Compositions for fecal floral transplantation and methods for making and using them and devices for delivering them
In alternative embodiments, the invention provides compositions, e.g., formulations, used for gastric, gastrointestinal and/or colonic treatments or lavage, e.g., orthostatic lavage, e.g., for inducing the purgation (e.g., cleansing) of a gastrointestinal (GI) tract, including a colon; and methods for making and using them. In alternative embodiments, compositions and methods of the invention are used for the stabilization, amelioration, treatment and/or prevention of constipation, for the treatment of abdominal pain, particularly non-specific abdominal pain, and diarrhea, including diarrhea caused by a drug side effect, a psychological condition, a disease or a condition such as Crohn's Disease, a poison, a toxin or an infection, e.g., a toxin-mediated travelers diarrhea, or C. difficile or the pseudo-membranous colitis associated with this infection. In alternative embodiments, the invention provides pharmaceuticals and products (articles) of manufacture for delivering these compositions and formulations to an individual, e.g., a human or an animal. The invention also provides devices for delivering a fecal material to a patient.
1. An acid-resistant capsule comprising a pharmaceutical composition comprising uncultured fecal bacteria suspended in a liquid comprising a cryoprotectant, wherein the uncultured fecal bacteria comprise bacterial species selected from a fecal microbiota of a healthy human donor, and wherein the cryoprotectant comprises glycerol.
2. The capsule of claim 1 , wherein the uncultured fecal bacteria do not contain viable Bacteroides.
3. The capsule of claim 1 , wherein the uncultured fecal bacteria consist essentially of bacterial species from the phylum Firmicutes.
4. The capsule of claim 1 , wherein the healthy human donor is pre-screened for infectious agents.
5. The capsule of claim 1 , wherein the uncultured fecal bacteria comprise less than 1.0% fecal non-floral material from the stool of the healthy human donor.
6. The capsule of claim 1 , wherein the capsule is adapted for small intestinal delivery.
7. The capsule of claim 1 , wherein the uncultured fecal bacteria are obtained from a frozen preparation.
8. The capsule of claim 1 , wherein the uncultured fecal bacteria are separated from rough particulate matter.
9. The capsule of claim 1 , wherein the pharmaceutical composition is stored in the frozen form.
10. The capsule of claim 1 , wherein the capsule is an enteric-coated capsule.
11. The capsule of claim 1 , wherein the capsule further comprises a polymer stabilizer.
12. The capsule of claim 1 , wherein the uncultured fecal bacteria are from a treated fecal flora.
13. The capsule of claim 1 , wherein the acid-resistant capsule is a graded release capsule.
14. An acid-resistant capsule comprising a pharmaceutical composition comprising a microbial preparation comprising a bacterial strain from the phylum Firmicutes, wherein the bacterial strain is selected from a fecal microbiota of a healthy human donor, wherein the bacterial strain is uncultured, and wherein the pharmaceutical composition comprises a cryoprotectant comprising glycerol and is formulated as a liquid.
15. The capsule of claim 14 , wherein the capsule is adapted for small intestinal delivery.
16. The capsule of claim 14 , wherein the pharmaceutical composition comprises less than 1.0% fecal non-floral material from the stool of the healthy human donor.
17. The capsule of claim 14 , wherein the microbial preparation comprises less than 1.0% fecal non-floral material from the stool of the healthy human donor.
18. The capsule of claim 14 , wherein the healthy human donor is pre-screened for infectious agents.
19. The capsule of claim 14 , wherein the uncultured bacterial strain from the phylum Firmicutes comprises anaerobic bacteria.
20. The capsule of claim 14 , wherein the microbial preparation is obtained from a frozen preparation.
21. The capsule of claim 14 , wherein the bacterial strain is separated from rough particulate matter.
22. The capsule of claim 14 , wherein the capsule is an enteric-coated capsule.
23. The capsule of claim 14 , wherein the capsule further comprises a polymer stabilizer.
24. The capsule of claim 14 , wherein the fecal microbiota is from a treated fecal flora.
25. The capsule of claim 14 , wherein the acid-resistant capsule is a graded release capsule.