Fecal transplant: a promising route?
This will surprise more than one person: using stool for therapeutic purposes did not start yesterday.12 But recent discoveries regarding the involvement of the intestinal bacteria in metabolic diseases have opened up a new field of research which aims to develop fecal transplants that are more targeted and better accepted clinically and psychologically
This will surprise more than one person: using stool for therapeutic purposes did not start yesterday. But recent discoveries regarding the involvement of the intestinal bacteria in metabolic diseases have opened up a new field of research which aims to develop fecal transplants that are more targeted and better accepted clinically and psychologically
Conclusive first steps
But trials in humans in this field are just beginning. The first study was carried out in 2012 in Dutch patients: half of them received the stools of healthy donors; the others received their own stools (placebo group). The donor stools were analyzed carefully to eliminate any risk of infection by viruses, parasites or harmful bacteria. Then the transplant took place over a thirty-minute period by injection into a tube, introduced into the noses of patients, which opened out into the small intestine. Six weeks later, those who received “healthy” stools exhibited improved insulin sensitivity and increased numbers of bacteria producing metabolically beneficial butyric acid. This first attempt can thus be counted as a success!
A modus operandi to be refined
The use of FMT in metabolic diseases still has a long way to go, with manychallenges to be faced: the medical history and the microbiotas of donors must be irreproachable to avoid any transmission of diseases and strains chosen in an appropriate manner and in the right quantity. Other issues: how will the donor flora be welcomed by that of the recipient? Will a single injection be sufficient for long-term colonization? Finally, a considerable psychological limitation: the inevitable repulsion of some patients in the face of this still little-known treatment, unless FMT becomes a common therapeutic practice, knowing that its spectrum of potential applications could extend to multiple sclerosis, Parkinson’s Disease or chronic fatigue syndrome. Who knows? Perhaps the future will see the advent of stool banks and capsules.
12 de Groot PF, Frissen MN, de Clercq NC, Nieuwdorp M. Fecal microbiota transplantation in metabolic syndrome: History, present and future. Gut Microbes. 2017 May 4;8(3):253-267. doi: 10.1080/19490976.2017.1293224