粪菌移植(fecal microbiota transplantation,FMT)是一种创新的方法,通过将健康供体的粪便微生物群移植到疾病患者体内,达到重建肠道微生态平衡的目的,为治疗疾病提供帮助。粪菌移植技术在复发性艰难拟梭菌感染(recurrent Clostridioides difficile infection,rCDI)的治疗中效果很好,并且其治疗潜力不仅局限于胃肠道疾病,而且在其他与微生物相关的疾病中被不断挖掘。探索FMT成功治疗疾病的影响因素,除了肠道细菌的恢复,还涉及肠道噬菌体的调节。肠道噬菌体是肠道微生物群的重要组成部分,在细菌的复杂动力学中发挥着重要作用,其转移可能与FMT的疗效有关。本综述回顾了肠道噬菌体的生物学特性和主要的生物信息学分析策略,总结了FMT中肠道噬菌体作用的临床研究,探讨了FMT中肠道噬菌体群落的变化和可能的作用机制,讨论了肠道噬菌体与FMT疗效的关系及其存在的安全性问题,既能提高对FMT中肠道噬菌体作用的理解,也能推动FMT的临床应用。
Fecal microbiota transplantation (FMT) is an innovative method to reconstruct the intestinal microecological balance by transplanting the fecal microbiota of healthy donors into patients, which provides help for the treatment of diseases. It has a good effect on the treatment of recurrent Clostridioides difficile infection (rCDI), and its therapeutic potential is not only limited to gastrointestinal diseases, but also can be continuously explored in other microbial-related diseases. In the exploration of factors for the success of FMT in the treatment of diseases, in addition to the recovery of intestinal bacteria, the regulation of intestinal phages is also involved. Intestinal phages, an important part of the gut microbiota, play an important role in the complex dynamics of bacteria; their transfer may be related to the curative effect of FMT. This review analyzed the biological characteristics of intestinal phage and the main bioinformatics analysis strategies, summarized the clinical research on the role of intestinal phage in FMT, explored the changes in the intestinal phage community in FMT and the possible mechanisms of action, and discussed the relationship between intestinal phage and the efficacy of FMT, as well as the existing safety issues. It can not only improve the understanding of the role of intestinal phages in FMT, but also promote the clinical application of FMT.