Research Team Steps In It
Some people discuss sports or the weather over dinner. Emma Allen-Vercoe discusses synthetic poop.
The University of Guelph biologist was out on the town one night with a colleague when she found herself talking about her research group’s attempts to formulate synthetic fecal matter. Even though development of the material, with its potential to help patients with Clostridium difficle-infected colons, was going well enough, Allen-Vercoe’s group was running into a problem: They couldn’t think of a name for their scatological creation. Thankfully, Allen-Vercoe’s colleague had the perfect solution. “He didn’t even have to think about it before he blurted out, ‘RePOOPulate,’ ” she tells Newscripts. “The rest is history.”
Now, Allen-Vercoe and her humorously dubbed creation have the potential to make a serious impact on the world of gastrointestinal disease treatment. According to a 2011 Scientific American article, C. difficle infections (CDIs) are on the rise, in part because of the increased usage of antibiotics, whose consumption can leave intestines vulnerable to attack by unhealthy bacteria. Such vulnerability may result in diarrhea, abdominal cramps, and, in cases with the elderly, even death.
To combat infection, some doctors have turned to fecal bacteriotherapy, in which a stool sample from a healthy donor is implanted into a CDI patient using equipment such as a colonoscopy probe. Once inserted into the gut, the sample stimulates the growth of good bacteria, eventually returning the bowel to equilibrium.
Scientific American notes that fecal bacteriotherapy has so far been performed on approximately 300 CDI patients with a more than 90% success rate. Although this is great news for chronic CDI sufferers who prove unresponsive to initial antibiotic regimens, the novel therapy is not without drawbacks. Physicians lack the ability to control all microbes appearing within a donor’s stool sample, and the handling of fecal matter comes with obvious hygienic concerns.
That’s where RePOOPulate comes in. Because the material is man-made, physicians have the ability to control its composition, which they derive through the isolation of various bacteria from a donor sample. What’s more, the material’s synthetic nature minimizes hygiene issues. It’s an exciting development that Allen-Vercoe’s team recently put to the test in two patients (Microbiome, DOI: 10.1186/2049-2618-1-3). Within a couple days, the bowels of both patients returned to full health, and over the next six months, neither patient experienced a relapse.
The results of the study are encouraging, but the research team still has many hurdles to overcome before RePOOPulate becomes a viable alternative to fecal bacteriotherapy involving real stool samples. Allen-Vercoe’s group plans to conduct a RePOOPulate trial in approximately 20 patients this summer and is busying working to refine the pseudoexcrement’s formula so as to maximize its effectiveness. “It will probably end up that there will be multiple RePOOPulate formulations using microbes from other very healthy donors, and we will try to tailor the ecosystems to the patients’ needs and lifestyles,” Allen-Vercoe says. For instance, she notes, a vegetarian donor might not be the best fit for a meat-eating patient.
Following a successful trial this summer, Allen-Vercoe hopes to expand into a much larger trial as well as find an industrial partner for the technology. “We definitely do have plans to commercialize the concept and are working with several potential partners to see if this is viable,” she says.
For all their efforts, Allen-Vercoe’s group has certainly grabbed the attention of gastroenterologists. “The work that this group is doing is very exciting,” says Christina M. Surawicz of the University of Washington. Surawicz, a fecal bacteriotherapy practitioner, notes that the thought of conducting transplants with RePOOPulate “is aesthetically more pleasing” than infusing a real stool sample. No arguments here.