부산대학교 도서관

Our understanding and utilization of fecal microbiota transplantation (FMT) has jump-started over the past two decades. Recent technological advancements in sequencing and metabolomics have allowed for better characterization of our intestinal microbial counterparts, triggering a surge of excitement in the fields of mucosal immunology and microbiology. This excitement is well founded, as demonstrated by 90% relapse-free cure rates in FMT treatment for recurrent Clostridioides difficile infections. Growing evidence suggests that in addition to bacterial factors, the host immune response during C. difficile infection greatly influences disease severity. In this review, we discuss recent advancements in understanding the interplay between immune cells and the microbiota and how they may relate to recovery from C. difficile through FMT therapy. FMT is effective for treatment of recurrent and severe C. difficile infection (CDI), with 90% relapse-free cure rates reported. The immune response is a key driver of recovery and pathogenesis during CDI. Antimicrobial defenses including the inflammasome, MyD88-activated neutrophils, and interferon (IFN)γ+ innate lymphoid cells (ILC)1s are essential for killing invading C. difficile and other pathobionts during infection. Overly robust inflammation via IL-23, Toll-like receptor (TLR)2 signaling, and T helper (Th)-17 cells increases tissue damage and can lead to more severe tissue damage during CDI. Type-2 barrier cytokines IL-33 and IL-25 aid in repair of toxin-mediated epithelial damage via intestinal eosinophil and ILC2 activation. The microbiota impacts various immune pathways that aid in recovery from C. difficile colitis, thus underscoring the importance of monitoring the immune responses before and after FMT therapy. [ABSTRACT FROM AUTHOR]