A group of researchers has counterintuitive advice: Saving your poo now could save your life someday.
In an opinion piece published Thursday in the journal Trends in Molecular Medicine, researchers make the case for autologous fecal microbiota transplantation, or FMT — using your own poop to restore your health later in life.
They speculated that the secret to being healthy in the future could be the complex ecosystem that currently lives inside the human body.
“Given the massive (and possibly permanent) loss of our microbial diversity due to industrial advancements, the creation of a microbial ‘Noah’s Ark’ is warranted to protect the long-term health of humanity,” they said. writes the researchers.
“However, given the highly personalized gut microbial compositions and the donor-recipient compatibility issue, creating a personal microbial Noah’s Ark using stool banks for future personal use could also be an attractive option,” they continued. .
Heterologous FMT occurs when feces from a healthy donor is transplanted into another person to restore the gut microbiome and improve health. At this time, FMT is not approved by the Food and Drug Administration, but the agency allows its use when a patient has Clostridioides difficile – one of the most common hospital-acquired infections — does not respond to standard antibiotic therapy.
The gastrointestinal tract is home to approximately 100 trillion microorganisms – bacteria, viruses, fungi and protozoa. Together they form the gut microbiota. Mounting evidence shows that the gut microbiome plays an important role in health and disease, capable of influencing both physical and mental states.
When a stool sample is transferred, it brings with it all of these microorganisms. The hope is that the traveling microbiota will repopulate in its new home, bringing balance and health. For example, the cure rate of Clostridioides difficile with heterologous FMT is up to 90 percent.
Although a considerable amount of research is still needed to determine exactly how autologous FMT might help people, the authors of the paper say it could potentially be useful in the fight against inflammatory bowel disease, l obesity and unhealthy aging, and in rebuilding a patient’s gut microbiome after chemotherapy and antibiotic use.
Christine Kee Liu, an assistant professor of medicine at Stanford University who was not involved in the article, said she thought a future with autologous FMT was possible and compared it to storage practices. already in place, such as egg freezing and the cord blood bank.
“I think there are significant hurdles, both logical and scientific,” Liu said. “But I wouldn’t be surprised if it becomes a viable treatment within the next two decades. Science and medicine have already achieved the “impossible” – look at the vaccines against Covid-19″.
In practice, it would look like this: When a person is young and healthy, probably between 18 and 35, their stool would be collected and stored for use later in life. Once the stools have been processed and stored, they can be delivered in several ways: ingested in capsules, rectally by enema or administered during a colonoscopy.
It is possible that autologous FMT could serve as a treatment for certain conditions, such as Clostridioides difficile, and as preventative medicine.
“For example, in the case of aging, we expect autologous FMT to be a more potent therapeutic approach to promote healthy host aging than heterologous FMT,” said the paper’s lead author. , Yang-Yu Liu. Liu (no relation to Christine Kee Liu) is an assistant professor of medicine at Harvard Medical School and a research associate at Brigham and Women’s Hospital.
Just as biodiversity helps a rainforest thrive, a gut is healthier when it harbors a wide array of microbiota. In a 2022 study, patients with less biodiversity in their gut were more likely to suffer from heart failure. Although the intestines undergo accelerated changes as a person reaches adulthood, older people with more diverse intestines tend to be healthier and live longer.
Over the past decade, research on the gut has grown, and many scientists hope that a better understanding of its complex relationship with the brain and body will revolutionize the number of diseases treated. The FDA is particularly interested in developing microbiome-based products to prevent, treat, and cure disease. For example, the FDA may soon fully approve a microbiome drug for the treatment of Clostridioides difficile infections that is an alternative to FMT. It could be available by the first half of 2023.
Additionally, some research associates westernization and urbanization with an overall loss of microbial diversity, claiming that things like high-fat diets and widespread antibiotic use influence the gut in ways that cause disease. Other studies support this idea, finding that people living in urban areas have less diverse guts than people living in remote traditional communities.
Autologous FMT could also circumvent more general donor-recipient compatibility issues, while broadening the eligibility pool.
At OpenBiome, a non-profit organization and the first public stool bank to open in the United States, the success rate in the donor screening process is just 3%. This conservative approach aims to ensure that nothing unwanted is passed along with the stool, but it means fewer samples overall. Donating when a person is young and healthy and then using their own stool could be the answer, wrote Yang-Yu Liu and colleagues.
Yet this therapy is just one potential tool in the toolbox for improving gut health. For some people, good gut health can be maintained through exercise, diet, stress reduction, and getting enough sleep.
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