News

Nov 13, 2023

Autistic patients swallow 'poo capsules' in clinical trial to help gut troubles

A new study will investigate whether good bacteria taken from donor poo can help

A new study will investigate whether good bacteria taken from donor poo can help alleviate tummy troubles in people with autism.

Everybody has a microbiome: the collection of microbes, such as bacteria, fungi, viruses that live naturally on our skin and in our nose, throat and gut, and play a "critical role" in our health and wellbeing.

University of Auckland researchers are launching a clinical trial to see whether microbiome transfer – in the form of capsules – can help counter gut problems for those living with autism, including pain, loose and frequent stools and indigestion.

So where does donor poo come in?

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Research has found introducing faeces or stool from a healthy donor can restore healthy bacteria in another person's gastrointestinal tract – in what's called faecal microbiota transplantation.

Faecal microbiota transplants (or gut biome transfers) are an emerging therapy being tested in a range of gastrointestinal conditions, including colitis, irritable bowel disease, and even neurological conditions such as multiple sclerosis and Parkinson's.

Now, Professor Wayne Cutfield​, a paediatric endocrinologist at the Liggins Institute, and co-lead investigator Professor Justin O’Sullivan​ are leading a proof-of-concept trial, trying to answer whether microbiome transfers could improve the gut function of autistic teenagers and young adults.

About 90,000​ people in New Zealand are autistic – and, for reasons that remain unclear, nearly half experience potentially distressing gut problems, the researchers say.

In the trial, about 50​ autistic people with gut issues impacting their day-to-day lives will receive the microbiome treatment, and as many will receive a placebo.

The researchers will take stool (poo) samples from healthy volunteers, process it to enrich for microbiome bacteria, then enclose the bacteria in capsules.

Cutfield said the screening process is stringent, to ensure the stool samples used are free from harmful viruses or organisms.

"We want the best possible bacteria, so we want the healthiest of people [for the] best possible donors."

The bacteria will be encapsulated in two layers of capsules so they have no taste or smell, and are specially designed to release the contents into the gut, rather than the mouth or throat, Cutfield says.

The capsules will be given over two days – 10 on one day, 10 the next – with medical supervision.

Participants recruited from across Aotearoa will be followed and assessed to see whether their symptoms ease, and whether their gut bacteria change over the course of the trial.

If the transfer is found to be helpful, it will be offered to those who get the placebo.

"Up until now, our evidence has come from animal trials and associations. So, this is really important and has the potential to be hugely beneficial," Cutfield said.

At Liggins, they’re also researching whether microbiome transfers could be useful for people with obesity, obesity-related disorders, and anorexia nervosa.

Cutfield says they’re not looking for a cure for autism – they want to see whether changing a person's gut microbiome can improve their quality of life.

The study, designed in collaboration with advocacy groups Autism New Zealand and Altogether Autism, aims to make people's guts work better, O’Sullivan said.

"Having a gut that works well is really important for people, it helps them feel good and healthy overall."

You can find out more here.