Fecal therapy is a game without rules
Doctors call for regulation of fecal transplants
Copper news based on the materials of New Scientist
Recently, it has become clear that fecal bacteria are a force: these microorganisms can even be treated. Now "transplantation", or the transfer of fecal masses with accompanying microflora is a real procedure. Studies show that this extraordinary medical intervention can help with intestinal inflammation, obesity, diabetes, cancer, immune disorders and even mental illnesses. In the USA, even a bank of fecal samples has been operating for several years.
This method of treatment has many advantages. According to scientists, in the future, such therapy can be applied with a wide list of violations. The intestinal microbiome is a flexible system, and it can be learned to manipulate in the laboratory. Studying the relationship between the composition of intestinal bacteria and health can also open up new ways of treatment.
On the other hand, the relationships are so complex that sometimes it is almost impossible to unravel them. Scientists warn that the transplantation of fecal masses can have unforeseen consequences.
"One patient after fecal transfer gained 15 pounds in weight (approximately 6.8 kg – "copper"). We have no idea what to do about it," says Arnab Ray, a gastroenterologist from New Orleans, Louisiana. According to reports, a lot can change after transplantation: skin condition, appetite, mood, intellectual and sexual functions, intestinal condition. And not always for the better.
In addition, there are concerns about whether the recipient's risks of delayed development of diseases increase. For example, recent studies have shown that some bacteria protect against colon cancer, while others, on the contrary, increase the likelihood of its development.
Finally, the transfer of fecal microflora can cause infection. Guidelines compiled by doctors from American healthcare institutions indicate that fecal mass donors should fill out the same questionnaire that is issued to blood donors. In addition, feces should be checked for the composition of bacteria and viruses.
But even that may not be enough. Antonio Gasbarrini, representing the United Organization of European Gastroenterologists (United European Gastroenterology), gives an example of the history of blood transfusion – in the first years of use, thousands of people were infected with hepatitis C and HIV. "No one can guarantee that there are no dangerous viruses in the intestinal microflora," he comments.
To find out whether such side effects are dangerous, large and detailed studies are needed.
It is still far from widespread implementation in clinical practice. The U.S. and Canadian governments have taken control of the regulation of fecal transplants. In other countries, it would be worth following their example. After all, despite the aura of "naturalness" that attracts some patients (although it is impossible not to understand the rejection of therapy by others), the procedure is still a kind of "drug therapy".
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08.06.2015