Fecal Microbiota Transplants Assignment Sample

Introduction of Fecal Transplants Assignment

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Gut microbiota indicates microorganisms including Achaea, bacteria that live in the gastrointestinal tract of the human body. According to Valdes et al. (2018), gut microbiota play a significant role in metabolism, developing innate immunity. In addition, gut microbiota plays an essential role in controlling gut microbiota. On the other hand, bacterium Clostridium difficile may develop infection or colon in the large intestine. The most common and highly recommended treatment for Clostridium difficile infection is Faecal Microbiota transplantation (FMT). The FMT helps to transfer good microorganisms from the healthy individual tool into the patient (host) to control the Clostridium difficile infection. This study is going to discuss the purpose and background of FMT. Foundation in microbial diversity is going to be covered in this study. Challenges of the FMT will be discussed in this report.

Purpose and background to the technology

Faecal Microbiota Transplantation (FMT) is recognised as a promising therapeutic strategy, which helps to control the alteration of gut microbiota tissue. In the context of Clostridium difficult infection (CDI), the method FMT played a significant role. The infection of CDI is caused by Clostridium difficile which is gram-positive, able to produce spores, able to produce toxin bacillus (Czepiel et al. 2019, Clinicaltrials.gov, 2020). 

 Schematic flow of diagnosis of CDI

(Source: Czepiel et al. 2019)

The gram-negative bacteria may affect epithelial cell cytoskeletal, which affect the balance of gut microbiota. It has been identified that disruption of gut microbiota is recognised as CDI (Czepiel et al. 2019). It has to be mentioned here that the gram-positive bacteria produce Toxin A which is enterotoxin and Toxin B which is recognised as cytotoxic, which affect gut microbiota and develop CDI. Around 5% of adults and 70% of infants have faced the issue of CDI, which create a significant global burden. In this aspect, proper treatment or strategies are essential to control the CDI and improve the health of people. The above figure indicates that patients with CDI may undergo multiple tests including NAAT, Toxin A/B ELA to detect presence of Clostridium difficile. In this aspect, Lin et al. (2019) stated that faecal Microbiota Transplantation (FMT) is one of common strategies, which help to reduce CDI and improve the wellbeing of people.

 Suggestion of FMT for CDI

(Source: Lin et al. 2019)

The above figure indicates that confirmed refractory CDI in an individual should contact a specialist and the ideal team suggested the FMT as the core solution for CDI. This literature claims that FMT is a solution, which helps to deliver faecal into the gastrointestinal tract of an individual; who has gut dysbiosis. In western countries, the FMT was used as a formal solution for CDI from the nineteenth century.

 Route of delivery of Faecal Microbiota Transplantation (FMT)

(Source: Fadda, 2020)

There are multiple types of routes identified to perform the FMT among individuals. This literature stated that oral capsules, colonoscopy and tube infusion are common routes of delivery for FMT (Lin et al. 2019). The above figure also indicates the infected microbiome, which indicates that it, reduces the diversity of the microbial community. On other hand, after implementing the process of FMT through capsule, tube invasion and IR/DR capsule increases the microbial community (Fadda, 2020). The above figure denoted that implementing the FMT helps to restore the microbial community and develop health and wellbeing of people.

Further, FMT is a process of transfer of faeces from a healthy donor into the GI tract of an individual, which helps to control the microbial community or biodiversity. The first step of FMT is to collect faeces from stool banks or a healthy donor, which is needed to be mixed with sterile normal saline with a 1:3 or 1:5 ratios (Fadda, 2020). It has been identified that a hand blender is one of common tools used in this step to homogenize the stool. Filtration is the next step, which helps to remove the large particles. In addition, in the context of frozen faeces, laboratory systems need to use 10% of glycerol, which ensures the success of FMT (Fadda, 2020).

According to Niina et al. (2019), key purposes of FMT are to maintain balance in gut microbiota through reducing alteration in gut microbiota. It has been identified that FMT played a significant role to maintain the balance of gut microbiome and it improves microbial diversity. It has been identified that controlling the CDI, FMT played a significant emerging role. However, it has to be mentioned here that besides CDI, the FMT method played a significant role in controlling inflammatory bowel disease. Now this section is going to discuss protocol or process of FMT to control the infection and improve the balance in gut microbiota.

• Step 1: a collection of donor faeces before 6 hours of performing the FMT process
• Step 2: In this stage, faecal mixed with 36 ml of Ringer's solution. This homogenisation is one of the common and most important steps of the FMT process (Niina et al. 2020).
• Step 3: Next step is to filter the solution to remove the large particles before implementing the process FMT to control alteration of gut microbiota.
• Step 4: Next stage is to administer slurry into the gastrointestinal tract of the patient and 40 ml of slurry should be administered into a patient during the FMT process.
• Step 5: Orally or rectally two types of processes were identified to induce the FMT process into the patients. It has been identified that rectally or colonoscopy is the most effective stage to conduct the process of FMT. It has to be mentioned here that efficiency or safety through colonoscopy is high compared to other routes of delivery.

Therefore, by focusing on the above discussion, it can be stated that FMT is one of the most effective and most significant processes that help to reduce the issue of alteration in gut microbiota and improve health and wellbeing of people.

Foundation in microbial biodiversity

Microbial diversity or microbial community is one of the common processes, which indicates the presence of a microorganism in the gastrointestinal tract of the body to improve the health and wellbeing of people (Cresci and Izzo, 2019, Haller, 2018). It has to be mentioned here that microbial diversity or gut microbiota is developed after one or two years of birth. According to Derrien et al. (2018) microbiota consist of bacteria, fungi, Achaea additionally presence of viruses and phases are also identified. From infancy to eh old age, the gut microbiota played a significant role to control health and wellbeing of individuals. It has been identified that minute changes identify song adults, in context of composition and structure of microbiota. Based on metabolism and structure themes, it can be stated that gut microbiota among adults and infants are quite the same and it plays a significant role in host-pathogen associated disease risk (Derrien et al. 2018).

Disruption of gut microbiota is identified due to the infection of Clostridium difficile, which caused severe health issues. Further, this restoration of gut microbiota is one of the common purposes of FMT. According to Ohara, (2019), restoration of microbiota or balance in gut microbiota indicates success of FMT process. This literature also stated that high throughput sequencing technology played a significant role in determining the restoration of microbial diversity. It has been identified that to investigate the restoration of microbial diversity, implementation of 16s rRNA sequencing is one of the most effective and most convenient processes. In contrast, Niina et al. (2019) stated that factor microbiome analysis or refraction analysis is another common strategy that helps to investigate microbiome diversity. This literature stated that utilizing MiSeq reporter technology to perform RNA sequencing help to determine microbial diversity followed by FMT in an individual. Based on High throughput genomics and RNAseq themes, raw data were trimmed and screened by utilizing the QIIME 2 View tool. Different types of bacterial groups including actinobacteria, fusobacteria and proteobacteria have been determined after utilizing 16s rRNA sequencing data.

 Restoring microbiome diversity after FMT

(Source: Niina et al. 2019)

The analysis and above figure indicate drastic changes in the population of bacteria before or after implementing the process of FMT. It has been identified that before implementing the FMT, actinobacteria was around 18.2%, firmicutes 28.4%, bactericide 0.3% and fusobacteria cannot be detected (Niina et al. 2019). In addition, after 42 weeks of the FMT method, it has been identified as an improvement of microbial diversity, which indicates the success of FMT. It has been identified that fusobacteria has increased to 42% after implementing the FMT (Niina et al. 2019). Therefore, the adobe data indicates the restoration of gut microbiota, which indicates that FMT played a significant role in developing microbial diversity. Therefore, restoration of microbial diversity indicates success of FMT.

Now, this section is going to discuss the application of the FMT method in the clinical section, those are discussed as follows.

1. Ulcerative colitis

Inflammatory Bowel Disease or Ulcerative colitis disease was identified among individuals with the issue of alteration in gut microbiota (Leonardi et al. 2020).

 Role of FMT in Ulcerative colitis

(Source: Leonardi et al. 2020)

Above figure indicates that FMT played a significant role in controlling the issue of alteration of gut microbiota (Leonardi et al. 2020). The above figure shows that before implementing the FMT, low microbial diversity was identified, which has been changed into high microbial diversity after implementing the FMT process (Cammarota and Ianiro, 2019). Therefore, the above discussion indicates that in order to restore microbial diversity FMT method has played a significant role in Ulcerative colitis.

1. Hepatic encephalopathy

Hepatic encephalopathy is one of major gut-microbiota alteration diseases, which affect the health of individuals. Implementation of reflaxmin, lactulose agents is a common treatment to control Hepatic encephalopathy (Hassouneh and Bajaj, 2021). This literature identified that implementation of FMT played a significant role in controlling the issue of Hepatic encephalopathy. Therefore, by keeping an eye on the above discussion, it can be stated that in controlling Hepatic encephalopathy, the FMT method played a significant role.

1. Metabolic syndrome

According to Allegretti et al. (2021) metabolism issues, diabetic disorders or cardiovascular issues are identified among people with the issue of obesity. Further, this literature stated that metabolic syndrome is also identified among people with the issue of obesity. In this aspect, this literature stated that lack of efficient technology and treatment affect the health of people who develop this disorder. In this regard, the author has stated that FMT implementation played a significant role in controlling metabolic syndrome disorder and improving the health and wellbeing of people (Mocanu et al. 2020). Here, it can be concluded that metabolic syndrome could be controlled through implementing FMT.

1. Irritable bowel disease

Irritable Bowel Disease (IBD) is one of the common global burdens, which affects around 12% of the total population. He IBD is recognised as a gastrointestinal disorder, which affects gut microbiota. In order to reduce the issue of disrupted gut microbiota, implementation of FMT played a significant role (El-Salhy et al. 2020). The cohort studies have been performed to determine the role of FMT in controlling IBD. It has been identified that FMT has played a significant role in maintaining balance in gut microbiome and reducing the issue of IBD effectively.

Therefore, by focusing on the above discussion, it can be stated that FMT is one of the crucial methods, which plays a significant role in maintaining balance in gut microbiota and improving microbial diversity.

Key technologies exploited

Demand for studying gut microbiome and microbiota diversity is gradually increasing, which are associated with multiple technologies. Now this section is going to discuss associated technologies to study gut microbiome. According to Panek et al. (2018), next-generation sequencing of 16s rRNA is one of common and most convenient methods to study the gut microbiota or microbial diversity. It has been identified that next generation sequencing is a high throughput method, which helps to sequenced bacteria DNA present in Stool, during the FMT stages (Hazan et al. 2021, Gweon and Na, 2021). This literature also stated that shotgun analysis methods allow this sequencing method to determine the presence of bacteria. By focusing on bioinformatics and modelling themes, next generation sequencing helps to develop sequences of arterial DNA. Further, this sequencing helps to analyse downstream informatics through utilizing the FASTQ data. On the other hand, Alekseyev et al. (2018) reported that Next Generation Sequencing (NGS) is one of the common and conceiving methods that help to determine sequences of DNA and interpret the presence of bacteria in case of FMT. The NGS is associated with multiple stages, which allow this technology to separate sample nucleic acid including DNA and RNA. Next stage is the type of NGS sequencing; the stage indicates target sequencing, whole exome and genome sequencing. In the case of FMT, this NGS method first identifies bacterial DNA and in the next step, it follows whole-genome sequencing in target sequencing. Next step of NGS is to perform ligation, where this technology performs DNA fragmentation (Alekseyev et al. 2018). The final stages of this technology are sequencing and analysing databases to interpret results. Therefore, by keeping an eye on the above analysis, it can be stated that NGS is an efficient method or technology while using the FMT method as a solution of microbial diversity.

In addition, Quantitative Insights into Microbial Ecology (QIIME) is one of the most common pieces of software, which helps to analyse the microbial community. In the case of FMT and determination of bacterial presence, QIIME played a significant role in determining the presence of Clostridium difficile in the human body. Further, this technology helps to determine the total number of microbes in the gastrointestinal tract. Therefore, it can be stated that QIIME is one convenient technology to analyse the microbial community and reduce the gut microbial alteration disorder. In the context of implementing FMT, QIIME is one of the most common and most convenient methods. Further, RT-PCR is another method or technology implemented in determining the sequencing and the presence of bacterial DNA. During the FMT, implementation of RT_PCR helps to terminate the microbial community and reduces the issue of gut microbiota disorder. However, it has to be mentioned here that NGS is one of the most common and most effective technologies compared to QIIME and RT-PCR.

Major recent innovations

Technological innovation in research mainly deals with the applications that involve new technology that result in the new product as well as it provides the best services that mainly brings changes in the existing product and try to provide the best services with the help of new technologies. Microorganism mainly helps to develop the identification, classification, and differentiation in composing with human health that mainly developed and include the studies that include different microscopic bacteria, fungi, microbes, and protests by the help of this microbe and bacteria that helps to do proper functions in treating the patients from several failures. This innovation in treatment helps to develop health and it also helps in the proper functioning of the body and it also helps to understand the fundamental structure of the body such as it can be seen that faecal transplantation is the major recent transplantation that is also known as the stool transplantation that brings new innovation in the treatment policies that include the stool of the health doner and transfer it into the gastrointestinal that treats the patients by providing the effective treatment that helps to treat the infection and restore the balance of bacteria in their body(Halkjær et al.2018). The main objectives of this innovation that help to use Clostridium difficult infection suggest carrying the even therapeutic potential that includes the inflammatory bowel diseases that cause the gastrointestinal disorder.

• Colonoscopy innovation in FMT

This innovation encourages the growth of good bacteria in the patient's body which helps the patients to reduce the severity. It also helps in certain gut health problems like it creates a balance between millions of bacteria. On the other hand, it also helps in owing to the advantages of having a healthy gut micro biome. This also helps to develop the metabolism and mechanism of action these are the things that are very essential factors that escalated for the human health failure innovation incolonoscopyhelp to make the FMT transplantation more effective in medical science as because these make the transplantation more effective and easy these new innovation has changed the whole concept of this FMT that mainly used to detect the changes and abnormality in the large intestine here in these techniques that include the flexible tube that is put into the rectum where a small camera has been fitted that help the doctor to see the entire colon. This innovation helps the doctors to do their treatment with the new invention of technology that is the CCD camera, which helps to identify the whole problems of the patient. According to the new study, this innovation helps to detect the earlier signs of cancer that allow the doctor to remove the polyps that can be dangerous for the patients.

• Noninvasive methods in medical science

The advantage of this innovative colonoscopy is the safe procedure that is done with the help of artificial intelligence which is very helpful for identifying the polyps. It also reduces the risk that can be caused due to diseases. Another procedure that is used is noninvasive methods (Houf et al.2021). This is also a new innovation that helps in examining the sounds and it also includes accessing the proper body function and inspection. These are the methods of innovation that are helping medical science to grow more and provide effective results to many patients by curing their diseases. This also helps in the emergency and develops the features that provide a segment of devices that are used inside our body without affecting the normal body functioning. This process does not require any incision into the body or it helps to remove the tissues. This also includes proper physical therapy that reduces the pain and also provides heat therapy that is prescribed for several weeks. This mainly focused on the new methods of innovation that encourage the course of surgery as well as it also helps in healthcare product regulatory that involved in the treatment related to the infection, transplantation medical therapy and also include the microbiologist that helps in the detecting the infectious diseases and physician this are the things that bring innovation in the medical science this also helps in making effective result in treatment by using new techniques and technology.

Challenges and future prospects

As is it very sure that demand is increasing among the people to live longer by fighting against the diseases that even multiply the possibility of living by the help of medical science. The new innovation in medical science creates and makes possible changes that are helping to fight against the diseases that also help in increasing the public expectation and raising the demand for the treatment as everyone wants to live and want a healthy life ahead. There are also some challenges that can also come from using new technologies as well as including new innovative methods in the treatment process regarding medical science.

• Challenges in innovation due to treatment.

 This includes a medical efficiency review. That mainly states that successful healthcare innovation that is used upon the medical care that can be harmful to the patient and that can create major obstacles for the health that involve the healthcare and culture into the risk. Another problem that can be met up by the innovation includes manufacturing access this mainly includes the problem that can cause healthcare harmful effect in the health care problem these are the intellectual property contamination problem or issues this includes the manufacturing that is cost efficiency it also includes this main state about the cost that is required for implanting the new techniques that address to the growth and medical pharmaceutical costs that is related to the access and quality of care(Huang et al.2020). This also includes the problem that is related to the customer efficiency and experiences  this mainly comes from the customer interaction and make the effective outcome by using new techniques that include the issues that come from the treatment like FMT that cause abdominal cramps, pain low-grade fever this are some basic issues that have to face by the customer

Another challenge that comes from the treatment and innovation include problems like health cost. This is the most important point that is the most important for the patient to go through this healthcare process. This process cannot be accessible for everyone because of the high cost of the treatment. Using and applying new techniques in the treatment involves huge costs that mainly include the expenditure as well as it also includes the provision of health services that are provided by the healthcare specialist doctor. Operating cost and it also includes all the treatment accessibility that is provided by the hospital to provide the best services to the patients (Ianiro et al.2021).

Management clinical trades that mainly conclude the role of clinical trade manager are the most important features that are worldwide captured by the healthcare system this mainly include the treatment that is not always effective that sometimes include the side effect that can cause trouble for the patients that create a negative impact on the customer it also creates the negative impact on the management. This also includes the problem to find out the new drugs that should be cost relevant also. This also includes the side effects of the medicine. These are the things that can cause an infection that causes trouble for the patient's party. 

• Future prospects of FMT

Here in this portation, it will mainly be discussed about the future prospects of FMT this include the restored immune function that basically help to reduce the cost of damage. in the future, this FMT can be very beneficial for growing the helpful bacteria this can be used to delicate and make a balance among different million bacteria these are the things that are very helpful for the environment and it also is very effective in medicinal purposes (Costello, et at.2020) this will be very helpful for the intestine that help to regulate the immune system.

In the future it will be very helpful and common, nowadays it is not used in many countries as because it required high technological implementation and it also helps in the developing first three years of life for both adults and children this are the things that include micro biome, this will bring a more effective change in the life of the common people. This is some innovation that can change the future prospects in medical science with the help of new innovation and implementation. These are the things that are mentioned above that bring a new change in medical science as well as it helps to maintain the balance between the innovation and technologies that cause a great impact in the human health positive effect in the medical science field. the researcher is also helping to make every field of science more effective so that it can be helpful for the survivor to trust in them as well as it makes the positive result in treatment against the diseases.

Conclusion

This report can be concluded that FMT is one of the most convenient and effective technologies to maintain microbial diversity followed by it reduces the issue of gut micro biota disorder. This report has discussed technology and purpose and background of the FMT. In this section, this report has identified that FMT is a convenient method to improve microbial diversity and microbial community. Further, this report has identified microbial diversity and the role of FMT. In this section, this study has identified that FMT played an emerging role to reduce the disruption of microbial diversity and improving microbial community. Finally, this report has identified challenges and future perspectives of FMT. It can be summarized that in future, the FMT will bring innovation while maintaining microbial diversity.

Reference list

Books

Cresci, G.A. and Izzo, K., 2019. Gut microbiome. In Adult short bowel syndrome (pp. 45-54). Academic Press.

Haller, D. ed., 2018. The gut microbiome in health and disease. Springer.

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Allegretti, J.R., Kassam, Z., Hurtado, J., Marchesi, J.R., Mullish, B.H., Chiang, A., Thompson, C.C. and Cummings, B.P., 2021. Impact of fecal microbiota transplantation with capsules on the prevention of metabolic syndrome among patients with obesity. Hormones, 20(1), pp.209-211.

Cammarota, G. and Ianiro, G., 2019. FMT for ulcerative colitis: closer to the turning point. Nature Reviews Gastroenterology & Hepatology, 16(5), pp.266-268.

Chiu, C.H., Tsai, M.C., Cheng, H.T., Le, P.H., Kuo, C.J. and Chiu, C.T., 2021. Fecal microbiota transplantation and donor screening for Clostridioides difficile infection during COVID-19 pandemic. Journal of the Formosan Medical Association, 120(2), p.791.

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Lin, T.C., Hung, Y.P., Ko, W.C. and Ruan, J.W., 2019. Fecal microbiota transplantation for Clostridium difficile infection in Taiwan: Establishment and implementation. Journal of Microbiology, Immunology and Infection, 52(6), pp.841-850.

Mocanu, V., Zhang, Z., Deehan, E.C., Kao, D.H., Hotte, N., Karmali, S., Birch, D.W., Samarasinghe, K.K., Walter, J. and Madsen, K.L., 2021. Fecal microbial transplantation and fiber supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial. Nature Medicine, 27(7), pp.1272-1279.

Niina, A., Kibe, R., Suzuki, R., Yuchi, Y., Teshima, T., Matsumoto, H., Kataoka, Y. and Koyama, H., 2019. Improvement in clinical symptoms and fecal microbiome after fecal microbiota transplantation in a dog with inflammatory bowel disease. Veterinary Medicine: Research and Reports, 10, p.197.

Ohara, T., 2019. Identification of the microbial diversity after fecal microbiota transplantation therapy for chronic intractable constipation using 16s rRNA amplicon sequencing. Plos one, 14(3), p.e0214085.

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Valdes, A.M., Walter, J., Segal, E. and Spector, T.D., 2018. Role of the gut microbiota in nutrition and health. Bmj, 361.

Ianiro, G., Masucci, L., Quaranta, G., Simonelli, C., Lopetuso, L.R., Sanguinetti, M., Gasbarrini, A. and Cammarota, G., 2018. Randomised clinical trial: faecal microbiota transplantation by colonoscopy plus vancomycin for the treatment of severe refractory Clostridium difficile infection—single versus multiple infusions. Alimentary pharmacology & therapeutics, 48(2), pp.152-159.

Ianiro, G., Maida, M., Burisch, J., Simonelli, C., Hold, G., Ventimiglia, M., Gasbarrini, A. and Cammarota, G., 2018. Efficacy of different faecal microbiota transplantation protocols for Clostridium difficile infection: a systematic review and meta?analysis. UEG Journal, 6(8), pp.1232-1244.

Green, C.A., Quraishi, M.N., Shabir, S., Sharma, N., Hansen, R., Gaya, D.R., Hart, A.L., Loman, N.J. and Iqbal, T.H., 2020. Screening faecal microbiota transplant donors for SARS-CoV-2 by molecular testing of stool is the safest way forward. The Lancet Gastroenterology & Hepatology, 5(6), p.531.

Houf, J., 2021. Faecal microbiota transplants: towards a healthy disgust scepticism. Medical Humanities, 47(4), pp.407-416.

Huang, Z., Chen, J., Li, B., Zeng, B., Chou, C.H., Zheng, X., Xie, J., Li, H., Hao, Y., Chen, G. and Pei, F., 2020. Faecal microbiota transplantation from metabolically compromised human donors accelerates osteoarthritis in mice. Annals of the rheumatic diseases, 79(5), pp.646-656.

Halkjær, S.I., Christensen, A.H., Lo, B.Z.S., Browne, P.D., Günther, S., Hansen, L.H. and Petersen, A.M., 2018. Faecal microbiota transplantation alters gut microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind placebo-controlled study. Gut, 67(12), pp.2107-2115.

Websites

Clinicaltrials.gov, 2020. Fecal Microbiota Transplantation (FMT) in Recipients After Allogeneic Hematopoietic Cell Transplantation (HCT). Available from:https://www.clinicaltrials.gov/ct2/show/NCT03720392 [Accessed 21/03/2022]