Treating a sick person by administering stool from a healthy person:the idea is certainly not very appealing but it is already proven to contain recalcitrant infections. And many studies are underway to validate the effectiveness of fecal grafting on other pathologies. The importance of a healthy intestinal microbiota is well established. We have known for several years that the 100,000 billion bacteria and yeasts housed in our bowels play a considerable role in the functioning of the body. When this digestive flora is disturbed, many physical and psychological disorders can occur.
Trying to solve them by restoring order to this army of microscopic roommates is therefore not absurd. This is the principle of faecal transplantation, which consists of transplanting healthy excrement into a patient, containing a balanced intestinal flora. Saddle banks have been created for this purpose in the United States and the Netherlands, in order to have a comfortable stock of grafts.
No establishment of this type exists in France:the samples are taken at the hospital and appeal for donations if necessary.
Faecal transplantation has been recognized as a medicine in France since 2014. It is mainly used to treat recurrent Clostridium difficile infections. , a pathogenic bacterium that causes very severe diarrhea and digestive inflammation. When antibiotics fail to control it, a fecal transplant is now possible.
Donor stools are screened to ensure that they will not pass on unwanted bacteria or parasites. Once homogenized and filtered, they are transferred to the patient whose colon has been previously purged. Transplantation is performed by enema, colonoscopy or through a probe introduced through the nose.
Video of the day:"The treatment works in more than 90% of cases," said Professor Harry Sokol, gastroenterologist at Saint-Antoine Hospital in Paris. Several hundred patients have already benefited from this treatment in France. Experiments are being carried out on other nosocomial bacteria, highly resistant to antibiotics, with success rates of around 50% according to the Raymond-Poincaré hospital in Garches.
All studies have shown that people with Crohn's disease have an extremely depleted microbiota. They are sorely lacking in certain bacteria that protect against inflammation. Several clinical trials are trying to remedy this using fecal transplants, with rather satisfactory results.
At Saint-Antoine Hospital, this treatment has reduced the need for corticosteroid therapy:87.5% of patients are in remission ten weeks after the transplant and 57% still six months later. But the effect does not seem to be sustainable in the long term. Several pilot trials have also been conducted on patients with ulcerative colitis, another inflammatory bowel disease, with encouraging results.
Diabetes and obesity could also benefit from this approach. The Faculty of Medicine of Saint-Louis (United States) has indeed shown that the transfer of the microbiota from one mouse to another could quickly modify its corpulence, with the same diet and level of physical activity.
The link between gut microbiota and mental health has long been established. In depressed people, certain unfriendly bacteria hijack all the tryptophan, an amino acid essential for the synthesis of serotonin, the hormone of good humor.
And microorganisms that produce dopamine – the hormone of motivation and pleasure – are in short supply. Hence the idea of modifying their intestinal flora so that they find a more perky behavior. This hypothesis will be tested in 2020 in Canada with two different approaches:the administration of capsules filled with fecal matter at the University of Calgary and the transplantation of microbiota by colonoscopy at the University of Toronto.
The effectiveness of faecal transplantation on multiple sclerosis and autism is also being assessed. An additional weapon for the management of these highly disabling diseases.
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