In Fecal Transplants, Not All Poop is Created Equal

Guest BloggerClinical Corner, Microbiome Environment


There’s nothing like a poop story to get the juvenile juices flowing. Crowding a Twitter and RSS feed recently were numerous alerts to a diaper pail full of baby poop headlines: Kardashian-like catnip for the health-minded.

A PubMed search (not all blogs had links) led to an interesting piece of research from Wake Forest School of Medicine in North Carolina, USA.

Human-origin probiotic cocktail increases short-chain fatty acid production via modulation of mice and human gut microbiome appeared in Scientific Reports online on August 23, 2018.

The study

The cocktail in question was tendered by 34 healthy infants. More than 300 lactobacillus and enterococcus strains were tested for probiotic qualities such as strength, adherence, and safety.

Ten strains made it into the final blend. One oral dose followed by 5 consecutive doses were given to the mice.

The cocktail worked. With nary a hangover (except for the ultimate sacrifice part) the mice showed a significant pop in short-chain fatty acids (SCFAs), particularly propionate and butyrate. Notably, these metabolites produced by gut bacteria are reduced in patients with diabetes, obesity, autoimmune disorders, and cancers.

In addition, inoculation of these probiotics in human feces also changed the microbiome and increased SCFA production.

The authors concluded

Results indicate that human-origin probiotic lactobacilli and enterococci could ameliorate gut microbiome dysbiosis and hence may prove to be a potential therapy for diseases involving reduced SCFAs production in the gut.

Fecal transplant history

Fecal transplant is not new. Chinese scientists used it 1700 years ago for gut disorders. Today, fecal transplant has resolved most cases of recurrent Clostridium difficile (C. Diff), a hospital-acquired scourge that can kills many thousands every year. Inflammatory bowel diseases are new targets.

But as is being discovered, not all stool is created equal. One study noted three failed transplants using one donor followed by rapid success when a new donor stepped in for fourth trial to resolve C.diff colitis in an immunosuppressed patient.

Donor quality matters

Donor species richness may determine outcomes as reported in a separate study with inflammatory bowel diseases. Scientists don’t know exactly what defines the best donor. As they untangle the qualifications they are searching, this time in the messy business of diapers.

Using healthy babies for the probiotic source has advantages. First, babies may have fewer age-related anomalies baked in to their microbiomes. And as any new parent knows, there is never a shortage of material.

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