Clermont-Ferrand (AFP)
When his doctor suggested a transfer of feces (TMF) to treat a serious infection of the colon, Ghislaine Grenet quickly overcame his reluctance. This unusual therapy, the object of all the attention of medical research, saved his life.
"At first it disturbs, because we say that it is still excrement we are injected.But we are so bad that we have to do something," says the 56-year-old woman, who has been suffering since several months of recurrent Clostridium difficile infection, a bacterium responsible for inflammation of the large intestine.
The fault with antibiotics used to treat other diseases that can cause an alteration of the gut microbiota by killing the "good" bacteria while allowing this "bad" bacteria to proliferate.
The main symptoms developed by patients are significant diarrhea, stomach pain and sometimes fever. A daily ordeal.
"Outside of my home, I absolutely had to look for toilets, it was impossible for me to work or lead a normal life," says the 50-year-old, waiting to be hospitalized on an outpatient basis at Clermont-Ferrand Estaing University Hospital Center. new administration of this unappealing mixture.
In the morning, a perfectly healthy donor - without digestive problems, no family history and rigorously selected after a complete biological assessment - came to deposit his stool at the pharmacy laboratory of the CHU auvergnat.
These excrements are then mixed with sodium chloride and packaged in bags or syringes. Before being administered by enema, colonoscopy or via a naso-jejunal tube (from the nose to the intestine).
Objective: rebalance the intestinal microbiota of the recipient who will change and look like that of the donor with this solution.
- 90% total healing -
"After a TMF, there are more than 90% cures without recurrence, where antibiotics do not do better than 30 to 40% cure in this recurrent form of colitis.It is really a treatment that works very well" says Dr. Julien Scanzi, gastroenterologist at Clermont-Ferrand University Hospital and Thiers Hospital (Puy-de-Dôme).
A month and a half later, Ghislaine Grenet "revives". Just like another patient, Sasha, 7, who could no longer go to school "because he was doing it 15 times a day".
The child, hospitalized for dehydration, had also declared a "C. difficile" infection after taking an antibiotic to treat bronchitis. "The TMF was the last resort," said his mother Aurélie, who "did not give much of his skin" without this therapy proposed today in a dozen hospitals in France.
The medical virtues of feces have been known for a long time. In 4th century China, excrement was already administered to treat severe food poisoning and diarrhea. In the 16th century, doctor and herbalist Li Shizhen made his patients swallow a "yellow soup".
But apart from a few experiments, especially among veterinarians and German soldiers taking example of Bedouins during the Second World War in North Africa, it was not until 2013 that a Dutch study scientifically valorizes its benefits.
- Not innocuous -
Today, research is no longer pinched: some 200 studies around the world are being conducted to find new applications. Because the prospects are vast: irritable bowel syndrome, ulcerative colitis, Crohn's disease, diabetes, obesity, Parkinson's or Alzheimer's disease, multiple sclerosis, autism and even peanut allergy.
"It is thought that the microbiota is involved in many diseases, without necessarily playing an important role in all diseases.Today, we are in the early stages of research to know which part of the mixture is responsible for the therapeutic effects", says Professor Harry Sokol, at the Saint-Antoine Hospital in Paris.
Because the gesture is "not trivial". "There is a risk of transmitting a pathogen", adds the gastroenterologist, who "receives many requests" refused for lack of "human resources", "donors" and a "sufficient territorial grid".
Even the National Assembly is currently studying the theme. An article in the bioethics bill proposes to "ensure the safety of drugs that are derived from the fecal microbiota by creating a specific legal framework for stool collection".
Companies have already positioned themselves on the niche of the intestinal flora. In the United States, the first stool bank "OpenBiome" was created in 2012.
In France, the Lyon start-up Maat Pharma aims to industrialise the TMF and plans to put a drug on the market in 2023. Another Clermont-Ferrand company initiated by Dr. Scanzi is being created to freeze its own feces. , for later use.
© 2019 AFP