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

TY - JOUR

T1 - Recent advances in our understanding of the gut microbiome

T2 - an analysis from the Gut Microbiota for Health Expert Panel of the British Society of Gastroenterology

AU - Alexander, James L.

AU - Mullish, Benjamin H.

AU - Thomas, Linda

AU - Weersma, Rinse K.

AU - Sokol, Harry

AU - Roberts, Lauren A.

AU - Edwards, Lindsey A.

AU - Emmanuel, Anton

AU - Gerasimidis, Konstantinos

AU - Hall, Lindsay J.

AU - Iqbal, Tariq H.

AU - Kinross, James M.

AU - McIlroy, James

AU - Monaghan, Tanya M.

AU - Sergaki, Chrysi

AU - Shawcross, Debbie L.

AU - Stewart, Christopher J.

AU - Lamb, Christopher A.

AU - Williams, Horace R.T.

AU - Hansen, Richard

AU - Hold, Georgina

N1 - 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/.

PY - 2026/6/2

Y1 - 2026/6/2

N2 - 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human work characterising the 16S rRNA gene amplicon signature of particular conditions in small cohorts has been superseded by larger, multicentre studies with extensive metadata.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.

AB - 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.

KW - GASTROINTESTINAL MICROBIOME

KW - IMMUNOTHERAPY

KW - INFLAMMATORY BOWEL DISEASE

KW - METAGENOMICS

KW - MICROBIOME

UR - https://www.scopus.com/pages/publications/105040700218

U2 - 10.1136/gutjnl-2026-338252

DO - 10.1136/gutjnl-2026-338252

M3 - Review article

C2 - 42230119

AN - SCOPUS:105040700218

SN - 0017-5749

JO - Gut

JF - Gut

ER -