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A Surprising Way To Rejuvenate Human Gut Microbiome Later In Life, New Research

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In recent decades, the gut microbiome has undergone significant changes as a result of changes in human lifestyle and diet. Type 2 diabetes, digestive system disorders, allergies, asthma, and other ailments have all been connected to these changes.

In an opinion piece published on June 30 in the journal Trends in Molecular Medicine, a team from Harvard Medical School and Brigham and Women’s Hospital (BWH) suggests that we can fight these trends by having young, healthy people store samples of their own gut microbiota that could be used later in life in an autologous fecal microbiota transplant (FMT).

“The idea of ‘rewilding’ the human microbiome has taken off in recent years and has been hotly debated from medical, ethical, and evolutionary perspectives,” explains Yang-Yu Liu, corresponding author.

It is yet unclear whether returning the microbiome of people living in industrialized civilizations to its ancestral form will have any positive health effects.

“In this paper, we proposed a way to rejuvenate the human gut microbiome.”

Donor stool FMTs have been effective in treating a variety of illnesses, most notably Clostridioides difficile (C. diff) infections, which affect half a million individuals in the United States and cause about 29,000 deaths annually.

One drawback of using donor feces, however, is that the host’s response can be unpredictable. This is likely due to genetic and environmental variances between the donor and the host.

To help in the development of microbiome-based treatments, Yang’s lab focuses on comprehending the ecological dynamics and organizational principles of the human microbiome.

The first stool bank to provide the opportunity for people to bank their own stool for potential treatment of C. diff infection is OpenBiome, a charity based in Somerville, Massachusetts. Yang and his coworkers investigated whether this strategy might be scaled-up for many additional diseases.

“Conceptually, the idea of stool banking for autologous FMT is similar to when parents bank their baby’s cord blood for possible future use,” adds Yang.

“However, there is greater potential for stool banking, and we anticipate that the chance of using stool samples is much higher than for cord blood.”

But putting this theory into practice presents a number of practical challenges, adds Yang. The essay delves deeper into some of these topics, including the best storage solutions, the appropriate amount of stool to store, and potential expenditures.

According to co-author Shanlin Ke, a postdoctoral research fellow in Yang’s lab, “autologous transplants would naturally avoid or at least mitigate donor-recipient compatibility issues, but a major disadvantage of autologous transplants is the need for long-term cryopreservation of stool samples, typically requiring liquid nitrogen storage.”

“The long-term safe storage and subsequent resuscitation and cultivation of stool samples is a fundamental research question by itself. To inform practical guidelines for stool banking,” according to Ke, “further research is needed to systematically test longer storage times and preservation, resuscitation, and cultivation procedures.”

Yang admits that extensive banking may result in a situation where individuals with greater financial means are more likely to have stored stool for later use.

“We do not anticipate that all individuals in our society are willing or able to pay the cost associated with the service of ‘rejuvenating’ their gut microbiome, in the same way that not all parents pay the cost of cord blood banking for their newborns,” he adds.

“But as scientists our job is to provide a scientific solution that may eventually benefit human well-being. Developing a reasonable business model and pricing strategy so that the solution is affordable to everyone would require the joint force of entrepreneurs, scientists, and perhaps governments.”

Asthma, multiple sclerosis, inflammatory bowel disease, diabetes, obesity, heart disease, and even aging could all be treated with autoimmune FMTs, according to co-author Scott T. Weiss, a Harvard professor of medicine and associate director of the Channing Division of Network Medicine at BWH.

“We hope this paper will prompt some long-term trials of autologous FMTs to prevent disease.”

Image Credit: Getty

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