal microbiota maintains the balance of immune state through interaction with immune system. Intestinal dysbacteriosis might be one of the reasons for complications after liver transplantation such as infection and rejection. Strategies such as selective digestive decontamination,ischemic preconditioning,probiotics and fecal microbiota transplantation can improve prognosis of liver transplantation.
Recently,intestinal flora,as an organ,is being paid much more attention accompanied with rapid development of molecular biotechnology. Intestinal microbiota maintains the balance of immune state through interaction with immune system. Intestinal dysbacteriosis might be one of the reasons for complications after liver transplantation such as infection and rejection. Strategies such as selective digestive decontamination,ischemic preconditioning,probiotics and fecal microbiota transplantation can improve prognosis of liver transplantation.
引文
1 Ren Z,Cui G,Lu H,et al.Liver ischemic preconditioning(IPC)improves intestinal microbiota following liver transplantation in rats through 16s r DNA-based analysis of microbial structure shift[J].PLo S One,2013,8(10):e75950.
2 童荔,杨志勤,易小猛,等.肝移植术后肠道菌群失调及其危险因素分析[J/CD].中华临床医师杂志:电子版,2014,8(5):868-872.
3 Lu H,He J,Wu Z,et al.Assessment of microbiome variation during the perioperative period in liver transplant patients:a retrospective analysis[J].Microb Ecol,2013,65(3):781-791.
4 Bruls T,Weissenbach J.The human metagenome:our other genome?[J].Hum Mol Genet,2011,20(R2):R142-R148.
5 Backhed F,Ley RE,Sonnenburg JL,et al.Host-bacterial mutualism in the human intestine[J].Science,2005,307(5717):1915-1920.
6 Human Microbiome Project Consortium.Structure,function and diversity of the healthy human microbiome[J].Nature,2012,486(7402):207-214.
7 Possemiers S,Bolca S,Verstraete W,et al.The intestinal microbiome:a separate organ inside the body with the metabolic potential to influence the bioactivity of botanicals[J].Fitoterapia,2011,82(1):53-66.
8 Bruzzese E,Callegari ML,Raia V,et al.Disrupted intestinal microbiota and intestinal inflammation in children with cystic fibrosis and its restoration with Lactobacillus GG:a randomised clinical trial[J].PLo S One,2014,9(2):e87796.
9 Kamada N,Seo SU,Chen GY,et al.Role of the gut microbiota in immunity and inflammatory disease[J].Nat Rev Immunol,2013,13(5):321-335.
10 Arumugam M,Raes J,Pelletier E,et al.Enterotypes of the human gut microbiome[J].Nature,2011,473(7346):174-180.
11 Choi JH,Kim GB,Cha CJ.Spatial heterogeneity and stability of bacterial community in the gastrointestinal tracts of broiler chickens[J].Poult Sci,2014,93(8):1942-1950.
12 Fukuda S,Toh H,Taylor TD,et al.Acetate-producing bifidobacteria protect the host from enteropathogenic infection via carbohydrate transporters[J].Gut Microbes,2012,3(5):449-454.
13 Sayin SI,Wahlstrom A,Felin J,et al.Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid,a naturally occurring FXR antagonist[J].Cell Metab,2013,17(2):225-235.
14 Li F,Jiang C,Krausz KW,et al.Microbiome remodelling leads to inhibition of intestinal farnesoid X receptor signalling and decreased obesity[J].Nat Commun,2013,4:2384.
15 Shankar V,Hamilton MJ,Khoruts A,et al.Species and genus level resolution analysis of gut microbiota in Clostridium difficile patients following fecal microbiota transplantation[J].Microbiome,2014,2:13.
16 Renz H,Brandtzaeg P,Hornef M.The impact of perinatal immune development on mucosal homeostasis and chronic inflammation[J].Nat Rev Immunol,2012,12(1):9-23.
17 Round JL,Mazmanian SK.The gut microbiota shapes intestinal immune responses during health and disease[J].Nat Rev Immunol,2009,9(5):313-323.
18 Bouskra D,Brezillon C,Berard M,et al.Lymphoid tissue genesis induced by commensals through NOD1 regulates intestinal homeostasis[J].Nature,2008,456(7221):507-510.
19 Laycock G,Sait L,Inman C,et al.A defined intestinal colonization microbiota for gnotobiotic pigs[J].Vet Immunol Immunopathol,2012,149(3-4):216-224.
20 Gaboriau-Routhiau V,Rakotobe S,Lecuyer E,et al.The key role of segmented filamentous bacteria in the coordinated maturation of gut helper T cell responses[J].Immunity,2009,31(4):677-689.
21 Ivanov II,Atarashi K,Manel N,et al.Induction of intestinal Th17cells by segmented filamentous bacteria[J].Cell,2009,139(3):485-498.
22 Hand TW,Dos SL,Bouladoux N,et al.Acute gastrointestinal infection induces long-lived microbiota-specific T cell responses[J].Science,2012,337(6101):1553-1556.
23 Yoon WS,Choi HJ,Park YK.Salmonella typhimurium harboring plasmid expressing interleukin-12 induced attenuation of infection and protective immune responses[J].J Gen Appl Microbiol,2011,57(2):115-122.
24 Round JL,Lee SM,Li J,et al.The Toll-like receptor 2 pathway establishes colonization by a commensal of the human microbiota[J].Science,2011,332(6032):974-977.
25 Atarashi K,Tanoue T,Shima T,et al.Induction of colonic regulatory T cells by indigenous Clostridium species[J].Science,2011,331(6015):337-341.
26 Maynard CL,Elson CO,Hatton RD,et al.Reciprocal interactions of the intestinal microbiota and immune system[J].Nature,2012,489(7415):231-241.
27 《中华消化杂志》编委会,王兴鹏.肠道菌群失调诊断治疗建议[J].中华消化杂志,2009,29(5):335-337.
28 Xu MQ,Cao HL,Wang WQ,et al.Fecal microbiota transplantation broadening its application beyond intestinal disorders[J].World J Gastroenterol,2015,21(1):102-111.
29 Mckay S,Gaudier E,Campbell DI,et al.Environmental enteropathy:new targets for nutritional interventions[J].Int Health,2010,2(3):172-180.
30 Armougom F,Henry M,Vialettes B,et al.Monitoring bacterial community of human gut microbiota reveals an increase in Lactobacillus in obese patients and Methanogens in anorexic patients[J].PLo S One,2009,4(9):e7125.
31 Rizzello M,De Angelis F,Campanile FC,et al.Effect of gastrointestinal surgical manipulation on metabolic syndrome:a focus on metabolic surgery[J].Gastroenterol Res Pract,2012:670418.
32 Stefater MA,Wilson-Perez HE,Chambers AP,et al.All bariatric surgeries are not created equal:insights from mechanistic comparisons[J].Endocr Rev,2012,33(4):595-622.
33 廖博雅,王莎莎,张军东,等.肠道微生物在人类疾病中的作用[J].胃肠病学,2015,20(2):126-128.
34 Malamut G,Verkarre V,Suarez F,et al.The enteropathy associated with common variable immunodeficiency:the delineated frontiers with celiac disease[J].Am J Gastroenterol,2010,105(10):2262-2275.
35 Compare D,Coccoli P,Rocco A,et al.Gut-liver axis:the impact of gut microbiota on non alcoholic fatty liver disease[J].Nutr Metab Cardiovasc Dis,2012,22(6):471-476.
36 Xie YR,Liu SL,Liu X,et al.Intestinal microbiota and innate immunity-related gene alteration in cirrhotic rats with liver transplantation[J].Transplant Proc,2011,43(10):3973-3979.
37 刘霞,刘社兰,解奕瑞,等.基于16S rRNA基因和细菌基因组间重复序列的DNA指纹图谱技术对肝硬化大鼠肝移植后肠道菌群多样性的研究[J].中国微生态学杂志,2010,22(3):193-198.
38 Xie Y,Luo Z,Li Z,et al.Structural shifts of fecal microbial communities in rats with acute rejection after liver transplantation[J].Microb Ecol,2012,64(2):546-554.
39 Ren Z,Jiang J,Lu H,et al.Intestinal microbial variation may predict early acute rejection after liver transplantation in rats[J].Transplantation,2014,98(8):844-852.
40 Wu ZW,Ling ZX,Lu HF,et al.Changes of gut bacteria and immune parameters in liver transplant recipients[J].Hepatobiliary Pancreat Dis Int,2012,11(1):40-50.
41 Arai M,Mochida S,Ohno A,et al.Selective bowel decontamination of recipients for prevention against liver injury following orthotopic liver transplantation:evaluation with rat models[J].Hepatology,1998,27(1):123-127.
42 Katchman E,Marquez M,Bazerbachi F,et al.A comparative study of the use of selective digestive decontamination prophylaxis in livingdonor liver transplant recipients[J].Transpl Infect Dis,2014,16(4):539-547.
43 Mccafferty K,Forbes S,Thiemermann C,et al.The challenge of translating ischemic conditioning from animal models to humans:the role of comorbidities[J].Dis Model Mech,2014,7(12):1321-1333.
44 Wu J,Feng X,Huang H,et al.Remote ischemic conditioning enhanced the early recovery of renal function in recipients after kidney transplantation:a randomized controlled trial[J].J Surg Res,2014,188(1):303-308.
45 Mullard A.Microbiology:the inside story[J].Nature,2008,453(7195):578-580.
46 Rayes N,Seehofer D,Theruvath T,et al.Supply of pre-and probiotics reduces bacterial infection rates after liver transplantation-a randomized,double-blind trial[J].Am J Transplant,2005,5(1):125-130.
47 Xing HC,Li LJ,Xu KJ,et al.Protective role of supplement with foreign Bifidobacterium and Lactobacillus in experimental hepatic ischemia-reperfusion injury[J].J Gastroenterol Hepatol,2006,21(4):647-656.
48 Ren ZG,Liu H,Jiang JW,et al.Protective effect of probiotics on intestinal barrier function in malnourished rats after liver transplantation[J].Hepatobiliary Pancreat Dis Int,2011,10(5):489-496.
49 Xie Y,Chen H,Zhu B,et al.Effect of intestinal microbiota alteration on hepatic damage in rats with acute rejection after liver transplantation[J].Microb Ecol,2014,68(4):871-880.
50 El FR,Bangar H,Haslam DB.The molecular basis of Clostridium difficile disease and host response[J].Curr Opin Gastroenterol,2015,31(1):24-29.
51 Zhang F,Luo W,Shi Y,et al.Should we standardize the 1,700-year-old fecal microbiota transplantation?[J].Am J Gastroenterol,2012,107(11):1755,1755-1756.
52 Eiseman B,Silen W,Bascom GS,et al.Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis[J].Surgery,1958,44(5):854-859.
53 Armstrong MJ,Pathmakanthan S,Iqbal TH.Fecal microbiota transplantation for Clostridium difficile infection[J].JAMA,2015,313(7):725-726.
54 Ray A,Smith R,Breaux J.Fecal microbiota transplantation for Clostridium difficile infection:the Ochsner experience[J].Ochsner J,2014,14(4):538-544.
55 Kelly CR,de Leon L,Jasutkar N.Fecal microbiota transplantation for relapsing Clostridium difficile infection in 26 patients:methodology and results[J].J Clin Gastroenterol,2012,46(2):145-149.
56 Gough E,Shaikh H,Manges AR.Systematic review of intestinal microbiota transplantation(fecal bacteriotherapy)for recurrent Clostridium difficile infection[J].Clin Infect Dis,2011,53(10):994-1002.
57 Kim JE,Gweon TG,Yeo CD,et al.A case of Clostridium difficile infection complicated by acute respiratory distress syndrome treated with fecal microbiota transplantation[J].World J Gastroenterol,2014,20(35):12687-12690.
58 Bakken JS,Borody T,Brandt LJ,et al.Treating Clostridium difficile infection with fecal microbiota transplantation[J].Clin Gastroenterol Hepatol,2011,9(12):1044-1049.
59 Angelberger S,Reinisch W,Makristathis A,et al.Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation[J].Am J Gastroenterol,2013,108(10):1620-1630.
60 van Nood E,Dijkgraaf MG,Keller JJ.Duodenal infusion of feces for recurrent Clostridium difficile[J].N Engl J Med,2013,368(22):2145.
61 Grehan MJ,Borody TJ,Leis SM,et al.Durable alteration of the colonic microbiota by the administration of donor fecal flora[J].J Clin Gastroenterol,2010,44(8):551-561.
62 Youngster I,Hohmann EL.Fecal microbiota transplantation for Clostridium difficile infection-reply[J].JAMA,2015,313(7):726.
63 Rao K,Young VB.Fecal microbiota transplantation for the management of Clostridium difficile infection[J].Infect Dis Clin North Am,2015,29(1):109-122.
64 Sipponen T,Kolho KL.Fecal calprotectin in diagnosis and clinical assessment of inflammatory bowel disease[J].Scand J Gastroenterol,2015,50(1):74-80.
2 童荔,杨志勤,易小猛,等.肝移植术后肠道菌群失调及其危险因素分析[J/CD].中华临床医师杂志:电子版,2014,8(5):868-872.
3 Lu H,He J,Wu Z,et al.Assessment of microbiome variation during the perioperative period in liver transplant patients:a retrospective analysis[J].Microb Ecol,2013,65(3):781-791.
4 Bruls T,Weissenbach J.The human metagenome:our other genome?[J].Hum Mol Genet,2011,20(R2):R142-R148.
5 Backhed F,Ley RE,Sonnenburg JL,et al.Host-bacterial mutualism in the human intestine[J].Science,2005,307(5717):1915-1920.
6 Human Microbiome Project Consortium.Structure,function and diversity of the healthy human microbiome[J].Nature,2012,486(7402):207-214.
7 Possemiers S,Bolca S,Verstraete W,et al.The intestinal microbiome:a separate organ inside the body with the metabolic potential to influence the bioactivity of botanicals[J].Fitoterapia,2011,82(1):53-66.
8 Bruzzese E,Callegari ML,Raia V,et al.Disrupted intestinal microbiota and intestinal inflammation in children with cystic fibrosis and its restoration with Lactobacillus GG:a randomised clinical trial[J].PLo S One,2014,9(2):e87796.
9 Kamada N,Seo SU,Chen GY,et al.Role of the gut microbiota in immunity and inflammatory disease[J].Nat Rev Immunol,2013,13(5):321-335.
10 Arumugam M,Raes J,Pelletier E,et al.Enterotypes of the human gut microbiome[J].Nature,2011,473(7346):174-180.
11 Choi JH,Kim GB,Cha CJ.Spatial heterogeneity and stability of bacterial community in the gastrointestinal tracts of broiler chickens[J].Poult Sci,2014,93(8):1942-1950.
12 Fukuda S,Toh H,Taylor TD,et al.Acetate-producing bifidobacteria protect the host from enteropathogenic infection via carbohydrate transporters[J].Gut Microbes,2012,3(5):449-454.
13 Sayin SI,Wahlstrom A,Felin J,et al.Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid,a naturally occurring FXR antagonist[J].Cell Metab,2013,17(2):225-235.
14 Li F,Jiang C,Krausz KW,et al.Microbiome remodelling leads to inhibition of intestinal farnesoid X receptor signalling and decreased obesity[J].Nat Commun,2013,4:2384.
15 Shankar V,Hamilton MJ,Khoruts A,et al.Species and genus level resolution analysis of gut microbiota in Clostridium difficile patients following fecal microbiota transplantation[J].Microbiome,2014,2:13.
16 Renz H,Brandtzaeg P,Hornef M.The impact of perinatal immune development on mucosal homeostasis and chronic inflammation[J].Nat Rev Immunol,2012,12(1):9-23.
17 Round JL,Mazmanian SK.The gut microbiota shapes intestinal immune responses during health and disease[J].Nat Rev Immunol,2009,9(5):313-323.
18 Bouskra D,Brezillon C,Berard M,et al.Lymphoid tissue genesis induced by commensals through NOD1 regulates intestinal homeostasis[J].Nature,2008,456(7221):507-510.
19 Laycock G,Sait L,Inman C,et al.A defined intestinal colonization microbiota for gnotobiotic pigs[J].Vet Immunol Immunopathol,2012,149(3-4):216-224.
20 Gaboriau-Routhiau V,Rakotobe S,Lecuyer E,et al.The key role of segmented filamentous bacteria in the coordinated maturation of gut helper T cell responses[J].Immunity,2009,31(4):677-689.
21 Ivanov II,Atarashi K,Manel N,et al.Induction of intestinal Th17cells by segmented filamentous bacteria[J].Cell,2009,139(3):485-498.
22 Hand TW,Dos SL,Bouladoux N,et al.Acute gastrointestinal infection induces long-lived microbiota-specific T cell responses[J].Science,2012,337(6101):1553-1556.
23 Yoon WS,Choi HJ,Park YK.Salmonella typhimurium harboring plasmid expressing interleukin-12 induced attenuation of infection and protective immune responses[J].J Gen Appl Microbiol,2011,57(2):115-122.
24 Round JL,Lee SM,Li J,et al.The Toll-like receptor 2 pathway establishes colonization by a commensal of the human microbiota[J].Science,2011,332(6032):974-977.
25 Atarashi K,Tanoue T,Shima T,et al.Induction of colonic regulatory T cells by indigenous Clostridium species[J].Science,2011,331(6015):337-341.
26 Maynard CL,Elson CO,Hatton RD,et al.Reciprocal interactions of the intestinal microbiota and immune system[J].Nature,2012,489(7415):231-241.
27 《中华消化杂志》编委会,王兴鹏.肠道菌群失调诊断治疗建议[J].中华消化杂志,2009,29(5):335-337.
28 Xu MQ,Cao HL,Wang WQ,et al.Fecal microbiota transplantation broadening its application beyond intestinal disorders[J].World J Gastroenterol,2015,21(1):102-111.
29 Mckay S,Gaudier E,Campbell DI,et al.Environmental enteropathy:new targets for nutritional interventions[J].Int Health,2010,2(3):172-180.
30 Armougom F,Henry M,Vialettes B,et al.Monitoring bacterial community of human gut microbiota reveals an increase in Lactobacillus in obese patients and Methanogens in anorexic patients[J].PLo S One,2009,4(9):e7125.
31 Rizzello M,De Angelis F,Campanile FC,et al.Effect of gastrointestinal surgical manipulation on metabolic syndrome:a focus on metabolic surgery[J].Gastroenterol Res Pract,2012:670418.
32 Stefater MA,Wilson-Perez HE,Chambers AP,et al.All bariatric surgeries are not created equal:insights from mechanistic comparisons[J].Endocr Rev,2012,33(4):595-622.
33 廖博雅,王莎莎,张军东,等.肠道微生物在人类疾病中的作用[J].胃肠病学,2015,20(2):126-128.
34 Malamut G,Verkarre V,Suarez F,et al.The enteropathy associated with common variable immunodeficiency:the delineated frontiers with celiac disease[J].Am J Gastroenterol,2010,105(10):2262-2275.
35 Compare D,Coccoli P,Rocco A,et al.Gut-liver axis:the impact of gut microbiota on non alcoholic fatty liver disease[J].Nutr Metab Cardiovasc Dis,2012,22(6):471-476.
36 Xie YR,Liu SL,Liu X,et al.Intestinal microbiota and innate immunity-related gene alteration in cirrhotic rats with liver transplantation[J].Transplant Proc,2011,43(10):3973-3979.
37 刘霞,刘社兰,解奕瑞,等.基于16S rRNA基因和细菌基因组间重复序列的DNA指纹图谱技术对肝硬化大鼠肝移植后肠道菌群多样性的研究[J].中国微生态学杂志,2010,22(3):193-198.
38 Xie Y,Luo Z,Li Z,et al.Structural shifts of fecal microbial communities in rats with acute rejection after liver transplantation[J].Microb Ecol,2012,64(2):546-554.
39 Ren Z,Jiang J,Lu H,et al.Intestinal microbial variation may predict early acute rejection after liver transplantation in rats[J].Transplantation,2014,98(8):844-852.
40 Wu ZW,Ling ZX,Lu HF,et al.Changes of gut bacteria and immune parameters in liver transplant recipients[J].Hepatobiliary Pancreat Dis Int,2012,11(1):40-50.
41 Arai M,Mochida S,Ohno A,et al.Selective bowel decontamination of recipients for prevention against liver injury following orthotopic liver transplantation:evaluation with rat models[J].Hepatology,1998,27(1):123-127.
42 Katchman E,Marquez M,Bazerbachi F,et al.A comparative study of the use of selective digestive decontamination prophylaxis in livingdonor liver transplant recipients[J].Transpl Infect Dis,2014,16(4):539-547.
43 Mccafferty K,Forbes S,Thiemermann C,et al.The challenge of translating ischemic conditioning from animal models to humans:the role of comorbidities[J].Dis Model Mech,2014,7(12):1321-1333.
44 Wu J,Feng X,Huang H,et al.Remote ischemic conditioning enhanced the early recovery of renal function in recipients after kidney transplantation:a randomized controlled trial[J].J Surg Res,2014,188(1):303-308.
45 Mullard A.Microbiology:the inside story[J].Nature,2008,453(7195):578-580.
46 Rayes N,Seehofer D,Theruvath T,et al.Supply of pre-and probiotics reduces bacterial infection rates after liver transplantation-a randomized,double-blind trial[J].Am J Transplant,2005,5(1):125-130.
47 Xing HC,Li LJ,Xu KJ,et al.Protective role of supplement with foreign Bifidobacterium and Lactobacillus in experimental hepatic ischemia-reperfusion injury[J].J Gastroenterol Hepatol,2006,21(4):647-656.
48 Ren ZG,Liu H,Jiang JW,et al.Protective effect of probiotics on intestinal barrier function in malnourished rats after liver transplantation[J].Hepatobiliary Pancreat Dis Int,2011,10(5):489-496.
49 Xie Y,Chen H,Zhu B,et al.Effect of intestinal microbiota alteration on hepatic damage in rats with acute rejection after liver transplantation[J].Microb Ecol,2014,68(4):871-880.
50 El FR,Bangar H,Haslam DB.The molecular basis of Clostridium difficile disease and host response[J].Curr Opin Gastroenterol,2015,31(1):24-29.
51 Zhang F,Luo W,Shi Y,et al.Should we standardize the 1,700-year-old fecal microbiota transplantation?[J].Am J Gastroenterol,2012,107(11):1755,1755-1756.
52 Eiseman B,Silen W,Bascom GS,et al.Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis[J].Surgery,1958,44(5):854-859.
53 Armstrong MJ,Pathmakanthan S,Iqbal TH.Fecal microbiota transplantation for Clostridium difficile infection[J].JAMA,2015,313(7):725-726.
54 Ray A,Smith R,Breaux J.Fecal microbiota transplantation for Clostridium difficile infection:the Ochsner experience[J].Ochsner J,2014,14(4):538-544.
55 Kelly CR,de Leon L,Jasutkar N.Fecal microbiota transplantation for relapsing Clostridium difficile infection in 26 patients:methodology and results[J].J Clin Gastroenterol,2012,46(2):145-149.
56 Gough E,Shaikh H,Manges AR.Systematic review of intestinal microbiota transplantation(fecal bacteriotherapy)for recurrent Clostridium difficile infection[J].Clin Infect Dis,2011,53(10):994-1002.
57 Kim JE,Gweon TG,Yeo CD,et al.A case of Clostridium difficile infection complicated by acute respiratory distress syndrome treated with fecal microbiota transplantation[J].World J Gastroenterol,2014,20(35):12687-12690.
58 Bakken JS,Borody T,Brandt LJ,et al.Treating Clostridium difficile infection with fecal microbiota transplantation[J].Clin Gastroenterol Hepatol,2011,9(12):1044-1049.
59 Angelberger S,Reinisch W,Makristathis A,et al.Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation[J].Am J Gastroenterol,2013,108(10):1620-1630.
60 van Nood E,Dijkgraaf MG,Keller JJ.Duodenal infusion of feces for recurrent Clostridium difficile[J].N Engl J Med,2013,368(22):2145.
61 Grehan MJ,Borody TJ,Leis SM,et al.Durable alteration of the colonic microbiota by the administration of donor fecal flora[J].J Clin Gastroenterol,2010,44(8):551-561.
62 Youngster I,Hohmann EL.Fecal microbiota transplantation for Clostridium difficile infection-reply[J].JAMA,2015,313(7):726.
63 Rao K,Young VB.Fecal microbiota transplantation for the management of Clostridium difficile infection[J].Infect Dis Clin North Am,2015,29(1):109-122.
64 Sipponen T,Kolho KL.Fecal calprotectin in diagnosis and clinical assessment of inflammatory bowel disease[J].Scand J Gastroenterol,2015,50(1):74-80.