Episode 023 - Dr Simon Baunwall - Evolving FMT in Denmark

Inside Matters

In episode 23 we chat with Dr. Simon Baunwall, a medical doctor and scientific researcher focused on fecal microbiota transplantation, also known as FMT. Dr. Baunwall is based at Arras University Hospital in Denmark.

This conversation centred around the establishment of fecal microbiota transplantation (FMT) as a therapy in Denmark.

Simon talked to us about his work which centres around establishing FMT as a standardised, scalable approach using a blood banking type model, is fascinating. We talked about his perspectives on how the field might evolve looking forward, the next indication after recurring C-difficile infection, and the progression of FMT delivered by colonoscopy to delivery by capsules.

And we had some interesting philosophical discussions around what is the mechanism of action and how do you define a dose. This is important, as historically what researchers have used is the wet mass of starting material, in other words, stool, that goes into the process. But what we discussed is actually, that's probably not a good definition or metric for dose!

Additionally, we talked about the regulations, which Simon's been very heavily involved with. I particularly enjoyed this episode because Simon is a self-confessed lover of the Inside Matters podcast.

In fact, he has listened to pretty much all the episodes. So it was amazing to have a loyal listener on the podcast to talk about their fantastic work in the microbiome and FMT space.

Timestamps:

00:00:00 Introduction

00:02:38 How Simon got involved in the microbiome

00:04:01 We can do better

00:05:47 Low tech

00:09:21 Patient improvement

00:12:33 The metabolite perspective

00:14:18 How the process is evolving

00:19:31 Universally perfect donor?

00:23:29 Are we doing too much?

00:25:25 Likelihood of false-positives

00:30:18 Undergoing repeated screenings

00:42:02 Preparing for it going wrong

00:44:51 Safety issues

00:50:29 What is your vision?

00:57:31 Is it actually safe?

01:01:48 Building in scale

01:05:20 Accessing screening as a private company

01:10:43 Two different donor types

01:20:09 The struggle to get enough donors

01:24:15 Limitations of diet studies

01:28:07 Dr Mark Hyman

01:30:39 Regulating FMT

01:34:50 Presenting stool as a “drug”