3Q: Eric Alm on the mysteries of the microbiome


Clostridium difficile infection is the most common hospital acquired gut infection, and our interest in the disease came after reading a scientific paper that showed fecal transplants work were effective even in cases where standard antibiotic therapy had failed. Patients, however, could not get access to treatment at that time, because doctors didn’t have access to the material for fecal transplants. We knew how to do it in the lab, and in 2013, my graduate student Mark Smith started a non-profit stool bank called OpenBiome, and we treated our first patient later that year. We’ve treated about 40,000 people so far. We’re partnering with over 1,000 hospital networks across the U.S. to make sure everyone has safe access to this medical procedure.”

Fecal matter pills used to treat peanut allergies in Boston study (VIDEO)


“There's evidence that when someone has a food allergy, gut bacteria send the wrong message about what the body should tolerate. 

‘We looked at babies who were allergic and babies who were not allergic and we analyzed their microbiota and we found significant differences between the babies that were allergic and the babies that were not allergic,’ said Dr. Rachid.

The thought is by transplanting another person's healthy gut bacteria into someone with an allergy, the microbiome can be repaired and send healthy signals to the immune system to tolerate allergens like peanuts.” 

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People V. Cancer: The Microbiome Connection (VIDEO)


“How does the gut microbiome help with patients’ receptivity to immunotherapy? What key factors influence it and what strategies offer the opportunity to shape it and augment therapeutic response?”

Watch the video below:

A User's Guide to Cheating Death: Germs (VIDEO)


“Are we too clean? Germ theory and hand washing saved millions of lives, but has the pendulum swung too far in the opposite direction? We talk about everything from regular soap versus anti-bacterial, our microbiome and the role of probiotics, the hygiene hypothesis and the rise of auto-immune diseases, and explore both fecal transplants and helminthic therapy.”

Watch the episode here!

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A medical solution aimed at malnourished children


“The THRIVE (transfer of healthy gut flora for restoration of intestinal microbiota via enema) trial is a small phase 1 study that will investigate whether faecal transplants can help severely malnourished children who fail to develop even after their nutritional needs are met.

Globally, about 35% of children who have severe acute malnutrition fail standard therapy, which includes specially formulated high-calorie food, says UCT’s Shrish Budree, a research fellow at OpenBiome and one of the investigators on the trial.

‘These kids don’t achieve their full growth potential and end up stunted, with an increased risk of infections and mortality,’ he says.

‘In the longer term, they are likely to be less productive adults, which has bigger implications for society at large. There is currently no alternative for the kids who don’t respond to standard therapy.’”

Read more: https://www.businesslive.co.za/bd/life/2018-08-29-a-medical-solution-aimed-at-malnourished-children/

WASTE NOT: Can poo transplants cure malnutrition?


"For physicians and researchers involved in the Cape Town trial, dubbed Thrive, healthy faecal matter is like gold. They believe it could be a fix for the 40% of severely malnourished children who do not respond fully to nutritional feeding.

SA will be the first country on the continent to test if such transfers can prevent stunting from malnutrition, which impairs mental development and dramatically increases child mortality rates. Malnutrition is common in SA and affects 19-million children globally."


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A Delicate Matter


“Screening donors on an individual basis is not only expensive—it is also not for the squeamish. Carolyn Edelstein is the executive director of OpenBiome, the first stool bank, which operates in the Boston area and provides physicians and researchers with prescreened fecal matter. Before stool banks existed, Edelstein says, physicians had “shelves and shelves of blenders” in which, if they got as far as finding and screening a donor and acquiring a sample, they would need to puree the donation so it could be siphoned through a colonoscopy tube. The blenders had to be thrown away afterward, as they could not be properly sterilized. It was not a sideline most doctors found alluring.

The 2014 FDA guidelines provided no role for—or regulation of—such organizations. “Limiting donations to people the patient or physician knows would eliminate the possibility of using a stool bank,” says Hoffmann. The guidance was updated in 2016, allowing physicians to use a hospital stool bank, but even then the stool sample had to be obtained under the direction of the treating physician.”

Fecal transplant outcomes not impacted by donor profile


“Fecal transplant donor profile does not appear to impact clinical outcomes in the treatment of Clostridium difficile infection, according to research presented at Digestive Disease Week.

Shrish Budree, MD, of OpenBiome and the University of Cape Town, South Africa, said success of fecal microbiota transplantation in the treatment of CDI is more likely due to other factors, such as clinical practice and accurate diagnosis.”

read more: https://www.healio.com/gastroenterology/infection/news/online/%7B1c576cad-a8ce-46e9-89d2-f7c159327ce7%7D/fecal-transplant-outcomes-not-impacted-by-donor-profile

Are You a Prospective Poop Donor?


“Potential stool donors currently must fill out a questionnaire similar to that of blood donors, and undergo blood and stool tests prior to their donation to "make sure you aren't giving anyone stool that could harm them," McSweeney said.

For example, the first U.S. stool bank, OpenBiome, requires that donors fill out a 200-point clinical questionnaire and take more than two dozen blood and stool screens.

Dr. Colleen Kelley is an assistant professor of gastroenterology with the Warren Alpert Medical School of Brown University, in Providence. "There is a very high bar to be a stool donor," she said. "OpenBiome rejects 97 percent of the donors who apply."

Read more: https://health.usnews.com/health-care/articles/2018-06-05/are-you-a-prospective-poop-donor

Do You Have the Right Stuff to Be a Stool Donor?

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“To do something as simple as going in and making a stool donation, and know that it can literally change someone’s life from one day to the next when they have a disease like C. diff, where they can’t even leave their house and the next day they can go about things fairly normally — to see that impact makes me feel good,” he said.”


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Here's Why People Are Donating Their Poop to Science


“At 40 bucks a poop, fecal donors can cash in on their flushings – and improve others' health.

"It's harder to be a stool donor at OpenBiome than it is to be accepted into Harvard or MIT – that's the level of rigor it takes," says Dr. Majdi Osman, an internal medicine physician and the nonprofit's clinical program director. That's because most of the chosen stool will eventually end up in someone else's colon; if it's not carefully screened, the recipient could wind up with any number of medical conditions with potential links to the microbiome.”

Read more: https://health.usnews.com/health-care/patient-advice/articles/2018-05-10/heres-why-people-are-donating-their-poop-to-science

Faecal transplantation: do not try this at home


“An important concern relates to the transplanted stools themselves. Majdi Osman is clinical programme director at OpenBiome, the largest stool bank in the USA. ‘We exclude 97% of volunteers’, he told The Lancet Gastroenterology & Hepatology. [...] The vast majority of exclusions occur at the clinical interview. ‘Only physicians can collect the material, and we vet all the centres who apply to make sure that they have the facilities to administer it safely’, adds Osman.”

What's Living In You? (VIDEO)


“Whether they make you fat, fart, or freak out, microbes play a central role in your life. Right beneath your nose—on your face, in your gut, and everywhere in between—trillions of bacteria, viruses, and fungi are so abundant in your body, they outnumber your human cells. But these aren’t just nasty hitch-hikers. Many are crucial to your survival.”

Watch the full episode here.

Fecal Transplant Increasingly Seen As an Option to Treat a Nasty Superbug


“…while research to date shows fmt to be safe and effective, experts note that studies haven't yet been done to determine what long-term risks of fmt could be. "None of us want to do any harm to the patients, and I think that's the one thing that's just kind of in the back of our minds is we don't have really long-term data," Parian says.

The primary known risk is passing along disease or infection in stool. "The stool can have microscopic amounts of blood in it. So we really treat it like a regular organ transplant," Parian says. "So we test them for really everything that could be passed with the blood as well as within the stool. Of course we make sure to screen all the donors." Or she adds they use stool purchased from a non-profit stool bank called OpenBiome, just outside of Boston, that carefully screens donors, and provides liquefied stool preparations to clinicians and researchers for fmt.”

Read more: https://health.usnews.com/health-care/patient-advice/articles/2018-03-13/fecal-transplant-increasingly-seen-as-an-option-to-treat-a-nasty-superbug

When Poop Becomes Medicine (VIDEO)


"Fecal transplants—where doctors try to cure sick people of various ills by giving them the stools of healthy donors—have been used since at least fourth-century China, according to texts that make reference to 'yellow soup.' The unusual treatment has been rediscovered many times since, but it’s finally starting to enter the medical mainstream. Partly, that’s because of a surge of interest in the microbiome—the trillions of microbes that share our bodies. Partly, it’s because many well-conducted studies have shown that fecal transplants are incredibly effective at treating Clostridium difficile—a nasty, hardy bacterium that causes severe, recurring, and potentially fatal bouts of diarrhea."

See the video here.

Nos selles, nouveaux médicaments


“On daigne à peine les regarder, encore moins les sentir. Nos excréments sont sans conteste l’un des plus grands tabous de notre société aseptisée. Pourtant, malgré le dégoût qu’ils inspirent, ils sont précieux.

Leur valeur? Quarante dollars pièce, précisément. Du moins dans le Massachusetts, aux États-Unis, où OpenBiome achète cet or brun depuis 2012 auprès de donneurs triés sur le volet. Cet organisme à but non lucratif est la plus grande banque de selles au monde. Sa mission : sauver des vies avec des matières fécales.

“Car celles-ci recèlent une richesse insoupçonnée, une armée de « bonnes » bactéries qui ont le potentiel de rééquilibrer les flores intestinales mal en point. En 2017, OpenBiome a ainsi expédié des fioles de selles filtrées dans près de 1 000 centres médicaux aux 4 coins des États-Unis, où ont été prodigués plus de 10 000 traitements.”