Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

Siew C. Ng, Michael A. Kamm, Yun Kit Yeoh, Paul K.S. Chan, Tao Zuo, Whitney Tang, Ajit Sood, Akira Andoh, Naoki Ohmiya, Yongjian Zhou, Choon Jin Ooi, Varocha Mahachai, Chun Ying Wu, Faming Zhang, Kentaro Sugano, Francis K.L. Chan

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Abstract

Objective The underlying microbial basis, predictors of therapeutic outcome and active constituent(s) of faecal microbiota transplantation (FMT) mediating benefit remain unknown. An international panel of experts presented key elements that will shape forthcoming FMT research and practice. Design Systematic search was performed, FMT literature was critically appraised and a 1-day round-table discussion was conducted to derive expert consensus on key issues in FMT research. Results 16 experts convened and discussed five questions regarding (1) the role of donor and recipient microbial (bacteria, viruses, fungi) parameters in FMT; (2) methods to assess microbiota alterations; (3) concept of keystone species and microbial predictors of FMT, (4) influence of recipient profile and antibiotics pretreatment on FMT engraftment and maintenance and (5) new developments in FMT formulations and delivery. The panel considered that variable outcomes of FMT relate to compositional and functional differences in recipient's microbiota, and likely donor-associated and recipient-associated physiological and genetic factors. Taxonomic composition of donor intestinal microbiota may influence the efficacy of FMT in recurrent Clostridioides difficile infections and UC. FMT not only alters bacteria composition but also establishes trans-kingdom equilibrium between gut fungi, viruses and bacteria to promote the recovery of microbial homeostasis. FMT is not a one size fits all and studies are required to identify microbial components that have specific effects in patients with different diseases. Conclusion FMT requires optimisation before their therapeutic promise can be evaluated for different diseases. This summary will guide future directions and priorities in advancement of the science and practice of FMT.

Original languageEnglish
Pages (from-to)83-91
Number of pages9
JournalGut
Volume69
Issue number1
DOIs
Publication statusPublished - 01-01-2020

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All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ng, S. C., Kamm, M. A., Yeoh, Y. K., Chan, P. K. S., Zuo, T., Tang, W., Sood, A., Andoh, A., Ohmiya, N., Zhou, Y., Ooi, C. J., Mahachai, V., Wu, C. Y., Zhang, F., Sugano, K., & Chan, F. K. L. (2020). Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE). Gut, 69(1), 83-91. https://doi.org/10.1136/gutjnl-2019-319407