Fecal microbiota transplantation in human metabolic diseases: From a murky past to a bright future?
by Jesse Conradie
Fecal microbiota transplantation (FMT) has proven to be an effective treatment in recurrent Clostridioides difficile infections. Long term side effects have not been established to date. The direct link between the gut microbiota and almost 95% of human disease has raised interest in the therapeutic application of FMT for the treatment of autoimmune, metabolic etc., disorders not previously linked with the gut microbiome. However, although FMT is considered safe in the long run, minor short term adverse effects from the procedure include transient diarrhea, abdominal cramps, fever, constipation. Although FMT is considered safe and well-tolerated in high-risk individuals, much research is still required before FMT can be established as an accepted therapy. Special consideration should be given to the current COVID-19 pandemic, as the SARS-COV-2 virus has recently been found to be present in the stool of infected individuals. This raises concerns about whether the oral-fecal transfer of SARS-COV-2 and other pathogenic microorganisms is possible. Therefore, the screening for SARS-COV-2 antigens should be added to the already established screening protocols before FMT treatment, and this would most likely include additional antigens as more pathogenic microbes emerge.
Although many studies have shown that the benefits of FMT outweigh the minor short-term risks, there still needs to be consideration when it comes to patients themselves, as the transplant of fecal matter from donors to recipients is not generally considered favourable. At the current moment, not many individuals outside of the world of science seem to be aware of the benefits of FMT, the future use of this technique in the treatment of many human diseases requires more public engagement and spreading of information regarding its safety and benefits.
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