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The story
Metagen Therapeutics, a venture company launched out of Juntendo University, has begun Japan’s first clinical trial transplanting gut bacteria collected from healthy donors’ stool — encapsulated into an oral “pill” — into patients with ulcerative colitis.
On 5ch, skeptical comments about cost-effectiveness emerged, with users arguing that “other people’s bacteria won’t take hold and will revert over time” and that “maintaining it costs millions of yen a year, making it impractical.” At the same time, the discussion expanded to cover the link between gut flora and autism, and how everyday diet affects the gut environment.
Gut Bacteria Transplant via “Oral Pill” — Clinical Trial Begins, a Japan First, Targeting Ulcerative Colitis Patients: “Donated Stool” Turned Into Capsule Formulation by Juntendo-Affiliated Venture
A joint Japan-US clinical trial has begun to test whether gut bacteria collected from the stool of healthy Japanese donors, administered to ulcerative colitis patients via an oral “pill,” can improve the gut environment and symptoms.
This is Japan’s first such attempt. The oral pill is a capsule formulation developed by Metagen Therapeutics (Tsuruoka City, Yamagata Prefecture), a drug-discovery venture spun out of academia including Juntendo University.
Source: yomiuri.co.jp / Original article here
What people said
No matter what Juntendo develops, it brings zero benefit to the huge number of ordinary UC patients out there.
> The response rate for symptom improvement reached 70.3%, remission induction rate 45.9%, no serious adverse events observed, safety confirmed
that's why.
Gut bacteria genes and their metabolites are needed for the human body to function properly, so there should be some baseline effect.
But the solution depends on where the root of the problem actually lies.
If the immune cells running wild in the gut are caused by a lack of gut bacteria metabolites, this method should work.
But if the type where the gut is contaminated with microplastics and constantly inflamed is the cause, then bacteria that actually eat and neutralize microplastics could be a more direct solution.
Though we'd need to verify whether it's even safe to put something like that in your stomach.
But maybe healthy people's guts actually already have those kinds of modern-adapted bacteria.
But flip that around: if you're already doing something like a Mediterranean diet regularly, your gut environment naturally improves on its own.
Though once things are already thoroughly broken down and constantly inflamed, the barrier is wrecked no matter what you eat, so everything ends up too irritating.
It breaks the barrier, microplastics and the like get in, and the immune cells can never quite fix it — it's an endless loop.
The relationship between autism spectrum disorder (ASD) and gut bacteria still isn't well understood.
Don't know if it's true or not,
but if this turns autistic kids who can only babble "ah" and "uh" into functioning normally, that'd be a real find.
Over time it reverts back.
To stop it from reverting you'd have to keep introducing donor bacteria regularly, which costs millions of yen a year.
It's just not practical.
Yeah, but this drug is marketed as human-derived.
With an enema it'll all just come back out afterward — make it a suppository instead.
> Gut bacteria extracted from stool are processed into powder form using a freeze-drying method
So it sounds like it's not literally feces itself,
but I doubt it'll taste like chewing up a Biofermin tablet.
Re: #30
Same goes for Biofermin, honestly…
Yeah, this drug is marketed as human-derived — as opposed to Biofermin.
there are all kinds of human- and animal-derived medicines out there.
I just eat Biofermin and Joa yogurt (a Japanese probiotic yogurt brand).
Background and Key Points
Ulcerative colitis is a chronic inflammatory bowel disease with no known cure — patients cycle through steroids, immunosuppressants, and biologics, and Japan has one of the world’s highest and fastest-rising UC populations, tracked as a “specified intractable disease” with public subsidies that don’t fully offset the cost of newer biologic drugs. Fecal microbiota transplantation (FMT) has been trialed abroad for years, mostly for recurrent C. difficile infection; the US already has FDA-approved oral capsule and enema formulations (Vowst, Rebyota) for that narrower use. What’s new here is Juntendo-linked Metagen Therapeutics running Japan’s first FMT trial specifically for UC, using freeze-dried donor stool bacteria in pill form rather than colonoscopic or enema delivery — a meaningfully different indication and delivery method than the US precedent, a distinction the thread never draws.
The thread’s actual fault line isn’t whether gut bacteria matter — everyone agrees they do — but whether transplanted donor bacteria can permanently colonize a new gut or merely produce a temporary boost that reverts without repeated, costly redosing (posters cite “millions of yen a year”). A related sub-argument is whether this differs meaningfully from cheap, already-available probiotics like Biofermin or Yakult’s Shirota strain, since both are technically “human-derived” bacteria.
What readers may miss: probiotics deliver a handful of cultured strains, while FMT transfers an entire donor’s bacterial community and its metabolites at once — mechanistically a much broader intervention, which is why researchers don’t consider Biofermin comparable despite posters’ jokes. Also unmentioned: the trial’s reported 70.3% response and 45.9% remission rates come from an earlier open-label study, not this new randomized Japan-US trial, whose actual results are still pending.
*This article is compiled from excerpts and a summary of the 5ch (Science News+) thread “Gut Bacteria Transplant via “Oral Pill” — Clinical Trial Begins, a Japan First, Targeting Ulcerative Colitis Patients: “Donated Stool” Turned Into Capsule Formulation by Juntendo-Affiliated Venture.”
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