Photo by Daniel Cati
You might not think twice as you flush it down the loo, but there are entire professions dealing with your poo. We profiled three Berliners for our shit issue. Here’s one of them.
Stool investigator
Who: Sofia Forslund from Sweden, 38 Job: Research group leader at the Max Delbrück Center for Molecular Medicine, working on DNA sequencing of gut bacteria Background: PhD in biochemistry from Stockholm, engineering diplomas in molecular biotechnology and bioinformatics Hours: 12:00-22:00 Salary: €5000 before tax
“My grandfather died of a heart attack when I was 12 and it really affected me. From then on, my goal was to cure diseases, to cure death. I’m actually a bit surprised to find myself working with shit. The six-strong research team I lead analyses stool samples, looking for links between different species of gut bacteria and metabolic diseases such as elevated blood pressure or unhealthy cholesterol levels which lead to central adiposity (belly fat) and insulin resistance, the precursor stage of diabetes. They’re all interrelated and can eventually lead to arteriosclerosis and serious heart disease or heart attacks. We aim to find ways to stop this before it is too late.
My goal was to cure diseases, to cure death. I’m actually a bit surprised to find myself working with shit.”
Personally, I’m not in the lab so much. My day-to-day work involves attending meetings, sending emails and programming software that can handle vast amounts of DNA sequencing data. We receive stool samples from various hospitals across the city, and have a special collaboration with the Charité clinics. They provide patients, who wish to participate in our studies, with sampling kits so they can collect the samples themselves. They put them in a tube with special chemicals, give them a shake and then send them to us in the mail. We freeze them, at minus 80 degrees, until they are analysed.
Our research is fundamental to the application of stool transplants. The stool transplant is one of the most powerful techniques used to change the gut’s bacterial ecosystem. There is evidence from old Chinese medical texts that stool transplants were performed before our recorded time. It’s not a routine procedure though – usually it’s only necessary when there’s a severe bacterial infection of the gut. It can happen to people after taking a lot of antibiotics. The bacteria causing the infection is very hard to kill, so the idea is not to eliminate it, but to outcompete it. With a transplant we reintroduce bacteria that might interact better with the host. So it’s a peaceful method of regaining control over the infection. I’m probably going to have surgery next year and have a lot of antibiotics, so I might go for it too to restore my gut afterwards.
I think it’s possible to apply stool transplants to metabolic diseases as well but we need to find out how it works exactly before we can start using it effectively. We’re not testing it out just yet. But there was an interesting case in the US when a very thin patient chose to receive a stool transplant from their much heavier family member and actually gained a lot of weight as a result. In theory, the opposite should be possible, too. A study in Amsterdam had mixed results with this, because the stool transplants didn’t actually take so well. So maybe one needs to find a fitting donor for each person and combine the treatment with dietary changes. Because the microbiom, once transplanted, might expect the diet it experienced back in the donor. We want to research this in more detail and find out what the determinants are: can we tell from sequencing someone’s stool when they’re sick, which treatment is most likely to work? And which donor to choose? Certain people can live a very unhealthy life and they will still stay thin and healthy, whereas other people may not be so lucky. And that’s possibly down to bacteria.”
