Fecal transplantation may treat obesity and type 2 diabetes, and the potential for medical value of microbial treasures is huge

no thumb

It is understood that obesity and type 2 diabetes are related to the imbalance of intestinal flora.Recent studies have found that fecal transplantation can help fight obesity and type 2 diabetes!This new discovery was published in the top journal Gut, which attracted industry attention.The research results were explored and released by researchers at the University of Copenhagen.They extracted the feces of mice eating a standard low-fat diet, filtered out concentrated phages, and transplanted them into mice that maintained a high-fat diet, and then continued to give mice a high-fat diet.During the observation, it was found that after receiving the transplanted virus, the obese mice significantly lost weight and the risk of type 2 diabetes was reduced.The first author of the study, Dr. Rasmussen, said: “This method of fecal transplantation changes the composition of the intestinal microbes so that mice with unhealthy lifestyles will not cause some common diseases due to poor diet.”In addition to discovering that the composition of viruses (bacteriophages) in the gut plays a crucial role in this microbiome balance, the method of filtering and concentrating the target microorganisms also solves a major problem in fecal transplantation-unfiltered fecesTransplantation can spread disease unintentionally.Last year, NEJM reported that an American patient died from this condition, which was also the world ’s first death due to fecal transplantation.The accident occurred in Massachusetts General Hospital.A 73-year-old man received fecal transplant oral capsules (NCT03720392) and experienced fever (39.7 ° C), chills, and changes in mental state after the trial medication, and eventually died of severe sepsis.The blood culture results showed that he was infected with a rare Escherichia coli (ESBL-producing E. coli) and originated from fecal transplant material.The paper pointed out that there are 21 other people who also took transplant capsules derived from the same donor. Only one of them had serious side effects. The remaining people tested positive for bacteria, but did not show symptoms.The adverse reactions of fecal transplantation include bacterial blood infection, fever, SIRS-like syndrome, aggravating the condition of patients with inflammatory bowel disease, and mild intestinal discomfort, but this discomfort generally disappears quickly after surgery, including bleeding, Diarrhea, bloating, abdominal pain, constipation, cramps and nausea.Since the outbreak of New Coronary Pneumonia, it has been confirmed that the virus will spread through the fecal mouth, which has also caused new fecal transplant-related concerns.Therefore, the guidelines and consensus emphasize the importance of standardized management of fecal transplantation, including material preparation, donor screening, and fecal transplantation operation specifications.After the above deaths, the US FDA also emphasized that fecal transplantation is still in the research stage, and donor selection should be strictly controlled.The guidelines and consensus stipulate that when selecting donors, close relatives are usually selected, but in the case of C. difficile treatment, family members and close contacts may be more likely to be carriers, so screening donor medical history, such as chronic diseases (such as intestinalIrritability, Crohn’s disease, gastrointestinal cancer, etc.), as well as examination of gastrointestinal pathogen infections (such as cytomegalovirus, salmonella, gastrointestinal parasites, etc.) are necessary.Obesity and smoking are also excluded.Sample preparation has not yet reached consensus on laboratory standards, and the recommended fecal material size is 30 to 100 grams.And fresh feces with strong bacterial viability should be collected and samples should be prepared within 6-8 hours.The sample is then diluted 2.5–5 times with saline, sterile water, or 4% milk.The suspension is then filtered through a filter and transferred to a drug delivery container and administered in a clinical environment.The concept of using feces to treat colon diseases originated in India.In some ancient Indian documents dating back more than 3,000 years, recommendations for treating various digestive tract diseases through the intake of cow dung and cow urine are documented.As early as the Eastern Jin Dynasty in the 4th century AD, the ancient Chinese medical book “Elbow Reserve Urgent Formula” also recorded the method of using fecal juice to treat food poisoning and severe diarrhea; in the 16th century after 1200, Li Shizhen in the Ming Dynasty in the “Compendium of Materia Medica”It also pointed out that the use of “yellow soup” (also known as “golden syrup”) containing fresh, dried or fermented feces can treat severe diarrhea, fever, vomiting and constipation.The first use of fecal transplantation in Western medicine was in 1958. American physician Ben Eiseman and his colleagues used fecal enema to treat four patients with C. difficile critical illness and quickly returned them to health.In recent years, fecal transplantation has become a popular method for treating severe diarrhea caused by C. difficile infection.Its efficacy in treating other gastrointestinal diseases including colitis (which may be more effective than vancomycin), constipation, irritable bowel syndrome, and neurological diseases such as multiple sclerosis and Parkinson’s disease has been experimentally confirmed.Research on fecal transplantation also involves the field of oncology, used to prevent or treat post-transplantation complications, and to improve the efficacy of immunotherapy.In 2012, the Massachusetts Institute of Technology established the first public fecal bank, and now there are many fecal banks throughout Europe to meet the growing demand for testing and treatment.The hypothesis behind the mechanism of fecal transplantation includes the use of competitive ecological footprints of beneficial flora in feces, colonization resistance, biological oxygen deprivation, immune regulation, lowering of intestinal pH and nutrition of bacterial metabolites.Microorganisms that inhabit the intestines all year round in transplanted feces, intestinal epithelial cells and other biological components and food-borne abiotic components (undigested food) and secretions from the stomach, intestine, pancreas and liver (such as hormones,Enzymes, mucus, bile salts, etc.) together constitute the intestinal micro-ecosystem.The significance of fecal transplantation lies in the reconstruction of intestinal microecological structure..
The phage colonization research of the University of Copenhagen shown above is an important research field of fecal transplantation.Phage colonization can work quickly and with good safety.Although the mouse experiment is only the first step, the widespread use of fecal transplantation still needs many years of animal and human test evidence.But in the long run, a well-defined phage mixture that minimizes side effects may be developed in the future to treat a variety of diseases.The current problem of antibiotic resistance is becoming more and more serious, and the testing and research of hundreds of millions of microorganisms in stool may become more and more important. After avoiding the risks associated with transplantation, the future of stool transplantation applications will be very worth looking forward to.The above content is only authorized for exclusive use by, please do not reprint without the authorization of the copyright party.


The author ouyangshaoxia