What is a fecal microbial transplant? - Kathryn M. Stephenson and David L. Suskind

翻译人员: Yip Yan Yeung 校对人员: Jacky He

1,700 years ago, a Chinese alchemist named Ge Hong

1700 年以前，中国炼丹师葛洪

was renowned for his special soup that could cure diarrhea-stricken patients.

以他能够治愈腹泻患者的 神奇汤药闻名天下。

The stew was deep yellow, and had an intense aroma.

炖料呈深黄色，味儿还很冲。

And, like many family recipes, it had a secret ingredient.

和很多私房菜谱一样， 它也有着神奇配料。

But in this case, that ingredient didn’t come from the kitchen—

但这个配料并不是出自厨房，

it came from the bathroom.

而是来自卫生间。

It might seem unwise to consume feces,

吃屎貌似不怎么明智；

and today, there aren’t many doctors who would prescribe Ge Hong’s recipe.

在今天，没多少医生 会根据葛洪的配方开药。

However, exciting new research suggests that taking poop into the body

但是，有项振奋人心的全新研究 表明将粪便摄入身体

in other ways might benefit our health.

从某种程度上还会对身体有益。

One such treatment is fecal microbial transplantation,

其中一种治疗方式 名为“粪菌移植”，

and the secret to how it works lives in your gut.

它的关键在你的肠道里面。

Trillions and trillions of bacteria, viruses, fungi, and archaea

上亿细菌、病毒、真菌、古菌

consider your bowels their home.

将你的肠子作为它们的家。

Collectively, these microbes make up what’s known as your gut microbiome,

这些微生物共同组成了你的肠道菌群，

and each of these organisms possesses dynamic, specialized abilities

每一种微生物都具备 动态、特有的能力，

that seem to be essential for human life.

对人类生命至关重要。

They break down our food, make vitamins,

它们分解食物、制造维生素，

train our immune system and circadian rhythm,

改善我们的免疫系统和昼夜节律，

and even protect us from infections.

甚至防止我们患上传染病。

In return, they receive a nice warm place to live,

作为回报，它们有了一个温暖的家，

complete with an all-you-can-eat buffet.

还能任吃自助餐。

Some research suggests our microbiomes might start forming in the womb,

一些研究表明我们的微生物组 可能在子宫里就开始形成了，

but if not, they certainly get started when we're born.

至少在出生后肯定形成了。

During a vaginal birth, infants take in some of their mother’s fecal matter

在顺产过程中，婴儿会 带走一些母亲的排泄物和

and microbe-filled fluids.

内含微生物的液体。

From then on, our microbiomes are constantly diversifying

从此，我们的微生物组 由于接触到各种食物和环境

with exposure to various foods and environments.

不断丰富。

This is essential for maintaining gut health.

这对维持肠道健康至关重要。

If poor nutrition, chronic disease or antibiotics disturb this delicate balance,

如果营养不良、慢性疾病或 抗生素破坏了这脆弱的平衡，

the body can become vulnerable to problems

身体就易受到各种问题的侵扰，

like bacteria and fungal overgrowth or infectious diarrhea.

如细菌或真菌过度生长， 即感染性腹泻。

But infusing a new batch of microorganisms into the intestine

但向肠道注入一批新的微生物

seems to help reset the gut microbiome—

似乎有助于重置肠道菌群——

this is where fecal microbial transplants come into play.

也就是粪菌移植的作用。

This line of treatment is still very new,

这种治疗方式还很新，

and there are tons of unanswered questions about how it works.

关于它的运作原理 依旧有许多未解之谜。

So currently, the US Food and Drug Administration only allows doctors

目前，美国食品药品 监督管理局（FDA）只允许

to use fecal transplants experimentally

医生试验性地通过粪菌移植

for battling one of the toughest gut infections—

对付一种最严重的肠道感染疾病——

antibiotic-resistant Clostridiodes difficile.

耐抗生素梭状芽胞杆菌感染。

This infectious bacterium forms spores in the colon that are immune to antibiotics

这种具备传染性的细菌 在结肠中形成对抗生素免疫

and very difficult to destroy.

且难以消灭的芽孢。

Patients dealing with this infection can experience months of intermittent fevers

患上这种传染病的患者 会连续几个月间歇性发烧，

alongside bouts of abdominal cramping and extreme diarrhea

还有一阵阵腹部绞痛和严重腹泻，

despite antibiotic treatment.

抗生素治疗也无济于事。

So when symptoms get this bad, it’s time for a fecal microbial transplant.

症状已经严重至此， 就该进行粪菌移植了。

To start the process,

第一步，

a gastroenterologist first retrieves some feces,

消化科医师先提取少许粪便，

typically from a stool bank.

通常来自于粪便银行。

These frozen samples are particularly impressive number twos—

这些冷冻的样本都是优质的粪便，

the selected donors go through a strict process

经过选拔的捐赠者 历经严格的流程，

to ensure their samples are infection-free.

确保样本没有任何传染病。

In fact, these protective protocols are so stringent,

这些保护性措施太过严苛，

one prominent stool bank’s acceptance rate is less than 3%.

以至于一家最大的粪便银行 接受率只有不到 3%。

Next, the gastroenterologist gets that sample inside the patient via a pill,

然后，消化科医师让患者 服下药片摄入样本，

or, more commonly, a tube into the stomach or colon.

更常见的做法是通过导管 注入胃或者结肠。

Finally, the transplanted microbes migrate through the tract

最后，移植的微生物在肠道中流动，

until they find the colon,

直到抵达结肠，

where they quickly multiply and displace the infectious invader.

它们在那里快速繁殖， 取代传染性的入侵者。

This process is so effective that it cures over 80% of patients

这个过程非常有效， 仅仅一个疗程

in just one treatment.

就能治愈超过 80% 的患者。

Because each stool sample is unique,

由于每个粪便样本都是独特的，

the FDA still classifies fecal transplants as an experimental treatment

FDA 仍旧将粪菌移植 划分为试验性治疗手段，

rather than a formal medication.

而不是正规的药物治疗。

But promising research in rodents suggests new ways

但是在啮齿类动物身上进行的 有前景的研究表明

we might use fecal bacteriotherapy in the future.

我们也许可以在未来 采用粪便细菌疗法。

For example, fecal transplants from non-diabetic mice

比如，来自未患有糖尿病 小白鼠的粪菌移植

improved insulin resistance in mice with type 2 diabetes.

改善了患有 2 型糖尿病的 小白鼠的胰岛素抵抗情况。

Similarly, some studies have shown mice exhibiting anxiety and depression

同样地，一些研究表明 表现出焦虑和抑郁的小白鼠

become calmer after transplants from their less anxious peers.

从较不焦虑的同伴那里 接受移植后会更加淡定。

Scientists studying humans have even started finding

研究人类的科学家们甚至发现了

different microbial patterns

不同的微生物规律，

associated with various intestinal, autoimmune, oncologic,

与各种肠道、自身免疫、肿瘤，

and even psychiatric disorders.

甚至是精神紊乱有关。

So, it seems entirely possible that altering a patient’s microbiome

因此，改变患者的微生物组

could allow for multiple new modes of treatment.

以产生多种新的治疗模式 是完全有可能的。

We still have a lot to learn about what makes the “best” gut microbiome,

我们还需要不断了解 什么是“最好”的肠道菌群，

or the most beneficial fecal transplants.

或者最有益的粪菌移植。

But for now, at least we can say that our feces have a bright future.

但现在，至少可以说 我们的粪便有光明的未来。