Via National Public Radio, and as published in the medical journal Microbiome, here is a study for you to read over lunch. Fecal supplementation therapy has been utilized occasionally for more than a decade. A posting from 2 years ago showed the efficacy of fecal transplants in patients suffering from chronic Clostridium difficile infections, and a student guest posting from last semester offered an improvement in the technology with a preliminary analysis in mice.
The principle is rather easy to understand; C. difficile generally causes disease in situations when it is a major component of the bacteria, after having outgrown the normal bacteria at that site. If the balance between the numbers of disease-causing bacteria and normal bacteria can be shifted back, disease should go away. Fecal transplants and fecal bacteria supplementation therapy are designed to do exactly this, and this is also the principle behind probiotic food supplements with regards to their potential contribution to digestive health. The problem with most probiotic bacteria (the kinds you get in yogurt or in pill form as a dietary supplement) is that they do not survive the passage through the low pH environment of the stomach. Consequently, fecal transplants and fecal supplementation therapies need to bypass the stomach to be useful, and in general bypass the “ick” factor with patients.
The researchers from three universities in Ontario, Canada performed a molecular analysis on the fecal bacterial profiles of several healthy volunteers. Non-pathogenic organisms were isolated in pure culture and grown in the laboratory in bacteriological media. Pure cultures of organisms were then mixed in defined amounts, based on the molecular profile analysis of the healthy volunteers, to produce a mixture of microorganisms in approximately the same proportions that they would be found in the lower digestive tract. This mixture was introduced into two patients suffering from multiple drug resistant C. difficile infection (CDI) during a routine colonoscopy procedure.
The figure summarizes one of the patient histories, treatment regimens, and medical outcomes. The trial procedure was done with two patients with similar disease histories, and in both cases the patients were completely symptom free at 32 weeks post-procedure. The researchers are following up this pilot study by enrolling additional patients, and by also examining the long-term persistence of the RePOOPulate bacteria in animal models with administered antibiotics. The authors note that treatment options in patients with multiple drug resistant C. difficile infections are essentially non-existent, and that repopulation by normal microorganisms represent the most effective approaches today.
A quick bonus for one lucky recipient who read down this far; why do you think I picked the graphic up at the top? Comment below!