Fecal transplantation: "Why did I decide to become a stool donor" | Science and health



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31-year-old Claudia Campenella heads the student support service at a university in the United Kingdom and donates faeces during her free time.

"Some friends think it's a bit weird or disgusting, but I'm not sure about it, it's very easy to donate and I just want to help with medical research. am happy to contribute. "

The material, filled with "good" bacteria, will be used in stool transplants – consisting of transferring faeces from a donor (bad, oral or nasal) into the intestines of the body. another patient as a treatment for diseases related to the intestines.

Campenella knows that giving is extremely helpful – that's why she does volunteer – but what qualifies her?

Scientists believe that some people's stools may contain an ideal mix of healthy bacteria to treat intestinal diseases, making them "superdrivers".

Campenella says she decided to start donating because she had read that vegans could be particularly qualified candidates.

There is no solid evidence that feces of vegan people are better than others, but researchers are studying what can make feces "superior".

Our intestines harbor millions of bacteria that live in a kind of community. This microbiome is diverse and unique. There are no two identical people.

Although fecal transplantation is still a relatively new medical field, studies suggest that some donors offer better quality material for the procedure.

Justin O. Sullivan, a specialist in molecular biology at the University of Auckland, New Zealand, is studying the concept of "super-donors" of feces.

"We find that" super-donating "transplants achieve remission rates that are perhaps twice as high as the average," said O. Sullivan.

"Our hope is that, if we can understand how this happens, we can improve the success of fecal transplantation and even test the procedure to detect new conditions badociated with the microbiome, such as Alzheimer's disease. , multiple sclerosis and asthma. "

Jon Landy is a gastroenterologist in the hospital network serving the western region of Hertfordshire, England, and participates in the coordination of the Fecal Transplant Unit.

He agrees with the idea of ​​a "super-charger", but says that finding it can be complicated.

"We still do not understand what a" super-loader "does," he says.

"We always make sure that donors are healthy individuals and have no disease but we do not test the microbiome as a whole to see what it looks like. "

" These are the kinds of investigations that need to be conducted, "he adds.

  Colonies of Clostridium difficile grown on a leaf: Clostridium difficile infection is considered a dangerous intestinal disease Photo: CDC / Divulgação

According to him, the presence of a larger number of species in the donor's feces has been shown to be one of the factors that most affect the outcome of the Fecal graft. And patients who respond well to transplants also develop a more diverse microbiome.

But studies suggest that the success of the procedure may also depend on the donor's compatibility with the patient.

And this may not be just a question of bacteria in the stool.

"Some cases of recurrent diarrhea have been cured with filtered stool transplants, all living bacteria have been filtered but still contain DNA, viruses and other debris."

"These viruses can affect the survival and metabolic function of bacteria and other transplanted microbes," says O & # 39; Sullivan.

Julie McDonald, a microbiologist at Imperial College London, England, is studying ways to increase the success rate of stool transplants.

Currently, most donations are used to treat Clostridium difficile infections, which can occur when the "good" bacteria present in the patient's intestine are removed by antibiotics. For the most vulnerable, it can be deadly.

McDonald's research suggests that fecal transplants play a very specific role, replacing something that has been lost as a result of the disease.

She found that patients with Clostridium difficile infections had almost imperceptible rates of short chain fatty acid valerate produced by healthy microbial metabolism of the intestine.

Levels could only be restored with a successful fecal transplant.

"In our laboratory, we try to know exactly how grafts work and we find that even if we stop transplanting the excrement themselves."

Instead of giving the patient a faecal injection, he would receive a stool-based treatment that could be considered less invasive.

According to her, this could help to get around the taboo problem related to stool donation.

Campenella wants people to "overcome the psychological barrier" and plan to become a donor.

"It's very easy to make a donation, it's simple.If you think about it, make sure that a nearby hospital offers the service and contact him."

"I collect my new sample at home in a container provided by the hospital, and I leave it at the hospital while I'm going to work, it's just a small effort ", he adds.

She is now considering becoming a blood donor as well.

"I have not donated yet, but it's something I could do."

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