“You’re transplanting what???”
Fecal Microbiota Transplant is a fairly new practice for replacing the microbiota in someone’s intestinal tract. Using donor feces, the patient is given an enema to flush their bowels and colon with properly working microbiota. This form of treatment is currently in different stages of clinical trial for the treatment of Clostridium Difficile, C.Diff for short. C. Diff is a bacterium that is in the gut microbiome of every single person that becomes harmful when the other natural microbiota in the GI Tract are destroyed, usually by antibiotic use. When those internal defenses are broken down, the C. Diff bacteria can cause watery diarrhea, dehydration, muscle cramping, vomiting, and in some cases dysentery. Thus, C. Diff most commonly affects older adults after hospital stays. This disease is most often treated with rounds of oral vancomycin or fidaxomicin.
So, why are we sharing poop? What is the benefit in all of this? According to the National Institute of Health and the CDC, 20% of people who are treated for Clostridium Difficile using those oral medications experience return of the disease. Also not to mention, it can get rather expensive. Thus scientist have began to question if these oral medications are the best treatment if theres a pretty significant chance the problem could return. So, since FMT replaces destroyed or ineffective gut microbiota using someone else’s good microbes, why not build back up internal defenses to rid the effects of C. Diff? This exactly what clinical trials are testing at the moment and also observing the long term effects of FMT. In the next few years, a double-blind trial will take place under various Medical centers to do a controlled study on the effectiveness of FMT on reoccurring Clostridium Difficile. If positive results are obtained, the scientists will follow-up with the successful cases for three years afterwards to record any longterm effects the fecal transplant may have had.
Given that the symptoms of C. Diff are so intense and without proper hydration and care can lead to death, I think borrowing someone else’s good microbiota could be a good thing. Not to mention, if this is a successful treatment, the use of antibiotics would go down for at least one disease. Yay for not supporting microbial resistance to antibiotics!
Diseases and Our Internal Defenses
Clostridium Difficile is one of many diseases associated with the microbiome inside our human bodies. Another disease that caught my eye was Non-Alcoholic Fatty Liver Disease. An article posted in the Cellular and Molecular Life Sciences Journal describes the research being conducted on the role that dysbiosis has on the epithelial barrier in the liver. Scientists are manipulating the gut microbiome through the use of probiotics, synbiotics, and probiotics in NADLF patients and seeing positive results! According to the article, the dysbiosis of the microbiome weakens the hepatic epithelial layer and allows for more bacteria to enter cells which leads to hepatic inflammation. And to go along with the conversation from before, FMT is being looked at as a possible solution!
Like I said before, there are numerous diseases associated with abberrant microbiota. A brief list may include obesity, inflammatory bowel disease, diabetes mellitus, metabolic syndrome, arteriolosclerosis, and some cancers. Although FMT may not work to treat all of these, it is comforting to know that science has revealed our tiny internal soldiers and we are working on ways to support the troops as much as possible.
CRAAP
You probably thought we were done discussing crap, didn’t you? …… cricket….cricket…
In all seriousness, CRAAP is a set of guidelines to find refutable sources and I feel as though my sources match majority, of not most of the criteria. To begin, C stands for currency. This applies to publication date, when the article was updated, and if the site itself if functional. R means relevance. This is asking if the data found is relevant to your research question or project and if the source is helpful in furthering the reader’s understanding of the topic. The first A is for authority. Who is the author? Who is the publisher? What makes the scientist experts in this field and why should we trust what they say? The second “A” is for accuracy. This brings into question if the presented information correct. One can find out the answer by looking at how many times and who has cited the source or comparing it to other journals or articles of similar content. And finally, P is for purpose. This questions why the article was published and why the research was done? Who was the audience and does the language indicate bias?
Applying the criteria above, I will now review my first source. This article was published just seventeen days ago. The material has yet to be updated because it is a mere two weeks old. Also, the trials being conducted are going to last a few years, so there are bound to be updated released. As for relevance, the article on discussing new clinical trials regarding FMT and the long term effects of reoccurring C. Diff. The publisher of the article is the National Institute of Health under the U.S Department of Health and Human Services. Although there is no specific author named, the site and sponsor are enough to verify the information. Also, the medical centers conducting the trial are world renown research facilities. One of them is right down the road, Duke University Medical Center. Because these trials are in the process of happening now, accuracy is hard to pinpoint without results, just yet. But, the explanations of the disease and the mechanisms of microbiota described are correct. The purpose was not to sell anything or take away from the audience, but rather to inform the general public of advancements in medicine and how longterm effects are being taken into account when new treatments are being investigated. There are no opinions to be made when factual evidence is put forth and research is being conducted without bias.
Now for the second article. This piece was published online six days ago and in text, but it was first received by the journal in August of 2018. Also, it was updated in December. The article contains information regarding research done of Non-Alcoholic Fatty Liver Disease patients, which is a microbiota-associated disease. Thus, the information is pertinent to this blog. The publishing journal is Cellular and Molecular Life Sciences, which is based in Switzerland. The article is followed by quite a few references and the website claims 169 citations. The fact that the journal is peer-reviewed gives it some authority and implies accuracy. Also concerning the correctness of the information, the description of the role of the microbiome in association with liver disease does align with further research conducted on this topic. And finally, the purpose of this article was to inform the general public about the role that the microbiome plays in a significant disease, and how treatment options are being explored.
For the reasons stated above, I do think my sources follow CRAAP criteria.
All Things Microbiology 