Science

Fecal transplants show promise treating alcoholism in first human trial

Fecal transplants show promise...
In a trial involving 20 subjects, 90 percent of those in the fecal transplant group reported reduced drinking behaviors two weeks later
In a trial involving 20 subjects, 90 percent of those in the fecal transplant group reported reduced drinking behaviors two weeks later
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In a trial involving 20 subjects, 90 percent of those in the fecal transplant group reported reduced drinking behaviors two weeks later
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In a trial involving 20 subjects, 90 percent of those in the fecal transplant group reported reduced drinking behaviors two weeks later

A first-of-its-kind Phase 1 clinical trial, from researchers at Virginia Commonwealth University, has found fecal transplants may be helpful in reducing drinking behaviors in those suffering severe alcohol use disorder (AUD). The results are preliminary, and certainly require further validation, but the study points to a compelling relationship between the gut microbiome and addiction disorders.

The idea fecal microbial transplants (FMT) can improve human health is not new. Modern medicine has been experimenting with the treatment for well over half a century, and Chinese medical practitioners have used the technique for millennia. Over the last decade, however, interest in fecal transplantation has surged, alongside frequent breakthroughs in gut microbiome research.

This new research focuses on the relationship between addiction and the gut microbiome. More specifically, the investigators set out to explore whether a FMT can positively influence drinking behavior in subjects suffering from alcoholism.

“People with alcohol use disorder are often discriminated against and given up on,” says Jasmohan Bajaj, lead author on the new study. “But it’s a disease like any other. There’s a genetic predisposition, and addictions may be promoted by those gut microbes.”

Prior animal studies have indicated FMT can improve negative alcohol-induced behaviors, but this new research is the first robust, placebo-controlled trial in humans. The trial recruited 20 subjects with clinically diagnosed alcohol-use disorder. The cohort was all male, in their mid-60s, and suffering alcohol-related cirrhosis of the liver.

The cohort randomly received either a placebo or active FMT gathered from a single donor high in Lachnospiraceae and Ruminococcaceae, two types of gut bacteria seen in low levels in AUD patients. After one FMT, administered via enema, a variety of physiological and behavioral factors were measured at two follow-up points – 15 days and six months.

“Nine of 10 patients that received the transplant actually had reduction in their cravings and a reduction in the urine measurement of alcohol-related metabolites,” sys Bajaj, referring to the first 15-day follow-up. “They reduced their drinking, objectively.”

This compared to only three of the 10 placebo subjects displaying similar levels of improvement.

Needless to say, this is a small preliminary study, so the researchers are clear in cautioning any broader conclusions regarding the efficacy of FMT for alcoholism are limited. This Phase 1 trial essentially serves as a proof-of-concept, primarily establishing the treatment as safe.

“We conclude in this Phase 1 trial that FMT in men with cirrhosis is safe, associated with reduction in short-term craving and consumption with beneficial microbial change,” the researchers write in the conclusion to the new study. “The FMT-assigned group also demonstrated lower AUD-related events over the follow-up, which need to be confirmed and extended in larger number of patients with AUD.”

The study was published in the journal Hepatology.

Source: Virginia Commonwealth University

5 comments
guzmanchinky
Fascinating. I wonder just how much more we will discover about this connection to our basic functionality.
jerryd
Too limited.
Since alcohol kills much gut life, it naturally hurts it and the person's health. Of course restoring it will help make them better but has little to do with the underlying problem, mental illness, just treating a symptom of it.
Techrex
Well, have they looked into transferring fecal samples from the world's most extreme athletes, into the G.I. tracts of physically weak people, to see if that improves their general health and level of energy or vitality? I mean, this thing might be a real, general panacea for many health deficiencies for many people everywhere. Like, if you got a fecal sample from 'Superman', would that give you a degree of his super strength? Or what if we tried to put fecal sample from inhuman species like insects, who can devour things we cannot, into the G.I. tracts of people? Would something like that enable us to eat grass, etc.? Also, there is a long-recurring science fiction or comic book storyline trope, where military scientists trying to make 'Super Soldiers', also put a genetically engineered E.coli bacteria in their G.I. Tract, which would enable them to digest and derive a lot more nutriment and food-energy from the normally undigestible fiber part of our diets, a thing which I suspect, would also give them chronic diarrhea! That sounds nuts, but in a world that is running out of food for our exploding global population, we might actually do something like that, to enable people to survive by eating grass or rotten food safely. Also, if you do suffer from Irritable Bowel Syndrome or Crohn's disease, try eating 'Archway Coconut Macaroon Cookies', to reboot your G.I. Tract's normal bacteria. Apparently, that option can help a lot of people with these disorders.
christopher
@jerryd - what part of the following did you not understand? "Nine of 10 patients that received the transplant actually had reduction in their cravings and a reduction in the urine measurement of alcohol-related metabolites".
ljaques
I hope this pans out. Alcoholism is a fatal disease in far too many cases. I watched half a dozen friends die from it after I sobered up in '85 (35 years sober last month). Maybe the FMT will prevent the addictive portion, because when alcohol hits an alcoholic's system, 6 drinks aren't enough and 1 drink is too much. There seems to be an allergy associated to alcoholism, so maybe FMTs will address that portion. Test on, VCU! Your research could potentially save millions of lives.