In this episode, James provides an overview of a medical procedure called intestinal microbiota transfer (IMT), also known as a ‘stool transplant’ or ‘faecal microbiota transplantation (FMT)’ amongst other descriptive nomenclature.
IMT involves the transfer of microorganisms into the intestinal tract of a recipient with the intention of modulating the microbiome in the recipient in a positive manner, and in turn, influencing disease processes and health in a positive manner. James describes a brief history of IMT, the various forms of IMT and how the procedure has evolved over time.
Transcript:
00:00:00:03 - 00:21:05:48
Hello, everybody. It's James here. And this is the first Biome Bite. The Biome Bites are shorter. Podcasts hosted by me and in Biome Bites, I’m the only guest, so essentially it's just me talking to you as the listener.
 
Today's episode will focus on something we've talked about a lot on the podcast, something called fecal microbiota transplantation, also known as FMT.
 
You may have heard of it referred to as stool transplantation, poo transplantation. Intestinal microbiota transfer, intestinal microbiome transplantation and potentially even other things I may not be aware of. And you've probably thought, what is that? You may have heard of it before and you want it and want more information.
 
So in today's Biome Bite we're going to give an overview of FMT, also known as IMT. If you refer to it as intestinal microbiota transfer, which is my preference and I'll get on to that in this episode. In subsequent Biome Bites relating to FMT, IMT, I'll dig deeper and talk through the latest evidence as well as how the industry is developing. So let's start with the basics of the basics.
 
What is FMT IMT?
 
FMT, and I'll just refer to it from now on in this episode as FMT is a medical procedure in which microorganisms are moved into the intestinal tract of a recipient with the intention of preventing treating, curing a disease or a condition.
 
Now, where do the microbes come from?
 
The microbes come from the stool, hence the name fecal microbiota transplantation. And that stool can either be derived from the person who's receiving the FMT, as in it's coming from themselves and going into themselves. And that's called an autologous FMT.
 
Or it can come from a related, unrelated, healthy, some cases even unhealthy. And I'll get to that in a later episode, the donor and in this case, when it's not come from the person who's receiving the microorganisms which are derived from the stool, it's called allogeneic. And you can look up the definitions of those words, but essentially they relate to the source of the material that's been moved in to someone else.
 
We also see in the case of allogeneic, it can come from more than one donor, so it can be mixed. I've seen in the medical literature it coming from up to seven donors in a trial in which they administered FMT to patients suffering from ulcerative colitis, a form of inflammatory bowel disease.
 
So I think it's important to understand that it's a procedure and it's not a medicinal product in itself. What's medicinal about FMT is the microorganisms that are being administered as part of the procedure.
 
Now we can ask ourselves, when did FMT first originate? Who was the first person to do it?
 
And the answer to that question is, is not actually that clear. And it's probably much older than you might think. So in 2022, we're doing FMT routinely for patients suffering from nasty infections associated with a bacterium called C difficile, also known as Cdif.
 
There's also been a large number of clinical trials in other disease areas like ulcerative colitis, as   I just mentioned, but also irritable bowel syndrome, IBS. And patients suffering from various different types of cancer as a means of improving how they respond to cancer drugs. And that's just a very, very small segment of all the possible indications in clinical trials.
 
So actually, the first recorded cases