COLLEEN KELLY STARTED using fecal microbiota transplants in 2008—one of the first gastroenterologists in the US to do so. Over the years, she has noticed some strange side effects. One of her C. diff patients, for instance, also suffered from alopecia universalis. He hadn’t been able to grow any hair since he was 16: not on his head, not in his armpits, not even on his eyebrows. But when he got a stool transplant from his sister, he started sprouting fresh patches.
When Kelly told a colleague about the result, she got a second shock: He had seen a fecal transplant recipient regrow hair too. The two doctors were stuck. They didn’t have the resources to analyze their patients’ microbiomes to see what bugs might have been responsible for the change. “You don’t know how bad I wish I had that,” she says.
Tabletop robots sort through fecal samples from around the world, identify species of bacteria, and use those to grow more.
She’s not alone. It’s becoming more and more clear that the microbiome has therapeutic potential beyond the gut. Some patients undergo significant weight changes after a transplant; others say their depression goes away. Yet doctors still can’t figure out how it works.
Which is why, in early August, the National Institutes of Health announced that it would fund a fecal transplant registry, maintained by the American Gastroenterological Association. For the first time, thousands of transplant patients will have their microbiomes sequenced before and after treatment so doctors can have a better shot at identifying not only the bugs that fight C. diff but also what’s causing all those side effects. If Kelly had access to that kind of analysis with her alopecia patient, she might have stumbled onto a new, targeted microbiome therapy—delivering just the right bacteria to trigger hair growth
