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Article History

Received: 22 August 2025

Accepted: 11 February 2026

First Online: 28 February 2026

Declarations

:

: This study was conducted in accordance with the ethical principle of the Declaration of Helsinki principles. All subjects and clinical information used in this study were obtained under conditions of informed consent and with approval of the institutional review boards of each participating institute (Beijing Friendship Hospital, 2022-P2-084–01; The First Affiliated Hospital of Kunming Medical University, 2022–95-2; Renji Hospital, Ly2022-081-B; Xijing Hospital, KY2022181-C-1; and the Sixth Affiliated Hospital of Sun Yat-sen University, 2022ZSLYEC-436).

: Not applicable.

: S.C.N. has served as an advisory board member for Pfizer, Ferring, Janssen and Abbvie and received honoraria as a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie and Takeda; has received research grants through her affiliated institutions from Olympus, Ferring and Abbvie; is a founder member, non-executive director, non-executive scientific advisor and shareholder of GenieBiome Ltd which is non-remunerative; is a shareholder of MicroSigX Diagnostic Holding Limited; is a founder member, non-executive Board Director, and non-executive scientific advisor of MicroSigX Biotech Diagnostic Limited, which is non-remunerative; and receives patent royalties through her affiliated institutions. FKLC serves as the Principal Investigator for the Faecal Microbiota Transplantation Service under the Hospital Authority (HA). He is a Board Director of EHealth Plus Digital Technology Ltd., an HA-owned subsidiary driving the eHealth+ programme to transform the Electronic Health Record Sharing System into a comprehensive digital healthcare platform and advance other IT initiatives within the eHealth ecosystem. Additionally, he is a Board Director of CUHK Medical Services Limited. FKLC is a shareholder of GenieBiome Holdings Limited and the co-founder, non-executive Board Chairman, and non-executive Scientific Advisor of its wholly owned subsidiary, GenieBiome Ltd. Similarly, he is a shareholder of MicroSigX Diagnostic Holding Limited and the co-founder, non-executive Board Chairman, and non-executive Scientific Advisor of its wholly owned subsidiary, MicroSigX Biotech Diagnostic Limited. He also serves as a Director of the Hong Kong Investment Corporation Limited and a member of the Steering Committee for the RAISe+ Scheme under the Innovation and Technology Commission. Furthermore, he is the Co-Director of the Microbiota I-Center (MagIC) Ltd. FKLC receives advisory fees and speaker honoraria from AstraZeneca and Comvita New Zealand Limited, as well as patent royalties through affiliated institutions for microbiome-related applications. QS is Scientists (Diagnostics) of GenieBiome Ltd. JZ is Chief Scientist (Diagnostics) of GenieBiome Ltd. The other authors declare no competing interests.