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[Interview] Fecal microbiota transplantation potential infinite with proper guideline
  • By Lee Han-soo
  • Published 2017.10.04 06:00
  • Updated 2017.10.03 19:26
  • comments 0

“Fecal microbiota transplantation (FMT)’s potential is infinite if there is an excellent set of guidelines.”

So said Professor Choi Myung-gyu at the St. Mary’s Hospital, a pioneer in the field of FMT in Korea, while outlining the bright prospects for the procedure and stressing the need for proper guides.

Choi, who was the former chairman of the Korean Society of Gastrointestinal Endoscopy대한소화기내시경학회, believes that the use of FMT can extend beyond clostridium difficile infection patients and serve as a cure for a variety of treatments, including intestinal ailments, to even psychological or genetic disease.

“Regarding clostridium difficile infection, FMT has already proven to be an outstanding treatment,” said Choi. “It has reduced the recurrence of the illness to as low as 10 percent.”

However, FMT does not have a limitation on operational numbers, so the reoccurring illness rate is minimal to those treated with FMT, Choi said, adding that with this in mind, it is important to note other illnesses treatable with FMT.

Professor Choi Myung-gyu of Seoul St. Mary’s Hospital talks about Fecal microbiota transplantation, during a recent interview with the Korea Biomedical Review.

Although various associations and research-oriented seminarians have shown interests in FMT and its possibilities, the field can be driven into chaos without proper guidelines and regulations, Professor Choi emphasized.

“FMT can be the key to solving various diseases,” said Choi. “However, there currently are no guidelines in an official capacity.”

Choi has recently reached out to the National Evidence-based Healthcare Collaborating Agency (NECA) 한국보건의료연구원 to set up funds to proceed with clinical trials to help establish the guideline.

“These guidelines cannot be made by one person,” said Choi. “We have reached out to NECA to fund specific gastrointestinal association and society to conduct clinical trials for FMT.”

Another important factor is for the Ministry of Health and Welfare 보건복지부 to set up regulations for using the stool for medical purposes.

“We have asked the ministry to regulate the use of stool for medical purposes,” Choi said. “But since the stool is a substance that comes out of the human body this has to be done correctly."

A loose regulation can become a disaster with unauthorized people or even professionals misusing the treatment, he noted.

The guideline Choi referred to not only covers additional treatment potential of FMT and how the donors should be selected but also includes how to manage and obtain stool.

“The guideline has to include how to obtain, manage and give the stool as a treatment in a healthy way,” stressed Choi.

Regarding donors, Choi outlined that it is important to outline which donors can give their stool and what kinds of test they have to take to see if a stool is in optimal condition to be transplanted. “Stool is not only made of good germs, but it has harmful germs that can harm patients if it is not inspected properly,” he said.

A group of medical professionals in the sector should make all these rules with the support of the government, Choi added. He also stated that it is necessary for clinical trials and guidelines to pass through a strict vetting by the ethics committee.

FMT can only reach its full potential in helping improve and saving patients life after the guideline is in place, Choi added.

Currently, Seoul St. Mary’s Hospital’s stool bank, in coordination with Gold Biome 골드바이옴, is supplying stool to various establishments within the Catholic University of Korea Hospitals. Choi expects the supply chain will spread to all domestic hospitals after the guideline is made.

Gastroenterology professors are expected to have a seminar on various uses of stool transplant in January of next year. Here they will vote on when and how FMT will be used for patients, according to Choi.

“This is not a definitive guideline, but will serve as a baseline in setting such guideline,” Choi said, urging patients to take caution with FMT until such guidance is present.

“Stool is currently not a perfect medication. I advise patients to ponder about its various possibilities first before receiving treatment from a professional,” he said. “FMT is not a short-term solution and should be viewed in a long-term perspective.”


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