Gut flora transfer: How does healthy gut flora get into a capsule?
DZIF scientists at the University Hospital Cologne produce frozen gut flora preparations in capsules. The production protocol is freely accessible for interested colleagues.
Clostridium difficile infections constitute the majority of hospital-acquired diarrhoeal infections worldwide. More and more frequently, particularly persistent cases are treated by transferring gut flora, i.e. a healthy person’s faeces, into a patient’s gut. This form of therapy is termed gut flora transfer or faecal transplant; it has not yet been approved as a treatment method, but is successfully being used for individual treatment in compassionate-use settings in some hospitals. The bacteria transferred with the faeces colonise the receiver’s gut and seem to promote healthy interactions between the microorganisms—displacing the pathogens.
Until recently, a colonoscopy was needed for this treatment. In 2014, physicians from the Harvard Medical School in Boston, USA, published data on the successful transfer of gut flora with capsules for the first time. However, a precise production protocol was not provided. Dr Maria J.G.T. Vehreschild’s team has now developed such instructions and established them at the Department I for Internal Medicine at the University Hospital Cologne.
Open access services for production protocol
“Being able to transfer gut flora with frozen capsules gives us, and our patients, a completely new degree of flexibility in terms of time, as well as reliability for planning and implementing of this form of therapy,” explains infectologist Maria Vehreschild, who is further developing faecal transplants at the DZIF. An important advantage of this method is that, finally, we can cure patients who are too weak for a colonoscopy. “We would like to make this option available for all interested scientists and hospital doctors,” stresses the physician.
Vehreschild’s team has a further goal. They want to test the use of faecal transplants in trials. Only in this way can the potential of this therapy form also be investigated for treating other diseases besides Clostridium difficile infections. However, to date, such tests have not been possible in Germany. As yet, a major obstacle has been the limited available data on the efficacy and safety of faecal transplants. In order to solve this problem, the Cologne physicians and Dr Stefan Hagel from the Jena University Hospital founded MicroTrans, a registry for recording faecal transplant cases. MicroTrans helps to develop standards and identify potential safety risks of the transplants.
“Patients in Germany are waiting for clinical trials, we would like to plan them as soon as possible,” hopes Maria Vehreschild.
