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Anaerobically cultivated human intestinal microbiota (ACHIM) is an investigational live biotherapeutic product. It is a standardized, complex culture of intestinal flora derived from a healthy donor and propagated in a laboratory under anaerobic conditions. This approach is an alternative to traditional fecal microbiota transplantation (FMT) that uses unprocessed donor stool. The mechanism of action involves restoring a healthy and diverse gut microbiome (eubiosis). This can help outcompete pathogenic bacteria, such as *Clostridium difficile*, and modulate the host's immune system, which is the rationale for its investigation in autoimmune diseases like systemic sclerosis. Clinical trials sponsored by Oslo University Hospital have evaluated ACHIM for the treatment of primary *Clostridium difficile* infection and gastrointestinal symptoms associated with systemic sclerosis.
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