Poster 107 Microbial Emulsion Matrices: A Novel Method to Produce Stable, Orally Available Capsules for Fecal Microbiota Transplantation to Treat Clostridium difficile
Author Insight from Zain Kassam, MD, MPH, FRCPC, OpenBiome / MIT Center for Microbiome Informatics & Therapeutics
What’s new here and important for clinicians?
Clostrium difficile infection carries with it a significant clinical and economic burden. Fecal microbiota transplantation (FMT) exhibits striking efficacy for recurrent Clostridium difficile infection (rCDI) compared to standard antibiotics. Oral delivery of FMT through frozen encapsulated stool reduces costs and risks associated with the procedures of alternative delivery modalities. However, stool encapsulation protocols developed to date are not scalable and produce unstable capsule products. OpenBiome has developed a new approach for stable oral delivery of FMT leveraging microbial emulsion matrix (MEM) technology. MEM is comprised of viable microbial communities suspended in aqueous microdroplets that are surrounded by long-chain fatty acids in a water-in-oil emulsion. This matrix protects the water-soluble hypromellose capsule shell from exposure to the aqueous stool microbiota. Thereby, MEM supports a scalable production process for capsules with long-term stability and microbial viability that can be used for FMT.
What do patients need to know?
C. difficile is the top hospital-acquired infection in the U.S., causing severe diarrhea and abdominal pain. For patients with recurrent C. difficile, fecal microbiota transplantation (FMT) is more effective than antibiotics for curing the infection. Patients have expressed a stronger preference to undergo FMT if an oral pill was available. OpenBiome has developed a streamlined production process for a FMT pill that is more stable than those currently available. Accordingly, our FMT pills will allow many patients to be treated while decreasing the risks, discomforts, and costs. These FMT pills are especially important for patients who cannot undergo potentially risky procedures normally used to do a FMT, such as a tube that goes from one’s nose-to-gut, colonoscopy, or enema. FMT pills also make possible long-term maintenance therapy for patients whose conditions may need multiple FMTs.
Zain Kassam, MD, MPH, FRCPC, OpenBiome / MIT Center for Microbiome Informatics & Therapeutics
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