[开放获取]    肠道菌群移植治疗银屑病专家共识（2026版）

doi:10.35541/cjd.20250564

Abstract

Abstract: 【Abstract】 Psoriasis is an immune-mediated, chronic, inflammatory, and relapsing disease. In addition to conventional treatments and biologic therapies, fecal microbiota transplantation（FMT） can modulate the gut-microbe-skin axis, thereby alleviating psoriatic symptoms. To further standardize the clinical exploration and application of FMT in the treatment of psoriasis, the Chinese Society of Dermatology, the China Dermatologist Association and other academic organizations developed this expert consensus, which addresses 8 key clinical questions of concern to clinicians. Following discussions among an expert group, 8 evidence-based recommendations for the use of FMT in the treatment of psoriasis were formulated, aiming to provide guidance for clarifying and standardizing the specific clinical application of FMT in the treatment of psoriasis.

Key words: Psoriasis, Therapeutics, Diagnosis, Practice guidelines, Aged, Fecal microbiota transplantation, Expert consensus, Recommendation

Chinese Society of Dermatology, China Dermatologist Association, Dermatology Branch of China International Exchange and Promotive Association for Medical and Health Care, Dermatology Branch of China Alliance for Rare Diseases. Expert consensus on fecal microbiota transplantation in the treatment of psoriasis （2026 edition）[J]. Chinese Journal of Dermatology, 2026, 59(5): 427-435.doi:10.35541/cjd.20250564

References ［54］

［1］	中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南（2023版）［J］. 中华皮肤科杂志, 2023,56（7）:573⁃625. DOI: 10.35541/cjd.20220839.
［2］	Diotallevi F, Campanati A, Martina E, et al. The role of nutrition in immune⁃mediated, inflammatory skin disease: a narrative review［J］. Nutrients, 2022,14（3）:591. DOI: 10.3390/nu14030591.
［3］	Visser MJE, Kell DB, Pretorius E. Bacterial dysbiosis and translocation in psoriasis vulgaris［J］. Front Cell Infect Microbiol, 2019,9:7. DOI: 10.3389/fcimb.2019.00007.
［4］	Polkowska⁃Pruszynska B, Gerkowicz A, Krasowska D. The gut microbiome alterations in allergic and inflammatory skin diseases ⁃ an update［J］. J Eur Acad Dermatol Venereol, 2020,34（3）:455⁃464. DOI: 10.1111/jdv.15951.
［5］	Groeger D, O'Mahony L, Murphy EF, et al. Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut［J］. Gut Microbes, 2013,4（4）:325⁃339. DOI: 10.4161/gmic.25487.
［6］	殷广, 李剑锋, 孙玉发, 等. 肠微生态移植重建治疗重度银屑病的临床研究［J］. 中华内科杂志, 2019,58（10）:782⁃785. DOI: 10.3760/cma.j.issn.0578⁃1426.2019.10.011.
［7］	Kragsnaes MS, Kjeldsen J, Horn HC, et al. Safety and efficacy of faecal microbiota transplantation for active peripheral psoriatic arthritis: an exploratory randomised placebo⁃controlled trial［J］. Ann Rheum Dis, 2021,80（9）:1158⁃1167. DOI: 10.1136/annrheumdis⁃2020⁃219511.
［8］	Chen YN, Chi CC. Levels of evidence and study designs: a brief introduction to dermato⁃epidemiologic research methodology［J］. Dermatologica Sinica, 2023,41（4）:199⁃205. DOI: 10.4103/ds.DS⁃D⁃23⁃00159.
［9］	中华人民共和国国家卫生健康委员会医政司. 原发性肝癌诊疗指南（2024年版）［J］. 中华消化外科杂志, 2024,23（4）:429⁃478. DOI: 10.3760/cma.j.cn115610⁃20240415⁃00203.
［10］	Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease［J］. Arthritis Rheumatol, 2015,67（1）:128⁃139. DOI: 10.1002/art.38892.
［11］	王丽玮, 徐浩翔, 段志敏, 等. 基于 16S rRNA 基因测序的寻常型银屑病患者肠道菌群差异研究［J］. 中华皮肤科杂志, 2020,53（9）:692⁃697. DOI: 10.35541/cjd.20200208.
［12］	Doaa M, Dalia M, Ahmed FS. Gut bacterial microbiota in psoriasis: a case control study［J］. Afr J Microbiol Res, 2016,10（33）:1337⁃1343. DOI: 10.5897/AJMR2016.8046.
［13］	Hidalgo⁃Cantabrana C, Gomez J, Delgado S, et al. Gut microbiota dysbiosis in a cohort of patients with psoriasis［J］. Br J Dermatol, 2019,181（6）:1287⁃1295. DOI: 10.1111/bjd.17931.
［14］	Zhang X, Shi L, Sun T, et al. Dysbiosis of gut microbiota and its correlation with dysregulation of cytokines in psoriasis patients［J］. BMC Microbiol, 2021,21（1）:78. DOI: 10.1186/s12866⁃021⁃02125⁃1.
［15］	Codoner FM, Ramirez⁃Bosca A, Climent E, et al. Gut microbial composition in patients with psoriasis［J］. Sci Rep, 2018,8（1）:3812. DOI: 10.1038/s41598⁃018⁃22125⁃y.
［16］	Tan L, Zhao S, Zhu W, et al. The Akkermansia muciniphila is a gut microbiota signature in psoriasis［J］. Exp Dermatol, 2018,27（2）:144⁃149. DOI: 10.1111/exd.13463.
［17］	Ashrafian F, Behrouzi A, Shahriary A, et al. Comparative study of effect of Akkermansia muciniphila and its extracellular vesicles on Toll⁃like receptors and tight junction［J］. Gastroenterol Hepatol Bed Bench, 2019,12（2）:163⁃168. DOI: 10.22037/GHFBB.V12I2. 1537.
［18］	Hiippala K, Jouhten H, Ronkainen A, et al. The potential of gut commensals in reinforcing intestinal barrier function and alleviating inflammation［J］. Nutrients, 2018,10（8）:988. DOI: 10.3390/nu10080988.
［19］	Eppinga H, Sperna Weiland CJ, Thio HB, et al. Similar depletion of protective Faecalibacterium prausnitzii in psoriasis and inflammatory bowel disease, but not in hidradenitis suppurativa［J］. J Crohns Colitis, 2016,10（9）:1067⁃1075. DOI: 10.1093/ecco⁃jcc/jjw070.
［20］	De Francesco MA, Caruso A. The gut microbiome in psoriasis and Crohn's disease: is its perturbation a common denominator for their pathogenesis?［J］. Vaccines（Basel）, 2022,10（2）:244. DOI: 10.3390/vaccines10020244.
［21］	Sikora M, Stec A, Chrabaszcz M, et al. Gut microbiome in psoriasis: an updated review［J］. Pathogens, 2020,9（6）:463. DOI: 10.3390/pathogens9060463.
［22］	Zhao Q, Yu J, Zhou H, et al. Intestinal dysbiosis exacerbates the pathogenesis of psoriasis⁃like phenotype through changes in fatty acid metabolism［J］. Signal Transduct Target Ther, 2023,8（1）:40. DOI: 10.1038/s41392⁃022⁃01219⁃0.
［23］	De Jesus⁃Gil C, Ruiz⁃Romeu E, Ferran M, et al. CLA+ T cell response to microbes in psoriasis［J］. Front Immunol, 2018,9:1488. DOI: 10.3389/fimmu.2018.01488.
［24］	Zakostelska Z, Malkova J, Klimesova K, et al. Intestinal microbiota promotes psoriasis⁃like skin inflammation by enhancing Th17 response［J/OL］. PLoS One, 2016,11（7）:e0159539［2025⁃09⁃25］. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159539. DOI: 10.1371/journal.pone. 0159539.
［25］	Pantelyushin S, Haak S, Ingold B, et al. Rorgammat+ innate lymphocytes and gammadelta T cells initiate psoriasiform plaque formation in mice［J］. J Clin Invest, 2012,122（6）:2252⁃2256. DOI: 10.1172/JCI61862.
［26］	Okada K, Matsushima Y, Mizutani K, et al. The role of gut microbiome in psoriasis: oral administration of Staphylococcus aureus and Streptococcus danieliae exacerbates skin inflammation of imiquimod⁃induced psoriasis⁃like dermatitis［J］. Int J Mol Sci, 2020,21（9）:3303. DOI: 10.3390/ijms21093303.
［27］	Gopalarathinam R, Sankar R, Zhao SS. Role of anti⁃inflammatory diet and fecal microbiota transplant in psoriatic arthritis［J］. Clin Ther, 2024,46（7）:588⁃596. DOI: 10.1016/j.clinthera.2024.05.005.
［28］	Chen HL, Zeng YB, Zhang ZY, et al. Gut and cutaneous microbiome featuring abundance of Lactobacillus reuteri protected against psoriasis⁃like inflammation in mice［J］. J Inflamm Res, 2021,14:6175⁃6190. DOI: 10.2147/JIR.S337031.
［29］	Zou X, Zou X, Gao L, et al. Gut microbiota and psoriasis: pathogenesis, targeted therapy, and future directions［J］. Front Cell Infect Microbiol, 2024,14:1430586. DOI: 10.3389/fcimb. 2024.1430586.
［30］	Kragsnaes MS, Jensen JRB, Nilsson AC, et al. Dynamics of inflammation⁃associated plasma proteins following faecal microbiota transplantation in patients with psoriatic arthritis and healthy controls: exploratory findings from the FLORA trial［J］. RMD Open, 2024,10（1）:e003750. DOI: 10.1136/rmdopen⁃2023⁃003750.
［31］	中国微生态调节剂临床应用专家共识（2025版）编写组. 中国微生态调节剂临床应用专家共识（2025版）［J］. 中国微生态学杂志, 2025,37（8）:869⁃887. DOI: 10.13381/j.cnki.cjm.2025 08001.
［32］	中华医学会肠外肠内营养学分会，上海预防医学会微生态专业委员会. 肠道菌群移植供体筛选与管理中国专家共识（2022版）［J］. 中华胃肠外科杂志, 2022,25（9）:757⁃765. DOI: 10.3760/cma.j.cn441530⁃20220606⁃00246.
［33］	Cammarota G, Ianiro G, Tilg H, et al. European consensus conference on faecal microbiota transplantation in clinical practice［J］. Gut, 2017,66（4）:569⁃580. DOI: 10.1136/gutjnl⁃2016⁃313017.
［34］	Kassam Z, Dubois N, Ramakrishna B, et al. Donor screening for fecal microbiota transplantation［J］. N Engl J Med, 2019,381（21）:2070⁃2072. DOI: 10.1056/NEJMc1913670.
［35］	Cammarota G, Ianiro G, Kelly CR, et al. International consensus conference on stool banking for faecal microbiota transplantation in clinical practice［J］. Gut, 2019,68（12）:2111⁃2121. DOI: 10.1136/gutjnl⁃2019⁃319548.
［36］	何植, 张发明. 中华粪菌库的原则、方案和风险管理［J］. 胃肠病学, 2017,22（4）:193⁃198. DOI: 10.3969/j.issn.1008⁃7125. 2017.04.001.
［37］	中华医学会肠外肠内营养学分会, 中国国际医疗保健促进交流会加速康复外科分会, 中国微生态治疗创新联盟, 等. 菌群移植标准化方法学的建立与临床应用中国专家共识［J］. 中华胃肠外科杂志, 2020,23（S1）:5⁃13. DOI: 10.3760/cma.j.cn44 1530⁃20200420⁃00231.
［38］	中国抗癌协会肿瘤与微生态专业委员会, 中国感染免疫与微生态研究转化协作组. 肠菌移植制备和质控实验室标准化技术规范中国专家共识（2023版）［J］. 中国微生态学杂志, 2024,36（6）:705⁃711+717. DOI: 10.13381/j.cnki.cjm.202406013.
［39］	国家卫生健康委员会医院管理研究所, 中华医学会肠外肠内营养学分会, 中华医学会肠外肠内营养学分会肠道微生态协作组. 肠道菌群移植临床应用管理中国专家共识（2022版）［J］. 中华胃肠外科杂志, 2022,25（9）:747⁃756. DOI: 10.3760/cma.j.cn441530⁃20220725⁃00324.
［40］	Nivet C, Duhalde V, Beaurain M, et al. Fecal microbiota transplantation for refractory Clostridioides difficile infection is effective and well tolerated even in very old subjects: a real⁃life study［J］. J Nutr Health Aging, 2022,26（3）:290⁃296. DOI: 10. 1007/s12603⁃022⁃1756⁃1.
［41］	Ding X, Yang X, Wang H. Methodology, efficacy and safety of fecal microbiota transplantation in treating inflammatory bowel disease［J］. Medicine in Microecology, 2020,6:100028. DOI: 10. 1016/j.medmic.2020.100028.
［42］	Goldenberg SD, Batra R, Beales I, et al. Comparison of different strategies for providing fecal microbiota transplantation to treat patients with recurrent Clostridium difficile infection in two English hospitals: a review［J］. Infect Dis Ther, 2018,7（1）:71⁃86. DOI: 10.1007/s40121⁃018⁃0189⁃y.
［43］	Youngster I, Mahabamunuge J, Systrom HK, et al. Oral, frozen fecal microbiota transplant（FMT） capsules for recurrent Clostridium difficile infection［J］. BMC Med, 2016,14（1）:134. DOI: 10.1186/s12916⁃016⁃0680⁃9.
［44］	Wang JW, Kuo CH, Kuo FC, et al. Fecal microbiota transplantation: review and update［J］. J Formos Med Assoc, 2019,118（Suppl 1）:S23⁃S31. DOI: 10.1016/j.jfma.2018.08.011.
［45］	向丽园, 张发明. 粪菌移植在艰难梭菌感染治疗中的应用［J］. 临床荟萃, 2018,33（5）:385⁃389. DOI: 10.3969/j.issn.1004⁃583X.2018.05.005.
［46］	Minkoff NZ, Aslam S, Medina M, et al. Fecal microbiota transplantation for the treatment of recurrent Clostridioides difficile （Clostridium difficile）［J］. Cochrane Database Syst Rev, 2023,4（4）:CD013871. DOI: 10.1002/14651858.CD013871.pub2.
［47］	Huang C, Yi P, Zhu M, et al. Safety and efficacy of fecal microbiota transplantation for treatment of systemic lupus erythematosus: an EXPLORER trial［J］. J Autoimmun, 2022,130:102844. DOI: 10.1016/j.jaut.2022.102844.
［48］	中华医学会肠外肠内营养学分会, 中国国际医疗保健促进交流会加速康复外科分会, 中国微生态治疗创新联盟, 等. 菌群移植途径的选择与建立临床应用中国专家共识［J］. 中华胃肠外科杂志, 2020,23（S1）:14⁃20. DOI: 10.3760/cma.j.cn441530⁃ 20200420⁃00228.
［49］	Xin Y, Huang C, Zheng M, et al. Fecal microbiota transplantation in the treatment of systemic lupus erythematosus: what we learnt from the explorative clinical trial［J］. J Autoimmun, 2023,141:103058. DOI: 10.1016/j.jaut.2023.103058.
［50］	DeLeon O, Mocanu M, Tan A, et al. Microbiome mismatches from microbiota transplants lead to persistent off⁃target metabolic and immunomodulatory effects［J］. Cell, 2025,188（15）:3927⁃3941. DOI: 10.1016/j.cell.2025.05.014.
［51］	Navarro⁃López V, Martínez⁃Andrés A, Ramírez⁃Boscá A, et al. Efficacy and safety of oral administration of a mixture of probiotic strains in patients with psoriasis: a randomized controlled clinical trial［J］. Acta Derm Venereol, 2019,99（12）:1078⁃1084. DOI: 10.2340/00015555⁃3305.
［52］	Buhaș MC, Candrea R, Gavrilaș LI, et al. Transforming psoriasis care: probiotics and prebiotics as novel therapeutic approaches［J］. Int J Mol Sci, 2023,24（13）:11225. DOI: 10.3390/ijms2413 11225.
［53］	Hills RD Jr, Pontefract BA, Mishcon HR, et al. Gut microbiome: profound implications for diet and disease［J］. Nutrients, 2019,11（7）:1613. DOI: 10.3390/nu11071613.
［54］	Fishbein SRS, Mahmud B, Dantas G. Antibiotic perturbations to the gut microbiome［J］. Nat Rev Microbiol, 2023,21（12）:772⁃788. DOI: 10.1038/s41579⁃023⁃00933⁃y.

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Expert consensus on fecal microbiota transplantation in the treatment of psoriasis （2026 edition）

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