Radio 4 talks to Professor Carding based at Norwich research park about his plans on a trial of Faecal Microbiota Transplantation (FMT) for people with ME/CFS and the radio presenter mentions it might also help people with Long Covid (00.52.00).
Transcript
Radio Presenter
Could there be hope in a science park here in Norwich for people with ME, indeed for other conditions such as Long Covid that seemed mysterious and damaging and ill understood. What's being investigated is Faecal Microbiota Transplantation (FMT) essentially injecting people with faecal matter, with poo.
I went to see, Professor Simon Carding at his lab at the Quadram Institute at the University of East Anglia medical school.
Professor Carding
We are looking at and an aerobic cabinet, which allows us to work with microbes in the absence of oxygen to try and replicate the conditions under which a lot of microbes in your gut exist.
Radio Presenter
Tell us specifically about what you're doing with faecal matter and the idea of injecting it, which sounds. To put it mildly. Crazy, gross. But it isn't?
Professor Carding
No. So it's not new. I mean, it's coming to the sort of popular press quite recently, but he actually dates back to the fourth century as part of Chinese medicine. Very recently in the last 10 years, we started to use it, adopted it in the NHS to treat a very nasty infection caused by Clostridium, difficile, or C difficile.
And this is now becoming a frontline form of treatment for patients that have recurrent episodes of infection by this potentially life-threatening infection.
Radio Presenter
So what's actually done what, what is involved?
Professor Carding
We select donors and this is broadly similar to the process we use to select blood donors. So, they provide blood samples, they fill in health questionnaires, the stool is taken and examine for the presence of any potential pathogens, as we want to exclude those. So, we select the donors on a strict criteria and we then take a stool sample and then we can basically emulsify it, put it into a syringe and then deliver that through a tube through the nose or through a colonoscope.
Increasing over, we're looking at encapsulating the stool, so we can actually use capsule delivery, which would be a real significant change in the way FMT delivered, opening up for treatment for a variety of patients and diseases.
Radio Presenter
A variety of diseases, which is why it's fascinating. So at the moment, you've explained what it is used for. How, why might that variety be?
Professor Carding
The thing to bear in mind here is that about 90%, maybe even all human diseases are associated with changes and the composition of your gut microbes. So lots of diseases now, opening up to the possibility of using FMT as a treatment, inflammatory bowel disease, irritable bowel disease but neurological diseases, dementias and cancers.
These are all opportunities to test the application of FMT is a treatment.
Radio Presenter
Fascinated by the idea that neurological diseases could be treated in this way.
Professor Carding
Yes. So my particular interest here is Myalgic Encephalomyelitis, ME, previously known as Chronic Fatigue Syndrome.
And we are planning FMT trial in patients with ME because they have disturbances in their gut microbes that causes lots of conditions throughout the body.
Radio Presenter
There are no treatment for ME are there? Is that, are you looking at potentially coming up with treatments in a reasonable kind of timeframe? Is that a realistic possibility, realistic hope for what you're doing here?
Professor Carding
That's certainly our aim is to understand more about the causes of ME, so we can develop more effective treatments. So few patients make a full recovery. There's clearly an urgent need to develop new therapies.
Radio Presenter
It's not around the corner, but it is a pathway?
Professor Carding
Absolutely. It's a pathway. Yes, collectively, I think there's some real hope here, that working together we will be able to develop new therapies.
Certainly in the next few years, I would hope.
Radio Presenter
More widely, we are much more aware now aren't we about the link that there is between our guts and our, and our brains actually, and the way we are much more generally.
Professor Carding
We're talking about the gut-brain axis here, the bi-directional communication between the brain and the gut and microbes play important part in that communication pathway. Because they can interact with all the neurons that are present in our gut, the immune system, that's present in our gut and the hormonal system that is present in our gut. So just being close to all these sensory systems allows them to influence a whole range of physiology, organ systems and we're particularly interested in how it may influence the brain.
Radio Presenter
And if that is the case, It, it sort of changes, doesn't it in a really fundamental way, the way in which at least in the west medicine has regarded a kind of division between what's going on down there and your stomach and what's happening in the rest of you.
Professor Carding
Yeah. So I think it's fair to say that China, Asian countries have had much more serious interest in FMT in using it, dating back as I said to the fourth century. We're only just becoming converts to the potential. There are questions that remain to be answered such. What's the best way for screening donors to make it absolutely safe? What is the best route of delivery?
So there's still some research done, but I think the potential is huge.
Radio Presenter
Professor Simon carding. Thank you very much.
Professor Carding
You're welcome. Thank you.
Other Information
More information about FMT for ‘Clostridioides difficile'
NICE: Faecal microbiota transplant for recurrent Clostridioides difficile infection
Please also see this question and answer about FMT in our Medical Matters database:
The Microbiota: Faecal Microbiota Transplantation (FMT)