Poop transplants, chemo and the ‘perfect microbiome’

Dr Hannah Wardill wants your poo. At least, she wants to study it.

Her work focuses on an issue invisible to most.  When patients undergo chemotherapy, their gut microbiome is – in her words – obliterated.

“The total number of bacteria decreases over time, the diversity of the microbiome decreases,” Wardill, who works at the University of Adelaide, tells Cosmos

“We tend to see certain species just obliterated.”

Her research is trying to undo some of that damage. But as the gut heals, some species recover more than others – and they’re not always the species we want to foster.

“We see these things called pathogen blooms, where these bad bacteria in the gut tend to dominate the environment,” Wardill adds. 

But how to fix this? There are 3 different strategies. You can feed the microbes that are already there, by ensuring they still get lots of fibre. This is harder than it sounds, as chemo patients usually lose their appetite.

The second strategy is to ensure the lining of the gut stays healthy – “protect their home,” says Wardill.

“Bacteria rely on the lining of our gut to provide them with environmental niches to colonise, they eat out mucus in our gut all day long.”

The third strategy is faecal microbial transplants – poo transplants.

“We’re investigating faecal transplants as a strategy to support microbial health in people going through chemotherapy,” she says. 

“So this is where we have donors, we put them into capsules, and we give the capsules to patients.”

Her work relies on the first and largest stool bank in Australia, based in Adelaide.

“What’s really unique about BiomeBank is that they’re not only a clinical service, but they’ve got this really big underpinning of research and development which is just incredible,” says Wardill.

Although she says there’s not a ‘best’ bacteria or microbe, some people do have incredible microbiomes for poo transplants.

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“What does the perfect microbiome look like? Honestly, I don’t think we’ll ever define that. Because, you know, think about all of us, we all have different genetics. But ultimately, we’re still a functioning human,” she adds.

“What we’re trying to understand is what attributes make for a functionally competent microbiome? We have definitely not defined that yet.”

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