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De Luca a Fazio: "Sembra un fratacchione"Trapianto del microbiota fecale,Professore del Dipartimento di Gestione del Rischio di BlackRock Policlinico di Milano all'avanguardia di Italpress   31-07-2024 - 12:53 Link copiato #iubenda-cs-banner .iub_ts_bc:not(.iubenda-custom-content) *,#iubenda-cs-banner [class*=" iub"],#iubenda-cs-banner [class^=iub],.iubenda-tp-btn:not([data-tp-nostyle]){ 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background-color: #fff; border-radius: 0.5rem; box-shadow: 0 12px 24px rgba(0, 0, 0, 0.12); font-family: sans-serif; content: 'Loading...'; display: flex !important; font-size: 13px; font-weight: bold; line-height: 1; justify-content: center; min-height: 50px; text-transform: uppercase;}#speakup-player:empty{ display: block;} MILANO (ITALPRESS) - Nel nostro Paese sono pochi i centri dedicati alla cura via trapianto di microbioma dell'infezione da Clostridioides difficile, batterio la cui presenza è associata un'alterazione della flora intestinale che causa diarrea, colite e, nei casi più gravi, la perforazione del colon con un elevato indice di mortalità. Da poco, il Policlinico di Milano è stato accreditato dal Centro Nazionale Trapianti per eseguire il trapianto del microbiota fecale umano (FMT) che ha riconosciuto e avallato l'innovativa procedura ideata dai professionisti della Gastroenterologia ed Endoscopia, dalla Medicina Trasfusionale e dalla Microbiologia e Virologia del Policlinico di Milano divenendo così anche il primo centro autorizzato per questo intervento in Lombardia.Per comprendere qual è la novità, però, è bene sapere cos'è il trapianto del microbiota fecale: si tratta di somministrare la componente batterica "buona" a persone con patologie associate a un disequilibrio della flora intestinale attraverso le feci di un donatore sano. Questa pratica è autorizzata in Italia soltanto per la cura delle infezioni recidive da Clostridioides difficile, patologia di cui negli ultimi anni si assiste a un aumento dei casi e colpisce soprattutto i pazienti più anziani.La difficoltà principale oggi nell'esecuzione del FMT, sta nell'individuare persone idonee alla donazione. Da qui la soluzione avanzata dal team di lavoro del Policlinico di Milano diretto da Flavio Caprioli, gastroenterologo responsabile del Programma e del Centro FMT: attingere dall'ampia platea di quanti donano periodicamente il sangue, ossia soggetti sani, dallo stile di vita bilanciato e propensi ad aiutare il prossimo. In questo modo si ottiene il doppio risultato di aumentare il reperimento di donatori idonei e unire sotto una unica supervisione le fasi di selezione dei donatori; raccolta di unità per la donazione, conservazione e analisi dei campioni; selezione del ricevente e somministrazione del trapianto. Il risultato è il frutto di un impegno di anni dell'ampio team di ricerca che include la Gastroenterologia ed Endoscopia sotto la direzione di Maurizio Vecchi, insieme alla Medicina Trasfusionale sotto la direzione di Daniele Prati e al team della Microbiologia e Virologia dell'Ospedale diretto da Annapaola Callegaro.In pratica, quel che per tutti è materiale di scarto, qui diventa un bene prezioso.La valutazione di idoneità per la donazione delle feci comprende approfondimenti anamnestici, ematici e, solo in seconda battuta, l'analisi biologica e microbiologica dei campioni ricevuti. Altro fattore cruciale è la variabile tempo: le persone che superano la prima fase di osservazione sono considerate idonee per 4 settimane, mentre il tempo massimo che deve passare tra analisi con esito positivo e l'effettiva donazione non può superare i 4 giorni.Gli operatori del Centro Trasfusionale del Policlinico di Milano sono in grado di intercettare durante le donazioni di sangue, profili aderenti a intraprendere l'iter per diventare anche donatori di microbiota. Ogni indagine prevede un doppio controllo prima che il materiale raccolto possa essere effettivamente inserito nella biobanca dell'Ospedale, procedura necessaria per garantire totale sicurezza prima e dopo l'intervento."L'esperienza del Centro Trasfusionale nella gestione delle donazioni e nel mantenimento degli standard di sicurezza favorisce la garanzia del rispetto delle normative, ma la normativa italiana non prevederebbe un coinvolgimento diretto dei reparti di Medicina Trasfusionale - dichiara Daniele Prati, direttore della Medicina Trasfusionale del Policlinico di Milano -. Esperienze positive in questo senso riguardano il Nord Europa e l'Australia e per questo motivo negli ultimi anni in Ospedale abbiamo iniziato un percorso per implementare questo programma con il supporto della Direzione Scientifica".Il trapianto di microbiota fecale è una pratica a basso grado di invasività e di breve durata. La procedura prevede una iniziale terapia antibiotica e la preparazione intestinale prima del trapianto, eseguito in endoscopia tramite una colonscopia, o attraverso clistere. La biomassa da traferire paziente viene rilasciata dalla biobanca dell'Ospedale con una procedura simile a quanto avviene per le unità di sangue. Il paziente è dimesso dopo una degenza che non supera le 72 ore.La ricerca, però, non si ferma mai e lo sguardo si allarga già a nuovi sviluppi del trapianto fecale per il trattamento di altre patologie."Le prospettive sono ampie e molte ricerche già avviate nel mondo iniziano a portare solide conferme verso manifestazioni infiammatorie dell'intestino comuni come la colite ulcerosa e la malattia di Crohn - dichiara Flavio Caprioli, gastroenterologo ed endoscopista al Policlinico di Milano e responsabile del Programma e del Centro FMT -. Nei pazienti oncologici, il trapianto di microbiota intestinale potrebbe contrastare gli effetti collaterali dovuti alle terapie in caso di melanoma, leucemia mieloide acuta, tumore al polmone. Anche nel trapianto del midollo emopoietico esistono dati preliminari relativi alla riduzione o alla prevenzione degli effetti collaterali cronici intestinali".Altri campi già coinvolti nello studio sulle possibilità terapeutiche del trapianto del microbiota intestinale riguardano le patologie neurologiche come il Parkinson e la depressione. Si guarda con fiducia anche ai primi risultati sui benefici nel trattamento delle malattie metaboliche come il diabete mellito di tipo 2."Poter organizzare l'intero iter del trapianto del microbiota fecale in Policlinico di Milano è un unicum che ci rende molto orgogliosi - dichiara Matteo Stocco, direttore generale del Policlinico di Milano -. Lo studio e l'analisi della fattibilità di questa procedura è il frutto di un'intuizione dei nostri specialisti e ricercatori che da anni hanno creduto in un metodo che potesse garantire a donatori e riceventi un servizio sicuro, altamente specializzato e vicino alle esigenze dei nostri pazienti e di chi in modo ricorrente dona il sangue al nostro Centro Trasfusionale".- Foto: Agenzia Fotogramma -(ITALPRESS).col4/com31-Lug-24 12:53. di Italpress   31-07-2024 - 12:53 Link copiato Commenti Leggi la Netiquette

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