Could Our Microbiome Treat Mental Disease and Other Illnesses? – Psychology Today

We are always looking for innovative new treatments,from immunotherapy to gene therapy to novel antibiotics. But what if we had innovative new treatments inside our own body, namely our gut bacteria?

What if some peoples gut bacteria could be used for treating other peoples diseases?

It has happened in the past.

In the 4thcentury in China, medical doctor Ge Hong created a new treatment for diarrhea.It was called yellow soup and was a broth made with... not with lemons... not with yellow bell peppers... but withpoop of a healthy person.

I can imagine the readers grimacing. Yet, this "yellow soup" worked very well in treating diarrhea.

More recently, when people are exposed to long antibiotic treatments, not only are the culprit bugs destroyed, but all their good bacteria are destroyed also.As a consequence, some peoples guts are colonized by a very-difficult-to-treat bug calledClostridium Difficile (C. Diff.)and despite additional antibiotic treatments, these patients sometimes develop recurrentC. Diff.infections.

Since no other treatment can kill these recurrent infections all of the time, some physicians try to use healthy peoples poop, sometimes using the sexual partners poop to treat the infected person (used as an enema).And surprise!The partners poop often cures the infected person.

Dr. Jessica Allegreti, from Harvard mentions inHarvard Health Publishingthat Fecal Microbiota Transplants (FMT) have a cure rate of 80 to 90% with very often only a single treatment in cases of recurrentC. Diff.infections.

Although how Fecal Microbiota Transplants work their magic isnt yet explained, one theory is that healthy bugs in our guts may secrete bactericidal compounds that killC. Diff.Another theory postulates that when healthy bugs are restored through a transplant, they outcompeteC. Diff.for nutrients.

But what if Fecal Microbiota Transplants (contained in peoples poop) could be used to treat diseases other thanC. Diff.infections?

What if Fecal Microbiota Transplants could be used to treat Crohns disease, recurrent urinary tract infections?What if FMT could treat mental illness, Alzheimers disease, Parkinsons disease, autism and even obesity?What if FMT could work against cancer?

At the beginning of this December, my husband and I interviewed, Dr. Sabine Hazan, gastro-enterologist, founder and CEO of Progenabiome in Ventura, California and Dr. Brad Barrows,the medical director of the company.Dr. Hazan does research and leads clinical trials on the microbiome and Fecal Microbiota Transplants.

Dr. Sabine Hazan and Dr. Brad Barrows in their office

Source: Chris Gilbert, MD, PhD

Dr. Hazan has done 150 clinical trials in the last 15 years.She explained that we have in our gut up to 100 trillion microbes and that there are more than 150,000 species of them, some well-known, others not so well-known.

Dr. Hazans theory is that-- just like Penicillin was discovered from the growth of mold-- all gut bacteria, gut fungi and viruses might have properties that have yet to be discovered.

She is currently analyzing the gut microbiome of people with chronic fatigue syndrome, chronic constipation, celiac disease, Crohns disease, ulcerative colitis, recurrent urinary tract infections, psoriasis, Lymes disease, Alzheimerss disease, Parkinsons disease, autism, colorectal cancer, obesity and several other conditions.In doing so, Dr. Hazan is discovering that patients with certain diseases have a very different gut microbiome than people without any disease.

But first lets take a look at what a microbiome looks like, from Dr. Hazans point of view:

Below is a chart which shows the microbiome of 26 randomly selected individuals. In the chart, each column represents a different individual and each color represents a different species of bugs. See how complex every microbiome is?

The microbiome of 26 randomly selected individuals

Source: Used with permission of Dr. Sabine Hazan

Now lets look at families.

Below is the microbiome of one family:

Microbiome of one family: Father, mother and 2 children

Source: Used with permission from Dr. Sabine Hazan

Father Mother Child#1 Child#2

See how the colors are kind of similar between father, mother and the 2 children?This means they have the same species of bugs in their guts.

Why is that?

Could it be that they are genetically related?But what about the mother and father who are not genetically related?Could it be because they kiss and have sex?Could it be because they eatthe same kind of food or because they live in the same house?

All of these possibilities arelikely.

Now compare the above family microbiome with the family microbiome below:

Family with one autistic daughter

Source: Used with permission from Dr. Sabine Hazan

MotherDaughter 1Daughter 2

This second family has a very different microbiome than the first which means that they have in their guts very different sets of bugs.

In this second family- mother, daughter 1 and daughter 2- one of the daughters has autism.Can you guess just by looking at the microbiome which one has autism?

Yes, you are right, it is the one in the middle, daughter 1.

Do you notice how different the microbiome of daughter 1 is from the rest of the family?It seems that it has too much of a certain bacteria (the one in green in the middle) and misses a lot of variety of gut bacteria, one of them beingBifidobacter.

Moreover, there is less diversity (number of different organisms in Daughter 1) indicating that her microbiome is much less balanced than that of her mother or sister.

Dr. Hazan's plan is to understand the role of microbiomein diseases and to use her findings to help her colleagues perfect the area of fecal transplant. Most importantly, she wantsto shed some light into the mechanism of why fecal transplant helps improve a disease or cures Clostridium Difficile.

Dr Hazan doesnt believe in a one pill fits everyone, nor should a probiotic fits everyone.She believes in precision medicine and individuality as well as the need to remain diversified.

The one thing we learned from the microbiome analysis is that a healthy microbiome is one that is diverse in its microbial composition Dr. Hazan says

She hopes to work with the FDA to organize a trial on autistic childrenusing the data she gathered from microbiome analysis.

Yes, she has.

Through the mentorship of Dr Thomas Borody, aleaderin fecal transplantation,Dr. Hazan is applying his methods and protocolsto use FMT ina clinical trial on patients with Crohns disease,transplanting them with the microbiome of healthy individuals. Her results will be published soon. She has also seen improvement in one case of Alzheimers dementia andone case of chronic urinary tract infection.

Dr. Moayyedi from McMaster University, Ontario, Canada performed Fecal Microbiota Transplantations on 38 patients suffering from ulcerative colitis. Nine of Moayyedis patients went into remission and were able to stop all treatments (results published in the Journal of Gastro-Enterologyin 2015).

Dr. Johnsen from Harstad University Hospital, Norway performed Fecal Microbiota Transplantations on patients suffering from Irritable Bowel Disease (IBS) and had 65% of patients improved - much better than placebo (Lancet2018)

We dont know yetbut as Dr Thomas Borody says it takes courage and years of perseverance to change paradigms. Dr. Borody is presently working on a protocol on FMT and Parkinsonsdisease.

We need more clinical trials on larger samples of patients.

The key will be to find the right Fecal Microbiota Transplant donor to treat each condition and to better assess the risk vs benefit ratio of Fecal Transplant in the future.

But here are more questions about Fecal Microbiota Transplants:

Some people put the FMT in capsules to be taken orally, but stomach and bile acids might destroy the therapeutic microbiota taken this way. Thus, gastroenterologists like to transplant gut bacteria via enemas or place them directly near the caecum via a colonoscopy.

We dont know yet.All that we know is that the risks are not zero.

One person died after a FMT in 2019, but that individual had leukemia and a severely weakened immune system and the donor had an E. Coli bacteria that was resistant to all antibiotics.

Since then, donors have been better selected.

Can poop be taken from a slim person and placed in the colon of an obese person so that the microbiota of the slim person takes over?

Well, the answer is yes...in rats:

Maria Guirro and colleague from Rovira University in Spain (study published inPLoS One2019) showed that transplanting gut bacteria from lean rats to obese rats created a change in the obese rats gut bacteria, making the obese rat gut bacteria similar to the ones from the lean rats and thus less able to harvest energy from food.

Clinical trials with humans are starting (see in references below)

One thing is for sure: Depending on what we eat, drink and how much stress we have in our life, our microbiome changes and those changes can trigger disease.

An example is that stress makes our stomach, liver, and gallbladder secrete more acid, and those acids will kill a lot of our good bacteria, creating an imbalance in our gut flora.On the other hand, eating yogurt will provide us with good bacteria, but too much sugar in our diet will create a growth of bad bacteria, creating another kind of imbalance and triggering other diseases.

So, lets be aware that we are not alone in our body: We are the host of trillions of friends living in our gut that help us remain healthy.Lets be good hosts and keep our microbiome balanced by eating less processed food, less sugar and having less stress in our life.

Because after all, the future might really be in our poopno sh*t!

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Could Our Microbiome Treat Mental Disease and Other Illnesses? - Psychology Today