This article summarizes articles introducing various aspects of FMT (Fecal Microbiota Transplantation, fecal microbiota transplantation), which has been attracting attention as a new treatment method in recent years.
The presentation will include a comprehensive overview of national and international regulations, adverse events, donors, and the field of stool banking.
We do not mention FMT for each disease, so if you have a disease you would like to know about, please request it.
Table of Contents
- The microbiome that lives in our bodies
- What is FMT? A Brief Explanation
- History of FMT Other people’s poop is good for diarrhea
- Handling of FMT (fecal microbiota transplantation) in various countries and summary of regulations and guidelines
- Donor Inspection Approach to Making FMT Safe
- Does a fat donor’s body shape “depress” the FMT?
- Does FMT (fecal transplantation) transfer the personality of the donor?
- Is FMT safe in the long run? ~Donor Disease Risk and Fecal Microbiota Transplantation~.
- Summary of adverse events of FMT (fecal transplantation) and considerations for safer practice.
- Searching for a Super Donor – Can you find a golden turd? ~ (in Japanese)
The numbers in parentheses in the text refer to the reference numbers at the bottom of the article.
The microbiome that lives in our bodies
Our bodies are made of our cells.
Cells attach to each other, send signals to each other, and repeatedly die and multiply through metabolism to create the body that we call “me,” protect its health, and support it throughout its life as an individual.
In recent years, it has become clear that it is not only our own cells that build “me” bodies and protect our health.
Countless microbiomes live throughout our bodies and are inseparable from our own cells and their workings.
Among other things, research has shown that the gut microbiome, including gut bacteria, is deeply linked to the maintenance of health and the development of certain diseases.
The composition and metabolic functions of the gut microbiome clearly contribute to the health of the human host.
Its gut microbiome is an elite group of people who live in symbiosis with us from the moment we are born, custom-made for our physical condition and lifestyle.
Although there are many different organisms and substances included in the term microbiome, it is estimated that an average 1 g of feces contains 100 billion bacteria, 100 million to 1 billion viruses, 100 million archaea, 1 million fungi and protists, 10 million colon cells, and 1 million metabolites (1). In this breakdown, the intestinal bacteria are by far the most numerous in number.
Excessive use of antibiotics and lifestyle changes are making it more difficult to maintain a healthy gut microbiome.
The extent to which the gut microbiome is directly causal to poor health is still under study, but at any rate, there is a long history of attempts in medicine to cure disease by improving the health of the gut microbiome.
What is FMT? A Brief Explanation
One of the most direct methods is Fecal Microbiota Transplantation (FMT) (2).
This method, which has been increasingly tested in clinical settings because it is so effective without knowing the detailed mechanism, has only recently been moved from folk medicine to formal medicine.
A very brief description of the general method of treatment is that a healthy person without specific diseases becomes a donor, whose stool is dissolved in saline solution, filtered, and the liquid is delivered to the patient’s intestines by colonoscopy or other means (3).
The beauty of this method is that even if the unhealthy characteristics of the patient’s gut microbiome are not so specific, the transfer (transplantation) of the entire ecosystem of the donor’s healthy gut microbiome gives the possibility of regaining health.
In other words, there is no need (at least for now) to strictly use Bacillus A for diarrhea, B for depression, C for obesity, etc.
The resulting excess can then be left to the self-regulating functions of the patient’s gut microbiome and the donor-derived gut microbiomes.
At present, this is the easiest and most effective way to adjust the microbiome for some diseases.
FMT began to gain attention in modern medicine because of its dramatic effect on recurrent Clostridioides difficile enteritis (rCDI), a disease that does not respond to antibiotics. (Previously Clostridium difficile infection)
Since then, its efficacy in inflammatory bowel disease (IBD, referring to ulcerative colitis and Crohn’s disease) and irritable bowel syndrome (IBS), which are also diseases of the digestive tract, although not as effective as rCDI, and in other non-infectious diseases, have been studied.
Examples range from type II diabetes, obesity, autoimmune diseases, Parkinson’s disease, autism spectrum disorders, multiple sclerosis, allergies, and depression (3).
As a promising method for treating systemic diseases, FMT has received tremendous attention over the past decade, with 2,400 English-language articles on FMT research published between 2011 and 2021.
As of August 2023, the disease with the highest number of FMT clinical trials enrolled on ClinicalTrials.gov is IBD, illustrating the large number of researchers trying to apply FMT to diseases other than rCDI.
Researchers are also attempting to understand the relationship between the gut microbiome and overall health through an organ-by-organ correlation known as the “gut-◯axis.
Well-known examples include the “gut-brain axis” (e.g., autism and depression), but other associations between the gut-cardiac axis (e.g., myocarditis and hypertension), gut-lung axis (e.g., pneumonia), gut-liver axis (e.g., nonalcoholic steatohepatitis), gut-immune axis (e.g., systemic lupus erythematosus and graft-versus-host disease (GVHD)), gut-skin axis (e.g., atopic dermatitis), and many other organ associations with the gut microbiome continue to be discovered day and night.
This series of articles will be divided into several sections to help those unfamiliar with FMT understand the features and possibilities of this treatment method. (Links are provided at the bottom of the articles)
We would like to provide a comprehensive overview of the scientific history of FMT, the attitudes of different countries, donors, and adverse events.
1. Bojanova DP, Bordenstein SR. Fecal Transplants: What Is Being Transferred? PLoS Biol. 2016;14(7):e1002503. doi:10.1371/journal.pbio.1002503
2. Gupta S, Allen-Vercoe E, Petrof EO. Fecal microbiota transplantation: in perspective. Ther Adv Gastroenterol. 2016;9(2):229-239. doi:10.1177/1756283X15607414
3. Wang JW, Kuo CH, Kuo FC, et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118:S23-S31. doi:10.1016/j.jfma.2018.08.011
本ブログ記事は、
シンバイオシス株式会社微生物事業部の研究員が
noteにて作成した記事を一部変更しております。
The original post can be found here.
Article Title: Summary of the current status of FMT in Japan and abroad. (Fecal Microbiota Transplantation, Intestinal Flora Transplantation)
Article Link: https://note.com/symbiosis17/n/n92081df43fbd
