Results from a recent randomized clinical trial have found autologous fecal microbiota transplantation (FMT) can effectively restore patient's gut microbiome after major antibiotic treatments. The study examined a group of cancer patients and found that fecal transplants can quickly and safely restore a compromised microbiome within days of treatment.
Each person's unique gut bacterial population is increasingly understood to be vitally important in maintaining our overall health, but some medical treatments can significantly destroy vast swathes of our microbiome. In particular, researchers have been studying the microbiome of patients undergoing allogenic hematopoietic stem cell transplantation – a treatment administered to patients with some types of blood or bone marrow cancers.
One part of the stem cell treatment involves the administration of strong antibiotics, and this can often decimate a patient's gut microbiome. It can take weeks, or even months, for a person's microbiome to restore itself, and during this time one can be much more susceptible to infectious diseases.
The new study examined 25 patients undergoing the stem cell treatment. Fourteen patients collected fecal samples before taking antibiotics (for fecal transplantation following the treatment) while the remaining 11 served as a control group undergoing regular standard of care.
After the antibiotic intervention the FMT group received their treated sample and the results were quite comprehensive. Within days, the FMT group demonstrated a recovery of beneficial gut bacteria, rapidly restoring their individual microbiome to its prior state, while the control group displayed significant delays in microbiome improvements.
"This important study suggests that clinical intervention using auto-FMT can safely reverse the disruptive effects of broad-spectrum antibiotic treatment," says Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, a major funding partner in the research project. "If validated in larger studies, this approach may prove to be a relatively simple way to quickly restore a person's healthy microbiome following intensive antimicrobial therapy."
The study's primary focus was on whether this process was safe and effective in restoring an individual's gut microbiome. At this stage there is no data on specific patient outcomes, such as whether the rapid microbiome restoration actually reduced incidences of infections, but plenty of other research is certainly suggesting that this could be an important factor in future cancer treatment.
It should be noted that this work concentrated on autologous transplantation, meaning it only studied the efficacy of restoring a person's regular microbiome using their own fecal sample. Further work needs to be done to understand the effects of possibly adapting a person's microbiome with other, more foreign, bacteria that could improve the efficacy of a given treatment. A study last year, for example, intriguingly suggested certain gut bacteria can either improve or reduce the efficacy of some cancer drugs. Other research has found fecal transplants from healthy individuals can improve the behavior of children with autism.
So, while this study does confidently suggest fecal sample banking can be useful in helping restore a patient's microbiome to normal following certain medical treatments, it certainly doesn't hypothesize any effects beyond that. And that's with good reason, we are still undeniably in the very early days of understanding the vast and complex effects of our microbiome and a great deal of research needs to be completed before we actively start tinkering with the giant ecosystem of bacteria inside us.
The study was published in the journal Science Translational Medicine.
Source: National Institutes of Health
