Imagine we could harness the power of good gut bacteria from healthy people to fight off stubborn gut infections in others. That's exactly what we're exploring today with a game-changing, and rather icky approach to gut health: faecal transplant capsules.
In this episode, host Sarah Taillier is joined by Dr. Hani Al-Salami and Dr. Armin Mooranian, both registered pharmacists from Curtin Medical School and CHIRI. Together, Dr Al-Salami and Dr Mooranian are leading a project to develop a prototype for faecal capsules. Such capsules offer new hope to patients battling resistant infections that don’t respond to standard therapies.
• [00:25 – 01:04] How faecal transplant capsules show promise for gut health in a novel trial.
• [02:06 – 02:30] How gut bacteria is crucial for gut health.
• [04:36 – 04:50] Does a capsule approach improve the ease of treatment?
• [08:09 – 08:39] How the capsule provides a non-invasive treatment for the serious bacteria infection, recurrent clostridioides dificile.
• [17:42 – 18:05] The potential for treating neurological diseases via gut health.
Dr. Hani Al-Salami
Dr Hani Al-Salami is an AHPRA registered Australian and New Zealand pharmacist, a clinician, an academic, and a Program Lead in Biotechnology and Pharmaceutical Sciences at Curtin Medical School and Curtin Health Innovation Research Institute. Dr Al-Salami’s research focuses on using bile acids as a bio-nano platform for therapeutic delivery, which is aligned with worldwide regulatory approvals, for commercialisation purposes in humans.
Dr. Armin Mooranian
Dr Mooranian is a clinical consultant pharmacist and lecturer at Curtin Medical School. He is registered with AHPRA-Pharmacy of Board of Australia and also holds New Zealand registration with the Pharmacy Council of New Zealand. Dr Mooranian's research at Curtin University has led to a significant advancement of knowledge in the field of quantum medicine, biotechnology and nanoengieering of advanced gene-based therapeutic delivery systems for the treatment of neurosensory disorders and cognitive dysfunction.
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Host: Sarah Taillier
Content creator: Anita Shore and Alex Foot
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00:00:00:04 - 00:00:24:22
Sarah Tailier
This is the future of where experts share their vision of the future and how their work is helping shape it for the better. Hello, I'm Sarah Tailier. Imagine we could harness the power of good gut bacteria from healthy people to fight off stubborn gut infections in others. That's exactly what we're exploring today with a game-changing approach to gut health.
00:00:25:06 - 00:01:04:11
Sarah Tailier
Fecal transplant capsules. We get the ick-factor. But this treatment being trialled by Dr Hany Salameh and Dr Armin Mooranian from Curtin Medical School is yielding extremely promising results in treating seriously debilitating gut conditions. In this episode, we discuss Curtin University and Australian Red Cross Lifeblood's development of faecal transplant capsules for Australian clinical trials. We look at common gut disorders where current treatments fall short and how gut biota from other people can be the panacea for your body.
00:01:05:00 - 00:01:24:15
Sarah Tailier
If you'd like to find out more, you can visit the links provided in the show notes. Let's start at the foundation of it all - the gut. It's often called our second brain and for good reason. Could you shed some light on why maintaining a healthy gut is so important to our overall well-being? I'll start with you, Armin.
00:01:24:15 - 00:01:45:22
Dr Armin Mooranian
The gut plays a central role, a very important role in the health and balance of the body. Traditionally, the gut was thought of, you know, you eat your food and go to the toilet. But that thinking and mentality have changed over the years a fair bit. We now know the gut is actually quite important in maintaining the entire body as a whole.
00:01:45:23 - 00:01:55:14
Dr Armin Mooranian
In actual fact, even the brain responds very well to the gut, and the gut is made up of lots of different things actually help the body to get on with its everyday activity.
00:01:56:06 - 00:02:05:19
Sarah Tailier
When we're talking about what is actually in the gut and what it's made of, there is that complex world that's really going on of gut microbiota. What is that? How does that actually fit into the picture?
00:02:06:01 - 00:02:30:24
Dr Armin Mooranian
Gut microbiota are the micro-organisms or bacteria, whatever you have, that are good and friendly to you, that naturally live in the gut. We're all born with it and in actual fact, we have three times more bacteria than human cells. So, human beings are more bacteria than human if you think about it. So these good, healthy bacteria live in your gut, you are born with it, and they do change over time.
00:02:30:24 - 00:02:57:17
Dr Armin Mooranian
For example, if you have a certain disease, there is an imbalance between good and bad. Diet plays a very, very important role, the dietary sources of good bacteria as well. But these bacteria, they're very different. Multiple species of them have an important role in keeping you healthy. They fight off bad bacteria that you come into contact with and also regulate everything else of the body and we now know is everything to do with your immune system, your metabolism, your mental health as well.
00:02:58:00 - 00:03:16:02
Dr Armin Mooranian
You've heard expressions that, you know, if you have a diet full of fast food, for example, you do feel a bit down that's been said as well that's actually evidence that the changes the bacteria, the microbiota of your gut, favouring more bad bacteria and signals being sent to the brain than good.
00:03:16:20 - 00:03:24:16
Sarah Tailier
So what are some of the common intestinal issues and can you describe how the current treatments work, what's on the market at the moment?
00:03:24:23 - 00:03:50:04
Dr Armin Mooranian
So there's lots of things that can go wrong with the microbiota of the gut. So the most obvious one is when you take antibiotics, antibiotics do kill bacteria, but they can't choose between good or bad. So one of the side effects is diarrhoea. We also know that the microbiota is disturbed by alterations in the diet. So we said like a bad diet and or fatty food takeaways do give the upset tummy as well.
00:03:50:23 - 00:04:15:03
Dr Armin Mooranian
But in addition, you do have more chronic conditions, irritable bowel syndrome, irritable bowel disease, where you have this permanent, if you like, disruption of the microbiota, that then also damages the lining and tissues of the intestine as well. So there are lots of ways to go about it. Traditionally, we'd be looking at probiotic supplements. You see them on the ads on TV all the time, the good bacteria in a capsule, but there are dietary sources of that as well.
00:04:15:03 - 00:04:35:11
Dr Armin Mooranian
So yogurt is also full of good, healthy bacteria. And then there is the FMT concept, which is the fecal microbiota transplantation that is transplanting the bacteria. So getting healthy bacteria from a donor and putting it into a recipient, someone who is in need of that. So there are many different ways of approaching and trying to restore the microbiota of your gut.
00:04:36:03 - 00:04:50:12
Sarah Tailier
Armin, you were just talking about some of the common ways that people try to really look after their gut health. What really makes this approach with using this special capsule? You're going to tell us all about what's actually inside this capsule. Why is it better?
00:04:50:16 - 00:05:14:08
Dr Hani Al-Salami
Okay. So notionally, we've always believed that probiotics, which are selective species of bacteria, we can just deliver them in capsules or they're going to go in and they're going to equalize the gut. That doesn't happen. So they happen for a few reasons. The first one is our body. We evolved not to take only bacteria. That's why the stomach is so acidic and they did like.
00:05:14:08 - 00:05:39:21
Dr Hani Al-Salami
So I said one of the reasons is because it's evolved to kill bugs so we don't have in our body. The second reason is, the back of is not bacteria is very different. Microbiome, as Armin's been saying, is actually tenfold more bacteria than our own cells. So in last question for us, I was presenting I said to them, look, you look at us as human, lots of bacteria or as bacteria with some human cells.
00:05:40:02 - 00:06:07:01
Dr Hani Al-Salami
So you have two options. And the reason is because this bacteria is viruses, it's fungi. It's all the other things which we believe they have a bigger impact than just purely the bacteria itself. So the vaccine, it produces polypeptides that produces a lot of fatty acids that produce a whole raft of soup, if you wish that. So we believe to be fundamental in reconditioning the gut into a healthy.
00:06:07:01 - 00:06:38:18
Dr Hani Al-Salami
Oh, so as Armin can describe very well that disease conditions are influenced by the health of the person, but the health of the person can then influence the gut itself. So you have this kind of tsunami of problems causing more problems. These problems cause more problems. And so the body's damaged the bacteria damage. The second thing you need to be in mind is that the control of the communication between bacteria and virus and the gut itself with the body is quite significant and well documented.
00:06:39:04 - 00:07:02:22
Dr Hani Al-Salami
So if you look into our gut and zoom in really close, you will see the intestine. There are lymph nodes that there are immune cells that can extend their arms too much into our side. And in a sense that the bacteria and the soup and that can influence the way they communicate with the brain and hence the gut-brain axis.
00:07:02:22 - 00:07:25:02
Dr Hani Al-Salami
So that's why so far, just giving one or two types of bacteria, we believe that the best in a capsule that's not going to work. And so far it has failed to treat that. It might help, but we don't have a clinical indication of just probiotics to treat a disease. And that's it. Not only this, if we take antibiotics as as mean saying and that's the whole purpose of it.
00:07:25:08 - 00:07:41:10
Dr Hani Al-Salami
So at the moment the FMT is being indicated clinically for people had really bad infection ahead of an antibiotic dose and then get invaded by that bacteria that colonise the gut. And the death rate is quite high in these conditions.
00:07:42:15 - 00:07:45:14
Sarah Tailier
Oh, wow. So what type of conditions can result from that?
00:07:45:20 - 00:08:08:14
Dr Hani Al-Salami
For example, there's something called Clostridium difficile or C. diff, in short, and that's a type of bacteria that exists. But if you let it rip, it will destroy you and it will kill you basically. So that. Hence the only treatment that's been effective is pretty much getting someone's poop, which has got bacteria, viruses, fungi, the whole, the whole soup and transplant into there.
00:08:09:01 - 00:08:39:15
Dr Hani Al-Salami
And that seems to be the life-saving approach. The problem with that is what currently happening is the transplantation process is a last copy, which means not everyone is eligible, which means it's very invasive, which means who can do it. They can't just willy nilly give it to anyone that's got the problem. That's one. Hence what we came up with, which is the capsule designed specifically to handle a sufficient amount of this bacterial content or gut content.
00:08:39:15 - 00:08:57:21
Dr Hani Al-Salami
It's taken orally over a couple of doses, for example. So maybe 23 capsules now. And the same thing tomorrow in the clinic by a specialist. The specialist then that can transform the gut conditions of the patient from suffering into a healthier, happier gut.
00:08:58:13 - 00:09:08:23
Sarah Tailier
What does that transition look like from someone who's starting off with, you know, a terrible gut that's it's really stripped and struggling to that evolution towards a healthier gut. What does that journey look like?
00:09:08:23 - 00:09:31:00
Dr Hani Al-Salami
So there's a famous YouTuber, a guy called Kevin Cross. He thought he was dying for sure. And he got to the stage where he's just waiting to die. And all of a sudden, after one dose of FMT, he is healthy and happy as you ever can be. So I was shocked myself. I didn't expect to see that massive impact that that would drive us.
00:09:31:00 - 00:09:54:22
Dr Hani Al-Salami
We both clinicians, we both are from hospitals and pharmacies before we know what it's like. In fact, as always, you deal with patients. You know, people don't go there because they're happy and healthy. They go there because they have a problem. So to see a transformation like that, that's what drives us, because we can give back to the community and ensure that all the training and all the investment that we had over the years is paying off to our clients.
00:09:54:22 - 00:09:58:11
Dr Hani Al-Salami
Our patients are people that could be my mum, my dad and so forth.
00:09:59:10 - 00:10:11:15
Sarah Tailier
So when we are actually looking at this fecal microbiota transplantation, this little capsule, can you talk me through either of you how that process actually starts? And and where do you actually how do you identify a good donor?
00:10:12:14 - 00:10:35:02
Dr Hani Al-Salami
Yeah, so the Red Cross and I can't speak on their behalf, but we're very close together. They have a very thorough process to to make sure that they screen their candidates. So we're blessed enough and we're lucky enough that people will go there and will donate their blood, their breast milk, and now it's feces and these people get screened.
00:10:35:02 - 00:10:57:13
Dr Hani Al-Salami
And that is one of the challenges that we have is actually because it's such a stringent screening process, very few make it so you end up with the feces and then you have to the the healthiest. And they may sound quite gross, but the healthiest feces are the most fresh one. They can take it straight from the from the toilet, straight to someone's mouth, basically.
00:10:57:13 - 00:11:33:00
Dr Hani Al-Salami
So the faster the better. And that's why we now creating a platform at Curtin, I believe the person that would have the ability to help expedite the process because I the so manual say you take it you then you filter and see how people can have different types but it can have chunky take the chunk out, you dilute it, you add something to it, and you basically just put it straight into the freezer, mass the freezer, and then we give it they give it to Fiona Stanley hospitals and all this and fill it, put it in a syringe and inject it and that's it.
00:11:33:11 - 00:11:35:01
Sarah Tailier
They inject it straight into the capsule.
00:11:35:01 - 00:11:40:17
Dr Hani Al-Salami
So the syringe, you have a very good size of the capsule. This is here is the transportation. So the cost of a.
00:11:40:17 - 00:11:41:02
Sarah Tailier
Yes.
00:11:41:07 - 00:12:06:18
Dr Hani Al-Salami
The capsule will be very similar. But what we're hoping for is we take this at the moment, that's what we're working on. We just started the process, the project itself. And the idea of it is to finalize what's the best process and platform that we can use to maximize outcome. Outcome means we have a robust capsule. They're firm, they are consistent, they've got enough amount of fecal matters.
00:12:06:24 - 00:12:30:15
Dr Hani Al-Salami
And that done so quickly that we don't lose out on the good stuff because a lot of bacteria die the minute you kill because copper is bacteria. So when you think about it and we have about an average of about 1 to 1.5 kg of fecal matter on us all the time. So so basically the minute it comes out of the gut, it's already in a hostile, different environment.
00:12:31:01 - 00:12:50:13
Dr Hani Al-Salami
And the question is, how can you save whatever is there by making the process so seamless, so, so quick, so smooth that we can have it put in the capsule and then give it and the toilet in the freezer and what would happen afterwards is we will deliver it to the hospitals where GPs can give them to patients other than nurses.
00:12:51:17 - 00:13:16:24
Sarah Tailier
That's an incredibly interesting process, especially with how fast you really need to be getting your hands on that stool. I really want to touch on the ick factor because I think it's something that we need to unpack. But there is quite a stringent cleaning process that you talk about, the screening process that goes on. How how do you address the ick factor if you're at a barbecue and someone says what you're doing, what how do you approach that?
00:13:17:18 - 00:13:35:10
Dr Armin Mooranian
Look, in actual fact, it's not any different to the medications and drugs that are in the capsules at the moment in the market. If you were to actually walk into a pharmacy, grab a capsule off the shelf and open it and look at the powder inside, it is very disgusting, very smelly. But you don't actually feel that unless you try your way through a capsule.
00:13:35:17 - 00:14:00:02
Dr Armin Mooranian
So this is actually no different. And the evolution of the pharmaceutical industry over the years has designed the delivery system dosages, capsules of various ability to actually hide, if you will, the odour or the ick factor that you get. And this actually before we even get into the concept of fecal microbiota, we have these problems with drugs, antibiotics or everything like that are actually just as disgusting.
00:14:00:09 - 00:14:20:07
Dr Armin Mooranian
It's just that they don't have the stuff associated with them. But rest assured that we just as disgusting if they do come into contact with you. So we are able to take these technologies that have naturally evolved over the years and apply that to their fecal space. The ick factor is actually that could be further dealt with, if you will, by many things.
00:14:20:07 - 00:14:39:00
Dr Armin Mooranian
You can add to the capsule to flavour, to colour, to have that enhanced appeal for the general public. And look, there have been many studies done that if you were to sort of blindfold people and just give them a capsule, the mind could play a lot of tricks on you. And if you actually do it, I do not disclose what is in there and say, yep, this is a jelly bean.
00:14:39:00 - 00:14:42:02
Dr Armin Mooranian
People think this is a jelly bean. So it's.
00:14:42:12 - 00:14:42:22
Dr Hani Al-Salami
That who.
00:14:42:22 - 00:14:59:01
Dr Armin Mooranian
Would be doing that? But the basic thing is with the science is advanced so much that you're able to add too many things to this potting mix soup, if you like, that is able to make it much more pleasant for the for the recipient for the for the patient.
00:15:00:07 - 00:15:03:09
Sarah Tailier
How significant is the potential of this pathway?
00:15:04:06 - 00:15:07:14
Dr Armin Mooranian
The pathway to coded or the treatment modality?
00:15:07:14 - 00:15:08:10
Dr Hani Al-Salami
It's extraordinary.
00:15:09:17 - 00:15:11:05
Sarah Tailier
Oh, either.
00:15:11:05 - 00:15:30:21
Dr Armin Mooranian
Well, yes, extraordinary is one way to put it. Absolutely. And look, the interesting thing about this is that it's a collection of things that make it effective. So it's you know, people have tried to take poo stool and isolate the good bacteria from it and give that to the patient. It hasn't worked as well. Likewise, sterile poo without the bacteria doesn't work as well.
00:15:31:08 - 00:16:07:07
Dr Armin Mooranian
So it seems to be a combination of things that we don't know at the moment. This area is rapidly evolving. We think that it's the combination of bacteria plus what they could possibly secrete in that stool environment as a combination delivers that medical benefit. And look, it's been applied traditionally in the local space. So what we mean by that is in the gastrointestinal gut area to treat things like, you know, Clostridium difficile, which is a bacteria that people can get, but also inflammatory bowel disease which is becoming more prevalent, IBS, IBD, you might your doctor might, you might hear terms of ulcerative colitis, colitis and Crohn's disease, these sort of things.
00:16:07:17 - 00:16:30:13
Dr Armin Mooranian
But the beauty of this technology and this application of fecal microbiota is that, as Hani did mention the gut-brain axis. We're able to diversify that treatment into much more diseases. We know that from our experience as a clinical pharmacist working in community and the hospital space, that one area of example is Parkinson's disease, which is the neurological conditions that's characterized by shaking and tremors.
00:16:30:13 - 00:16:52:23
Dr Armin Mooranian
And the very most famous case out there is Michael J. Fox. The young actor was diagnosed at the age of 29. We've seen from my own practice that a couple of years before the actual clinical diagnosis of Parkinson's disease, the shaking tremors, people complained of problems with the gut. Constipation is a very big and they come to the pharmacy all sorts of remedies and doesn't do the trick.
00:16:52:23 - 00:17:31:20
Dr Armin Mooranian
So this reinforces the fact that your gut is actually talking to you, talk to the brain, say something is wrong. And this is an expand into the areas of Alzheimer's disease, which is a one type of dementia, forgetfulness and also multiple sclerosis. We now know that diabetes, before you get your sugar levels going very, very high, similar doctor actually starts off with your gut playing, playing up where there's a change of bacteria, the bad bacteria from years and years of bad diet is taking risk and this bad bacteria is sending signals to other organs in the body, making you resistant to glucose, needing, you know, treatments to help with the sugar levels and so forth.
00:17:31:20 - 00:17:38:23
Dr Armin Mooranian
So we've been able to over the years to look outside of the gut space and to use that FMT platform for multiple diseases as well.
00:17:39:12 - 00:17:42:03
Sarah Tailier
I didn't realize how expansive its potential really is.
00:17:42:03 - 00:18:05:14
Dr Hani Al-Salami
So there's that sort of I don't know what I always tell my students and patients that have Type 1 diabetes, a very good example because Type 1 diabetes, people believe or scientists believe that it starts within six months of life as an insult in your gut that confuses the immune system. And it lasts until is 19, 20 or 17, so many years later.
00:18:06:00 - 00:18:25:00
Dr Hani Al-Salami
But then you back year is wiped out, save about 90% of your pancreas by then. Then that's when you go to the masses in diabetic. But what would happen if you saved it early so that these are the kind of things and I know this sounds gross but mum sat on the mum because you actually have them in one thing.
00:18:25:01 - 00:18:37:05
Dr Hani Al-Salami
But so would that mean that if you if you condition the mum's gut correctly, would that give you a healthier baby? And I'm not giving any promises or anything whatsoever. We just starting this work. But that's how far it goes.
00:18:38:01 - 00:18:53:20
Dr Armin Mooranian
And it's applicable to a range of patients, not just the, you know, the adult population, but also in the pediatric children's space as well. There's data emerging that some common conditions like autism has may have had to have disturbances in the gut. So that gut-brain axis becoming more and more critical in everyday practice.
00:18:54:15 - 00:19:03:00
Sarah Tailier
Is there anything I know that's this is not specifically what we're here for today, but is there anything that you'd recommend? Simple things that we can do to look after our guts.
00:19:03:14 - 00:19:25:22
Dr Armin Mooranian
Most important thing is to try to keep the microbiota, the gut bacteria happy in your gut. And there's evidence to show there are lots of things you can do. A good diet is first and foremost the most important thing. You don't have control over our genetic factors, but you'll be surprised that genetic factors actually contribute a small amount in there over a problem with the gut, environment and personal decisions actually impact hugely.
00:19:25:22 - 00:19:45:07
Dr Armin Mooranian
So diet is a very important one. The good old adage says healthy diet and exercise and distress and they've all been associated with a bad, bad gut. You know, if you're stressed if you're eating a lot of junk food, for example. So, yeah, a lot of that you can do a diet for is a good diet. Be sure that processed food is best avoided as well.
00:19:45:07 - 00:20:02:07
Dr Armin Mooranian
And as we find, the processed food is becoming more predominant in the Western diet, in Western societies, we're seeing a direct correlation to microbiota change in the gut, and this is translating to more and more prevalence of a lot of conditions. And it may not be as black and white directly, but it's definitely an important factor to consider as well.
00:20:03:02 - 00:20:28:04
Dr Hani Al-Salami
It's very complex, so may I just say that the conditioning of the gut as a very tricky business and identifying what's good and what's fat is a very tricky business. And identifying why the intervention is the reason for healing. It's also a tricky business. So as you can see, there's a lot and a lot of complexity. That's why you cannot just get it prescribed for and not just go to your GP and say, Can you give me some FMT capsules?
00:20:28:04 - 00:20:38:24
Dr Hani Al-Salami
You know, it has to be in a clinic proper with accommodation. So and especially in children, that becomes very complicated. But we're trying our best.
00:20:38:24 - 00:20:42:05
Sarah Tailier
I'll ask one more question about the alcohol, cause I think that's really interesting.
00:20:42:05 - 00:21:02:23
Dr Armin Mooranian
Yeah, alcohol's effect on the body are a bit too diverse and I guess the difficulty comes about saying the chicken or the egg, was it alcohol, which has been proven to increase the blood-brain barrier permeability. So basically your gut, your brain has this wall. Think like, you know, at this wall, alcohol basically takes the bricks away and allows the bad guys to get in.
00:21:03:14 - 00:21:22:01
Dr Armin Mooranian
So if the question becomes the whole the important thing about the brain axis, what's alcohol's effect? The question becomes like chicken or the egg, did the alcohol cause the brain to become more leaky so things getting or did it damage the bacteria, which then indirectly add to that? So we don't know. And to do a study on that is actually quite difficult.
00:21:22:05 - 00:21:22:22
Dr Hani Al-Salami
Almost impossible.
00:21:22:22 - 00:21:24:00
Dr Armin Mooranian
I would say. Yeah, yeah.
00:21:24:13 - 00:21:25:07
Dr Hani Al-Salami
To be accurate.
00:21:25:20 - 00:21:48:08
Dr Armin Mooranian
So it's because it's effects be shown to, you know, it promotes cancer, it makes the brain more susceptible to bad things getting in there. So alcohol consumption has been linked to Parkinson's. Alzheimer's just purely on its own, even with the healthiest of diet. So singling out what it can do, because there's so much that that's why the general consensus is don't drink it.
00:21:49:14 - 00:22:05:22
Sarah Tailier
Hani, every researcher has a story and maybe a moment of inspiration propels them into their field of study. Could you give us a glimpse into what drew you towards the nature of pharmaceutical encapsulation and specifically the development of FMT capsules?
00:22:06:08 - 00:22:29:05
Dr Hani Al-Salami
Okay, thank you, Sarah. And that's a good question. So as a pharmacist, I once sold a farm. I've always wanted to be a pharmacist and have graduated and did my internship and a pharmacy and then moved to a hospital. And I've been dealing with patients pretty much all my life. And everyone I went back in in the doctorate, I still maintained a part composition of locum in these places.
00:22:29:14 - 00:22:53:20
Dr Hani Al-Salami
So I've got a firsthand feeling, an understanding of how what patients go through. And we've had patients who have gone through drastic measures and very bad disease, and it's simple ones as well, but across a range. So that that kind of V-shape way of thinking. And then I've got some close relatives that have gone through some bad episodes and have as well.
00:22:54:09 - 00:23:19:23
Dr Hani Al-Salami
So when you accumulate your own family health of suffering from from different conditions into your patient that you see every day that looks after you, the you get paid to do a job and and then the job becomes, you know, you always asking yourself, what else can I do to help more than you realize that despite all the advancements that we have, we actually call up I will say, primitive, that the scope of medications is actually quite simple.
00:23:19:23 - 00:23:41:22
Dr Hani Al-Salami
So, for example, if you look into insulin discovery as injectables, it was in 1921. So that's more than a hundred years ago. And we still inject the same insulin in the same way. So metformin, which is another drug for diabetes, a first line treatment has been around for hundreds plus. So we have not really broken.
00:23:42:00 - 00:24:15:21
Dr Hani Al-Salami
But that transformed into something very new. However, there's a lot of will be invested in it and there's a lot of ways around it. The advantage of FMT is that, first of all, you have synthesised anything as human to human. So there is a voluntary friendly approach to start with. In my opinion, our heroes are not us. That the donors, that those who gave up their time all the way and pay that expensive pocket exit into the Red Cross and they provide the guts for us to use.
00:24:16:03 - 00:24:26:13
Dr Hani Al-Salami
So the other kind of two that they are prepared to do this and the least we can do is invest in make it happen. And that has been my drive for the last ten years or so for the old. But, you know.
00:24:27:19 - 00:24:53:11
Sarah Tailier
You certainly don't look a million years old. Just for the record, some really close to home motivations for you. I wonder. Armin, the innovation as well doesn't happen in a vacuum. It's often the accumulation of years of dedication and pivotal experiences along the way. Could you share maybe a defining moment in your career that really highlighted the importance of pushing the boundaries in medical treatment technologies?
00:24:53:18 - 00:25:17:20
Dr Armin Mooranian
So I guess it can be put down to wouldn't be a single episode, but rather what was building up over time. Similar to Hani, was a clinical pharmacist, worked and community and hospital. One of the advantages of clinical pharmacy is being frontline patient care. And I went through my undergraduate and did a master in clinical pharmacy code and while still maintaining the pharmacy practice.
00:25:18:13 - 00:25:41:22
Dr Armin Mooranian
And one of the things that always struck me as interesting is pursuing the boundaries or pushing the bounds of science to, you know, just find new discoveries, treatments. Because a lot of the patients I was dealing with don't seem to be benefiting from cutting edge sciences or that you come across in any newspapers and so forth. So I was puzzled by the fact that we can, you know, put a man on the moon, but our knowledge of the human body is still quite primitive.
00:25:41:22 - 00:25:58:12
Dr Armin Mooranian
And what we think we know give it time. We turn back and say, No, we don't know, sorry about it, we made a mistake. So one of the motivations of me for me to come back into research was to actually push the boundaries of science with a clinical background in mind, clinical pharmacy. Because I want to end of the day, it's the patients that have to benefit.
00:25:58:12 - 00:26:18:15
Dr Armin Mooranian
So my moment would be that being in the pharmacy, being wanting to push the bounds of science to the full extent and asking the question of why, what kind of be better? Why does one patient experience this, the other patient totally different? What are we? What are we missing here? And that's the big motivation for me to basically is a career in research.
00:26:18:15 - 00:26:27:12
Sarah Tailier
And yet Allgood research involves partnerships. Who are some of the partners that have come along for the journey to get you to this stage?
00:26:27:21 - 00:26:45:00
Dr Hani Al-Salami
So we've been lucky enough that the Red Cross Lifeblood chose our lab and skillsets to utilise to establish this platform. And they are supported by the WA Health Department as well as Rothbury Health. So funding.
00:26:45:24 - 00:26:57:10
Sarah Tailier
I've got a question of just in case it might lead to a few more people donating healthy poo. What qualifies for a good poo? What should people be looking at if they are thinking about donating to Red Cross Lifeblood?
00:26:57:15 - 00:27:16:21
Dr Hani Al-Salami
Thank you. That's a very good question. What I would encourage people to do is the resources are a thing as a bad donor. Don't make an assumption that no one wants it to, you know, develop. Lot people do. And you would be surprised we had the same thing in the organ transplantation space where they said, oh yeah, my livers is damaged.
00:27:16:21 - 00:27:37:14
Dr Hani Al-Salami
I can't let that. You don't know this and always think of it as the other choice for that person is death. So the question then becomes is would it have with this alive, with this optimal level, God or something else, or do they just die? So so to do this, I think that from out in the sun is a lot of blood.
00:27:37:19 - 00:27:53:22
Dr Hani Al-Salami
You can go and can get a car parked there. Just give it a go. You've got nothing to lose. You're not going to change anything or anything whatsoever. Give it a go, have a go, and they wait to see whether you're eligible or not. They will screen you your food and other things as well. They they they've got a whole list of items.
00:27:53:22 - 00:28:02:16
Dr Hani Al-Salami
That's how it gets approved by the TGA for the work to get done here in humans. But once you are proved you can you can be a lifelong donor. And then video.
00:28:03:09 - 00:28:27:03
Dr Armin Mooranian
What I would like to add is in the FMT space, it's actually a learning curve for all of us, for scientists, for clinicians, for donors, patients funding bodies. So it's very important that people do donate because like I say, it's a learning curve. We also don't know all the answers. And unless we get a lot of people turning up to donate, unless we get the ball rolling, we actually won't have all the answers of what is a good donor?
00:28:27:03 - 00:28:31:15
Dr Armin Mooranian
What's what else do are we looking at? What effects would it have to benefit the patients? Also, in the end of the day.
00:28:32:13 - 00:28:34:17
Sarah Tailier
Do you know if we're getting many donations at the moment?
00:28:35:01 - 00:28:58:05
Dr Hani Al-Salami
Now there is a there's a there's there's a fair bit bottom. But I have to say that the success rate is quite low. Maybe because we we put the bar too high. I'm not sure this is something that I'm not in my hand at all. That cross has it to deal with it, but they have significant interaction with the regulatory bodies and that being watched all the time.
00:28:58:05 - 00:29:23:13
Dr Hani Al-Salami
So whatever they do is be monitored heavily. And I mean, as if only yesterday we got an email that changed the platform a little bit because, you know, they what we thought would be a good idea that every pathway said none of us a bit to visit but so so we are also being guided by what's possible. I mean, sometimes a scientist and pharmacy, we tend to kind of freely just give it a hell of a go and admit back for our time.
00:29:23:14 - 00:29:34:08
Dr Hani Al-Salami
So it's all about the balance, as Armin said. And I would like to echo that, that we still don't know a lot of things despite all the science and all this knowledge. Yeah, very little, in my opinion.
00:29:35:24 - 00:29:38:24
Sarah Tailier
Well, that's inspired me to donate to heart. Plenty of other people do as well.
00:29:39:06 - 00:29:39:20
Dr Hani Al-Salami
Fingers crossed.
00:29:40:09 - 00:29:51:15
Sarah Tailier
Thank you so much, Armin and Hani, for coming in today and walking us through the fascinating world of gut health and your really innovative and important research. I can't wait to find out what's next.
00:29:51:19 - 00:29:53:01
Dr Armin Mooranian
Thank you for having us.
00:29:54:10 - 00:30:07:20
Sarah Tailier
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