The 12th Invest in ME Conference, Part 1
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New frontiers of fecal microbiota transplantation

Discussion in 'Other Health News and Research' started by Waverunner, Aug 16, 2014.

  1. Waverunner

    Waverunner Senior Member

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    The yuck-post of the day ;). Just yesterday we had this post about IBD and the many things, which can go wrong and how the causes are not addressed in current clinical practice of medicine. Some good news. Gastroenterologists might be on the verge of being able to actually cure patients, improve their quality of live and get a lots of intestine related problems under control because we now start to get specific microbiome treatments. The solution for many problems seems to be found in the microbiome.

    Some highlights:

    Treating the microbiome lead to improvements and/or cure of 70% of IBS patients. It can be 100% effective in curing c. difficile and also works for IBD. It is also very promising, that we start to get microbiome pills, like SER-109. These can be taken like probiotics and have a remarkable effect. I feels good to know, that we are on the right way.

    American Gastroenterological Association. "New frontiers of fecal microbiota transplantation." ScienceDaily. ScienceDaily, 14 August 2014. <www.sciencedaily.com/releases/2014/08/140814124547.htm>.

    http://www.gastro.org/news/articles/2014/08/14/new-frontiers-of-fecal-microbiota-transplantation

    Fecal microbiota transplantation (FMT) is one of the most innovative new treatments of the 21st century. Experts believe that this procedure, which transplants microbes from one human gut to another through fecal matter, could offer the cure to a vast range of diseases and shed new light on the role of the microbiome in gastrointestinal diseases. New research presented this weekend at the American Gastroenterological Association's 2014 James W. Freston Conference in Chicago, IL, highlights significant advances in this field, and confirms the promise of FMT to advance our understanding of GI disease and aid in the development of new microbiome-based therapeutics to treat a broad range of GI disorders.

    "The 2014 AGA James W. Freston Conference promises to be an important and stimulating meeting in microbiome and FMT research and technology," said course directors Stacy A. Kahn, MD, and David T. Rubin, MD, AGAF, both from The University of Chicago Medicine. "This is the first international conference on FMT and brings together leaders from across the field and will highlight advances in basic science and clinical research. In addition, the conference will also create a forum to discuss the ethical and regulatory issues in this emerging field."

    FMT Beyond C. Difficile

    While FMT has been proven to be safe and effective for patients with recurrent C. difficile infection, its efficacy in treating other diseases is still in question. Data presented at the AGA James W. Freston Conference will provide evidence that FMT is an effective treatment for a range of other GI disorders. One study reports that 70 percent of subjects who received FMT for refractory irritable bowel syndrome (IBS) had a resolution and/or improved symptoms. Patients reported improved abdominal pain (72 percent), bowel habit (69 percent), dyspepsia (67 percent), bloating (50 percent) and flatus (42 percent). Quality of life was also improved in 46 percent of patients.

    Data also confirm the potential for FMT in treating inflammatory bowel disease (IBD), both ulcerative colitis and Crohn's disease. A study out of Montefiore Medical Center finds that colonoscopic FMT, followed by self-administered fecal enemas, resulted in improved symptoms and decreased medication requirements, especially in IBD patients with concomitant C. difficile infection.

    On the Horizon: Orally Delivered Microbes

    FMT has multiple liabilities, including invasive delivery, cost and complexity of donor management, variability of FMT preparation, and the potential to transmit pathogens. A new study, to be presented at the meeting, holds the answer to these challenges -- an orally delivered community of microbes. SER -- 109, developed by Seres Health, Inc., proved to be remarkably efficacious and safe with a 100 percent cure rate for the treatment of recurrent C. difficile infection in the study population. The pill works to rapidly repair the microbial imbalance cause by chronic antibiotic treatment for C. difficile by inducing the formation of a diverse and healthy microbiome. This pill has the potential to replace FMT and maximize utility for clinicians and patients.

    New Understanding of the FMT Patient

    Due to the "yuck" factor, some patients and clinicians are reluctant to consider FMT. New data to be presented at the AGA James W. Freston Conference sheds light on the factors that lead to acceptance of FMT. The study found that patients who have children are more likely to accept FMT, suggesting that parents may be more willing to try emerging procedures for the sake of their children. Having a college degree was also a significant factor, implying that a better understanding of the disease may affect one's willingness to undergo FMT. The main concern for undergoing FMT was the risk of disease transmission. Since FMT is a potentially life-saving procedure, medical practitioners should use this knowledge when counseling patients and their families on the decision to undergo FMT.
     
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  2. DeGenesis

    DeGenesis Senior Member

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    I know this goes against what you just posted but I've heard that quite a few people are failing with fecal transplants... That study is pretty clear though.

    So hard to find a donor. If the mother's flora is messed up I think the baby's is as well?

    Anyway I read on a forum, don't remember which one, that some hospitals are already using FMT to treat C. diff that will just not respond whatsoever to antibiotics. Yep, it's happening.
     
    Waverunner likes this.
  3. Waverunner

    Waverunner Senior Member

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    I fully agree, that microbiome transplants are no 100% cure for diseases like IBD or IBS. Of course, we also have to take into account, that when this treatment works, people might feel inclined not to spend anymore time on some disease forum and therefore others might not take notice of the positive effect it had.

    In addition to this, as you pointed out, microbiome transplants, if not standardized, are always a gamble. The wrong donor and no effect or even worse outcome if infections are present. This is why we need to screen donors or to get as many standardised (made in labs) microbiome treatments as possible. I guess the case for c. difficile is not that negative, because the tolerance for donors seems very high, while in IBD, things might look different. Moreover, we always have to take into account how the microbiome is treated. Some methods only reach the very last part of the intestine, while a gastroenterologist reaches the complete large intestine and therefore might have a better effect. Lots of work needs to be done but as soon as we have different clinical microbiome treatments and we can screen patients, we can use trial and error to really find out, how helpful microbiome based treatments are.
     
    Sasha, aimossy and DeGenesis like this.
  4. goldberg

    goldberg

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    I would say that any medical procedure "if not standardized" is a gamble,

    microbiome transplants are safe even in immunocompromised patients,look at this study:
    http://www.nature.com/ajg/journal/v109/n7/full/ajg2014133a.html
    They screened patients with "HIV/AIDS (3), solid organ transplant (19), oncologic condition (7), immunosuppressive therapy for inflammatory bowel disease" and "there were no related infectious complications in these high-risk patients."
     
    aimossy and Waverunner like this.

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