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Stool transplant donors must fit the recipient
In recent years, a new therapy for severe diarrheal diseases has been increasingly reported. In so-called stool transplantation, people whose intestinal flora is out of whack is transferred a mixture of bacteria from the faeces of a healthy person. The microbes of donor and recipient should be as similar as possible.
Bacterial mix from the stool of a healthy person
It has been known for years that stool transplants can help against severe diarrhea. In this method, formerly known as "fecal therapy", patients whose intestinal flora is out of balance, the bacterial mix from the stool of a healthy man is transmitted. A new study now suggests that donor and recipient should be better coordinated in stool transplants to enhance their effects. As the "mirror" reports online, therefore, those strains of bacteria that previously lived in the gut of the recipient, settle better in the months after the procedure. The team around Peer Bork from the European Molecular Biology Laboratory (EMBL) in Heidelberg concludes that the compatibility between donor and recipient is more important than previously assumed. The researchers report in the journal "Science" about their new findings.
If the intestinal flora is out of balance, some patients may help with stool transplants. Donor and recipient should fit together. (Image: Alex / fotolia.com) Success rate of over 90 percent
In animals, the stool grafting has been used for some time. In human medicine, the issue received much attention when researchers from Amsterdam published a study in early 2013 in The New England Journal of Medicine, which covered people whose bowels had been spread by the notorious diarrheal germ Clostridium difficile. The scientists at EMBL now report that the success rate of stool transplantation in recurrent infections with the intestinal bacterium Clostridium difficile, which can cause life-threatening diarrheal diseases, is over 90 percent. The bacillus bacterium is usually harmless to healthy people, but can be particularly dangerous to the weakened and elderly. In Europe alone, there are over 39,000 undetected Clostridium difficile infections each year. After a stool transplantation, digestive problems such as diarrhea, stomach cramps or flatulence usually occur only for a short time. However, cases have also been described with other unwanted side effects. For example, the case of a woman was reported who had a high weight gain after stool transplantation.
Antibiotics attack intestinal flora
In the current study, the physicians analyzed in ten patients for three months how the intestinal flora changed after a stool transplantation. They not only observed how bacterial species developed, but also differentiated between the different strains of a species. The recipients had taken in the months before and after the procedure no antibiotics, because these attack the intestinal flora with. It was found that after the procedure those microbial strains best settled in the intestine of the patient, who already lived there before. Consequently, one could increase the chance of success of the method, if you better tune donor and recipient to each other. It is not just about the species, but also about the respective tribes.
The target is a kind of fecal pill
In so-called chair banks so far only one unit mix is offered. However, since this preparation only fits a small proportion of patients correctly, individual adaptation would be better in order to optimize stool transplantation. "Ultimately, the goal is to develop a chair transplant in the form of a pill," says first author Simone Li from the EMBL. "Our work shows that this will most likely be more of a personalized bacteria cocktail than a patent solution for everyone." For those who do not want to wait for the fecal pill, there are also the "do-it-yourself" Guided by Canadian gastroenterologist Michael Silverman, published years ago in the magazine "Clinical Gastroenterology and Hepatology". It describes how to use a stool dispenser, saline solution, hand mixer and an enema bag to recolonise his bowel by hand. (Ad)