Study: chair flora transplantation in the treatment of colon and metabolic diseases

Reference

Grehan MJ, Borody TJ, Leis SM, Campbell J, Mitchell H, Wettstein A. Permanent change in the intestinal microbiota by administering the donor's stool flora. J Clin Gastroenterol. 2010; 44 (8): 551-561.

participant

Ten patients who undergo "faecal bacteriotherapy", which is often referred to in the United States as "faecal transplant". The intestine is cleaned with antibiotics and then administered chair suspensions of healthy donors every day. In this study, the first infusion about a colonoscopy was administered and the following doses were administered over a period of 60 minutes over a nasal jejunal hose or via enema. The intestinal flora was analyzed 4, 8 and 24 weeks after the first infusion and compared with the originally infused chair suspension of the donor to determine whether the donor flora had developed into a stable microbiota of the chair.

most important knowledge

In every post-infusion interval in which the samples were evaluated, "the bacterial populations in the stool samples of the patients mostly consisted of bacteria that came from the samples of healthy donors." ... This is a groundbreaking study and suggests that manipulation of the microbiota of the large intestine is effective and is promising for new therapies in the treatment of colon or metabolic diseases. ”

A stool transplant is nothing new. Case reports that describe this technique go back to the late 1950s. A report by Eiseman et al. is considered the first to describe the use of stool inlays, in this case to treat pseudomembranous enterocolitis.

This is a groundbreaking study and suggests that manipulation of the microbiota of the large intestine is effective and is promising for new therapies in the treatment of colon or metabolic diseases.

Since then there have been a number of reports on the use of donor chair, which was administered both rectally and via a gastric tube.

Two other reports on chair transplants were in the same September edition of the published magazine for clinical gastroenterology like the study by Grehan et al. They are of almost the same importance as Grehan's study and deserve special mention.

in a report report yoon et al. from the Montefiore Medical Center in the Bronx over 12 cases of c. Difficile successfully treated with donor droppings, which was transplanted into the large intestine by colonoscopy. Reports again over 19 patients with c. Difficile treats with a stool transplantation that is carried out via colonoscopes. The treatment was successful in all 19 patients treated and patients remained disease -free after a follow -up period of 6 months to 4 years.

This therapy can be useful in the treatment of other types of illnesses apart from gastroenteritis.

Borody et al. reported on remarkable results in a small study on the treatment of ulcerative colitis (UC) with chair transplant therapy in 2003. They treated 6 patients with "severe, recurring symptoms in which UC was confirmed by colonoscopy and histology". Using "Retention increments ..., which were repeated for 5 days a day, a complete reversal of the symptoms was reached in all patients after 4 months ... At that time, all other UC medication was deposed." At the age of 1 to 13 years ... there were no patient clinical, colonoscopic or histological indications on UC. "

Borody is currently recruiting participants for a study in which stool transplants are used to treat Parkinson's patients.

At a conference in September 2010, Anne Vrieze and colleagues described the results after the transplantation of the chair flora of lean donors in patients with metabolic syndrome. Her study was a double -blind, randomized, controlled study. Starting with 18 male subjects with a newly diagnosed metabolic syndrome, half received stool material from lean male donors and the other half was implanted as a control. At the end of the study, the sober triglyceride levels at the subjects who received donor droppings were significantly reduced. No effect was observed in the control group, which was again administered their own droppings. The peripheral and hepatic insulin sensitivity improved significantly after 6 weeks in the test group, but not in the control group. ¹³

Current knowledge indicates that the intestinal community of the bacterial flora contains at least 1 x 10 bacteria, which consist of 500 to 1,000 different types of bacteria. ^{14 Our current methodology is obvious to test this in order to identify only a handful of types and with more To treat limited trunks of "probiotics", possibly a simple approach to achieve permanent benefits. Even if the stool transplantation sounds primitive, it could actually be a more demanding option and offer the ability to reproduce a healthy daring mökosystem in sick patients. As unattractive as it may sound, it could prove to be useful therapy in the coming years.}