{"id":1565,"date":"2019-05-25T19:42:32","date_gmt":"2019-05-25T16:42:32","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=1565"},"modified":"2019-05-28T16:19:31","modified_gmt":"2019-05-28T13:19:31","slug":"fekal-mikrobiyota-transplantasyonu-fmt","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/fekal-mikrobiyota-transplantasyonu-fmt\/","title":{"rendered":"FEKAL M\u0130KROB\u0130YOTA TRANSPLANTASYONU (FMT)"},"content":{"rendered":"\n<p>K\u00f6keni 4. y\u00fczy\u0131la dayanan ama bakteri geneti\u011fi ve i\u015flevi ile ili\u015fkili ara\u015ft\u0131rmalar son y\u0131llarda h\u0131z kazand\u0131\u011f\u0131 i\u00e7in ancak  g\u00fcn\u00fcm\u00fczde pop\u00fclerle\u015febilmi\u015f  &#8220;Fekal Mikrobiyota Transplantasyonu&#8221;Sa\u011fl\u0131kl\u0131 bir insan\u0131n d\u0131\u015fk\u0131s\u0131ndan elde edilen mikrobiyal solusyonun hasta ki\u015finin Gastrointestinal Sistemine nakledilmesidir.<\/p>\n\n\n\n<p><br> Konunun detaylar\u0131na ge\u00e7meden \u00f6nce k\u0131saca tarih\u00e7esinden bahsedecek olursak; ilk kez \u00c7in&#8217;de 4. y\u00fczy\u0131lda g\u0131da zehirlenmesi ve a\u011f\u0131r diyare ge\u00e7iren insanlara oral yoldan uygulanm\u0131\u015ft\u0131r ve sol\u00fcyona  &#8220;Sar\u0131 \u00c7orba&#8221; ad\u0131 verilmi\u015ftir.  16. y\u00fczy\u0131lda hastalar\u0131n diyare, kab\u0131zl\u0131k vb. gibi \u015fikayetleri ortadan kald\u0131rmak i\u00e7in uygulan\u0131rken  ve 17. y\u00fczy\u0131lda veterinerlik alan\u0131nda kullan\u0131lm\u0131\u015ft\u0131r. 2. D\u00fcnya Sava\u015f\u0131&#8217;nda Afrika&#8217;da Alman askerleri taraf\u0131ndan kullan\u0131lan FMT, modern t\u0131pta ilk kez Eiseman B. taraf\u0131ndan 1958 y\u0131l\u0131nda kullan\u0131lm\u0131\u015ft\u0131r. G\u00fcn\u00fcm\u00fczde ise, antibiyotik tedavisi yetersiz kald\u0131\u011f\u0131nda tekrarlayan Clostridium difficile enfeksiyonlu hastalar i\u00e7in tercih edilen bir tedavi y\u00f6ntemi olmu\u015ftur.<\/p>\n\n\n\n<p><br> Gastrointestinal mikrobiyotas\u0131n\u0131 bir doku gibi kabul etmemiz gerekir.\u00c7\u00fcnk\u00fc gastrointestinal sistemdeki mikrobiyota miktar\u0131 v\u00fccudumuzdaki t\u00fcm h\u00fccrelerin say\u0131s\u0131ndan 10 kat daha fazlad\u0131r. V\u00fccudumuzda mikroorganizmalar en \u00e7ok deri, solunum, genito\u00fcriner ve gastrointestinal sistemde bulunurken, bunun %70&#8217;i kolonda bulunmaktad\u0131r.\u0130ntestinal mikrobiyotan\u0131n; canl\u0131larda metabolik, fizyolojik ve imm\u00fcnolojik  olaylarda rol\u00fc b\u00fcy\u00fckt\u00fcr. \u0130ntestinal sistem mikrobiyotas\u0131n\u0131n v\u00fccuttaki bu denli \u00f6nemli mekanizmalarda \u00f6nemli bir rol\u00fcn\u00fcn olmas\u0131  son y\u0131llarda kendisinin ilgi oda\u011f\u0131 olmas\u0131na sebep olmu\u015f ve son zamalarda yap\u0131lan bilimsel \u00e7al\u0131\u015fmalar\u0131n \u00e7o\u011funun odak noktas\u0131 olmu\u015ftur.1990&#8217;lara kadar hakk\u0131nda yap\u0131lan \u00e7al\u0131\u015fma say\u0131s\u0131 100 civar\u0131ndayken, 2010&#8217;lu y\u0131llara geldi\u011fimizde hakk\u0131nda yap\u0131lan \u00e7al\u0131\u015fmalar\u0131n 500&#8217;\u00fc a\u015fmas\u0131 bu konunun ne kadar da pop\u00fclerle\u015fti\u011finin g\u00f6stergesidir.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"text-align:center\" class=\"has-background has-vivid-cyan-blue-background-color\"><strong>\u0130ntestinal Mikrobiyota<\/strong><\/p>\n\n\n\n<p>\u0130nsan gastrointestinal (GI) sistemi, insan v\u00fccudundaki konak\u00e7\u0131, \u00e7evresel fakt\u00f6rler ve antijenler aras\u0131ndaki en b\u00fcy\u00fck aray\u00fczlerden (250-400 m2) birini temsil eden bir sistemdir.GI kanal\u0131n\u0131 kolonize eden bakteri, arke ve \u00f6karyot toplulu\u011funa &#8216;ba\u011f\u0131rsak mikrobiyotas\u0131&#8217; denir ve karma\u015f\u0131k ve kar\u015f\u0131l\u0131kl\u0131 olarak yararl\u0131 bir ili\u015fki olu\u015ftururlar.Mikrobiyota, ba\u011f\u0131rsak b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fcn veya ba\u011f\u0131rsak epitelinin \u015fekillendirilmesi hatta korunmas\u0131nda, enerji sa\u011flanmas\u0131nda, patojenlere kar\u015f\u0131 korunmas\u0131nda  ve konak\u00e7\u0131n\u0131n ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n\u0131n d\u00fczenlenmesinde ve daha nice \u00e7e\u015fitli fizyolojik fonksiyonlar d\u00fczenleyerek konak\u00e7\u0131ya bir\u00e7ok fayda sa\u011flar.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"text-align:center\" class=\"has-background has-vivid-cyan-blue-background-color\"><strong>\u0130ntestinal Mikrobiyotan\u0131n Geli\u015fimi<\/strong><\/p>\n\n\n\n<p>Bebeklerde \u0130ntestinal Mikrobiyotan\u0131n kolonize olmas\u0131 gastrointestinal ve imm\u00fcn sistemin geli\u015fiminde \u00e7ok \u00f6nemlidir. Do\u011fum s\u0131ras\u0131nda yenido\u011fan\u0131n vajinal kanaldaki bir\u00e7ok mikroorganizma ile kar\u015f\u0131la\u015fmas\u0131 sindirim sistemi mikrobiyotas\u0131n\u0131n olu\u015fumunda \u00f6nemlidir. Do\u011fumun ger\u00e7ekle\u015fti\u011fi yol, bebe\u011fin sindirim sisteminin mikrobiyotas\u0131n\u0131 do\u011frudan etkiledi\u011fi bilinen bir ger\u00e7ek.<\/p>\n\n\n\n<p><br> \u0130nfantlarda gastrointestinal sistem mikrobiyotas\u0131n\u0131 etkileyen di\u011fer \u00f6nemli fakt\u00f6rler; beslenme \u015fekli, gestasyonel ya\u015f, hospitalizasyon ve infantil d\u00f6nemde s\u0131k antibiyotik kullan\u0131m\u0131d\u0131r.<\/p>\n\n\n\n<p><br> Yeti\u015fkinlikte, intestinal mikrobiyota son \u015feklini al\u0131r ve intestinal mikrobiyotan\u0131n %95&#8217;ini Firmicute ve Bacteriodes kapsar.<\/p>\n\n\n\n<p><br> Ya\u015f\u0131n ilerlemesiyle birlikte gastrointestinal sistemde hem bakteri say\u0131s\u0131nda hem de bakteri \u00e7e\u015fitlili\u011finde belirgin azalmalar meydana gelir. Bunda ila\u00e7 kullan\u0131m\u0131, diyet, ya\u015fam ko\u015fullar\u0131 fazlas\u0131yla etkindir.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"text-align:center\" class=\"has-background has-vivid-cyan-blue-background-color\"><strong>Fekal Mikrobiyota Transplantasyonu<\/strong><\/p>\n\n\n\n<p>Fekal Mikrobiyota Transplantasyonu sa\u011fl\u0131kl\u0131 bireyden al\u0131nan d\u0131\u015fk\u0131n\u0131n s\u0131v\u0131 bir kar\u0131\u015f\u0131ma d\u00f6n\u00fc\u015ft\u00fcr\u00fcl\u00fcp spesifik hastal\u0131klar\u0131 olan bireylere transfer edilmesidir. Ba\u011f\u0131rsak floras\u0131nda bulunan yararl\u0131 bakterilerin transferi hem ba\u011f\u0131rsak mikrobiyomunu g\u00fc\u00e7lendirmeye hem de semptomlar\u0131 azaltmaya y\u00f6neliktir.<\/p>\n\n\n\n<p><br> S\u00fcre\u00e7 ilk olarak, aile ge\u00e7mi\u015finde otoimm\u00fcn, metabolik ve malignant  hastal\u0131\u011f\u0131n olup olmamas\u0131n\u0131n tespitiyle ve herhangi bir potansiyel patojenin  taranmas\u0131yla ba\u015flar. Sonras\u0131nda fe\u00e7es su veya tuzlu suyla kar\u0131\u015ft\u0131r\u0131l\u0131p filtrelenir.Kar\u0131\u015f\u0131m, bir nazogastrik t\u00fcp, nazojejunal t\u00fcp, \u00f6zofagogastroduodenoskopi, kolonoskopi veya tutma lavman\u0131 yoluyla uygulanabilir. FMT ile ilgili \u00e7o\u011fu klinik deneyim, tekrarlayan veya refrakter Clostridium difficile enfeksiyonunun tedavisinden kaynaklanmaktad\u0131r.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"text-align:center\" class=\"has-background has-vivid-cyan-blue-background-color\"><strong>Fekal Mikrobiyota Transplantasyonuna Uygun Adaylar<\/strong><\/p>\n\n\n\n<p>FMT, tedavi edilmesi zor olan veya \u00fc\u00e7 seferden fazla tekrarlayan Clostridium Efficile infeksiyonlar\u0131 i\u00e7in uygulan\u0131r. Fazla antibiyotik kullan\u0131m\u0131ndan kaynakl\u0131 yararl\u0131 bakterilerin say\u0131ca azalmas\u0131, zararl\u0131 C. Difficile  bakterisinin prolifere olmas\u0131na sebebiyet verir ve bu hastalarda ciddi diyare g\u00f6zlenir. C. Difficile bakterisi normalde antibiyotikle tedavi edilebilse de, baz\u0131 hastalarda antibiyotik fayda etmemektedir. \u0130\u015fte bu hastalara FMT uygulan\u0131r.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"text-align:center\" class=\"has-background has-vivid-cyan-blue-background-color\"><strong>Fekal Mikrobiyotan\u0131n Transplantasyonunun Yan Etkileri<\/strong><\/p>\n\n\n\n<p>FMT&#8217;nin yan etkileri aras\u0131nda hafif kar\u0131n rahats\u0131zl\u0131\u011f\u0131, kramp, \u015fi\u015fkinlik, ishal veya kab\u0131zl\u0131k ve nadiren tarama ile test edilemeyen hastal\u0131klar\u0131n bula\u015fmas\u0131 bulunur. Ate\u015f, \u015fiddetli kar\u0131n a\u011fr\u0131s\u0131 veya \u015fi\u015flik ya da a\u00e7\u0131k k\u0131rm\u0131z\u0131 veya siyah kan i\u00e7eren kusma veya d\u0131\u015fk\u0131 g\u00f6r\u00fcrseniz, t\u0131bbi yard\u0131m alman\u0131z gerekir.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p class=\"has-background has-pale-cyan-blue-background-color\"><strong>KAYNAKLAR:<\/strong><\/p>\n\n\n\n<ol><li>http:\/\/guncel.tgv.org.tr\/journal\/56\/pdf\/100307.pdf<\/li><li>https:\/\/www.klimik.org.tr\/wp-content\/uploads\/2018\/05\/FEKAL-M%C4%B0KROB%C4%B0YOTA-TRANSPLANTASYONU-Tarkan-Karakan.pdf<\/li><li>https:\/\/www.turkiyeklinikleri.com\/article\/tr-fekal-mikrobiyota-transplantasyonu-endikasyonlar-ve-uygulamalar-83142.html<\/li><li>https:\/\/dergipark.org.tr\/download\/article-file\/378365<\/li><li>https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5433529\/<\/li><li>https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4749851\/<\/li><li>https:\/\/academic.oup.com\/femsec\/article\/79\/3\/763\/492968<\/li><li>https:\/\/aga-cms-assets.s3.amazonaws.com\/201951716551&#8212;CGHPDF_FMT.pdf<\/li><li>https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2635633<\/li><li>https:\/\/dergipark.org.tr\/download\/article-file\/422718<\/li><li><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>K\u00f6keni 4. y\u00fczy\u0131la dayanan ama bakteri geneti\u011fi ve i\u015flevi ile ili\u015fkili ara\u015ft\u0131rmalar son y\u0131llarda h\u0131z kazand\u0131\u011f\u0131 i\u00e7in ancak g\u00fcn\u00fcm\u00fczde pop\u00fclerle\u015febilmi\u015f<\/p>\n","protected":false},"author":52,"featured_media":1568,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,165],"tags":[187,184,181,183,185,186,182],"acf":[],"views":1790,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1565"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/52"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=1565"}],"version-history":[{"count":9,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1565\/revisions"}],"predecessor-version":[{"id":1576,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1565\/revisions\/1576"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/1568"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=1565"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=1565"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=1565"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}