No more dangerous than an appendectomy
Russian scientists: do not be afraid of fecal microbiota transplantation
According to Academician Vadim Markovich Govorun (Institute of Bioorganic Chemistry of the Russian Academy of Sciences), the risk of complications during fecal microbiota transplantation is less than 0.001%. However, it is necessary to carefully monitor the metagenome of the donor material and assess the immune status of the patient.
Such a procedure as fecal microbiota transplantation (TFM) is used in cases of severe disorders of the intestinal microbiome – for example, with pseudomembranous colitis, which occurs as a result of long-term therapy with powerful antibiotics. However, recently in the USA, after such an operation, a patient died for the first time – his weakened immunity could not cope with antibiotic-resistant bacteria that he inherited with a new microflora. The infection was also received by another person who was transplanted material from an infected donor. The US Food and Drug Administration (FDA) has demanded that all experiments with intestinal microbiota transplantation be temporarily stopped until the reasons are clarified.
During the investigation, it turned out that in both cases, patients, together with the intestinal flora of donors, received a strain of E. coli that produces broad-spectrum beta-lactamase. This enzyme destroys not only penicillin antibiotics, but also next–generation drugs - cephalosporins. In addition, the weakened immunity of the patient played a role.
"In the Russian Federation, fatal complications after appendix removal amount to 1.5%. Despite the fact that such operations have been carried out for a very long time, this figure cannot be overcome year after year. If we count all the published protocols for fecal transplantation, then the risk of complications, including death, is less than 0.001%," said Academician Vadim Markovich Govorun, head of the Proteomics laboratory of the Institute of Bioorganic Chemistry named after M.M. Shemyakin and Yu.A. Ovchinnikov of the Russian Academy of Sciences (Moscow) during his plenary report in Novosibirsk on multi-conferences "Biotechnology – medicine of the future".
According to the scientist, this operation should by no means be prohibited, because in some cases, for example, in acute leukemia, when the body's immune system cannot cope with sepsis, and antibiotics no longer work, TFM is practically an alternative way to save the patient. However, careful monitoring of the metagenome of the donor material and assessment of the immune status of the recipient are necessary.
"That is, it is a matter of context. On the one hand, if we do some procedure, being carried away by it immensely, we can do harm. On the other hand, if we analyze in detail all the risks that exist in a patient and get closer to understanding the pathogenesis, we have a very good chance of helping a person," the researcher said.
Portal "Eternal youth" http://vechnayamolodost.ru