2023-06-25 17:30:00
More than 200,000 people suffer from cirrhosis in France, according to Inserm. This liver disease corresponds to a chronic inflammation and can lead to various complications. The pathology notably has the consequence of modifying the composition of the intestinal microbiota: the number of “bad” bacteria increases, which increases the risk of infection. British researchers have found a potential way to reverse the phenomenon and improve the health of people suffering from cirrhosis. Thanks to faecal microbiota transplants, it would be possible to treat the disease. Their work is carried out as part of a project called PROMISE and are run by King’s College London.
Cirrhosis: why act on the intestinal microbiota?
In principle, antibiotics can treat infections caused by bacteria. But they are not always effective in people with cirrhosis, because they have usually been exposed to these molecules for a long time and the bacteria have then become resistant to treatment. “Infections, especially resistant infections, are a death sentence for liver patients,” says Dr Lindsey Edwards, of King’s College London. Patients with chronic liver disease are often prescribed antibiotics, but they are at high risk for multidrug-resistant infections.” However, this resistance to microbes also makes liver transplantation, one of the treatment options for cirrhosis, complicated.
For these various reasons, scientists are seeking to treat the microbiota of affected people. A first trial was carried out by the team from King’s College London: it involved 32 people with cirrhosis. A faecal microbiota transplant was performed by endoscopy. “The results showed not only that it was safe and well tolerated in these patients, but also that it altered the gut microbiota, improved gut barrier function and mucosal antimicrobial immunity,” the authors note.
Fecal transplant to treat cirrhosis: a second study to be planned
After these first encouraging results, the team is launching the second phase of its study with the PROMISE trial. 300 people residing in the United Kingdom will take part in this research, one of the modalities of which is changing: the means of administering the fecal microbiota transplant. “Patients told us they would rather take tablets than have an endoscopy, says lead author Debbie Shawcross. The capsules are tasteless and odorless and may offer new hope to patients with cirrhosis who no longer have treatment options.” These capsules will come from freeze-dried stools of healthy people. Participants will not know if they are taking these capsules or if they are taking a placebo: but whatever the product, they will have to take it every three months for two years.
In France, 30% of people with cirrhosis are in the severe stage of the disease. Each year, it causes between 10,000 and 15,000 deaths in the country.
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