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Gut Microbiology Articles and News

AUTISM SPECTRUM (ASD) AND INTESTINAL FLORA TRANSPLANTATION SEEM TO BE A GOOD MATCH. [DISCUSSION OF TARGET DISORDERS AND METHODS.]

Gut Microbiology Articles and News

2019.07.16

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THE INTESTINAL FLORA TRANSPLANT (FECAL TRANSPLANT, FMT) COMMUNITY IS FULL OF NEW REPORTS EVERY DAY.

The relationship between intestinal bacteria and various diseases is being reported one after another, and it seems as if it is becoming a matter of saying “so and so”.
Since bacteria are a part of us, it may be easier to start from the premise that “completely unrelated” disorders and diseases are no more than serious injuries.

RATHER THAN LOOKING UP THE NAMES OF DISEASES THAT ARE ASSOCIATED WITH INTESTINAL BACTERIA, I THINK WE SHOULD SPEND MORE EFFORT AND RESEARCH MONEY ON THINKING OF IT AS A CONNECTION TO THE BODY AS A WHOLE, LIKE IF YOU PUSH A BUTTON OVER HERE, A WILL GLOW, BUT IF THERE IS NO BATTERY FOR A, B WILL RING.

These things, due to lack of knowledge, experience, and human skills, I always have a hard time saying it right, “Eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee!” I get “Eeeeeeeeeeee!

Ever since I was a little girl, I was told, “If I have to take a shit, I have to tell you in advance. You have to tell me in advance that you want to go to the bathroom. If you don’t, you’ll get your pants dirty.”
I used to take a shit while stressing to my mom (why can’t I say the three words “toilet” when the time comes), so
I’m confident in my ability to speak logically and verbally.

When I am working on intestinal bacteria, I feel the frustration of “I have something in mind, but I can’t put it into words. I feel it so keenly.
I cannot have confidence in my ability to respond to all possible questions and counter-questions with a firm and confident answer.
Therefore, I immediately try to get by with humanities-like ambiguity.

We started the “Thesis Statement” series to arm ourselves a bit against such a nay-nay state.

In this issue, we present a paper on intestinal flora transplantation in children on the autism spectrum.

Enterobacterial Transplant Therapy Alters Gut Ecology and Improves Gastrointestinal Symptoms and Autistic Tendencies

脳腸相関

The study was conducted in 2017 by a research team led by Professor Rosa Krymarnik-Brown of the Center for Environmental Biotechnology and Biodesign Sweat at Arizona State University in the United States.

Microbiota Transfer Therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study

Let’s start with a summary.

background

When you skim through, you basically ignore the background.
I don’t recommend this way of reading if, like me, you don’t have sufficient knowledge of the disease in question.
I finally realized that I can’t get really useful insights by just picking and choosing the results and discussion.

So, let’s read the background properly.

  • Autism spectrum disorder is an area of difficulty in social skills and communication, and tends to repeat the same behavior or have a pattern of interests and behaviors.

(Wait a minute, that’s me. ……)

  • I think this disorder has something to do with intestinal flora. Because many people have gastrointestinal problems and it is also related to a strong tendency to autism
  • Studies to date have reported that autism is related to intestinal flora and that antibiotic treatment improved gastrointestinal symptoms and autistic tendencies.

This study seeks to evaluate the effects of gut flora transplantation using a method called Microbiota Transfer Therapy (MTT) on 18 children on the autism spectrum.

The result is Happeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee!

After two weeks of pre-treatment with antibiotics, we did an intestinal flora transplant with intestinal cleansing.
The total schedule is about 10 weeks, including the gut transplant and then daily maintenance transplants.

My GSRS, a measure of gastrointestinal symptoms, improved by 80%, and my autistic symptoms improved significantly!
Shhhh…and then some!
The effect lasted for 8 weeks after the transplant period was over.

Also, they did a gut flora analysis test and found that the donor’s bacteria are partially viable!
In particular, the diversity of intestinal bacteria and the increase in Bifidobacterium, Prevotella, and Desulfovibrio were observed. It was observed that the number of

What I mean by that is (conclusion)

This method, MTT, replaced the bacterial and viral composition of my gut and improved my gastrointestinal symptoms and autistic symptoms! Yo, a ray of hope!
Moreover, the fact that the effect lasted for 8 weeks suggests that the effect is quite long-lasting, he said.

That’s great!
Maybe our method should be NTT or something like this. (I’ll get complaints from big companies.)

Also, I’m amazed that you wrote so casually “replacing viruses as well”.
By the way, viruses, fungi, and bacteria all fall into the category of “microorganisms,” but do you know the difference between them?
I wrote about it in my previous blog, if you want to take a look.

https://shinbiosis.com/intestine-flora/microbe-virus/

I don’t know if I should say this myself, but I think the quality of fun and clarity has gone down compared to six months ago.
I guess I’m slowing down after a while. Dejected.

Below are the points of concern.

IS THE MTT METHOD REVOLUTIONARY?

自閉症と便移植

A standard protocol for intestinal flora transplantation has not yet been established.

The following literature summarizing FMT methods by European experts and
European consensus conference on faecal microbiota transplantation in clinical practice

The following document, compiled primarily by the American Gastroenterological Association
Fecal Microbiota Transplant National Registry

The following are very helpful and have been used as guidelines for our donor bank operations and affiliated medical institutions for evaluation and adverse event reporting.
However, they all only summarize the minimum and current situation, such as “it would be safe to do this” and “there are other ways to do this,” and have yet to elucidate effective protocols. However, they have not yet clarified effective protocols.

VARIOUS FMT PROTOCOLS EXIST, BUT THIS IS THE FIRST TIME I HAVE LEARNED ABOUT THE MTT METHOD.

In brief, the procedure is as follows.

  1. 14 days of vancomycin
  2. Half to full day fasting and bowel cleansing
  3. Gut transplantation (2.5 x 10 to the 12th power of bacteria), either orally or from the rectum.
  4. Intestinal bacterial transplantation with oral maintenance implications (2.5 x 10 to the 9th power of bacteria/day) while taking stomach acid suppressants.

This method was conceived by Professor Thomas Borody, who apparently has been clinically applying intestinal flora transplantation in Australia since 1987.

I have a feeling that you and our bacteria artisan would get along well. When our bacteria artisan first started doing intestinal flora transplants and went to the donor to ask for poop, he was misunderstood as a “sock hobbyist”.

Still, there are many transplant methods that use antibiotics, aren’t there?
It is not hard to understand in theory that it is better to have the current bacteria retreat and then introduce new ones, but I can’t deny that it seems unnatural.

As for the bacteria, they are trying their best to protect their host, and they are doing their best to achieve this balance.
Just like the father who painstakingly renovated his house as his children grew up, even destroying his own study.
But then one day, a contractor from Spine House (Sekitsui-House) comes along and says, “There are some problems with the earthquake resistance of the house, so we’ll have to clear the land once and for all.

I also wonder if the bioactive potential will also be unavailable, making it harder for the transplanted bacteria to find their own territory.

Is the bacterial solution used special?

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The transplantation bacteria solution used in this study was also described.

Standardized human gut microbiota, or SHGM for short, is a bacterial solution that already sounds like a product.

I have read more about this.
I got the impression that donor testing is only a minimal test for infectious diseases.
If it is OK to do so, I think it is not necessary to do as much donor testing as the firm does.

It says that the donor stool was filtered in a messy anaerobic environment to make it more than 99% bacteria only, according to GMP standards.
I thought to myself, “Is this GMP a great way to do it? I looked it up and found that it is nothing but “Good Manufacturing Practice (GMP) for pharmaceuticals and quasi-drugs.
(Reference: Simple GMP that anyone can understand)

This bacterial solution is kept frozen at -80 degrees Celsius and delivered to the patient’s home each week on a full load of dry ice.
The family is instructed to boil water to dissolve the fungal solution just prior to transplantation.

I have a small question here.
I know that both gut transplants and maintenance transplants are done by mouth. This is unusual in a time when colonoscopies are predominant.

But apparently it doesn’t seem to be an oral capsule.
What I mean is that it seems to be “taking the fungal solution by mouth”.
There are descriptions of mixing it with chocolate milk or juice and drinking it, but I wonder if it smells like poop at all. ……
Also, I’m not sure if it’s safe to drink the bacteria, even though the stomach acid has a low pH mechanism because it’s not good for foreign substances like bacteria to pass through the stomach. I wonder if it is safe to suppress stomach acid. ……

The questions are endless.

Is autism more compatible with intestinal flora transplantation than intestinal disease?

自閉症と便移植

This research, conducted in a variety of ways different from ordinary intestinal flora transplantation, has produced remarkable results.

Leaving aside Clostridioides difficile infections, which are head and shoulders above the rest, such a high response rate is impressive compared to less dramatic results in other intestinal diseases such as ulcerative colitis and irritable bowel syndrome.
In fact, there is indeed a feeling of a high response rate for transplants for autistic children at our affiliated medical institutions, although the number of cases is small.

It may be a brain-gut correlation, but there seems to be no doubt that gut bacteria and overall health are related.

Still, don’t you think it would be good to start with the gut first?
I think we need to dig deeper into this issue, but I think it may be related to something I have been thinking about for some time.

What I mean is that people with intestinal disease may have too poor an intestinal environment for the transplanted intestinal bacteria to play an active role.
Children on the autism spectrum, for example, may have gastrointestinal symptoms, but there is still a place for the intestinal bacteria unit sent in to play an active role, as the frozen Aquarius-like presence that managers hand out to baseball players practicing in the middle of summer.

But in the case of serious intestinal disease, it’s like throwing frozen Aquarius into an erupting volcano, and you’re in a state of scalding water.
That is what I am thinking.

For example, if organic acids are being properly produced, the pH of the stool should be slightly acidic. If this is tilted toward alkaline, the person may have a poor intestinal environment.
Or, someone who is not consuming fiber or polysaccharide-based grains that the intestinal bacteria can utilize and energize. (Like someone on a carbohydrate restriction.)

In the case of such people, it was mentioned that we should at least give them a lunch box when we transplant the intestinal bacteria. (We are still exploring how exactly to do this.)

This theory leads us to hypothesize that when symptoms appear in the intestine, the transplanted intestinal bacteria may not be easily nurtured.

On the warmth of the research team

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There is much more to write, but it is getting quite long, so I’ll just leave you with one last thing.

That is, the paper conveys the warmth of the people involved in this research.

The study did not rule out a placebo effect.
Also, the general children who participated in the study as controls were the children of friends family members of the patients’ families and the children of the researchers.
And the patients who participated in the study had a choice of oral or rectal route, and children under 12 years of age were allowed to eat breakfast, hungry! This is done with the following considerations.

That is by no means to say that this study is appropriate. Both gastrointestinal symptoms and autistic tendencies are statistically analyzed using multiple indicators and testing for viruses as well as intestinal bacteria.

They are sincere and tolerant.
I personally believe that this attitude of the research team may have led to this increased response rate.

I guess it’s not about the treatment, but about choosing your doctor.
Very thought-provoking and good paper.

Too bad, however, that the terminology of statistical analysis and DNA analysis was too difficult for me to fully appreciate this paper.
In the next issue, I will introduce the progress of this study after 2 years. ( [After ASD] Discussion on protocols and time difference to improvement in fecal transplantation | Symbiosis Institute|Institute for Intestinal Flora Transplantation (FMT, Fecal Transplantation) and UFB)

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