Fecal Mater Transplants (FMT) + Syncrytia

Fecal Mater Transplants (FMAT)

• Originally used for recurring c.diff (HAI/Antibiotic resistant) 

  • Antibiotics killing microbiome (dysbiosis) 

• Remove pt’s microbiome and replace with a ne healthy one

• Reluctant b/c

  • Sounds gross

  • Liability

• Trans of pathogens from donor (missed in screening)

• Not a constant source

• Treatment failure high = not approved by Health Canada 

• Synthetic cocktails = not efficient

  • New pill shows promise

  • Affects mental illness

• Being considered for diverticulitis (bacteria in stomach folds) 

Syncytia

• Fusion of cells to create a multinucleated cell

• Cell loses characteristics = losses ability to function

• HIV, RSV, SARS, Herpes, Vaccina (Chicken Pox)

Syncytia - how it works

• Fusion between infected cell and non-infected cell

• Becomes multinucleate = syncytium   

  • Loses ability to function 

Cryopathic effects

• CPE = cellular effects

• Normal cells

  • Confluent growth

  • Grows at bottom in single layer

  • When covers surface = touching

  • When touching = contact

  • Contact = stops growing 

  • CANCER CELLS DON’T STOP

• Poliovirus

  • Cells killed completely

  • Shrink, detach from surface, lyse

• Adenovirus

  • Partial detachment from surface

  • Clump together

• Respiratory syncytial virus

  • RSV

  • Adjacent cells fuse together = manu nuclei 

  • Called a syncystium 

• Rabiesvirus

  • Formation of inclusion bodies = thick and dense inside cell

RSV

• Long rod = cover cell

• Dangerous for babies

  • Lungs not fully developed

  • Weak immune system 

• Dangerous for elderly

  • Scaring on lung tissue = decrease surface area = decrease gas exchange

  • Weakened immune system

• Symptoms

  • Fever

  • Coughing 

  • Runny nose (rhinitis)

  • Exhaustion

• Prevention

  • Wear mask

  • Wash hands

  • Avoid contact

• Care

  • Dr, meds, recuperate 

  • NO DRUGS DIRECTLY treat RSV

Palivizumab - RSV drug

• _mab = monoclonal antibody 

  • Directed against the virus 

Spread of RSV

• 1st = resp droplet mostly contact

• 2nd = syncytial in cells (spreads to neighboring cells via fusion making them multinelic and losing function of gas exchange) 

• Can be upper and lower respiratory tract infection

• Severe in <6months of age 

• Most have by age 2yrs

Treatment of RSV

• Supportive care

  • Suction and supplementary O2

• Ribavirin = antiretro-viral in clinical trials

  • Better for immunocompromised pt

• Bronchodialators and steroids not recommended for treatment 

• Palivizumab

  • _mab = monoclonal antibody 

    • Directed against the virus