Wednesday , October 20 2021

and whose microorganisms found in our stools could help the sick heal?


Between 1980 and 2012, the number of new skin cancers tripled more than in France. This disease now affects nearly 80,000 new people each year. In 10% of cases, diagnosed individuals have melanoma. If this type of skin cancer is the rarest, it is also the most aggressive. With 15,404 new cases of cutaneous melanoma estimated in 2017 in the metropolitan area of ​​France (8,061 men and 7,343 women) and 1,783 deaths (1,036 men and 747 women), this disease accounts for nearly 4% of all cancers and 1.2% of cancers.

Cutaneous melanoma is of good prognosis if detected early enough, and thus the importance of early diagnosis, explains the National Cancer Institute. The treatment is based on surgical excision. On the other hand, diagnosed late, the patient is far less likely to escape. In fact, this cancer has a great metastatic potential: it can spread rapidly to ganglionic relays and other organs. Doctors then try complementary treatments such as ganglion dissection, radiotherapy, chemotherapy, metastasis excision, or immunotherapy.

The latter is intended to stimulate a patient's immune system to attack and destroy cancer. Although these treatments can greatly improve the survival of patients with melanoma, they are effective in only 40 to 50% of them. For this reason, researchers at the Lawson Health Research Institute in Canada are investigating the impact of faecal implants on the life of patients with cutaneous melanoma treated with immunotherapy. They are preparing to start a clinical trial, as stated in the August 16 press release on their official website.

Preliminary research has shown that the human microbiome, the various collections of microbes in our body, could play a role in the patient's response to immunotherapy. "The gut microbiome helps build the immune system at an early age, so it makes sense that a healthy gut can improve the response to immunotherapy," Dr. Jeremy Burton, a scientist who specializes in immune system research. microbiome. "This led us to consider the potential of fecal transplants," he continues. The goal is to transplant the microbiome into the donor so that the healthy bacteria colonize the patient's gut.

"Our institute is well positioned to move forward"

In a first phase of the clinical trial, the researchers studied the use of fecal transplants to alter the microbiome of patients and improve their response to immunotherapy treatments. From now on, after collecting stools from healthy donors, scientists will transplant them to 20 Britons with cutaneous melanoma. In detail, patients will ingest oral capsules specially prepared for their attention. Over time, researchers will evaluate the evolution of their cancer, microbiome, immune system, and general health status.

"Melanoma is the least common skin cancer, but the most lethal and death rates are rising," says Dr. John Lenehan, who will participate in the study. "Anti-PD1 immunotherapy drugs can be extremely effective, but we want to help more patients respond, which is our goal."

If researchers now focus on cutaneous melanoma, they also see a potential for other cancers. "We are one of the first teams in the world to study fecal transplants in cancer patients, an advanced study of possible uses for multiple forms of disease," notes Dr. Saman Maleki, a Lawson research assistant specializing in cancer immunology. "With experts in microbiology, infectious disease, cancer and immunology, our institute is well positioned to move forward," he says.

Potential for the treatment of other diseases

"Fecal transplants have saved the lives of countless patients with recurrent Clostridium difficile colitis," Dr. Michael Silverman, a pioneer in stool training. "We're starting to see its potential for treating other diseases," he explains. Today, Lawson researchers are planning fecal transplant studies for many other diseases, including non-alcoholic fatty liver disease, multiple sclerosis (MS), and cancer treatment toxicity. "But to perform this study, we need stool donors," Dr. Silverman.

Remember that melanoma can occur on healthy skin in 70 to 80% of cases or is due the malignant transformation of a mole. Therefore, the importance of having your suspicious moles regularly is screened by a dermatologist. It is also possible to refer to the ABCDE rule (for Asymmetric, Edges, Color, Diameter and Evolution), a self-detection technique developed by specialists. According to the latter, a task or a mole with one or more of the following characteristics may be suspected: Asymmetry, irregular edges, uneven color, increasing diameter or rapidly developing.

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