If I had a small intestine transplant for someone who produced lactase, would it cure it?
I know lactose intolerance isn’t deadly I’m just curious if it’s possible.
In: Biology
Because lactose intolerance is unpleasant but not serious, and easily managed by simply avoiding dairy or taking lactase pills when you eat dairy.
Lactose intolerance is extremely common in humans affecting upwards of 65 percent of the population. This is most prevalent in Asian populations.
Interestingly most humans are not born lactose intolerant but rather lose the ability to process it after we stop breast feeding.
Humans likely developed adult lactose tolerance as a result of living in close proximity to cows. Ancient humans in Europe began raising wild cows (Aurochs) for meat.
At some point we attempted to consume cow milk and it would have made us sick. But attempting to store cows milk resulted in the production of the first cheeses.
Cheese production at a very basic level is actually very simple, you store milk and it because cheese with time. Many cheeses have lower lactose content and are far easier to digest. So this is likely how early humans consumed milk, as an early preserved processed food.
One theory is living so close to cows and eating cheese resulted in certain bacteria colonizing or developing in our guts that could process the lactose.
Alternately humans got a random mutation that kept the lactose processing component of our guts active as we aged.
As for curing lactose intolerance it’s fairly complicated. It may be fixable with fecal transplants, this is an active area of study for various reasons.
But lactose intolerance is relatively easy to treat with medication. They make pills that contain the lactase enzyme we are missing that can process the lactose.
Lactose tolerance is the abnormality. Mammals _normally_ stop producing the enzyme that digests lactose, a type of sugar, after infancy.
People who are lactose tolerant have a genetic adaptation where they never stop produce lactase.
There is nothing to cure in lactose intolerant people. What they can do is take lactase pills to put the enzyme artificially into their gut for a meal.
Surgery is always risky, due to unexpected reactions to anesthesia and infection, so it’s avoided unless other treatments have failed. Also, tissue implants would require you to take anti-rejection drugs for the rest of your life, which cause other side effects. So taking a side-effect-free pill before meals is the BEST treatment possible for lactose intolerance.
Look up the Thought Emporium on YouTube. The guy “cured” his lactose intolerance by genetically modifying a retro virus to implant the genes that make lactase into the cells of his intestine
The cause of lactose intolerance is entirely genetic, it’s a gene that gets turned off mostly by age but also compounded by the lack of lactose (so if you don’t drink milk for a long period, the gene starts to turn off).
Genetic solutions are still cutting edge and because this problem has non-genetic solutions already (lactase pills or lactose free products) not to mention the effect of lactose intolerance is not life threatening, there’s really no reason to look for a genetic solution.
A CRISPR intervention might work for gene editing. Those are only starting to get approvals. There is a tremendous backlog.
Maybe the dairy industry could pay for it?
There are a LOT of things we could likely “cure” with putting serious resources behind it. But when it is something that doesn’t warrant serious resources because it isn’t that serious of a condition then it usually doesn’t get the money. This would fall squarely in that category.
You’d be on immunosuppressive drugs the rest of your life to not reject the small intestine, which sounds worse than taking lactaid when you want to have some dairy.
Getting an organ transplant isn’t like swapping parts on a car. You’re basically stuck taking immunosuppressants for the rest of your life so your body doesn’t attack the transplanted organ. The immunosuppressant levels that you need for intestinal transplants are some of the highest of all transplants (and part of the reason they are so rare). They are also one of the least successful transplant types. This all means that you have to be way more careful in your daily life than you ever would have to be just watching out for dairy since accidentally getting coughed on or eating slightly spoiled food can lead to serious or even deadly complications.
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