' The subsequent rescue WMTs successfully stopped the progression of the disease with quick improvement. The plateaus and reversals occurred during the whole course of WMT. The stool and blood samples from the first WMT to the last were collected for dynamic microbial and metabolomic analysis. We observed the microbial and metabolomic changing trend consistent with the disease status. This case report for the first time shows the direct clinical evidence on using WMT for treating ALS, indicating that WMT may be the novel treatment strategy for controlling this so-called incurable disease. '
As usual, this very progressive use of FMT for a very serious illness originates out of China while the US seems to confine the majority of uses for FMT to C-Diff. Do we really have any drugs that can stop ALS progression? FMT is literally and figuratively, "the shit", yet not one US study reported its use in PD or ALS despite results seen in studies done in China showing very significant benefit in terms of motor and non motor symptom improvement in PD and progression stoppage and symptom improvement in ALS. China seems to view FMT as knowing that it can help diseases that progress with no treatments to stop the progression, they also seem very aware of the safety profile of FMT performed properly and choose to advance research into new areas where other countries are choosing not to.
One look at PubMed shows endless repeated studies for FMT and C-Diff, but it is just an endless loop of the same studies being repeated over and over. The preliminary studies for FMT/PD in China were small but very positive results were obtained in a very short period of time clearly paving the way for further studies to confirm and elucidate the methods of action involved, but nobody in the world has seemed to follow through on those impressive initial results that I wrote about here :
Compare the cost of FUS or DBS to the cost of a poop transplant. FMT can be a very affordable procedure and if the initial studies done in China are to be believed, very effective in reducing both motor and non motor symptoms in PD or stopping disease progression in ALS. I guess it is just better if the US continues to ignore the potential of FMT in a multitude of health issues beyond just C-Diff, because that seems to be what they are doing.
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Well, FMT is available in the US, but it is only used for a few health issues, the main one being C-Diff. It is also used for serious IBS conditions that do not respond to standard treatments.
As far as PD, the only countries that have tested it in PwP and reported their results that I am aware of are China and Israel.
As mentioned, it looks like China set up to do this sort of thing and the US is not. Not enough money in it to motivate this unpatentable treatment :-(. From the fulltext:
"Here we aimed to report the first human case with ALS accompanied by refractory constipation who benefited from the washed microbiota transplantation (WMT)...
WMT is an improved methodology of fecal microbiota transplantation (FMT) based on the automatic purification system and washing process[9] , whose methodology was standardized by the expert consensus in 2020[10] . WMT is a routine clinical technology in China, which only needs ethical approval...
The constipation was well controlled since the first course of fresh WMT through mid-gut tube. Because the satisfactory improvement in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R), 40- item Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40), clinical classification of muscle tone and Modified Ashworth Spasticity Scale was observed since the first WMT (Fig. 1 and Fig 2), the long-term treatment using WMT through mid-gut or colonic transendoscopic enteral tube was strongly required by the patient and was approved by the expert group. Initiation of WMT brought about a plateau of her symptoms. The impaired balance and gait were gradually improved when muscle tone decreased."
Case report of improvement with Parkinson's. In both cases there was constipation which may be a relevant indication:
" The patient’s tremor in legs almost disappeared at 1 week after FMT but recurred in the right lower extremity at 2 months after FMT. Lessons: Gut microbiota reconstruction may have therapeutic effects for Parkinson’s disease patients, especially those who have gastrointestinal symptoms and limited treatment choices."
"Date\scale Before FMT / 1 wk after FMT / 1 mo after FMT / 3 mo after FMT
UPDRS III (ON) ........46 ...................32 .............................40..............................44"
Based on this treatment would need to be repeated every week or two to remain effective.
The two studies done in China had a much longer efficacy period of months to two years from a single FMT treatment at the beginning of the study, but both of those were preliminary studies with just 11 participants in one study.
That, is a breath of fresh air and both are RCTs and relatively close to completion with larger participant groups than either of the preliminary studies from China. One study from Helsinki and one from Belgium. I will be very interested in seeing their results.
Thanks for sharing this info for a so-called incurable disease ❤️ It's timely, as I was just reading about the connection between leaky gut and spinal cord lesions.*Did you know that 50% of dopamine production occurs in the gut??
Gut "dysbiosis" is definitely an issue for me. How do we fix leaky gut without having to have repeat FMTs??
I think the Keto (low carb)/Wahl's (high fiber) diets combo are an important part of healing the gut and so is reducing toxic burden in the body. I cut out most processed food and try to eat food in it's natural state. I'd choose a baked potato over French fries, for example. Gluten is a non negotiable for me, same with MSG, it makes eating out a challenge and not very fun.
I bought Zeolite for detoxification. I work hard at not adding to my toxic load with lifestyle choices.
I'm diligent about using nontoxic products in and around our house and personal care products, we have filtered water to drink and air purification. I live in a bubble because of chemical sensitivity. It's just my life and these choices help me live more comfortably.
When you look at animal models of PD, they are often produced with poisons and those poisons have been shown to cause dysbiosis. In FMT the results are achieved at least partially by significantly improving the gut microbiome. I think this is why people see benefit with the probiotic PS-128 because it has a positive impact on the gut microbiome.
I am so interested in this concept of FMT. My father was weirdly healthy and I am sure his s#$@ could have been used to help tons of us with degenerative diseases. Thanks for sharing this!
What I also find very interesting in animal FMT studies is that when they FMT'd older mice donor microbiota into younger mice, the younger mice took on elevated inflammatory levels in the central nervous system, retinal inflammation and altered cytokine signaling.
On the other hand when donor microbiota from young mice was FMT'd into older mice, those negative aging effects were reversed in the older mice. Imagine if those effects were to translate to humans.....
Does anyone remember the clinical trial of Young Plasma for Parkinson's? It was promising and then it disappeared. Small study of 16 people in 2016 - didn't report results until 2020. Doesn't this imply that PD is an autoimmune disease? clinicaltrials.gov/ct2/show...
Lifestyle is EVERYTHING. I met a woman through my environmental medicine clinic, whose brother in law was a patient of Dr. Perlmutter. He did FMT in Germany. He also took the probiotic Saccharomyces Boulardii. No silver bullet, it's a combination of detoxify, fortify and maintenance. You don't get to go back to your old ways, it's a lifestyle - otherwise why bother?
I provided a link to the Stanford trial. I recall reading and article about a woman in the trial who had complete remission of her PD from young plasma. From my research, the mechanism for this therapy is the increase in growth factors (IFG-1 and others).
IV PRP was given to a 6 year old boy with cerebral palsy and several of his metrics improved. pubmed.ncbi.nlm.nih.gov/261...
Why growth factors? Because they regulate the HPA axis. I believe that injury to and dysregulation of the HPA axis is the seat of NDD (more research needed PD warrior's). A lot of chemicals, hypoxia, anoxia and head trauma are toxic to the hypothalamus.
Two more case reports of using FMT for ALS with results that add confirmation to the first case report and clearly suggest that FMT can be very beneficial for people with ALS, which has little in the way of effective treatments :
Here is a relevant quote from the report of the two cases of ALS :
Case 1
' Case 1 was a 71-year-old man with a 6-month history of poor appetite, 20 kg weight loss, and progressive limb weakness over 3 months. He had experienced breathing and swallowing difficulties and slurred speech over the last 2 months. '
' Six months before admission, the patient had taken antibiotics orally for 7 days due to a cold and fever and developed limb weakness after antibiotic withdrawal, but did not develop dysphagia or dyspnea. After that, no fever and any infection occurred, and antibiotics were not used. The patient’s condition gradually progressed.'
' Three months before admission, his limb weakness worsened and his body weight decreased by 20 kg. Two months before admission, the patient began to experience dyspnea, dysphagia, slurred speech, and coughing when drinking water. Owing to type II respiratory failure two weeks before admission, he underwent endotracheal intubation and mechanical ventilation.'
' After admission, piperacillin sodium and tazobactam were injected intravenously for 11 d (June 22th to July 3rd), and antibiotics were discontinued three weeks before FMT. '
' Riluzole, edaravone, and butylphthalide treatment for 2 weeks showed no noticeable improvements. Before FMT, respiratory parameters were synchronized intermittent mandatory ventilation-volume control mode: FiO2 = 35%, tidal volume (TV) = 450 mL, positive end expiratory pressure (PEEP) = 5 cmH2O, respiratory rate (RR) = 15/min. '
Clinical improvement after FMT
Case 1
In Case 1, the patient underwent the first FMT on the 32nd day of admission. Before FMT, the patient was mechanically ventilated (synchronized intermittent mandatory ventilation-volume control mode, FiO2 = 35%, TV = 450 mL, PEEP = 5 cmH2O, RR = 15/min) and fed enterally. The patient was unable to hold objects, sit, or stand independently (Supplemental Materials Video 1). Five days after the first FMT, he began weaning off ventilation for a maximum weaning period of 6 h. On the 10th day, he commenced noninvasive ventilation (NIV) with an oxygen concentration of 3–5 L/min, and shifted from nasogastric tube feeding to oral intake. After 4 weeks, he no longer required supplemental oxygen and could eat orally without choking; however, his limb muscle strength remains unchanged (Supplemental Materials Video 2). Subsequently, the patient underwent a second FMT and was discharged (Supplemental Materials Figure S1a).
Six weeks after the second FMT, upon readmission, he utilized NIV, could tolerate spontaneous breathing for 1 h per day, improved oral intake with a 50% increase from the first admission, and an increased thigh circumference by 5–9 cm. His muscle strength also showed a slight improvement, allowing him to stand with assistance (Supplemental Materials Video 3). His ALSFRS-R scores before treatment, and after the first and second FMT, were 15, 18, and 20, respectively (Table 1).
Case 2
' Case 2 was a 76-year-old man with a 6-month history of progressive limb weakness and reduced appetite, who had lost 15 kg over the past 3 months. He had experienced breathing and swallowing difficulties and choking over in the last 2 months. He experienced no systemic infections or specific medications during the course of the disease. '
' The patient’s respiratory distress worsened, leading to admission. Upon admission, the patient’s body temperature was 36.7°C, leukocytes levels of 11.66 × 10^9/L, neutrophils percentage of 92.5%, lymphocytes percentage of 5.2%, CRP levels of 13.3 mg/dL, IL-6 levels of 148.4 pg/mL, while blood gas analysis indicated type II respiratory failure (PO2 53 mmHg, PCO2 72 mmHg). Chest computerized tomography imaging showed multiple mucus thrombi in both lungs with cord shadow. Considering respiratory failure with lung infection, the patient received endotracheal intubation, mechanical ventilation, and antibiotics. Physical examination revealed level 4 limb muscle strength, muscle atrophy, and abnormal reflexes in both the lower (bulbar, cervical, thoracic, and lumbar segments) and upper motor neurons (cervical and thoracic segments). EMG demonstrated extensive neurogenic damage. According to the revised El Escorial criteria and the Japan ALS severity classification, the patient was diagnosed with late-onset classic ALS, grade 5. '
Case 2
In Case 2, the patient underwent the first FMT on the 47th day. Ten days after the first FMT, improvements in ventilation were evident: his FiO2 was reduced to 40% and PEEP to 3 cmH2O. Two weeks after FMT, the patient was weaned off ventilation three times a day, each period lasting 20 min. Four weeks after FMT, the weaning time was extended to 18 h daily. The gastrostomy tube was replaced with a nasogastric tube, and the patient began oral intake of liquid food (approximately 50–100 mL). The patient could then sit independently (Supplemental materials Figure S1). The second FMT was administered 5 weeks after the first FMT. Two weeks later, the patient was transitioned to NIV without supplemental oxygen, and discharged (Supplemental Materials Figure S1b).
Three months after the second FMT, during a readmission, he used NIV for approximately 12 h daily, walked independently for short durations, and wrote independently using a pen (Supplemental Materials Video 4). He could eat approximately 150 grams of food orally per meal without choking, resulting in a weight gain of 5 kg. His ALSFRS-R scores before and after the first and second FMT, were 15, 16, and 23, respectively (Table 1). Unfortunately, we do not have records before FMT. However, an assessment figure after the first FMT and a video taken after the second FMT are available in the Supplemental Materials.
Interestingly, both cases were in their seventies and at a fairly advanced state of disease progression and still showed significant improvement
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