Overview
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ABSTRACT
Bacteria that inhabit our body (microbiota) are shaping a symbiotic superorganism with our epithelial cells of our mucous membranes and our skin. Roughly 1014 bacteria populate the entire body, so evidence suggest that microbiota take part in maintaining human health. In case of dysbiosis the microbiota can be achieved by transplantation of an entire healthy microbial population. This paper gives definitions and regulations of transplants: fecal, vaginal and skin microbiota, and their interest inClostridium difficileinfections, certain digestives disease, skin pathologies and vaginosis.
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Jean-Pierre LEPARGNEUR: Medical biologist, former director of the Cedibio laboratory in Toulouse (France)
INTRODUCTION
The extreme importance of human bacterial ecosystems is increasingly recognized. Our various microbiota - the immense bacterial populations with which we live in constant symbiosis and which play a major role in our physiological equilibrium - have been attracting particular attention since 2005, particularly well beyond the classic infectious diseases which until now have viewed bacteria with a very negative a priori. This is all the more true as techniques for studying human microbiota are becoming ever more effective. Metagenomics (a molecular method) has enabled considerable progress, and now advances in microbial culture mean that many more fastidious bacteria can be isolated. At the same time, numerous studies have highlighted the occurrence of profound imbalances in our mucosal and skin bacterial ecosystems in a number of pathologies: Clostridium difficile colonization after antibiotic therapy, diabetes, obesity, neurodegenerative diseases, colorectal cancer for the intestinal bacterial ecosystem; vaginosis (vaginal dysbiosis), in which the imbalance of the microbiota is both qualitative and quantitative, with a decrease, or even disappearance, of a healthy, predominantly lactobacillary microflora replaced by an anaerobic polymicrobial flora with Gardnerella vaginalis, Prevotella bivia and Atopobium vaginae in particular; or finally for the skin flora associated with psoriasis and atopic dermatitis. So when a pathology dependent on a profound imbalance in an ecosystem is demonstrated, it becomes a therapeutic target, and a transplant of the microbiota of a "healthy" individual can then be envisaged.
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KEYWORDS
fecal, vaginal, skin microbiota transplantation | adverse events | Clostridium difficile
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Microbiota transplants
Bibliography
Bibliography
Firms specializing in fecal transplant preparations
In France
MAAT Pharma in Lyon [email protected]
In the USA
Rebiotix in Roseville Minnesota [email protected]
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