Fecal microbiota transplants (FMTs) have been explored for years as a potential solution to treat patients suffering from gut disorders like irritable bowel syndrome (IBS). And the technology surrounding this treatment keeps advancing. Case in point – three Boston microbiome companies are currently racing to make bacteria-filled pills based on the FMT procedure that hopes to heal the gut microbiome without needing stool donors. However, even with all these encouraging findings – the long-term effectiveness of FMT as a therapy, the stigma surrounding this treatment, and the adverse effects of this approach, still pose challenges – leaving many questions unanswered.
Now, a new Gastroenterology study discusses the efficacy of FMTs in patients with IBS three years after the procedure was performed. The study findings are vital to the future of FMT research and potential gastrointestinal disease therapies. But there is more to this story. These research results could lead to additional breakthrough treatments for mental health disorders.
What the Study Found
For decades, studies have reported the microbiome’s contribution to various conditions ranging from IBS to autism spectrum disorders (ASD). The differences in gut microbiome quality following FMT have been studied and modified in several study trials. However, according to Medical Life Sciences, while four of these studies reported favorable findings, the other three failed to identify evidence of improvement in quality of life. But now, researchers in Norway may have some answers. Their newly published report provides the evidence needed to show the efficacy of FMTs. The research included a three-year follow-up of post-transplant patients with IBS and included an analysis of fecal samples and questions about the quality of life. One hundred twenty-five patients were assessed at the three-year mark, 38 of whom were treated with placebo, whereas 42 and 45 patients received differing amounts of donor stool. All transplanted fecal specimens exhibited a high level of microbial diversity and originated from a single 36-year-old healthy male. Symptoms were assessed using IBS Severity Scoring System (IBS-SSS) and the Birmingham IBS Symptom Questionnaire.
The compelling findings revealed that recipients receiving FMT had higher response rates than placebo recipients at two and three years from the transplant. Those who received FMT had significantly reduced abdominal symptoms, fatigue, and increased quality of life 2 and 3 years after FMT. These patients also reported less distension, abdominal pain, troubling bowel habits, and better quality of life. In addition, the fecal microbial profile, which was similar at baseline in all three groups, changed significantly over the three years. About 75 percent of severe IBS patients responded to FMT with a significant reduction in symptoms compared to over 50 percent of patients with moderate IBS symptoms.
Another Significant Finding
Though these results were vital to the future of FMTs, it’s not the whole story. The study also highlights the potential importance of ten bacterial species in IBS symptom scores, with more than half of these species showing higher signals in responders. The species have been associated with many physical and mental health conditions, including Autism Spectrum Disorder (ASD), depression, anxiety, aging, and chronic fatigue syndrome. Six of the ten bacteria that appeared to affect IBS symptoms and fatigue are Alistipes, Parabacteroides johnsonii, Bacteroides spp., Prevotella spp., Eubacterium biforme, Faecalibacterium prausnitzii, and Coprobacillus cateniformis. The roles that these bacteria play in IBS symptom manifestation and fatigue are yet to be determined. However, bacterial species such as Alistipes play a significant role in disorders such as depression and anxiety.
So how do these findings help other research in the long run? These results are crucial to the evolution of new IBS therapies – but they could also be vital in developing potential treatments for mental health disorders. In other words, connections between gastrointestinal and psychiatric disorders are very real. For instance, one review found that 44 to 84 percent of people with IBS also had anxiety and/or depression. With this knowledge, conducting further research into FMTs and the roles of these ten bacterial species may unlock better treatments for mental health disorders. It may even help research currently taking place in this area. Clinical trials that look specifically at fecal transplants to treat psychiatric disorders are coming down the pipeline, with one Canadian clinical trial already due to wrap up sometime this year.
Additionally, researchers at this year’s International Society of Microbiota Annual Meeting, held in Paris, Sorbonne University, will discuss prospective studies to develop microbial interventions, such as FMTs for depression care. Dr. André Schmidt of the University of Basel, Switzerland, will be one of the key speakers who will present data from a randomized controlled trial exploring the clinical and biological effects of probiotic supplementation in patients with depression. His talk plans to discuss data from two depressed patients receiving fecal microbiota transplantation. Future studies will also be suggested to develop microbial interventions as add-on therapies for depression.
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