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FECAL TRANSPLANTS: A Guide

Framework for rational donor selection in fecal microbiota transplant clinical trials
Published: October 10, 2019

 
Am J Gastroenterol. 2020 Jan 10. doi: 10.14309/ajg.0000000000000499. [Epub ahead of print]
Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.

Abstract

OBJECTIVES:
Fecal microbiota transplantation (FMT) has emerged as an effective treatment option for Clostridioides difficile infection (CDI) and is considered an investigational therapy for a number of other diseases. Social media has facilitated widespread exposure of the public to the gut microbiome and FMT, ultimately acting as a catalyst for the Do-It-Yourself (DIY)-FMT movement. The aims of this study were to identify factors that influenced willingness to pursue DIY-FMT including common indications, screening processes, sample preparation, and self-reported efficacy and safety outcomes.

METHODS:
A twenty-five-point cross-sectional survey was posted online through the websites and social media pages of the Peggy Lillis Foundation, The Fecal Transplant Foundation, and The Power of Poop. Responses were cataloged through the Research Electronic Data Capture tool, and descriptive analyses were performed.

RESULTS:
Eighty-four respondents completed the survey between January 2018 and February 2019. The majority were female (71%) and white (92%). Most (80%) reported performing FMT on themselves; 87% used Internet resources to assist in the process, and 92% knew their stool donor. Inflammatory bowel disease (35%) and irritable bowel syndrome (29%) were the 2 most common conditions that respondents attempted to treat. Only 12% reported adverse events, whereas 82% reported improvement in their condition.

DISCUSSION:
DIY-FMT is being used for many indications, including those for which there is little evidence. There was a high self-reported success rate among respondents with few adverse events. There is a need for increased awareness around DIY-FMT and research around this phenomenon, which may impact public health.


 
Drugs From Bugs: Why Gates, Zuck And Benioff Think The Next Blockbusters Will Come From Inside Your Gut
Forbes magazine Feb 7, 2020.


"The race is on for FDA approval of the first drug made from gut bacteria. But the science is young and unproven. At Oppenheimer in New York, Mark Breidenbach says investor enthusiasm in microbiome companies is on a downswing because “there is no consensus about what the microbiome can do.” Amusa is more bullish. “The science is turning,” he says. “When it comes through with proof, these biotech companies will be worth not hundreds of millions of dollars, but billions. " "


"In the U.S., more than a million people suffer from autism, and there are no drugs to treat it; an additional million have Parkinson’s. What would be the value of an FDA-approved drug for either condition? “I can’t give you a market size,” says Donabedian. “But if either one hits, it will be huge.”

Chris Howerton, a biotechnology analyst at Jefferies, a New York investment bank, is less shy. “If every single microbiome paper turns into a proven therapy, it could impact the drug markets for most major categories of disease, which together were worth $350 billion in 2018 in the U.S. alone,” he says. “The breadth of the microbiome’s potential application is really tantalizing.”



 
Location
San Diego
Two dead and four hospitalized after fecal transplants from OpenBiome:

 
Two dead and four hospitalized after fecal transplants from OpenBiome:

It's concerning, but this organization has treated about 55,000 people according to the article, so it's still a good track record. No one should ever die though. At times only the sickest patients are getting these FMT treatments, people dying with C. difficile, so considering that, one could say it's still a very good safety record.
 
I think I made a breakthrough in my understanding of FMT and performing a DIY FMT a few months ago, just to let you all know!! Just not sure how or when I will communicate this. I haven't made another attempt at a DIY FMT yet.
 

Spooky1

Well-known member
Location
South Northants
Wow, sounds interesting.
I hear that Prof Brorody in Australia has claimed the Crohn's Cure, according to the Daily Mail. Yeah, just as i'm fighting cancer along comes a Crohn's cure, just my luck. Let's all be hopeful.
 
Wow, sounds interesting.
I hear that Prof Brorody in Australia has claimed the Crohn's Cure, according to the Daily Mail. Yeah, just as i'm fighting cancer along comes a Crohn's cure, just my luck. Let's all be hopeful.
Sorry to hear about the cancer my friend. I did read the latest paper Borody released about crohn's, it was nice to hear more people in very long remission without drugs and with FMT, and very likely cured.
 

Lady Organic

Moderator
Staff member
Profound remission in Crohn’s disease requiring no further treatment for 3–23 years: a case series
Gaurav Agrawal, Annabel Clancy, Roy Huynh & Thomas Borody
Gut Pathogens volume 12, Article number: 16 (2020)
 
Here are the results of a search of clinical trials posted/planned from 01/01/2018 to 06/16/2020 for fecal transplant in crohn's disease:
link to clinicaltrials.gov

There were 6 studies, 2 of them in the USA. This doesn't include any studies that are in progress before this date though. One study is using pills that they are making themselves, not the ones from openbiome found here link, which the cost is now about 4x what it was about a year ago from what I recall.
 
latest progress on a FMT pill by Vedanta biosciences which contains 16 strains of bacteria from clostridium cluster xiva and iv, intended to treat IBD. There is a phase 2 study planned for the next 12 months. link

This is not a full spectrum Fecal Transplant which would contain many more strains of bacteria from these groups of bacteria but could be enough to colonize the gut and begin to fix some of the damage to the microbiome which could be the main cause of chronic inflammation, dare I carefully say, a cure. But a Full spectrum fecal transplant could still be superior to these bacterial selections and include beneficial fungi and viruses too, as well as more strains, there are hundreds of strains, the human microbiome contains around 10,000 strains of bacteria and about 1000 species and some ibd patients not only have damage to clostridium but other groups of bacteria as well, although clostridium may be the most important group.
 
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Faecal microbial transplantation more effective and less costly than antibiotics to treat C-diff infections JUNE 29, 2020
by University of Birmingham


 
"We have used mice colonized with microbiotas from humans with inflammatory bowel disease to study what happens when these mice receive a microbiota transplant from a set of healthy humans. We find that the mouse gut immune system is changed by microbiota transplants, becoming broadly less inflammatory and protecting mice from colitis. "

 
A predictive index for health status using species-level gut microbiome profiling
"Herein, we introduce the Gut Microbiome Health Index (GMHI), a biologically-interpretable mathematical formula for predicting the likelihood of disease . GMHI is formulated upon 50 microbial species associated with healthy gut ecosystems. GMHI is the most robust and consistent predictor of disease presence (or absence) compared to α-diversity indices. Validation on 679 samples from 9 additional studies results in a balanced accuracy of 73.7% in distinguishing healthy from non-healthy groups."

"As researchers uncover more details regarding which gut commensals may play a significant role in host health and disease, a promising translational application of this knowledge would be towards developing analytical tests or quantitative methods that provide indication of one’s health based upon a gut microbiome snapshot "

 
82 year old man receives FMT for C diff and his alzheimers improves dramatically over the course of a few weeks, and cognitive tests return to normal after a few months.
 
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Location
San Diego
I did a search on clinicaltrials.gov for studies on fecal transplant excluding completed and erroneous listings, and including studies that were currently active in some way, the results were 197 studies that were active as of today.

clinicaltrials.gov search
Impressive, but unfortunately only a small handful of them are looking at Crohn's. The vast majority are for C. diff and other infections, UC, IBS, and an assortment of random stuff. I think this reflects the realtive lack of success that FMT has shown in Crohn's feasibility studies up till now.
 
Impressive, but unfortunately only a small handful of them are looking at Crohn's. The vast majority are for C. diff and other infections, UC, IBS, and an assortment of random stuff. I think this reflects the realtive lack of success that FMT has shown in Crohn's feasibility studies up till now.

I took another look, and if you go through the search results there are 12 studies on FMT for crohn's, results # 25, 29, 44, 53, 63, 74, 91, 122, 131, 132, 157, 167. This doesn't include the completed studies though, but we don't need more studies we need better studies that improve on the method to increase efficacy rate.

I would list the links to the studies but I'm kind of busy right now!!
 
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