DIY Fecal Transplants

Been a while since I posted.  Continuing on the news related to fecal transplants, a friend forwarded me this post about how do-it-yourself fecal transplants have become quite common amongst people with GI issues.  In particular, it references a study where 94% of patients suffering from C. Difficile infection were cured with a transplant.  Apparently the FDA is evaluating whether fecal transplants are safe, so that has pushed it "underground", which means that folks find ways to do it themselves.  The whole idea makes a lot of sense.  Very curious to see how the FDA proceeds with it.

Here's the article: Why DIY fecal transplants are a thing (and the FDA is only part of the reason)

Curing Gut Problems with Synthetic Pseudo-Poo

Read an interesting article about artificial poop transplants. The basic idea is very similar to traditional fecal transplants. To restore the normal balance of gut bacteria, you introduce fecal matter from a healthy patient into the intestines of an unhealthy patient.

Looks like researchers have introduced an artificial version of the fecal matter that is grown in the lab. It's less gross and safer for the patient.

Here's the full article: http://m.popsci.com/science/article/2013-01/scientists-develop-synthetic-pseudo-poo-fecal-transplants

Probiotic in breastmilk reduces painful cramps

Thought this one was interesting. Apparently the bacteria Lactobacillus reuteri found in breastmilk decreases the force of muscle contractions associated with inflammatory bowel disease (IBD). It is passed on from mother to baby in breastfeeding. Interesting, but might be a tough one to add to your supplement list.

Here's an excerpt:

"It might not be possible for most of us to get breast milk from the tap," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but we can still benefit from some of the life-supporting substances it carries. This research shows that the relationship between humans and microbes can be beneficial for both. The Lactobacillus finds a new home, and we're no longer up tight."

Helminthic Therapy Spot on CBS 5 News

This is a pretty old spot from CBS 5 in San Francisco, but thought it was interesting. For more info on this topic, see my old post - "I'll Take a Parasite Please: Helminthic Therapy and the Hygiene Hypothesis".

Faecalibacterium prausnitzii and other butyric acid producing bacteria may be a treatment for IBD

Saw this article ("Gut bug may hold key to inflammatory bowel disease treatment") today about trials in mice of F. prausnitzii that produced promising results in the treatment of inflammatory bowel disease (IBD). See my blog post from August 2009 on the initial findings related to F. prausnitzii - Lack of Faecalibacterium prausnitzii Bacteria May Contribute to Crohn's.

Here's an excerpt from the more recent article about the trials:

While the exact causes are unclear, IBD is known to be the result of an overactive immune response that is linked to an imbalance of the normal types of bacteria found in the gut.

Several recent studies have identified butyric acid as a potential therapeutic agent for IBD. Some gut bacteria produce butyric acid naturally in the intestines, but in IBD patients some of these strains are heavily depleted.

Trials in mice have shown that injecting one such strain Faecalibacterium prausnitzii into the digestive tract is effective at restoring normal levels of gut bacteria and treating the symptoms of IBD.

In addition, novel identified butyrate-producing strains, such as Butyricicoccus pullicaecorum, have been shown to exert similar effects.

Butyric acid has well-known anti-inflammatory effects and is able to strengthen intestinal wall cells - making it an ideal therapeutic agent against IBD.

In addition to butyric acid, it is hypothesized that strains such as F. prausnitzii and B.pullicaecorum secrete other anti-inflammatory compounds that may enhance the therapeutic effect.

Prof. Filip Van Immerseel, a medical microbiologist from Ghent University in Belgium said that a new treatment for IBD would be welcomed.

“Conventional drug therapy has limited effectiveness and considerable side effects. Probiotics are live bacterial supplements or food ingredients, which when taken in sufficient numbers confer health benefits to the host,” he said.

There are likely more strains of gut bacteria that produce butyric acid, so I wouldn't be surprised to see a probiotic treatment in the coming months or years.

Good Bacteria - Lactobacillus Plantarum

Read an article about a particular probiotic called Lactobacillus Plantarum. Here's an excerpt:

Lactobacillus plantarum is a resilient and highly adaptive bacterium that can survive at vast temperature ranges (1-60 degrees Celsius) and a wide scale of atmospheric pressures. The name "plantarum" indicates that this bacterium is a "species of the plants." According to several specialists, including Dr. Bengmark, the adhesive properties of L plantarum make it a powerful tool to fight off pathogenic bacteria such as E Coli, while repairing the intestinal lining.

Mannose-specific adhesions are common among gram negative strains, but not gram positive (lactobacillus). Interestingly, according to Dr. Bengmark's research, L-plantarum uses mannose-specific adhesions, which makes it possible that L plantarum can compete with both gram- positive and gram-negative pathogenic strains for receptor sites and valuable nutrients in the mucosal membrane. It also secretes anti-microbial substances that help to inhibit the formation of pathogenic gram-positive & negative colonies.

These characteristics make L plantarum a potent aide for irritable bowel syndrome, Crohn's disease, and Colitis. In fact, several studies have shown that L plantarum is able to survive through harsh environments including rounds of antibiotics. This is especially important for emergency situations when someone may have to take an antibiotic. According to Donna Gates, Body Ecology Diet, the L. plantarum in your intestines will survive the antibiotic onslaught, maintaining long-term health by ensuring that a yeast overgrowth will not occur.

Apparently only 25% of the Western population has this strain in their guts. So how do you get it? Another excerpt:

L. Plantarum is found in abundance in many fresh vegetables and fermented foods such as sauerkraut, kimchi, pickles, and brined olives. However, be careful of store-bought processed alternatives which use cheap vinegars to pickle vegetables. The real cultural dishes use natural fermentation or salted foods and/or put them in a brine solution, all methods which allow Lactobacillus plantarum to survive and thereby be ingested. Many of these dishes can easily be made at home on a continual basis.

Maybe time to add some kimchi.

Bacteroides ovatus (B. ovatus) May Help IBD Suffers

Saw an article about some recent work regarding a bacteria called Bacteroides ovatus (B. ovatus) that helps repair the intestinal lining. Here's the excerpt:

The group focused on the bacterium Bacteroides ovatus (B. ovatus), which is one of an assortment of intestinal microflora in humans. B. ovatus thrives in the oxygen-free environment of the large intestine, where it breaks down xylan—a fiber found in plants—and other sugars for energy and growth.

The team created a strain of B. ovatus that used xylan to induce secretion of human keratinocyte growth factor, a protein that helps repair and restore the intestine’s delicate lining. This increased the ability of the intestine to repair IBD-inflicted damage.

The researchers found that IBD-affected mice treated with oral doses of xylan and the engineered strain of B. ovatus had intestinal tissues that healed more rapidly. This group of mice also lost less weight and had lower levels of rectal bleeding. In addition, dosing mice with B. ovatus provided protection from induced IBD and limited the development of subsequent intestinal inflammation.

Maybe this will end up as another probiotic supplement at some point in the future.

Probiotics May Help Prevent Crohn's Disease

Saw an interesting mention of a research report in a Wall Street Journal article. Here's the excerpt:

Crohn's Disease: Probiotics—live microorganisms that appear to improve gastrointestinal health—may prevent the onset of Crohn's disease, according to a study in the Proceedings of the National Academy of Sciences. The researchers fed young mice, who had been bred to develop a Crohn's-like inflammatory bowel disease, diets that included a high dose of eight probiotic bacteria strains. The disease, ileitis, was entirely prevented in five of those 11 mice, and markedly less severe in five of the remaining six. A lower dose of the bacteria, given to another set of mice, provided little beneficial effect. The researchers suggested, based on necropsies of the mice, that the probiotics guarded against ileitis by stimulating the immune system of the gut lining.

Caveat: It's not known whether probiotics would prevent actual Crohn's disease in humans, or what dose would be required. (Read the Report)

This kind of raises an interesting question around the Specific Carbohyrdrate Diet (which I'm using). How do you train or sensitize your immune system to handle different types of gut bacteria if you're on a diet that is targeted at eliminating many strains of bacteria in the gut? Perhaps you slowly introduce new bacteria (or foods that allow those other bacteria to develop). That way your body can slowly develop (or re-develop) it's sensitivity to these.

I'll Take a Parasite Please: Helminthic Therapy and the Hygiene Hypothesis

I've been wanting to post on this topic for a while, but never got around to it. I just saw this article in ABCNews titled "Allergy Desperation: I'll Take a Parasite, Please" (linked to from this blog post). It includes a story of a guy named Jasper Lawrence who in desperation from long-term allergy problems decided to infect himself with hookworms. The result was that his symptoms were dramatically diminished (if not cured). Why?

Here's a good excerpt from the article that sums it up:

The hypothesis goes that until recently, humans were fighting off some sort of parasite or another for millions of years, ever since humans evolved into humans. That co-existence eventually led humans to evolving an immune system that worked with parasites.

"When you're born you have an immune system, but your immune system is a blank slate," said Weinstock.

Weinstock explained that just as humans create a functioning digestive system by populating their digestive system with bacteria, humans historically developed an immune designed to account for parasites in the body.

But in the last 150 years, the industrialized world's clean food supply and plumbing suddenly removed parasites from people's bodies. In response, researchers now widely think that people's immune systems stopped developing properly.

Weinstock said most people still have a powerful "attack" function of their immune system, but that many believe the immune system does not develop to regulate properly in the absence of helminthes (parasitic worms).

"People who are not exposed to helminthes have sloppy regulation," said Weinstock. As a result some people's immune systems go off kilter and misfire against their own bodies creating autoimmune disorders such as allergies, asthma, or inflammatory bowel disease.

There has been a lot of research into this area and the general "hypothesis" mentioned has been around since the 1980's. The theory is called the hygiene hypothesis. Basically, our overly hygienic lifestyles in developed nations (particularly in the northeast) means that our immune systems have not been properly balanced and exposed to regulating agents. The lack of this exposure causes all sorts of downstream effects when your body encounters mostly innocuous allergens -- basically it over-reacts. The type of therapy described in the article, helminthic therapy, is meant to correct this problem (albeit later in life than probably should have been the case).

In helminthic therapy, you purposely expose the body to parasites such as hookworms. This exposure forces the immune system to develop the proper regulation systems and as a result it no longer over-reacts.

Sounds great! Pass the bowl of hookworms over so I can load up. Perhaps not so fast. Immune development is really complex and many of these parasites can have serious side effects (... they are parasites after all ...), so it's likely wise to wait for many of the clinical trials underway to be completed. You never know, within a few years you may find hookworms in the same category as probiotics!

Fecal Bacteriotherapy

In reading through a recent report on the autoimmune disease treatment options (mostly from a market sizing perspective), I came across a therapy called fecal bacteriotherapy. The treatment is a last resort option for patients with pseudomembranous colitis or ulcerative colitis. The therapy is based on the premise that these diseases are caused by imbalances of bacteria in the colon or small intestine and so by transplanting fecal bacteria from a healthy individual (i.e. microflora from someone that doesn't have any GI issues) to an afflicted patient you restore the balance of bacteria in the gut. By introducing a "healthy" mix of bacteria, you can replace whatever pathogenic bacteria is there (e.g. Clostridium difficile in the case of pseudomembranous colitis) with healthy, probiotic bacteria. It's not unlike other probiotic therapies, but this one literally uses all the bacteria from a healthy person rather than just a subset.

I found this interesting for two reasons. One is that it's interesting to see a related disorder where they have pinpointed the bacterial agent that causes the disease. And second, it might be another last resort option for people for Crohn's or UC.