Monday 23 September 2013

Bacteriotherapy to combat chronic C. difficile infection

A technique that restored the normal intestinal microflora in a mouse model of Clostridium difficile infection may lead to the design of an effective therapy for this highly contagious and tenacious infection in humans, according to researchers in London. They identified bacteria in the intestines of healthy mice that helped to re-establish the proper balance of microflora when given to infected mice. 

"This approach is completely novel in that we can restore the microflora and in that way develop a more rational approach to treatment," said Brendan W. Wren, FRCPath, a professor of microbial pathogenesis at the London School of Hygiene and Tropical Medicine, at a press briefing about the research. 

Although Dr. Wren was not an author of the paper describing this mouse study (Lawley TD, Clare S, Walker AW, et al. Targeted restoration of the intestinal microbiota with a simple, defined bacteriotherapy resolves relapsing Clostridium difficile disease in mice. PLoSPathog. 2012;8(10):e1002995), he has been a collaborator with the authors on previous studies investigating C. difficile 

Chronic, relapsing C. difficile can be a stubborn infection, resistant to treatment with vancomycin. Treatment of infected mice with feces from healthy mice restores healthy microbiota and resolves the disease. The researchers identified a mixture of six intestinal bacteria from healthy mice that helped to re-establish healthy microbiota in infected animals. They sequenced the genomes of these health-inducing bacteria to identify them precisely. 

"We're in a new era for the treatment of C. difficile," Dr. Wren said at the press briefing. "With a bit more research, we'll be able to choose specific bacteria to potentially readjust the balance of the microflora [in humans] when it's been disturbed. So this is very important for C. difficile infection, but I also think that, as a general principle, bacteriotherapy may be important in other chronic conditions such as ulcerative colitis and Crohn's disease, which are diseases that are also due to an imbalance of the gut microflora."

Posted by Tim Sandle

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