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

Research output: Contribution to journalArticle

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
JournalGut
DOIs
Publication statusAccepted/In press - 01-01-2019

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Gastroenterology
Endoscopy
Joints
Microbiota
Tissue Donors
Fecal Microbiota Transplantation
Bacteria
Fungi
Viruses
Research
Homeostasis

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ng, Siew C. ; Kamm, Michael A. ; Yeoh, Yun Kit ; Chan, Paul K.S. ; Zuo, Tao ; Tang, Whitney ; Sood, Ajit ; Andoh, Akira ; Ohmiya, Naoki ; Zhou, Yongjian ; Ooi, Choon Jin ; Mahachai, Varocha ; Wu, Chun Ying ; Zhang, Faming ; Sugano, Kentaro ; Chan, Francis K.L. / Scientific frontiers in faecal microbiota transplantation : Joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE). In: Gut. 2019.
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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.",
author = "Ng, {Siew C.} and Kamm, {Michael A.} and Yeoh, {Yun Kit} and Chan, {Paul K.S.} and Tao Zuo and Whitney Tang and Ajit Sood and Akira Andoh and Naoki Ohmiya and Yongjian Zhou and Ooi, {Choon Jin} and Varocha Mahachai and Wu, {Chun Ying} and Faming Zhang and Kentaro Sugano and Chan, {Francis K.L.}",
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Scientific frontiers in faecal microbiota transplantation : Joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE). / Ng, Siew C.; Kamm, Michael A.; Yeoh, Yun Kit; Chan, Paul K.S.; Zuo, Tao; Tang, Whitney; Sood, Ajit; Andoh, Akira; Ohmiya, Naoki; Zhou, Yongjian; Ooi, Choon Jin; Mahachai, Varocha; Wu, Chun Ying; Zhang, Faming; Sugano, Kentaro; Chan, Francis K.L.

In: Gut, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Scientific frontiers in faecal microbiota transplantation

T2 - Joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

AU - Ng, Siew C.

AU - Kamm, Michael A.

AU - Yeoh, Yun Kit

AU - Chan, Paul K.S.

AU - Zuo, Tao

AU - Tang, Whitney

AU - Sood, Ajit

AU - Andoh, Akira

AU - Ohmiya, Naoki

AU - Zhou, Yongjian

AU - Ooi, Choon Jin

AU - Mahachai, Varocha

AU - Wu, Chun Ying

AU - Zhang, Faming

AU - Sugano, Kentaro

AU - Chan, Francis K.L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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