Researchers from the University of Adelaide have demonstrated the use of “Faecal Microbiota Transplantation” (FMT) to induce remission in patients with ulcerative colitis, a disease of the large intestine and rectum.
The study published today in the Journal of the American Medical Association involved 73 adults with mild to moderate active ulcerative colitis, with results showing similar remission rates to current clinical therapies.
University of Adelaide lecturer Dr Sam Costello led the double blind study in collaboration with the South Australian Health and Medical Research Institute (SAHMRI), using new procedures to streamline the FMT process.
“The most important difference in this trial compared to previous studies is the use of anaerobic (oxygen free) stool processing,” said Dr Costello.
“A large percentage of gut bacteria perish if they are exposed to oxygen, this method allowed us to deliver more live organisms to patients than before.”
Patients received either a donor FMT that had been anaerobically processed or their own stool as placebo via a colonoscopy and two enemas. Costello said the anaerobic stool processing was the reason they found a good therapeutic effect with only three treatments.
“The effects we saw were similar to other studies but used a much lower intensity FMT, with previous studies using up to 40 treatments.”
Patients with FMT showed a 32 per cent rate of remission compared to 9 per cent with placebo.
“This study shows that we can modify the disease with FMT and that it is a potential new therapy for ulcerative colitis,” said Dr Costello.
“Not only that, but it could be the first of many therapies based on microbial manipulation.”
Current therapies for ulcerative colitis focus on suppression of the immune response, a treatment that has potential side effects of infection and malignancy.
Costello will conduct further research into FMT as a therapeutic option, with future trials focusing on the maintenance of remission in patients.
An agreement between the University of Adelaide and Microbiota, a company based in the United Kingdom, was reached in 2018 to commercialise the development of a microbial therapeutic from the study.
Costello said further research could help develop a more sophisticated method of ‘artificial FMT’.
“Our long-term aim is to develop rationally designed microbial therapies that can replace FMT,’’ said Dr Costello.
“These will have bacteria in a pill that can carry out the therapeutic effect without the need to take whole faeces.”Jump to next article