The new Transversal Unit for the Study of the Human Microbiome (UTMAH) will promote microbiota transplantation and research to be used in different pathologies. The Unit is involved in the development of a pioneering microbiota transplantation system that replaces colonoscopy transfer with capsules that can be ingested by the patient
The gut microbiota is the set of bacteria found in the gastrointestinal tract of all human beings from birth and which plays a key role in many aspects of the host's physiology and in the right development of the immune system. Imbalances in this microbiota, known as dysbiosis, are becoming increasingly common and are associated with many pathologies, both digestive and extra-digestive. The experience acquired in its treatment by the Bellvitge University Hospital (HUB) since 2014 has now been reinforced with the creation of the Transversal Unit for the Study of the Human Microbiome (UTMAH), which is the result of joint work between the Digestive System and Microbiology services.
One of the main goals of the new unit will be to ease the transplantation of faecal microbiota (TMF) for patients affected by infection caused by the bacterium Clostridioides difficile. This is one of the most frequent digestive tract infections, the result of a process of dysbiosis, and is characterised by severe episodes of diarrhoea. As Dr Jordi Guardiola, head of the Digestive System Service at the Bellvitge Hospital, points out, "faecal microbiota transplantation has become the reference treatment for recurrent C. difficile infection, with cure rates of 85 - 90%."
The microbiota for transplantation comes from a healthy donor, who undergoes an extensive series of tests confirming the absence of pathogens harmful to the recipient. Until now, these transplants had to be performed with a colonoscopy, during which the new microbiota was transferred to the recipient. The HUB's Microbiome Unit is currently involved in the development of a pioneering alternative system using capsules that are swallowed by the patient.
These capsules contain an amount of healthy microbiota equivalent to that of colonoscopy, but in freeze-dried form. The contents of the capsules are released beyond the stomach and allow reconstitution of the intestinal microbiota on contact with the patient's digestive system.
Some 1,500 nosocomial cases of C. difficile colitis are diagnosed in Catalonia, according to VinCat data, in addition to an undetermined number of community cases, but only around 15 faecal microbiota transplants are performed yearly, mostly at the HUB.
The new unit will boost the microbiota bank, pioneered in 2018 by the HUB. To increase donations and thus increase transplants, the aim is to attract more microbiota donors through an exhaustive analysis process carried out by specialists from the Microbiology Service of the HUB, which ensures that there is no presence of any pathogen in the whole process. The role of the HUB-ICO-IDIBELL Biobank is also essential, where donor and recipient samples will be stored to ensure the traceability of the entire transplant.
A lever for change in research
Advances in next-generation sequencing systems and the support of bioinformatics are leading to an increasingly broad understanding of the gut microbiota and the relationship that its alteration may have with a wide spectrum of disorders and diseases, such as metabolic syndrome, inflammatory bowel disease, intestinal colonisation by multi-resistant germs or irritable bowel syndrome, among others (not only of a digestive nature).
The equipment at the Microbiology Service’s disposal will make it possible to support research projects of other HUB services. It will also enable collaborations with research groups from other centres studying the microbiome. All of this will always take place aiming at the development of personalised medicine," explains Dr M. Ángeles Domínguez, head of the Microbiology Service at the HUB.
The creation of the new Microbiome Unit at the Bellvitge Hospital is one of the seven operations included in the 4locaLHealth Territorial Specialisation and Competitiveness Project (PECT), which is promoted by Hospitalet City Council to consolidate the municipality as an ecosystem for research and innovation in health through the activation of a biomedical node focused on personalised medicine. The PECT 4locaLHealth is funded by the Generalitat de Catalunya and the EU’s European Regional Development Fund (ERDF).