Fecal Microbiota Transplantation (FMT) For PD And Much Much More

[chartist]

While many of us are aware of the potential that FMT has shown for PD, Clostridium difficile (C. diff) and IBS that has not responded to standard therapy, I wrote this to highlight the fact that FMT has shown the potential to also help a multitude of other diseases and health issues that are often seen in people with PD. From what the preliminary studies have shown in PD so far, FMT looks like it may be the best adjunctive treatment in terms of symptom relief compared to just about anything including treatments that are only in the very early testing stages. Wouldn't it be nice to get an FMT treatment for PD that also helps your digestive issues, diabetes and rheumatoid arthritis all at the same time while not generating severe side effects? FMT has been tested in at least 85 health issues and that list is growing.

An FMT study promoted and funded by the Michael J Fox Foundation (MJFF) at this time would potentially breakdown the barriers that seem to be keeping the US from doing a high quality study with a large number of participants. FMT has already shown it has a very good safety profile in humans and animals with the newer form of FMT, WMT being even safer and more refined.

Currently in the US, FMT is only approved for C. diff and IBS and it has saved lives and is what is used when all other therapy options have failed. Currently, If you have enough money, you will be able to find a doctor in the world who will give you FMT treatment for PD. There are two companies in the world that I am aware of who will send you the frozen capsules to take on your own at home, but this foregoes one of the regular used steps of FMT treatment, antibiotics to essentially kill off the existing gut bacteria to allow the transplant to start out with a clean slate.

Fecal Microbiota Transplantation (FMT) is the process of taking fecal matter from a healthy donor who has been screened according to stringent standards, testing the fecal transplant for pathogens, and if found to meet predetermined standards is then implanted in the intestinal tract of a recipient, usually via colonoscopy delivery, who has a health condition such as Clostridium difficile (C. diff) to treat the condition and improve the health status of the recipient.

Although this approach has worked well in C. diff patients who have failed to respond well to standard therapy, it does require rigorous donor and fecal screening to prevent passing on dangerous pathogens or health conditions from the donor to the recipient.

FMT Delivery Methods

Besides delivery via colonoscopy, as described above, another delivery method besides colonoscopy delivery is via capsules of frozen transplant material. These FMT capsules have shown effectiveness similar to the colonoscopy-delivered FMT in studies, but very importantly, they avoid the potential for problems seen in colonoscopy delivery, such as damage to the colon itself, which is definitely counterproductive. Another advantage of FMT capsules is they are more cost-effective.

There is a third delivery method via the nose to the duodenum, but this method has shown reduced efficacy in some studies when compared to colonoscopy delivery or FMT capsule delivery. It also carries the risk of aspiration, which does not seem worth the risk, when capsules seem to have better efficacy and completely avoid the risk of aspiration.

Lastly, there is a fourth delivery method delivering FMT via enema. In studies to date, the capsule delivery method seems like a good option in terms of safety and ease of use, especially in longer-term use of FMT. Between FMT capsules and enema delivery, the effectiveness seems to vary on a personal level with some recipients achieving a better response to one over the other.

Another very important consideration is the quality of the donor transplant which is thought to be a major cause of significant variability in study results. This problem should be minimalized in time as donor screening parameters are refined significantly and improved.

For some, the whole concept of FMT may be distasteful or unpleasant, but when you consider that you are just manipulating the gut microbiome with a more healthful group of bacteria over the existing not so healthy bacteria, it makes more sense. Consider that when bacteria-free mice were given an FMT from people with Parkinson's disease, the mice got PD-like symptoms. When people with PD were given FMT from healthy human donors, their PD symptoms were significantly reduced. This gives a good indication of what the right and wrong gut bacteria can do for us.

In newer studies, two or three highly potent antibiotics are often used before the administration of FMT in order to essentially kill off the existing microbiome to help allow the FMT to get off to a good strong start and take hold without having to battle with the existing gut microbiome for dominancy. The antibiotics are generally stopped two days prior to the FMT. This procedure allows the FMT to essentially start with a clean slate.

The Future of FMT: Washed Microbiota Transplantation

A newer version of FMT is called Washed Microbiota Transplantation (WMT). This "washing process" is considered a safer and more refined form of FMT and is becoming more commonly seen in newer studies. The following article goes into significant detail on how the washing process filters out many potential pathogens from the FMT and can be repeated multiple times to refine the finished FMT product :

ncbi.nlm.nih.gov/pmc/articl...

History of Fecal Microbiota Transplantation

Although FMT has been around for decades, it remains relatively obscure to the general public. The first FMT in humans was done in 1958 and has been done in animals for over 100 years, according to the following article. There is also literature suggesting that FMT was practiced in ancient times :

ncbi.nlm.nih.gov/pmc/articl... first fecal transplantation in,for more than 100 years.

Expanding Therapeutic Applications of FMT

In more recent years, it has been found that FMT has shown the ability to potentially help other health conditions, and the list of health conditions and diseases that FMT seems to be able to help to varying degrees has grown significantly. In the US, the approved use of FMT is mainly for the treatment of C. diff or severe IBS that has not responded to standard therapy. The US is starting to expand research into other uses for FMT, but the US seems to be limited in this respect.

FMT, when done properly, is proving to have a very good safety profile which is often times very significantly better than prescription medications that are typically used for the health conditions that they are now testing FMT for.

The Potential of FMT in China

In China, they seem to be on a faster track to actually testing FMT in many health conditions in people. In fact, if the studies are an accurate indication of FMT progress, China is clearly doing the more cutting edge studies in greater number when compared to FMT studies done in the US. Most of these studies are very small in size, but diverse in terms of disease pathologies that they are testing FMT for. Some of the results that have been obtained are quite impressive, but because of the small size of the trials, will require further testing in larger groups in order to justify the use of FMT as a mainstream treatment option for multiple diseases and health conditions.

List of Diseases Tested for FMT Treatment

Some important examples of this are testing of FMT for :

1. Parkinson's Disease

2. Autoimmune Hepatitis

3. ALS

4. Ulcerative Colitis

5. Pneumonia

6. Primary Sclerosing Cholangitis (PSC)

7. Psoriasis and Psoriatic Arthritis

8. Alzheimer's Disease

9. Alcoholic Liver Disease

10. Diabetes Type 2

11. Hepatocellular Carcinoma (HCC)

12. Melanoma

13. Systemic Lupus Erythematosus(SLE)

14. Non-Alcoholic Fatty Liver Disease (NAFLD)

15. Autism Spectrum Disorder (ASD)

16. Crohn's Disease

17. Hepatitis B Virus (HBV)

18. Insulin Resistance

19. Major Depressive Disorder (MDD)

20. Graft Versus Host Disease (GVHD)

21. Treatment Of Multidrug-Resistant Organisms

22. Alcoholism

23. Autoimmune Diseases

24. Cancer

25. Psychiatric Disorders

26. Type 1 Diabetes

27. Multiple Sclerosis (MS)

28. Anxiety

29. Covid-19 / Long Covid

30. Chronic Kidney Disease (CKD)

31. Cardiovascular Disease (CVD)

32. Stroke

33. UTI

34. Systemic Sclerosis

35. Ankylosing Spondylitis

36. Anti-Aging

This is an incomplete list, but to give further perspective on just how many diseases FMT has been tested for, the following review discusses 85 diseases that FMT has been tested for :

ncbi.nlm.nih.gov/pmc/articl...

Here is a relevant quote from this comprehensive review of studies :

' The current review aimed to create an encyclopedia of clinical FMT reports of benefits, including case reports, case series reports, real-world studies, and RCT studies. Since FMT was formally named in 2011, a total of emerging 85 diseases treated by FMT have been reported. The number of studies on FMT/WMT has increased dramatically within the past decade. Integrated with our previous systematic review on FMT-related AEs from 2000 to 2020 worldwide, we profiled the back side and front side of FMT. Although many further controlled trials will be needed, the dramatic increasing in reports has shown the promising future of FMT for dysbiosis-related diseases in the gut or beyond the gut. '

Given the huge potential of uses for FMT, the chances for serendipitous discoveries for new uses for FMT is very high because often, when a person is treated with FMT for one condition, it may turn out to have a positive effect on another health issue that that person may have. As an example of this, in a 2023 FMT study for Parkinson's disease, one patient had complete clearing of psoriasis that had been unresponsive to a highly potent topical steroid and other treatments. Here is a link to that study :

ncbi.nlm.nih.gov/pmc/articl...

FMT Studies and Case Reports

Now I would like to discuss a few FMT studies or case reports to give more specific ideas of how FMT can affect various diseases or health conditions. Keep in mind that most FMT studies are small and will require larger randomized, placebo-controlled trials to confirm initial study findings.

It is worth mentioning that seven of the study links used in this article are from China, while two are from the US and one of the US studies was a review of other studies, two studies were from Australia, one study was from the UK, one study was from Iran, one study was from India and one study was from Ukraine.

Autism

This systematic review showed that FMT achieved multiple improvements in children with autism spectrum disorder (ASD) and saw significant improvement in autism symptoms in these children :

ncbi.nlm.nih.gov/pmc/articl...

This is what the systematic review concluded :

' In conclusion, this review showed that, in the observational and case studies, the FMT showed its potential in reducing the CARS, ABC, and SRS scores and improving ASD symptoms among children with ASD. FMT may be a potential therapy for alleviating symptoms of ASD in children with ASD. However, rigorously designed randomized double-blind placebo-controlled trials are needed to establish the safety and efficacy of FMT as a treatment to ASD. '

Ulcerative Colitis

This next FMT study was done in ulcerative colitis (UC) patients and found significant benefit for UC patients beyond standard therapy :

ncbi.nlm.nih.gov/pmc/articl...

' Even single transplantation of fecal microbiota (fresh material) bears the potential to be a well-tolerated and safe method of treatment in a large number of patients with mild-to-moderate UC, contributing to an increase in the effectiveness of basic therapy after 4 and 8 weeks, as well as a significant improvement in the abundance of the gut microbiota as early as 4 weeks after FMT. The addition of FMT to the standard therapeutic protocols for UC warrants efficacy at reaching clinical improvement and preservation of gut eubiosis, in line with the goals of precision medicine. '

Insulin Resistance

This next randomized controlled trial (RCT) illustrates that FMT reverses insulin resistance (IR) in people with type 2 diabetes in just four weeks :

ncbi.nlm.nih.gov/pmc/articl...

This RCT reached the following conclusion :

' In conclusion, our study showed that FMT improved the BMI, PBG, HbA1c, FBG, HOMA-HBCI, and HOMA-IR of T2DM patients in 4 weeks and also promoted the engraftment of donor-associated microbiota in participants. Results from our trial will serve as a basis for the long-term intervention of FMT in T2DM patients and the further development of novel biotherapeutic strategies aimed at combatting T2DM through the safe, effective, and affordable bacterial formulations. '

Major Depressive Disorder

This next pilot randomized controlled trial (RCT) found that FMT delivered via enema for the treatment of Major Depressive Disorder (MDD) met or exceeded all study feasibility targets and was safe :

pubmed.ncbi.nlm.nih.gov/366...

Here is a relevant quote from the RCT :

' All feasibility targets were met or exceeded. This study found that enema-delivered FMT is feasible, acceptable, well-tolerated, and safe in patients with MDD. '

Alzheimer's Disease

The following is only an animal study of FMT in an Alzheimer's model that showed that benefit was achieved very quickly in this AD animal model in terms of improvement in cognition as well as pathology:

ncbi.nlm.nih.gov/pmc/articl...

Here is a relevant study quote :

' We report significant changes in amyloid plaque burden and cognitive measures in the 5xFAD mouse model of Alzheimer’s disease following a 7-day fecal microbiota transplantation. A complete reversal in cognitive measures in 32-week-old (at commencement of treatment) 5xFAD mice who received FMT from 8–10-week-old (young) wildtype donors and normalization in cognitive measures accompanied by decreases in amyloid plaque load in 32-week-old transgenic mice receiving FMT from age-matched donors suggest a novel treatment strategy for Alzheimer’s disease that is easily translatable to human patients and supports other studies that show that clearing amyloid plaques in the brain is associated with cognitive improvements. We also demonstrate that donor age plays an important role in fecal microbiota transplantation that must be further investigated. '

To add further confirmation to the above AD study, the following systematic review of studies in humans and animals with AD shows that FMT is effective in the treatment of AD :

ncbi.nlm.nih.gov/pmc/articl...

Here is what the systematic review concluded :

' In conclusion, FMT can potentially become one of the modalities in treating AD, exerting its effect through the microbiota-gut-brain axis. The diversity of the gut microbiota in AD patients is widely changed compared with the healthy population as the types of bacteria abundant in healthy people differ from those in AD patients. This is speculated to participate in AD pathophysiology because the original gut bacteria metabolize peptides, soluble fibers, and dietary proteins, bringing out SCFAs and tryptophan along with other metabolites. These products work to lessen gut inflammation along with BBB permeability. Animal studies have demonstrated the FMT effect to restore the SCFAs and a healthy microbiome to disrupt the Aβ oligomers, decreasing AD's pathogenesis. However, the lack of clinical trials due to ethical concerns has hindered our findings in humans. '

' Nevertheless, two case reports were identified in which 82- and 90-year-old patients had received FMT from fit donors and the recipients exhibited cognition improvements. Future recommendations from this review would be to conduct further studies, especially randomized controlled trials, where FMT is implemented in patients of AD at various stages of the disease, following them up for longer durations. Thus, a further detailed assessment of its effect as a possible AD intervention could be evaluated. '

The above study clearly describes the multiple methods of action that FMT utilizes in order to be effective in people with AD.

Severe Alcoholic Hepatitis (SAH)

This next randomized trial shows how FMT in Severe Alcoholic Hepatitis (SAH) increases survival and decreases infections over standard therapy :

pubmed.ncbi.nlm.nih.gov/364...

Here is an important quote from the trial :

' In severe alcoholic hepatitis, FMT is safe and improves 90-day survival and reduces infections by favorably modulating microbial communities. It can be a useful alternative to prednisolone therapy.'

Autoimmune Diseases

Autoimmune diseases encompass a large group of diseases that are generally difficult to treat and the following systematic review and meta analysis comprehensively discusses the effectiveness of FMT as a treatment for autoimmune diseases :

ncbi.nlm.nih.gov/pmc/articl...

This systematic review and meta-analysis is, in my opinion, very important, and reached the following conclusions after analyzing multiple studies involving the use of FMT for autoimmune diseases and I find their results quite compelling and very important for people who have these hard-to-treat autoimmune diseases :

' Based on this systematic review and meta-analysis, the application of FMT in the treatment of autoimmune diseases is effective and relatively safe, and it is expected to be used as a method to induce remission of active autoimmune diseases. The transplantation route, source of fecal bacteria, application of antibiotics, and fecal types had no significant effect on the curative effect. Multiple long-term treatments with FMT could improve the curative effect. '

Amyotrophic Lateral Sclerosis (ALS)

The following is a single case report of a woman with Amyotrophic Lateral Sclerosis (ALS) who was treated with FMT which resulted in disease improvement as well as a stoppage of disease progression. Subsequently, this woman had a trauma to her scalp which required the use of antibiotics. The antibiotics resulted in a worsening of disease symptoms and loss of the symptom relief that had been obtained from the FMT. After the the antibiotic regimen was completed, she was immediately put back on FMT with a resulting improvement of her symptoms and another stoppage of disease progression. There currently are no drugs available for ALS which can stop disease progression or offer significant symptom relief, so this case report is very important and warrants further study in a larger group of people with ALS :

ncbi.nlm.nih.gov/pmc/articl...

Here is an important quote from the case report :

' In conclusion, we for the first time reported the positive clinical outcomes of using WMT for treating ALS. Although the disease condition of the present case was exacerbated by the use of antibiotics, the administered WMTs successfully reversed the worse status of the disease through a long-term follow-up. The current clinical findings would open a new window on the microbiota-based treatment for the life-threatening ALS. '

Parkinson's Disease

This next study deals with FMT and Parkinson's disease (PD). In this study, FMT reduced symptom scores by very significant amounts for 3 months which was the study length with just one treatment and also stopped constipation and small intestinal bacterial overgrowth (SIBO), which are both very common health problems in PD.

ncbi.nlm.nih.gov/pmc/articl...

Here is a relevant study quote :

' After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms. '

Insulin Resistance (IR) and Diabetes

This next study shows how FMT reverses Insulin Resistance (IR) in type 2 diabetic patients while also improving diabetes disease parameters in just 4 weeks :

ncbi.nlm.nih.gov/pmc/articl...

Here is a relevant study quote :

' In conclusion, our study showed that FMT improved the BMI, PBG, HbA1c, FBG, HOMA-HBCI, and HOMA-IR of T2DM patients in 4 weeks and also promoted the engraftment of donor-associated microbiota in participants. Results from our trial will serve as a basis for the long-term intervention of FMT in T2DM patients and the further development of novel biotherapeutic strategies aimed at combatting T2DM through the safe, effective, and affordable bacterial formulations. '

Stroke

This last systematic review of FMT and stroke shows that FMT is effective and can improve survival rate:

pubmed.ncbi.nlm.nih.gov/361...

Here is what the systematic review of multiple studies concluded :

' Our systematic review of preclinical studies showed that manipulating gut microbiota via FMT can be a possible therapeutic approach for the treatment of stroke and recovery of post-stroke complications. '

Anti-Aging

I want to add this last animal study because it shows another interesting aspect of FMT that may also apply to humans, but so far there are no studies to confirm this effect in humans. The following study shows that when you give FMT to older mice from younger mice, the older mice start acting younger, and some of their health parameters are altered more toward the parameters seen in younger mice. Also, when FMT from older mice is transplanted to younger mice, the younger mice take on health parameters seen in older mice :

microbiomejournal.biomedcen...

Here is an important quote from the study :

' We show that microbiota composition profiles and key species enriched in young or aged mice are successfully transferred by FMT between young and aged mice and that FMT modulates resulting metabolic pathway profiles. The transfer of aged donor microbiota into young mice accelerates age-associated central nervous system (CNS) inflammation, retinal inflammation, and cytokine signaling and promotes loss of key functional protein in the eye, effects which are coincident with increased intestinal barrier permeability. Conversely, these detrimental effects can be reversed by the transfer of young donor microbiota. '

' These findings demonstrate that the aging gut microbiota drives detrimental changes in the gut–brain and gut–retina axes suggesting that microbial modulation may be of therapeutic benefit in preventing inflammation-related tissue decline in later life. '

Conclusion

So the information and studies above illustrate the broad-ranging health effects of FMT, and future studies will only further broaden the potential health range of FMT. Given the newer standards for screening donors and fecal transplants as well as the newer WMT version, the safety profile of FMT is very good and improving and better than most drugs used to treat the diseases that FMT is being used for around the world.

One downside to FMT is availability since, in the US, it is mainly approved for C. diff and IBS-d, which has failed under a standard of care treatment. Increased ease of use and lower cost via FMT capsules make it a non-invasive approach to potentially treating many diseases and health issues. Larger studies will help to establish FMT as a mainstream viable treatment option. FMT also shows the ability to do more than some current treatments for the diseases it is being used for. While drugs are often designed to treat one specific disease or its symptoms, FMT offers the potential to treat multiple diseases or health issues at the same time in each individual.

FMT is clearly showing how important the gut microbiome is to our health on multiple levels and how manipulating the gut microbiome through FMT can greatly improve our health! It can also help drive healthcare costs down and significantly reduce the use of prescription medications as well as the side effects associated with their use.

Art

[PDTom]

That's why I had microbiome transfers done.... everything on my homepage... my microbiome is now very good! I have published my reports.... parkinsonclub.de/en/microbi...

[chartist in reply to PDTom]

Thank you for the link, Tom! FMT is very impressive!

Art

[Boscoejean in reply to PDTom]

in what country was this done?

[chartist in reply to Boscoejean]

This sentence is a quote from what I wrote and gives a breakdown of where the studies I reported on came from :

' It is worth mentioning that seven of the study links used in this article are from China, while two are from the US and one of the US studies was a review of other studies, two studies were from Australia, one study was from the UK, one study was from Iran, one study was from India and one study was from Ukraine. '

As you can see, the majority of the studies were from China. I also mentioned that China seems to be pursuing actual human FMT studies much more rigorously than most other countries including the US and UK. I wish the US was doing more human FMT studies other than repeat studies of C. diff, but they are not.

Art

[Boscoejean in reply to chartist]

sorry I wasn't more specific on the question because I was just trying to find out where PDTom received the FMT - my husband would like to do this but seems like it will be a while before it is available in the US. I looked up Canada and it appears that they only allow it for C-diff - We really are not up for a long trip anywhere. I know what you mean because I had looked on clinical trials to see if there were any such studies in the US and yes not available for anything else than C-diff

[Ob6842 in reply to chartist]

It’s so unfortunate that more studies are not being done! I’m 2 years in, and have a daughter that’s super healthy, and wants to be my FMT donor!

[chartist in reply to Ob6842]

Ob6842,

The one group who should be pushing for FMT studies in PwP is the Michael J Fox Foundation (MJFF), but I haven't seen that yet. They fund a lot of studies, but this would be a very important one worthy of them putting more than the usual amount of effort and money into it, but not so far??? I guess they're too busy looking for the cure.

I'm still waiting on the results from the Helsinki FMT/PD study. The lead for the study said they were going to try and release the study results last fall, but it is winter already and no results yet. That study completed months ago.

Art

[PDTom in reply to Boscoejean]

Germany and Slovakia....

[Boscoejean in reply to PDTom]

Thanks and glad you could get the treatment

[chartist in reply to PDTom]

Tom,

I have a few questions for you if you have time to answer them.

1. Was it easy to get the FMT done in Germany or was it hard to obtain ?

2. Did they have you take multiple potent antibiotics prior to having the FMT implanted?

3. What form of FMT did they use such as colonoscopy delivery, capsules or enema?

4. What did it cost to have it done there?

Thank you!

Art

[PDTom in reply to chartist]

1. It was not easy at that time and I think I was lucky that the doctor had done it at all with me.

2. no, no antibiotics! Only a remedy for intestinal cleansing.

3. the first time (Germany) colonoscopy 200ml, the second time in Slovakia 10 x 20ml ... Enema.

4. ca. 1200 Euro Germany, ca. 4.500 Euro slovakei

more details...

parkinsonclub.de/en/my-method

[chartist in reply to PDTom]

Tom,

Thank you very much for the details!

Art

[Ob6842 in reply to PDTom]

There is a study being recruited for FMT in the US. It’s in a pill form I think. There is also a $200 charge to be a participant.

[chartist in reply to Ob6842]

Good to know. Do you have a link for it ? If it is just at the recruiting stage it could be two or three years before the results come available. To the best of my knowledge the Helsinki study has not yet released their results, but the study is complete.

Art

[Ob6842 in reply to chartist]

It is through Dr. Piper Dobner, a ND based out of Portland, OR. She is at Flora Medicine there. It is a sterilized stool-derived postbiotic product, that has had a lot of success. Sounds very interesting….

[Smittybear7]

Thanks for sharing!

[chartist]

You're welcome, Smittybear7!

Art

[Boscoejean]

I appreciate your very detailed review of this subject

[chartist in reply to Boscoejean]

Thank you for saying so!

I wish MJFF would fund a large FMT study in order to advance one of, if not the best chance, for major symptom relief from PD.

Did you notice the animal study which was the last one I included? That showed that when they gave FMT from old mice to young mice, the young mice had an increase in inflammatory markers and generally started showing symptoms seen in older mice.

When they gave FMT from the young mice to the old mice, the old mice started acting younger and showed measurable changes such as reduced inflammatory markers and reduced eye degeneration. Obviously such a human study has not been done and given the ramifications of such an outcome if it also happened in humans, is highly unlikely to be done.

Art

[Boscoejean in reply to chartist]

maybe we need to send emails to them and suggest this idea

[MarionP]

Watch out there Chartist, you may find that the cops are going to take down your entry as "off topic."

There's something you didn't mention but I am bringing up and it won't be in "off topic," just off the topic you started here.

This may be of no help to those of us who already have pd, but I read an article a bit ago that discussed surgical severing of the vagus nerve as a means of stopping any migration of that bad misfolded tau protein that has been observed to transmit along it from the gut.

I am wondering if anybody knows whether doctors are at the point where they might be willing to consider that. The article referred to having done it with mice and thus successfully stopped misfolded tau transmission along the vagus nerve into the brain after the surgery.

Now I guess we can also wonder whether cutting the Vagus nerve would have any influence on the potential benefits of FMT.

[enjoy2013 in reply to MarionP]

I discussed it with my GI specialist and he indeed confirmed that the vast majority of patients getting accidentally or purposely their vagus nerve cut experience more problems than benefits. Don’t forget the big number of innervations it has!

[MarionP in reply to enjoy2013]

Any idea about where the cut is done makes a difference? I'm totally ignorant about the problems experienced after cutting the vagus nerve, would love to know more (actually any information would be more than I know).

[enjoy2013 in reply to MarionP]

It was a conversation during my visit, so we didn't enter into those details. Except he said "whatever the reason for vagotomy". Just have a look in an atlas of anatomy, you'll see there's no innocent spot on that huge nerve. I used to be strong in anatomy.

When the gastroenterologist referred to "all" the range of complications, I got it that was a risk I didn't want to take. Gastroparesis is enough.

[chartist in reply to MarionP]

I just realized that I did not respond to this in the right place so I am responding again in the right place.

Hah! Yeah both of the posts went down, but this is PD specific and holds a lot of promise for PwP.

Regarding severing the vagus nerve, given that not every function of it is known, it seems risky. Since it is known to be tied to internal organ functions, even more so!

Art

[Boscoejean]

I read an article that seems to suggest that there could be a leaky blood brain barrier that fosters the development of Parkinson's so could there be something that could resolve this problem and get rid of the leaky blood brain barrier? Maybe there is no way to know if it is the cause or the result.

ncbi.nlm.nih.gov/pmc/articl...

[chartist in reply to Boscoejean]

Either way, melatonin and its metabolites as well as vitamin B1 work to repair a compromised blood brain barrier aside from the myriad of beneficial activities it already does to fight PD.

aging-us.com/article/102537...

Here is a relevant quote :

' Our results suggest that melatonin reduced MMP-9-induced permeability of the BBB. Melatonin reduced MMP-9 expression and activity, which was induced by IL-1β through the regulation of the NOTCH3/NF-κB signaling pathway in pericytes, suggesting that pericytes regulate BBB integrity and function. '

And this on B1 and other B vitamins :

thestaracademy.co.za/repair....

Here is a relevant quote :

' Vitamin B1 (thiamine) deficiency disrupts the blood-brain barrier, and supplementation restores its integrity (80-81). Researchers have also found that vitamins B12, B6, and B9 (folate) can restore the integrity of the blood-brain barrier in adults with mild cognitive impairment and elevated homocysteine. Homocysteine is an inflammatory compound that can contribute to blood-brain barrier breakdown at high levels, and the B vitamins normalized homocysteine levels (82-83). '

Art

[6daniparky]

Grazie!

[MBAnderson]

Exhaustive. As usual.

[chartist]

I guess I am guilty as charged, Marc!

Art

[enjoy2013]

Art, Thank you so much for this great article.

[chartist in reply to enjoy2013]

Thank you for saying so!

Art

[MarkPrana]

Brilliant, and thoroughly well-researched, post. I had previously read this study that adds weight to the argument of a strong connection between the gut microbiome and PD:nature.com/articles/s41467-...

Thanks for sharing Art,

BW,

Mark

[chartist in reply to MarkPrana]

MarkPrana,

Thank you very much for the very kind words and I'm glad you liked it!

Art

[binnyrox]

Thank you immensely Art, for the meticulous and time consuming research you have always shared

Without your generous information and kind steadfast support, we would have not embarked on FMT.

The third FMT still going well - will update you soon

Our very best

d&ww

[chartist in reply to binnyrox]

d&ww,

You are very welcome! I thought you might like it.

I am very happy to hear that this third FMT is going well and I will keep an eye out for your updates! The chat feature does not always send a notification so I check regularly.

Art

[CuriousMe12]

Thanks Art. Sounds like a great line for more pd investigation. I wonder why there isnt more pd study in this area ?

[chartist in reply to CuriousMe12]

China seems to be the one who is pushing the envelope when it comes to FMT. The US has only approved FMT for C. diff and IBS, but only after certain requirements are met. Since FMT screening has advanced in recent years the safety in these severe C. diff and IBS cases has been very good.

The one US/ FMT/PD study seemed to be not very good, but still managed to get positive effects. There is an FMT/PD study of significant size which is supposed to release their results this year and I think that one is from the Netherlands if I remember correctly, but I'm not positive on the country of origin. Since it is larger, the data should be more robust than the small China/FMT/PD studies from two years ago and the US/FMT/PD study from this year.

This may be the study and it is from Helsinki with 48 PD participants and it is an RCT :

classic.clinicaltrials.gov/...

Art

[chartist in reply to chartist]

So I wrote to the contact person for the Helsinki study because their estimated completion was June 2023 and I wanted to ask when they might be releasing the FMT/PD study results, since theirs is the largest FMT/PD study to date with 51 participants.

I was sent an automated reply saying that he was on a two month vacation and would return in early October 2023 and reply then.

This morning I got a reply from him saying :

' I hope that we can publish this fall. BR Filip '

Art

[parkie13]

Thank you so much for posting, great amount of work on your part. I have a question, What kind of testing does the donor has to go through? How long does it take?

Is there a big difference in results, between killing your biome and not using the antibiotics?

Thank you Mary

[chartist in reply to parkie13]

Hi Mary, it's been awhile!

Here is a link that explains the donor screening process in China. I use this link because I feel that China is much more progressive as regards FMT in multiple health issues in comparison to the US which mainly only uses FMT for Clostridia difficile and severe IBS :

ncbi.nlm.nih.gov/pmc/articl...

I think the newest FMT studies have moved toward multiple potent antibiotic usage prior to and stopped two days before the actual FMT. I don't know if there is a big difference, but the outcomes seem to be better with the use of antibiotics to try and minimalize the existing gut microbiome in order to improve the effects of the healthful bacteria present in the FMT. It seems like that extra step should make it much easier for the FMT to get off to a very good start without having to fight the existing gut microbiome for dominance.

Art

[MBAnderson]

Exhaustive research, Art

[chartist in reply to MBAnderson]

Thank you for mentioning it, Marc!

I put a significant amount of effort into this one because I realize that FMT can be a very good treatment modality in many, many diseases and health issues.

Art