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For the first time, the US Food and Drug Administration has granted approval for a feces-based microbial treatment, which is used to prevent a recurring diarrheal infection that can become life-threatening.
The approval, announced Wednesday, is years in the making. Researchers have strained to harness the protective qualities of the complex, diverse, yet variable microbial communities found in healthy people's intestines and stool. Early on, rich fecal matter proved useful for restoring balance and blocking infection in those whose microbiomes have been disturbed—a state called dysbiosis, which can occur from disease and/or use of antibiotic drugs. But, our understanding of what makes a microbiome healthy, functional, and protective remains incomplete.
Doctors, meanwhile, pushed ahead, informally trying an array of methods to transplant fecal microbiota from healthy donors to the guts of patients—via enemas, tubes through the nose, and oral poop-packed capsules. Fecal microbiota transplants (FMTs) have been used to treat various ailments, from obesity to irritable bowel syndrome, to mixed success. But it quickly became apparent that FMTs were most readily effective at preventing recurrent infection from Clostridioides difficile (C. difficile or just C. diff).
(Score: 3, Informative) by Immerman on Monday December 05 2022, @05:30PM
This is actually a wonderful step, long overdue. Fecal transplants have been used to incredible effect in the lab for decades now as something approaching a miracle cure for some kinds of persistent intestinal problems, with no significant side effects.
It originates from the growing recognition that our intestines host a diverse ecosystem of symbiotic microbes on which our health relies. It's so important in fact that roughly half the sugars in human breast milk can't be digested by human babies, but instead feed the symbiotic microbes as they establish their colonies.
And just like a macroscopic ecosystem, if that intestinal ecosystem gets too badly disrupted it can collapse to the point that it can no longer recover on its own. Especially not in a world where virtually everyone practices a level of cleanliness impossible in the world we evolved for. If you're not regularly getting a little shit in your diet, then your body has no way to replace lost species. Until a few hundred years ago that was never really a problem, quite the opposite in fact, since a whole lot of diseases evolved to transmit that way.
So now we've developed a much safer way to do what used to happen unavoidably - transplanting a chunk of healthy gut microbiome into someone whose own has collapsed. By doing so in a controlled manner, using donors who have been screened for infectious diseases, its possible to get a supercharged version of the natural method, without the accompanying risk of disease.