A group of researchers has come up with some counterintuitive advice: saving your poop now could one day save your life.
In an opinion paper published Thursday in the journal Trends in Molecular Medicine, researchers make the case for autologous fecal microbiota transplantation (FMT) – using your own poop to restore your health later.
They speculate that the secret to future health may be the complex ecosystem that now lives in the human body.
“Considering the massive (and possibly even permanent) loss of our microbial diversity due to industrial advances, there is a need for a global ‘microbial Noah’s Ark’ to protect long-term human health,” the researchers write.
“However, given the highly individualized gut microbial composition and donor-recipient compatibility issues, using fecal banks to create a personal microbial Noah’s Ark for future personal use may also be a worthwhile option,” they continue.
Heterologous FMT involves transplanting feces from a healthy donor into another individual to restore the gut microbiota and promote health. Currently, FMT has not been approved by the U.S. Food and Drug Administration, but the agency allows its use when patients with C. difficile, one of the most common hospital-acquired infections, do not respond to standard antibiotic therapy.
The gastrointestinal tract is home to about 100 trillion microorganisms – bacteria, viruses, fungi and protozoa. Collectively, they are the intestinal microbiome. There is growing evidence that the gut microbiome plays an important role in health and disease and can influence physical and mental status.
When a stool sample is transferred, it brings all these microbes with it. The hope is that the traveling microbiota will repopulate in their new home, bringing balance and health. For example, C. difficile has a 90% cure rate with heterologous FMT.
While much research is still needed to determine exactly how autologous FMT helps people, the authors of the paper say it may help fight inflammatory bowel disease, obesity and unhealthy aging, as well as rebuild a patient’s gut microbiome after chemotherapy and heavy treatment. Using antibiotics.
Kristin Liu, an assistant professor of medicine at Stanford University who was not involved in the paper, said she thinks the future of autologous FMT is possible and likens it to storage practices that already exist, such as egg freezing and cord blood banking.
“I think there are major logical and scientific hurdles,” Liu said. “But I wouldn’t be surprised if this becomes a viable treatment in the next few decades. Science and medicine have achieved the ‘impossible’ before – look at the Covid-19 vaccine.”
In practice, it looks something like this: when a person is young and healthy, perhaps between the ages of 18 and 35, their feces is collected and stored for later use. After the stool is processed and stored, it can be delivered in a variety of ways: capsule ingestion, rectal enema or colonoscopy.
Autologous FMT may be available as a treatment for certain diseases, such as C. difficile, or as a preventive medicine.
“For example, in the context of aging, we anticipate that autologous FMT may be a more effective treatment for promoting healthy host aging than allogeneic FMT,” says the paper’s senior author, Yang-Yu Liu, Liu (no relation to Christine Kee Liu) is an associate professor of medicine at Harvard Medical School and an associate scientist at Brigham Associate Scientist at Women’s Hospital.
Just as biodiversity helps rainforests thrive, the gut is healthier when it’s home to a variety of microbiota. In the 2022 study, patients with less gut biodiversity were more likely to develop heart failure. Although bile changes at an accelerated rate as a person enters late adulthood, older adults with more diverse gut tend to be healthier and live longer.
Over the last decade, research on the gut has evolved and many scientists hope to better understand the gut’s complex relationship with the brain and body, which will revolutionize the number of diseases treated. the FDA is particularly interested in developing microbiome-based products to prevent, treat and cure disease. For example, the FDA may soon fully approve a microbiome drug for the treatment of C. difficile infection that is an alternative to FMT. It could be available in the first half of 2023.
In addition, some studies link westernization and urbanization to an overall loss of microbial diversity, requiring high-fat diets and widespread use of antibiotics to drive disease in ways that affect the gut. Other studies support this idea, finding that people living in urban areas have less diverse guts than people living in remote areas of traditional communities.
Autologous FMT can also bypass the more common problem of donor-recipient compatibility while expanding the eligibility group.
The donor screening process for OpenBiome, a non-profit organization and the first public fecal bank to open in the United States, has a pass rate of only 3%. This conservative approach is designed to ensure that nothing extra passes with the stool, but it does mean fewer samples overall, Yang-Yu Liu and colleagues write, adding that donating when a person is young and healthy and then using their own stool may be the solution.
Nonetheless, this therapy is just one potential tool in a toolbox for improving gut health. For some people, good gut health can be maintained through exercise, diet, stress reduction and adequate sleep.