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Alexander, James L., Mullish, Benjamin H., Thomas, Linda, Weersma, Rinse K., Sokol, Harry, Roberts, Lauren A., Edwards, Lindsey A., Emmanuel, Anton, Gerasimidis, Konstantinos, Hall, Lindsay J. 
ORCID: https://orcid.org/0000-0001-8938-5709, Iqbal, Tariq H., Kinross, James M., McIlroy, James, Monaghan, Tanya M., Sergaki, Chrysi, Shawcross, Debbie L., Stewart, Christopher J., Lamb, Christopher A., Williams, Horace R.T., Hansen, Richard and Hold, Georgina
(2026)
Recent advances in our understanding of the gut microbiome: an analysis from the Gut Microbiota for Health Expert Panel of the British Society of Gastroenterology.
Gut.
ISSN 0017-5749
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Abstract
At around 10 years ago, at the time of the first publication by the Gut Microbiota for Health Expert Panel of the British Society of Gastroenterology, recognition of the gut microbiome’s importance in health and disease was transitioning from fringe interest towards major global pursuit. A decade on, we appraise the considerable progress made in the field, while acknowledging ongoing challenges. Earlier human work characterising the 16S rRNA gene amplicon signature of particular conditions in small cohorts has been superseded by larger, multicentre studies with extensive metadata. Studies increasingly employ shotgun metagenomics and other ‘omic’ techniques—coupled with refined bioinformatic tools and disease models—to better characterise perturbation in gut microbiome functionality. The arrival of ‘gold standard’ pipelines for microbiome analysis and increased mechanistic validation of signals are key developments towards more clinically-translatable outcomes. Novel clinical areas where the gut microbiome has relevance have emerged, including early life and the efficacy of certain treatments (including immune checkpoint inhibitors and vaccination). Enthusiasm for ‘microbiome diagnostics and treatments’ has grown, but barriers to widespread adoption remain. Faecal microbiota transplant (FMT) is established for treating recurrent Clostridioides difficile infection, with donor-derived ‘next generation’ FMT products licensed for this condition in certain countries. Beyond FMT, other microbial therapeutic techniques—including nutritional, bacteriophage and probiotic therapies—show promise, but have not fulfilled their high expectations yet. Gut microbiome research is now well-established and shows significant translational potential; the future focus will be translational work to drive its utility in clinical diagnostics, prognostics and therapeutics.
| Item Type: | Article |
|---|---|
| Additional Information: | Publisher Copyright: © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
| Uncontrolled Keywords: | gastrointestinal microbiome,immunotherapy,inflammatory bowel disease,metagenomics,microbiome,gastroenterology,sdg 3 - good health and well-being,das not required, no data associated with output ,/dk/atira/pure/subjectarea/asjc/2700/2715 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 15 Oct 2026 15:03 |
| Last Modified: | 18 Oct 2026 23:11 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/104807 |
| DOI: | 10.1136/gutjnl-2026-338252 |
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