Rural Indians have a healthier gut, because of which they hold the key to tackle one of the emerging diseases that is largely impacting urban India, a new research has found.
Stool transplant, scientifically known as fecal microbiome transplantation (FMT), is an emerging treatment for inflammatory bowel disease (IBD)— a group of ailments involving colon and small intestine— for which inexpensive treatment options are limited.
“This is where our study comes into play. It would help identify good FMT donors. At AIIMS, we are doing FMT to manage IBD since 2013. Patient acceptability is very high,” Vineet Ahuja, a professor at AIIMS and one of the principal investigators of the study told DH.
Ahuja in collaboration with scientists at the Translational Health Sciences and Technology Institute (THSTI), Faridabad, and Oxford University Hospital mapped the gut microbiome— the huge colony of good bacteria living in the intestine— of 84 Indians from three different zones and compared them.
One of the underlying purposes was to identify ideal FMT donors.
They examined individuals from rural and urban pockets of Ballabhgarh in Haryana, and people from Leh, who rarely develop IBD.
The healthiest gut was found in rural Ballabhgarh, who scientists said would be the best suited FMT donors.
“In our study, we could detect about 54 core bacteria among three distinct population. Approximately, 20% bacterial species are look similar. But it is difficult to generalise, since India is a large country and the population is highly diverse, the gut microbiota are also diverse,” said THSTI scientist Bhabatosh Das, another principal investigator of the project.
“The findings have high translational value, considering the identification of ideal subjects as donor for fecal microbiome transplantation,” scientists reported in a recent issue of the journal Scientific Reports.
Inflammatory bowel disease is on a sharp rise in Indian cities accounting for world's second highest number of patients after the USA.
The last count done in 2010 puts the number at 1.4 million as against 1.64 million in the US. Since then, no counting was done.
Once the first line of treatment with medicines fails, FMT is increasingly being considered as an emerging treatment option for IBD, approved by the US Food and Drug Administration.
“In India only 4-5 centres carry out FMT, which is a non-commercial therapy,” said Ahuja.
IBD includes ulcerative colitis and Crohn's disease, both resulting from a combination of genetic susceptibility, environmental exposure and poor functioning to the intestinal microbiota.
Many drugs have serious side effects.
Since new generation medicines like monoclonal antibodies are too expensive to be used in most of the Indian hospitals, the doctors are on the look out for an affordable option.