Translational strategies for oral delivery of faecal microbiota transplantation DOI
Srinivas Kamath, Robert V. Bryant, Samuel P. Costello

et al.

Gut, Journal Year: 2025, Volume and Issue: unknown, P. gutjnl - 335077

Published: April 29, 2025

Faecal microbiota transplantation (FMT) has emerged as a transformative therapy for Clostridioides difficile infections and shows promise various GI systemic diseases. However, the poor patient acceptability accessibility of ‘conventional’ FMT, typically administered via colonoscopies or enemas, hinders its widespread clinical adoption, particularly chronic conditions. Oral administration FMT (OralFMT) overcomes these limitations, yet faces distinct challenges, including significant capsule burden, palatability concerns microbial viability during gastric transit. This review provides comprehensive analysis emerging strategies that aim to advance OralFMT by: (1) refining processing technologies (eg, lyophilisation) enable manufacturing low-volume formulations reducing burden (2) developing delivery improve organoleptic safeguard targeted colonic release. These advancements present opportunities expand therapeutic scope, beyond C. infections, towards conditions requiring frequent dosing regimens. While this primarily focuses on optimising delivery, it is important contextualise within broader shift defined consortia. Live biotherapeutic products (LBPs) offer an alternative approach, interplay between LBPs in practice remains unresolved. We postulate continued innovation multidisciplinary approach can further increase efficacy scalability by enabling disease site targeting, co-delivery compounds overcoming colonisation resistance. Realising goals positions cornerstone personalised care across range diseases rooted microbiome health.

Language: Английский

Translational strategies for oral delivery of faecal microbiota transplantation DOI
Srinivas Kamath, Robert V. Bryant, Samuel P. Costello

et al.

Gut, Journal Year: 2025, Volume and Issue: unknown, P. gutjnl - 335077

Published: April 29, 2025

Faecal microbiota transplantation (FMT) has emerged as a transformative therapy for Clostridioides difficile infections and shows promise various GI systemic diseases. However, the poor patient acceptability accessibility of ‘conventional’ FMT, typically administered via colonoscopies or enemas, hinders its widespread clinical adoption, particularly chronic conditions. Oral administration FMT (OralFMT) overcomes these limitations, yet faces distinct challenges, including significant capsule burden, palatability concerns microbial viability during gastric transit. This review provides comprehensive analysis emerging strategies that aim to advance OralFMT by: (1) refining processing technologies (eg, lyophilisation) enable manufacturing low-volume formulations reducing burden (2) developing delivery improve organoleptic safeguard targeted colonic release. These advancements present opportunities expand therapeutic scope, beyond C. infections, towards conditions requiring frequent dosing regimens. While this primarily focuses on optimising delivery, it is important contextualise within broader shift defined consortia. Live biotherapeutic products (LBPs) offer an alternative approach, interplay between LBPs in practice remains unresolved. We postulate continued innovation multidisciplinary approach can further increase efficacy scalability by enabling disease site targeting, co-delivery compounds overcoming colonisation resistance. Realising goals positions cornerstone personalised care across range diseases rooted microbiome health.

Language: Английский

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