Latest news with #Cdiff
Yahoo
5 days ago
- Health
- Yahoo
‘Poop transplants' have been happening for decades. Now researchers have identified some unintended consequences
Fecal microbiota transplants are common medical procedures dating back decades that can help restore the gut health of people with colon infections - but scientists now warn of newly discovered consequences from the procedure. The 'poop transplant' is the transfer of the stool of a healthy donor to a recipient. The stool contains beneficial bacteria that can improve the patient's gut bacteria, which guards immune health and helps to regulate metabolism. They are approved by the Food and Drug Administration to treat people with common C. diff infections that may cause severe gastrointestinal symptoms and inflammation in hospital patients who have been on antibiotics. Roughly 48,000 procedures are done each year. Now, University of Chicago researchers say a study in mice and experiments with human tissue have revealed some long-lasting and unintended consequences due to transplanting microorganisms from only one section of the digestive tract. 'I think it's a bit of a wakeup call to the field that maybe we shouldn't willy-nilly put large bowel microbes into different parts of the intestine that shouldn't be there,' Dr. Orlando 'Landon' DeLeon, postdoctoral researcher at the university, said in a statement. 'If we're designing good therapeutics, we should be aware of the importance of matching the regional microbiota to their proper environments, so that we provide better overall health benefits.' DeLeon is the lead author of the new research, which was published on Friday in the journal Cell. To reach these conclusions, the authors gave three groups of mice transplants of microorganisms from the middle part of the small intestine that connects to the colon, and a standard fecal transplant from the colon. The test showed that the microorganisms from each transplant were able to colonize the entirety of the intestinal tract in the mice -- not just certain regions. This created what they called regional gut mismatches, lasting for up to three months following a transplant. The microbes also altered their new intestinal environments, 'terraforming' the lining in ways that caused changes in the recipient's metabolism, behavior and energy balance. There were shifts in liver metabolism, including activity in genes associated with immune function. The mice also exhibited different eating behaviors. The gut has several distinct regions with vastly different microbial ecosystems. Imbalances in gut bacteria have been tied to a risk of cancer. 'There are microbes along the entire intestinal tract, and we just study predominately the last third of it (the colon),' DeLeon said. 'So, how can you expect [a transplant], with microbes from a third of the intestinal tract at the end of it, to fix the rest of the intestine?' What this means for human patients may be murky right now, but the authors say more caution is needed with the transplants going forward. They advocate for an approach that would transfer microorganism from all regions of the intestine and not just largely from the colon. In the future, they plan to conduct further study related to how different microbes exert their influence in different parts of the intestine and how the gut regions terraformed by microbiota mismatches can be restored. 'We have absolutely no idea what's in FMT, except that it's a combination of microbes,' Dr. Eugene Chang, the Martin Boyer Professor of Medicine at the university and senior author of the study, said. 'But even a single FMT will cause a change in the host-microbe relationships in these very different regions of the bowel that may be very difficult to reverse.'
Associated Press
09-06-2025
- Business
- Associated Press
Acurx Pharmaceuticals Announces Presentation of Results from Leiden University Medical Center Public-Private Partnership for Its DNA pol IIIC Inhibitors at the Federation of American Societies for Experimental Biology Scientific Conference
Results are from Acurx's ongoing scientific collaboration with Leiden University Medical Center (LUMC) partially under a grant from Health Holland to further study the mechanism of action of DNA pol IIIC inhibitors LUMC highlighted Acurx's new class of promising antimicrobials, ibezapolstat and related analogues Novel chemotype specifically targeting gram-positive bacteria through an unexploited target Ibezapolstat ready to enter pivotal Phase 3 clinical trials for C. difficile Infection (CDI), with no cross resistance reported to date Ibezapolstat has previously been granted FDA QIDP and Fast-Track Designations and has received SME (Small and Medium-sized Enterprise) designation by the EMA STATEN ISLAND, N.Y., June 9, 2025 /PRNewswire/ -- Acurx Pharmaceuticals, Inc. (NASDAQ: ACXP) ('Acurx' or the 'Company') is a late-stage biopharmaceutical company developing a new class of small molecule antibiotics for difficult-to-treat bacterial infections. Its lead antibiotic candidate, ibezapolstat (IBZ), is ready to advance to international pivotal Phase 3 clinical trials for treatment of patients with C. difficile infection (CDI). The Company today announced that a presentation of a poster and an oral presentation regarding Acurx's overall DNA pol IIIC inhibitor platform was presented at a scientific conference on May 21 by Mia Urem, PhD, from Leiden University Medical Center in the Netherlands entitled: 'A Unique Inhibitor Conformation Selectively Targets the DNA Polymerase PolC of Gram-Positive Priority Pathogens'. This scientific conference is sponsored by the Federation of American Societies for Experimental Biology and is the premier venue for the newest research and technological trends in molecular 'machines' inside the human body that ensure DNA replication and expression of genes to create proteins that make up a cell. The distinctive non-planar conformation of ACX-801 and IBZ, together with high conservation of the induced binding pocket in PolC, suggests that this is a general mechanism for this class of inhibitor and is conserved in Gram-positive bacteria. According to Dr. Wiep Klaas Smits, Associate Professor/Principal Investigator, Leiden University Medical Center: 'Our findings with regards to the structural biology of DNA pol IIIC in complex with inhibitors have important implications for the development of this novel class of antibiotics to treat high priority, multi-drug resistant, gram-positive infections.' Acurx's Executive Chairman, Bob DeLuccia, stated: 'This research outcome provides a deeper understanding of the mechanism of action and selectivity of ibezapolstat in the gut. These data will guide the rational design of new compounds with improved inhibitory activity and drug-like characteristics that will be crucial in addressing the pandemic of antimicrobial resistance.' POSTER AND PRESENTATION ARE ON ACURX WEBSITE About the Federation of American Societies for Experimental Biology Since its inception 20 years ago, this conference has been the premier venue for the newest research and technological trends that aid in studying the molecular 'machines' inside the human body. These biological elements ensure faithful DNA replication and expression of genes to create the many proteins that make up a cell. The Machines on Genes scientific conference covers all aspects that govern the central building blocks of life, DNA replication, transcription, and translation, as well as activities that impact these processes such as DNA repair, DNA editing, and RNA editing. There is special emphasis on how they work, how they interact with one another, and how they may be used as diagnostic tools or as targets for novel therapies. About Leiden University Medical Center Antimicrobial resistant microorganisms are a major threat to global health and pose a significant economic burden. Increasing resistance to multiple agents and resistance to so called last-resort antibiotics underscore the necessity to develop therapeutics that have a novel mode of action. DNA replication is a process that can be successfully targeted by small molecules. Ibezapolstat, an inhibitor of the replicative DNA polymerase pol IIIC from Gram-positive bacteria identified by screening library of dGTP analogues, has shown promising results for the treatment of Clostridioides difficile Infection in a recent Phase 2a clinical trial, but the molecular basis of selective inhibition is not fully characterized as no structural information is available on pol IIIC proteins from pathogens. Ongoing research project will determine the structure of pol IIIC from the multidrug-resistant organisms methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococci (VRE) and/or penicillin resistant Streptococcus pneumoniae (PRSP) in the absence and presence of lead compounds. These results will reveal the structural space of inhibitor-binding and guide the rational design of inhibitors with optimal pharmacological properties and organism-specificity that will be demonstrated by in vitro polymerase inhibition assays and in vivo minimal inhibitory concentration determination. Leiden University was the first university to be established in the Netherlands. Its motto is praesidium libertatis – bastion of freedom. The University wishes to create an increasingly attractive and challenging working climate for top academics and young researchers that is guided by quality and excellence. Leiden University Medical Center (LUMC) research aims to meet the highest international standards of quality and academic integrity. LUMC promotes excellent research through greater collaboration, both disciplinary and interdisciplinary; stronger positioning and greater scope for top talent; and better supervision and more support for young researchers. The presented research was performed in part as a public-private partnership that includes the Dutch Top Sector Life Sciences and Health ('Topconsortium voor Kennis en Innovatie' or 'TKI' Life Sciences and Health) and is represented by Stichting Life Sciences Health – TKI (aka, Health~Holland). This foundation is tasked by the Dutch government to promote and stimulate public-private partnerships (PPPs) to undertake R&D projects in the life sciences. To promote such partnerships, the Minister of Economic Affairs and Climate Policy has allocated certain funds to Stichting LSH-TKI, to grant allowances to projects under the TKI-programme Life Sciences & Health. Stichting LSH-TKI has designated the Board of Directors of LUMC as delegated grantor for the PPP allowance allocated to the LUMC. Together with Acurx Pharmaceuticals the PPP has led to the research project entitled 'Bad bugs, new drugs: elucidation of the structure of DNA polymerase C of multidrug resistant bacteria in complex with novel classes of antimicrobials.' The collaboration project was co-funded by the PPS Allowance made available by Health~Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships. Acurx previously announced that it had received positive regulatory guidance from the EMA during its Scientific Advice Procedure which confirmed that the clinical, non-clinical and CMC (Chemistry Manufacturing and Controls) information package submitted to EMA supports advancement of the ibezapolstat Phase 3 program and if the Phase 3 program is successful, supports the submission of a Marketing Authorization Application (MAA) for regulatory approval in Europe. The information package submitted to EMA by the Company to which agreement has been reached with EMA included details on Acurx's two planned international Phase 3 clinical trials, 1:1 randomized (designed as non-inferiority vs vancomycin), primary and secondary endpoints, sample size, statistical analysis plan and the overall registration safety database. With mutually consistent feedback from both EMA and FDA, Acurx is well positioned to commence our international Phase 3 registration program. The primary efficacy analysis will be performed using a Modified Intent-To-Treat (mITT) population. This will result in an estimated 450 subjects in the mITT population, randomized in a 1:1 ratio to either ibezapolstat or standard- of-care vancomycin, enrolled into the initial Phase 3 trial. The trial design not only allows determination of ibezapolstat's ability to achieve Clinical Cure of CDI as measured 2 days after 10 days of oral treatment, but also includes assessment of ibezapolstat's potential effect on reduction of CDI recurrence in the target population. In the event non-inferiority of ibezapolstat to vancomycin is demonstrated, further analysis will be conducted to test for superiority. About the Ibezapolstat Phase 2 Clinical Trial The completed multicenter, open-label single-arm segment (Phase 2a) study was followed by a double-blind, randomized, active-controlled, non-inferiority, segment (Phase 2b) at 28 US clinical trial sites which together comprise the Phase 2 clinical trial. This Phase 2 clinical trial was designed to evaluate the clinical efficacy of ibezapolstat in the treatment of CDI including pharmacokinetics and microbiome changes from baseline. from study centers in the United States. In the Phase 2a trial segment,10 patients with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally, twice daily for 10 days. All patients were followed for recurrence for 28± 2 days. Per protocol, after 10 patients of the projected 20 Phase 2a patients completed treatment (100% cured infection at End of Treatment (10 of 10). In the Phase 2b trial segment, 32 patients with CDI were enrolled and randomized in a 1:1 ratio to either ibezapolstat 450 mg every 12 hours or vancomycin 125 mg orally every 6 hours, in each case, for 10 days and followed for 28 ± 2 days following the end of treatment for recurrence of CDI. The two treatments were identical in appearance, dosing times, and number of capsules administered to maintain the blind. In the Phase 2b trial, the Clinical Cure rate in patients with CDI was 96% (25 out of 26 patients), based on 10 out of 10 patients (100%) in Phase 2a in the Modified Intent to Treat Population, plus 15 out of 16 (94%) patients in Phase 2b in the Per Protocol Population, who experienced Clinical Cure during treatment with ibezapolstat. Notably, in the combined Phase 2 trial, 100% (25 of 25) ibezapolstat-treated patients ) who had Clinical Cure at EOT) (End of Treatment) remained cured through one month after EOT, as compared to 86% (12 of 14) for the vancomycin patient group. Ibezapolstat was well-tolerated, with no serious adverse events assessed by the blinded investigator to be drug- related. The Company is confident that based on the pooled Phase 2 ibezapolstat Clinical Cure rate of 96%, Sustained Clinical Cure Rate of 100% and the historical vancomycin Clinical Cure Rate range of 70% to 92% and a Sustained Clinical Cure historical range of 42% to 74%, we will demonstrate non-inferiority of ibezapolstat to vancomycin in Phase 3 trials, in accordance with the applicable FDA Guidance for Industry (October 2022), with favorable differentiation in both Clinical Cure and Sustained Clinical Cure. In the Phase 2 clinical trial (both trial segments), the Company also evaluated pharmacokinetics (PK) and microbiome changes and test for anti-recurrence microbiome properties, including the change from baseline in alpha diversity and bacterial abundance, especially overgrowth of healthy gut microbiota Actinobacteria and Firmicute phylum species during and after therapy. Phase 2a data demonstrated complete eradication of colonic C. difficile by day three of treatment with ibezapolstat as well as the observed overgrowth of healthy gut microbiota, Actinobacteria and Firmicute phyla species, during and after therapy. Very importantly, emerging data show an increased concentration of secondary bile acids during and following ibezapolstat therapy which is known to correlate with colonization resistance against C. difficile. A decrease in primary bile acids and the favorable increase in the ratio of secondary-to-primary bile acids suggest that ibezapolstat may reduce the likelihood of CDI recurrence when compared to vancomycin. The company also reported positive extended clinical cure (ECC) data for ibezapolstat (IBZ), its lead antibiotic candidate, from the Company's recently completed Phase 2b clinical trial in patients with CDI. This exploratory endpoint showed that 5 of 5 IBZ patients followed for up to three months following Clinical Cure experienced no recurrence of infection. Furthermore, ibezapolstat-treated patients showed lower concentrations of fecal primary bile acids, and higher beneficial ratio of secondary to primary bile acids than vancomycin-treated patients. About Ibezapolstat Ibezapolstat is the Company's lead antibiotic candidate planning to advance to international Phase 3 clinical trials to treat patients with C. difficile infection. Ibezapolstat is a novel, orally administered antibiotic, being developed as a Gram-Positive Selective Spectrum (GPSS®) antibacterial. It is the first of a new class of DNA polymerase IIIC inhibitors under development by Acurx to treat bacterial infections. Ibezapolstat's unique spectrum of activity, which includes C. difficile but spares other Firmicutes and the important Actinobacteria phyla, appears to contribute to the maintenance of a healthy gut microbiome. In June 2018, ibezapolstat was designated by the U.S. Food and Drug Administration (FDA) as a Qualified Infectious Disease Product (QIDP) for the treatment of patients with CDI and will be eligible to benefit from the incentives for the development of new antibiotics established under the Generating New Antibiotic Incentives Now (GAIN) Act. In 2019, FDA granted 'Fast Track' designation to ibezapolstat for the treatment of patients with CDI. The CDC has designated C. difficile as an urgent threat highlighting the need for new antibiotics to treat CDI. About Clostridioides difficile Infection According to the 2017 Update (published February 2018) of the Clinical Practice Guidelines for C. difficile Infection by the Infectious Diseases Society of America (IDSA) and Society or Healthcare Epidemiology of America (SHEA), CDI remains a significant medical problem in hospitals, in long-term care facilities and in the community. C. difficile is one of the most common causes of health care- associated infections in U.S. hospitals (Lessa, 2015, NEJM). Recent estimates suggest C. difficile approaches 500,000 infections annually in the U.S. and is associated with approximately 20,000 deaths annually. (Guh, 2020, NEJM. Based on internal estimates, the recurrence rate for the antibiotics currently used to treat CDI is between 20% and 40% among approximately 150,000 patients treated. We believe the annual incidence of CDI in the U.S. approaches 600,000 infections and a mortality rate of approximately 9.3%. About the Microbiome in C. difficile Infection and Bile Acid Metabolism C. difficile can be a normal component of the healthy gut microbiome, but when the microbiome is thrown out of balance, the C. difficile can thrive and cause an infection. After colonization with C. difficile, the organism produces and releases the main virulence factors, the two large clostridial toxins A (TcdA) and B (TcdB). (Kachrimanidou, Microorganisms 2020.) TcdA and TcdB are exotoxins that bind to human intestinal epithelial cells and are responsible for inflammation, fluid and mucous secretion, as well as damage to the intestinal mucosa. Bile acids perform many functional roles in the GI tract, with one of the most important being maintenance of a healthy microbiome by inhibiting C. difficile growth. Primary bile acids, which are secreted by the liver into the intestines, promote germination of C. difficile spores and thereby increase the risk of recurrent CDI after successful treatment of an initial episode. On the other hand, secondary bile acids, which are produced by normal gut microbiota through metabolism of primary bile acids, do not induce C. difficile sporulation and therefore protect against recurrent disease. Since ibezapolstat treatment leads to minimal disruption of the gut microbiome, bacterial production of secondary bile acids continues which may contribute to an anti-recurrence effect. Beneficial effects of bile acids include a decrease in primary bile acids and an increase in secondary bile acids in patients with CDI, which was observed in the Company's Ph2a trial results and previously reported (Garey, CID, 2022). In the Ph2b trial, ibezapolstat-treated patients showed lower concentrations of fecal primary bile acids, and higher beneficial ratio of secondary to primary bile acids than vancomycin-treated patients. About Acurx Pharmaceuticals, Inc. Acurx Pharmaceuticals is a late-stage biopharmaceutical company focused on developing a new class of small molecule antibiotics for difficult-to-treat bacterial infections. The Company's approach is to develop antibiotic candidates with a Gram-positive selective spectrum (GPSS®) that blocks the active site of the Gram-positive specific bacterial enzyme DNA polymerase IIIC (pol IIIC), inhibiting DNA replication and leading to Gram-positive bacterial cell death. Its R&D pipeline includes antibiotic product candidates that target Gram-positive bacteria, including Clostridioides difficile, methicillin- resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), drug- resistant Streptococcus pneumoniae (DRSP) and B. anthracis (anthrax; a Bioterrorism Category A Threat-Level pathogen). Acurx's lead product candidate, ibezapolstat, for the treatment of C. difficile Infection is Phase 3 ready with plans in progress to begin international clinical trials next year. The Company's preclinical pipeline includes development of an oral product candidate for treatment of ABSSSI (Acute Bacterial Skin and Skin Structure Infections), upon which a development program for treatment of inhaled anthrax is being planned in parallel. To learn more about Acurx Pharmaceuticals and its product pipeline, please visit Forward-Looking Statements Any statements in this press release about our future expectations, plans and prospects, including statements regarding our strategy, future operations, prospects, plans and objectives, and other statements containing the words 'believes,' 'anticipates,' 'plans,' 'expects,' and similar expressions, constitute forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by such forward-looking statements as a result of various important factors, including: whether ibezapolstat will benefit from the QIDP designation; whether ibezapolstat will advance through the clinical trial process on a timely basis; whether the results of the clinical trials of ibezapolstat will warrant the submission of applications for marketing approval, and if so, whether ibezapolstat will receive approval from the FDA or equivalent foreign regulatory agencies where approval is sought; whether, if ibezapolstat obtains approval, it will be successfully distributed and marketed; and other risks and uncertainties described in the Company's annual report filed with the Securities and Exchange Commission on Form 10-K for the year ended December 31, 2024, and in the Company's subsequent filings with the Securities and Exchange Commission. Such forward- looking statements speak only as of the date of this press release, and Acurx disclaims any intent or obligation to update these forward-looking statements to reflect events or circumstances after the date of such statements, except as may be required by law. Investor Contact: Acurx Pharmaceuticals, Inc.; David P. Luci, President & CEO Tel: 917-533-1469; Email: [email protected] View original content: SOURCE Acurx Pharmaceuticals, Inc.
The Independent
06-06-2025
- Health
- The Independent
‘Poop transplants' have been happening for decades. Now researchers have identified some unintended consequences
Fecal microbiota transplants are common medical procedures dating back decades that can help restore the gut health of people with colon infections - but scientists now warn of newly discovered consequences from the procedure. The 'poop transplant' is the transfer of the stool of a healthy donor to a recipient. The stool contains beneficial bacteria that can improve the patient's gut bacteria, which guards immune health and helps to regulate metabolism. They are approved by the Food and Drug Administration to treat people with common C. diff infections that may cause severe gastrointestinal symptoms and inflammation in hospital patients who have been on antibiotics. Roughly 48,000 procedures are done each year. Now, University of Chicago researchers say a study in mice and experiments with human tissue have revealed some long-lasting and unintended consequences due to transplanting microorganisms from only one section of the digestive tract. 'I think it's a bit of a wakeup call to the field that maybe we shouldn't willy-nilly put large bowel microbes into different parts of the intestine that shouldn't be there,' Dr. Orlando 'Landon' DeLeon, postdoctoral researcher at the university, said in a statement. 'If we're designing good therapeutics, we should be aware of the importance of matching the regional microbiota to their proper environments, so that we provide better overall health benefits.' DeLeon is the lead author of the new research, which was published on Friday in the journal Cell. To reach these conclusions, the authors gave three groups of mice transplants of microorganisms from the middle part of the small intestine that connects to the colon, and a standard fecal transplant from the colon. The test showed that the microorganisms from each transplant were able to colonize the entirety of the intestinal tract in the mice -- not just certain regions. This created what they called regional gut mismatches, lasting for up to three months following a transplant. The microbes also altered their new intestinal environments, 'terraforming' the lining in ways that caused changes in the recipient's metabolism, behavior and energy balance. There were shifts in liver metabolism, including activity in genes associated with immune function. The mice also exhibited different eating behaviors. The gut has several distinct regions with vastly different microbial ecosystems. Imbalances in gut bacteria have been tied to a risk of cancer. 'There are microbes along the entire intestinal tract, and we just study predominately the last third of it (the colon),' DeLeon said. 'So, how can you expect [a transplant], with microbes from a third of the intestinal tract at the end of it, to fix the rest of the intestine?' What this means for human patients may be murky right now, but the authors say more caution is needed with the transplants going forward. They advocate for an approach that would transfer microorganism from all regions of the intestine and not just largely from the colon. In the future, they plan to conduct further study related to how different microbes exert their influence in different parts of the intestine and how the gut regions terraformed by microbiota mismatches can be restored. 'We have absolutely no idea what's in FMT, except that it's a combination of microbes,' Dr. Eugene Chang, the Martin Boyer Professor of Medicine at the university and senior author of the study, said. 'But even a single FMT will cause a change in the host-microbe relationships in these very different regions of the bowel that may be very difficult to reverse.'
CBC
31-05-2025
- Health
- CBC
How much does your gut health impact your overall health? A lot, doctors say
Social Sharing You may be hearing a lot about the gut microbiome these days — it's been mentioned everywhere from wellness podcasts to the grocery aisle. Doctors are tapping into it to try and treat some diseases differently. The gut microbiome is the community of all the bacteria and viruses in our intestines, including friendlier microbes that promote health as well as some foes that can cause illness. One evolving procedure is the fecal transplant, where a small sample of stool from the colon of a healthy person is given to a recipient for therapeutic purposes. Despite the ick factor, they have been used to treat potentially fatal, recurring bacterial infections for which antibiotics have been less effective. Now, doctors and researchers are looking to see whether fecal transplants can be used for other hard-to-treat illnesses. Avoiding scorched-earth regimen Health Canada approved fecal transplants for recurrent C. difficile infections in 2015. Impacting the colon, these infections lead to diarrhea and, if recurring, dehydration that can wreak havoc on the body. The goal with the transplant is to have the healthy bacteria outcompete the C. difficile and wipe out the stubborn infection. Overall, for recurrent C. difficile, fecal transplants were significantly more effective, greater than 85 per cent, compared with less than 50 per cent for antibiotics. Dr. Nikhil Pai, a pediatric gastroenterologist and associate clinical professor at McMaster University in Hamilton, said antibiotics can create a terrible cycle. "What ends up surviving after this scorched-earth antibiotic regimen are bacteria that cannot only make things worse, but can affect a lot of other things such as just general nutrition and metabolism," Pai said. In adults, a 2023 review of clinical trials published by the respected Cochrane Library concluded fecal transplants may also help control Crohn's disease and ulcerative colitis, two forms of inflammatory bowel disease that harm the gut when the body's immune system mistakenly attacks itself. WATCH | Debunking myths of fecal transplants: The power of poop: What fecal transplants can and cannot treat 6 years ago Duration 2:39 Bruce Vallance, a pediatrics professor at the University of British Columbia, said inflammatory bowel disease is essentially chronic inflammation of the gastrointestinal tract, possibly triggered by the bacteria living in our intestines. It can happen at any age, he said. "We're trying to figure out whether certain microbes are driving the disease and whether we could target those microbes, deplete them and hopefully remove them from the intestine so there's no longer any trigger for disease." Some researchers are also looking into using fecal transplants for teenage anorexia nervosa, known for its difficulty to treat and high death rate. Research suggests there is a gut-brain connection, and scientists are finding there is an association between anorexia and imbalances in the gut microbiome, which could influence a person's behaviour. Building slimy 'mini guts' Vallance and his team are also studying whether certain microbes that may drive Crohn's and colitis can get through a key mucus layer in the intestines. To that end, he's been working with doctors at BC Children's Hospital to take fecal samples and biopsies that offer a snapshot of what's going on in the human colon. Vallance builds "mini guts" — a 3D model of the intestines in the shape of a ball — to study how the microbes function. He's focusing on growing bacteria in the epithelium, or gut lining, which contains proteins with sugars on them that form a slimy coating. "It doesn't look nice and it doesn't sound nice, but that sticky coating is actually really important in terms of how we interact with our gut microbes," Vallance said. It's what creates the barrier against dangerous bacteria that can cause diseases like Crohn's and colitis. Another trial focuses on short bowel syndrome in children who have had parts of their small intestine surgically removed. It can cause an excessive build-up of bacteria, leading to abdominal pain, bloating and diarrhea that's traditionally treated with antibiotics. There have been other unintentional benefits of the fecal transplant. Pai recalled, while at his other position at Children's Hospital of Philadelphia, treating an autistic child who had recurrent C. difficile. "After their treatment, there were comments from the family that this child was also just showing some real improvements and changes in their behaviour as well as noted by their teachers in school," Pai said. "I don't think it's any surprise that other aspects of him also got better." Why we are what we eat Bringing back healthier bacteria also benefits the body as a whole, Pai said, which could be why the boy saw improvements in other areas. "The comment or the idea that we are what we eat is very true," Vallance said. What we eat and digest is also individualized, to that extent that everyone's poo is like a fingerprint — or poo print, he said. "Everybody has their own unique blueprint." When people eat a high-fibre diet full of vegetables, for instance, more fibre reaches the colon, where microbes ferment it and release beneficial factors such as butyrate, a short chain fatty acid. Vallance said butyrate can help signal our immune system what to do and when. But people with inflammatory bowel disease tend to have much less butyrate, a helpful regulator to prevent the immune system from overreacting, he said. Carrie Daniel MacDougall, an associate professor at MD Anderson Cancer Center's epidemiology department in Houston, specializes in nutrition and the microbiome, including the role of dietary fibre. Daniel MacDougall and her team showed that adding dietary fibre in the form of canned beans changed the gut microbiome of cancer patients within eight weeks and is thought to encourage beneficial gut bacteria to do their thing. Cancer prevention guidelines already emphasize increasing fibre with whole foods like beans, as well as fruits and vegetables. "A lot of what we're learning about the scientific mechanisms and the gut microbiome also has a huge impact on public health," Daniel MacDougall said. Gut health "has a lot of crossover with other diseases like heart disease, inflammatory bowel disease. "We're all learning from each other's research."
Health Line
06-05-2025
- Health
- Health Line
Could Fecal Transplants Help with Weight Loss and Other Metabolic Issues?
Fecal transplants have been successfully used to treat gastrointestinal conditions. Researchers are currently studying whether they may also be used for weight loss and other metabolic issues. A fecal microbiota transplant (FMT) is a procedure that transfers healthy donor stools into a person's intestines for therapeutic purposes. FMTs have been used in the United States since the 1980s. The goal of an FMT is to help reset the bacteria in a person's gastrointestinal tract, which may then subsequently treat related conditions, such as ulcerative colitis (UC) and recurring Clostridioides difficile (C. diff) infections. Researchers are discovering possible connections between gut microbiota imbalances and a variety of health conditions, including metabolic diseases and those associated with weight gain. Researchers theorize that FMT could possibly help treat these conditions. While FMT is not considered a weight loss treatment, researchers are continuing to investigate the possible links between metabolic conditions and a disrupted gut microbiota. This article takes a closer look at these potential connections and what current research has uncovered. Can a fecal microbiota transplant from a lean donor reduce body weight? Medical weight loss may be recommended for a number of metabolic diseases, including obesity and diabetes. Some people might consider FMT if other treatments haven't worked, or if they don't want to use conventional medical interventions, such as weight loss medications or surgeries. The idea here is that resetting the microbiota might help improve overall metabolism and weight loss. What the research has found Recent research suggests that FMT may have some benefits for treating obesity. According to one 2022 review, FMT may potentially reduce insulin resistance and high blood lipids that contribute to obesity. However, the authors of the same clinical review also note that many clinical trials of FMT and metabolic disorders often do not succeed because of ineffective donors. This can make it challenging to discern whether FMT can benefit certain candidates for the treatment. Separately, a 2023 meta-analysis reported that FMT could potentially improve both blood glucose and insulin in people with obesity, and possibly assist in weight loss. The authors also found a correlation between a reduced body mass index (BMI) in participants with obesity and related metabolic diseases after undergoing FMT. Nevertheless, the current literature still has mixed results. One 2022 randomized clinical trial on FMT and bariatric surgery found that FMT had no effect on weight loss from lean fecal transplant donors. Can a fecal microbiota transplant be used for other metabolic diseases? Metabolic diseases are conditions that are thought to develop due to metabolic dysfunction. Overweight and obesity are common examples. Other types of metabolic-related conditions include diabetes and multiple sclerosis (MS). What the research has found Several studies are currently being conducted on the role of FMT in MS and diabetes treatments, as well as other metabolic diseases. However, other research has noted the possible long-term risk of developing metabolic issues after FMT, including obesity. What health disorders have fecal microbiota transplants been used for successfully? While the use of FMTs for metabolic disorders is still being investigated, this treatment does have a record of helping certain GI disorders, including C. diff infections and ulcerative colitis (UC). FMT may help treat C. diff infections by restoring healthy bacteria in the gut microbiota. In particular, a doctor may recommend FMT as a second-line treatment when two rounds of antibiotics fail to clear the infection. Some people may also need more than one course of FMT for recurring C. diff infections. Overall, the success rate is 94% after one or two treatments. Fecal transplantation is also sometimes used in the treatment of UC. In these cases, treatment typically involves a total of four rounds of FMT. The exact success rate of FMT for UC is not as clear as it is for C. diff. Possible future uses for FMT It's not just weight loss and metabolic disorders that are being explored as candidates for FMT. In fact, scientists are also looking at FMT as a possible emerging treatment for a broad spectrum of health issues, including liver disease, chronic fatigue syndrome, irritable bowel syndrome (IBS), mental health conditions, and more. Potential drawbacks of FMT for metabolic disorders While fecal transplants continue to be researched for treating a variety of conditions, there are also some drawbacks to consider. First, while FMT is considered safe overall, the long-term effects are also unknown. The risk of drug resistance and other negative effects appears greater when proper screening of donor samples is not followed. One 2021 review of FMT and its overall safety found that some of the possible short-term side effects included: abdominal pain bloating gas constipation diarrhea bloody stools nausea fever bowel perforations worsening GI disorder symptoms Ironically, the same review found that obesity, inflammatory bowel disease (IBD), and IBS were all possible long-term adverse effects of FMT. Autoimmune diseases and fatalities were also noted. Also, researchers are unclear whether transferring fecal samples could put recipients at risk of other microbiota-related conditions, such as diabetes. What's more, these FMT treatments are expensive, ranging from $1,600 to $17,000 without insurance. Takeaway FMT is a procedure in which a fecal sample from a healthy donor is given to a person with an unhealthy microbiota. Despite its success in treating C. diff and some cases of UC, scientists still do not fully understand how and why FMT works, and which microbes may be the most beneficial. While early evidence suggests FMT may help people with metabolic issues lose weight and experience better insulin resistance, there isn't enough clinical backing for this to be a mainstream treatment just yet.
