Feces capsules against intestinal inflammation

New variant of stool transplantation with feces capsules

15/10/2014

Pathological proliferation of the intestinal bacterium Clostridium difficile can lead to life-threatening intestinal inflammation. Here, a therapy with the help of so-called stool transplants offers a possible starting point to stabilize the intestinal flora and to push back the spread of the pathogenic bacterium. The research team led by Elizabeth Hohmann of the Harvard Medical School in Boston has now tested a new method of so-called fecal microbiota transplantation (FMT), in which orally administered fecal capsules replace the more expensive procedures of stool transplantation. The results were presented by the scientists in the renowned journal „Journal of the American Medical Association“ (JAMA).

Antibiotics is regarded as a miracle weapon of modern medicine and has saved millions of lives in the past. However, the medicines also attack the intestinal flora, which causes them to lose their balance and that individual intestinal bacteria can pathologically multiply. One of these bacteria is Clostridium difficile. Although the bacteria themselves are rather harmless to humans, they are found in the intestines of many patients. However, Clostridium excretes difficile toxins (toxins), which can lead to damage to the intestine in larger quantities. Thus, after taking antibiotics threatens an antibiotic-associated colitis (colitis), which can be fatal in the worst case.

Previous methods of stool transplantation are extremely impractical
Patients suffering from symptoms such as stinging abdominal pain, diarrhea and fever following antibiotic treatment suspect that pathogens in the intestine may multiply excessively. The intestinal flora is permanently disturbed and in severe Clostridium difficile infections may possibly use a dissolution of the intestinal wall, which leads to life-threatening blood poisoning. The stool transplantation of a healthy fellow human here is a promising measure to restore the balance of the intestinal flora. However, previous methods were rather unsuitable for use in medical practice. Because it required fresh Stuhlsuspensionen, which were mostly taken by relatives of the patients. To make sure that stool samples do not pose a risk, it was first necessary to identify suitable, healthy donors and then to thoroughly examine the stool samples, write Hohmann and colleagues. However, since the fresh stool samples are only about six hours durable, here is a time problem. In addition, the current practice of stool transplantation via a tube compared to the intake of faeces capsules is extremely impractical.

Kot capsules without side effects and with good treatment results
In their study, the researchers tested the use of FMT capsules stored at minus 80 degrees Celsius on twenty patients, the average age of 64.5 years, who had undergone multiple episodes of moderate to severe Clostridium difficile infection. Patients received 15 capsules on two consecutive days and were subsequently followed for a six-month period to detect the onset of clinical symptoms and side effects, the researchers report. It should be noted that no serious adverse events were caused by the fecal capsules. In a total of 90 percent of the subjects had the treatment led to a resolution of the diarrhea. Although are „larger studies needed to confirm these findings and to assess long-term safety and efficacy“, but overall, FMT capsules offer a promising approach for treating antibiotic-associated bowel inflammation, according to the findings of Elizabeth Hohmann and colleagues. (Fp)