Higher levels of spore fusion are associated with greater chances of successful transplantation

From intractable intestinal infections to metabolic syndrome, from skin cancerfor chronic inflammatory bowel disease, such as irritable bowel syndrome, and Tourette’s syndrome: many diseases can be treated with faecal microbiota transplantation (FMT), and researchers from the Catholic University, Rome and the University of Trento have shown that the higher the level of fusion in the cultured microorganisms, the greater the chances of treatment success.

This is the essence of the study published in the journal nature medicine Coordinated by Gianluca Janero, Researcher in Gastroenterology at the Catholic University and Consultant at the University of Oklahoma Gastroenterology at the Agostinho Gemelli University Clinical Complex Foundation “IRCCS” and by Professor Nicola Segata, Professor of Genetics at the University of Trento and in Sibiu Department of the University of Trento and the European Institute of Oncology in Milan, Italy.

“Microbiota transplantation,” Antonio Gasparini, professor of internal medicine at the Catholic University and director of the Department of Medical and Surgical Sciences and the Operating Units of Internal Medicine and Gastroenterology and the CEMAD Center for Digestive Diseases of the Agostino Gemelli IRCCS University Polyclinic explains, “are new therapeutic frontiers that span different areas of medicine, not only gastroenterology, but even, for example, oncology, (it has been noted that effectiveness Some cancer treatments are affected by microbes. It is clear and most obvious that the gut microbiota – the group of microorganisms that live in symbiosis in our gut and perform many functions in addition to the digestive system – are important to human health and have a critical role in both the digestive and immune systems. system, and even (through the gut-brain connection managed by the vagus nerve) to the nervous system, with potential implications for complex diseases such as multiple sclerosis and autism.”

Transplantation is done by isolating and purifying the donated germs collected from the stool and transferring them in various ways (in capsules or during colonoscopy) to the donor patient. What is not really clear about this treatment procedure is how well the microorganisms are cultured in the intestine of the recipient patient.

Using complex genetic sequencing techniques and computer analysis, experts analyzed a total of more than 1,300 gut microbiota samples (collected from feces) from donors and recipient patients with eight different diseases (Clostridium difficile, multi-resistant intestinal bacteria infection, metabolic syndrome, melanoma). Chronic inflammatory bowel disease, irritable bowel syndrome, chemotherapy diarrhea, Tourette’s syndrome).

“Thanks to the ability of analysis based on genomic sequencing techniques,” Segata explains, “to identify the different bacterial strains present in microorganisms, which have a specific pattern for each person, we were able to understand whether a particular strain was transmitted from donor to recipient.”

Ianiro explains, “We have seen that patients with higher levels of microorganism affinity have a better clinical response; vaccination is also greater in patients with infectious diseases (who have less severe microbiota-dysbiosis) than those with From chronic diseases. Diseases (those with dysbacteriosis are more complex and branched).

Ignero adds: “We also found that patients treated with antibiotics prior to the transplant procedure had a high incidence of vaccination, and that infusion of germs via multiple routes of administration (eg, capsules with colonoscopy) encouraged vaccination. I found that some microbial species (particularly bacteria) proteus and actinomycetes) feed better than others (eg, phylum Firmicutes).

Finally, “We have shown that by using AI we can predict with appropriate accuracy the composition of the donor microorganism after transplantation, and this can then lead to the identification of the best donors whose stool is most successful in increasing the diversity of microorganisms (which is a parameter of the health of the microorganisms). ) post-faecal transplant,” notes Ianero and Segata.

“This study is the result of a fruitful collaboration and years of study by our research group on gut microbiota transplantation. Thanks to these advances in knowledge about the conditions that increase transplant success,” Giovanni Camarotta, associate professor of gastroenterology at Catholic University and UOC Director of Gastroenterology, explains. Gastroenterologist at Agostino Gemelli IRCCS University Polyclinic Foundation, “We will increasingly be able to exploit the procedure in clinical practice to treat many diseases.

“This is why we recently won a follow-up grant, with our Trento and Milan group and our Medical Oncology Unit, a randomized controlled trial aimed at evaluating whether fecal transplantation succeeds in improving the therapeutic response to immunotherapies,” concludes Ianero. The patients With advanced kidney cancer. Professor Camarota concludes that already for other cancers, such as melanoma, there is preliminary and promising evidence about the relationship between germs and the success of immunotherapy.


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