Thanks for putting this list together, it must have taken a while!
I already had a list of fecal transplant forum threads from my earlier research into this subject.
I'd like to see the Borody study replicated. He seemed to achieve a 41% long term ME/CFS cure rate (since 70% x 7/12 = 41%) with fecal transplant. Though note that most of the ME/CFS patients he treated had gut issues such as IBS, so he was focused on this IBS subset (and the ones without gut issues did not response to the treatment).
That figure at first glance seems a little too good to be true, and I
read that in Dr Kenny De Meirleir's own trials of fecal transplant for ME/CFS, he found that this treatment does help, but its benefits only last for around 10 weeks (after which he says the bad bacteria would return).
And note that at
Borody's own clinic, the Centre for Digestive Diseases in Australia, he does not appear offer bacteriotherapy or FMT treatment for ME/CFS. According to the
website, he treats ulcerative colitis and IBS with FMT, but not ME/CFS. So his study claims to have found an amazing cure for ME/CFS with IBS, but he is not offering this treatment at his clinic.
Superdonors
However, if you listen to this
interesting radio interview with Dr Thomas J. Borody, he says his team identifies people who he calls fecal transplant "
superdonors", whose microbiome has a track record of curing many patients.
So it seems that not all fecal transplant material is equal. And this may be why Borody had a higher success rate in treating ME/CFS, because he may have used superdonors to supply the fecal transplants.
The idea of fecal transplant
superdonors makes intuitive sense, if you think about it. With a fecal transplant, you are hoping that the donor bacteria is going to be tough and resilient enough to battle with and fight off the bad bacteria that you have in your gut.
And presumably some fecal donors are going to possess bacteria species that are good fighters, and can really kick arse in the intestinal battlefield, and ultimately win over the bad bacteria. These are the super donors.
This article talks about
superdoners, and the "
donor effect", which seems to be vitally important in the treatment of chronic diseases like IBD:
The effectiveness of FMT for C. diff has generated interest in using FMT to treat IBD. Results from a recent FMT-for-IBD trial suggest an unexpected possibility: although any well-screened donor appears effective for treating C. diff, it appeared that only one of six donors used in this trial produced feces that effectively treated IBD.
Note:
FMT = fecal microbiota transplant;
C. diff = Clostridium difficile (a bacterium which causes a frequently fatal intestinal infection that often only fecal transplant can cure).
So here they found that only
1 in 6 fecal donors possess a microbiome that is tough and resilient enough to treat inflammatory bowel disease (IBD).
I imagine for ME/CFS treatment, you might also only get a good long term result when you receive a fecal transplant from a superdoner: your average healthy, well-screened donor is fine for treating Clostridium difficile infection, but may not provide the right sort of fecal transplant microbiome to create a long term benefit in ME/CFS.
More information on fecal transplant
superdoners in
this article:
Superdonors
Dr. Bartlett's group is interested in investigating the idea of superdonors, a concept that originated with a 2015 study published in Gastroenterology evaluating FMT as a therapeutic intervention for patients with active ulcerative colitis. Of 70 patients in the study, nine who received FMT achieved remission. Seven of those patients received stool from a single donor, raising the possibility that fecal material from some donors may be more effective than stool from others.
In another study, published in 2016 in Science, UK researchers disputed the idea of a universal donor, arguing instead that compatibility between donor and recipient microbial strains was responsible for successful transplant outcomes.