Australian scientists have begun innovative research to develop an “artificial super stool” which they hope will ease the urgent need for human stool donations to treat chronic gut infections.

The collaborative research – between Australian microbiome biotechnology company BiomeBank and Victoria’s RMIT University – aims to create a “new generation of microbial therapies” to replace donor-derived faecal microbiota transplantation (FMT).

Technology that “replicates the complex community of microbes in the human gut” will be manufactured in Australia as part of the project.

Currently material for FMT – an established life-saving therapy for Clostridioides difficile and emerging treatment for other gut conditions including Ulcerative Colitis – can only be harvested from healthy human donors, which is time-consuming, expensive and difficult to scale-up for widespread clinical use.

BiomeBank CEO Thomas Mitchell said: “This will be a game-changer in the treatment of gut conditions. An important outcome will be enabling microbial therapies to reach more patients around the world.

“BiomeBank will use this new manufacturing technology to develop second generation therapies to treat multiple diseases for the broader market.”

RMIT School of Engineering researcher Professor Namita Choudhury said the collaborative project builds on her team’s previous success developing technology to produce multiple strains of probiotic bacteria in a single bioreactor.

She noted: “The new FMT manufacturing technology will support the growth of many beneficial bacteria strains simultaneously.

“While individual probiotic bacteria can be cultivated commercially, we need multiple strains in order to restore the complex microbial diversity of the gut when this is lost due to illness, malnutrition or overuse of antibiotics – and we need to produce these varied strains efficiently and cost-effectively.”

Dr Matthew Young, at funding partner Innovative Manufacturing Cooperative Research Centre, emphasised the FMT manufacturing technology would be “the first of its kind” and presented a “significant opportunity for BiomeBank and Australia, by creating pathways towards a manufacturing industry for microbial therapies in this country”.

He added: “Australia is leading the way globally in developing and implementing new manufacturing and business models in the medical space.”

Dr Young said the “manufacturing technology developed” as part of this project will allow the manufacture of synthetic FMT or defined microbial products “in a controlled, standardised way – ensuring quality, safety and efficacy, and opening up new business and export opportunities for high-value medical treatments.”


What is FMT?

Traditionally, FMT is the process by which gastrointestinal bacteria is transferred from an approved donor to a patient with altered microbial diversity for the purpose of restoring normal bacterial balance to the patient’s gut. It is most commonly used to treat recurrent Clostridium Difficile Infection (CDI), a potentially life-threatening bacterial condition.

While enthusiasm for FMT is currently at an all-time high, the concept of using faecal matter for medicinal purposes is by no means new. The earliest literary account of oral faecal administration for the alleviation of diarrhoea dates back to 4th century China, with the inaugural use of FMT for pseudomembranous colitis taking place in 1958. Thirty years later, Schwan et al published the first report of FMT in a patient with CDI.

In Australia, FMT is now accepted as a standard of care for those affected by recurrent CDI. Perhaps nowhere is the idiom ‘One man’s waste is another’s treasure’ more apt.

Where to next?

Recent avenues of exploration include using FMT to treat:

  • Autism
  • Cognitive impairment
  • Chronic Fatigue Syndrome
  • Crohn’s Disease
  • Depression
  • Epilepsy
  • Hair loss
  • Heart disease
  • HIV
  • Inflammatory Bowel Disease (IBD)
  • Irritable Bowel Syndrome (IBS)
  • ITP Multiple Sclerosis
  • Liver disease
  • Obesity
  • Parkinson’s
  • Rheumatoid arthritis
  • Type II diabetes
  • Ulcerative colitis
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