The next medical breakthrough is already living inside you

The things that live inside our bodies are going to be one of the biggest revolutions in 21st century healthcare. Collectively, they’re called the “microbiome”.

We’ve known about the role of “friendly” gut bugs since the start of modern bacteriology. However, they have, in large part, been treated as mere bit-part actors. We now know that this assumption is wildly incorrect – and the germs in your digestive system are more important than you have probably ever realised.

Understanding the makeup of your microbiome is big business. uBiome will give you an analysis, for a very modest price. I’ve already had this bowel biology performed. While it wasn’t as insightful as 23andMe’s genetic test, it certainly made me think more about my tiny symbionts.

If you’re not satisfied with what you discover, you can start meddling with your microbes. Church & Dwight make a supplement called PB8, which contains eight strains of beneficial gut bacteria. Hariom Yadav and Sushil G Rane, writing in The FASEB Journal, found that supplements like this help to control obesity in mice.

You may think that a link between healthy bugs and a healthy gut is obvious. But what if I told you that probiotic supplementation has been shown to be protective against ADHD and autism in young children? It’s surprising – but that’s exactly what Anna Pärtty et al published in Pediatric Research.

But why would gut bugs be linked to autism? Surprisingly, it’s obvious – when you think about it. To survive as a species, bacteria have to move from host to host. If you’re less sociable than average, it means that any lapses of personal hygiene are less likely to result in your bacteria moving to someone new. If these bugs can (quite literally) change your mind, then they can make you more socially connected. Your poorly-washed hands will then be more likely to transmit them to other people. Therefore, there’s constant evolutionary pressure on the bacteria to make their hosts more socially connected.

The effect on autism is a promising avenue for future research and treatment. There’s already a cluster of sufferers’ families who are buying such “probiotic” treatments regularly. A less medicalised market also exists with yoghurt brands; such as Activa and Yakult. As we discover more about different microbes and their potential, these markets will only diversify and expand.

As we touched on earlier, another way gut microbes affect your health is their influence on weight loss. One approach that has already found its way onto supermarket shelves today is to make diet products with soluble fibre. Brands taking advantage of this effect include Ultimate Sports Nutrition’s “Ultralean” product. Often made from chicory, these natural inulin sweeteners are indigestible without the help of your gut bugs. That means they work as a “prebiotic” – basically germ food. When the bacteria get to work on the soluble fibre, your body misinterprets this as an overload of carbohydrates and it tells you to stop eating. That’s fascinating because you don’t even need to add any microbes to start reaping the health benefits of bacteria.

Another emerging treatment is faecal transplants – also known as a transpoosion (pronounced like transfusion). This can be done in various ways: eating poo pills, or piping slurry into either end of the intestines. Again, it’s high on the yuk factor – but there’s good evidence that the treatment can offer very significant health benefits. It’s now an accepted intervention for stubborn Clostridium difficile (C. diff) infections. That’s a big deal, as C. diff is a tricky infection to tackle with antibiotics. However, it is a bit unpredictable and it’s highly likely that we’ll soon see more specialist treatments developed. These will involve a carefully-blended artificial culture of bacteria.

Sadly, some of these early experimental treatments have shown that things can go horribly wrong. We already know that obese people often have very different microbiomes from those of the healthy. This should have served as a warning, but apparently not…

In a case reported in Open Forum Infectious Diseases, one woman was offered a faecal transplant for C. diff. Unwisely, she insisted on using her overweight daughter as a donor. In a process described as “like a switch flipped”, her metabolism changed dramatically. This led her to acquire a serious weight problem. It appears that she has literally “caught” obesity.

Of course, if you can “catch” being fat, then it’s fair to assume that the process could potentially work the other way round. Obesity is a huge and growing problem in the developed world. Globally, more people are now overweight than underweight. It’s no surprise that weight management is a lucrative field for big pharma. Furthermore, there’s also a large informal healthcare sector – consisting of supplements and foodstuffs. As our knowledge of bacteria improves, we’ll see a broadening range of biologically-based products for controlling our gluttony.

Some surprising factors may alter our gut bugs, with important knock-on effects for our general health. Two strands of recent research lend weight to this theory. Firstly, a study in Pediatrics showed that kids who thumb-suck have less frequent allergies – presumably because the constant flow of germs fine-tunes the immune system during development. Similarly, Heidi Kääriö’s PhD thesis showed that children raised on animal farms had immune system changes – likely due to bacteria-laden dust in the air.

The second useful strand of research shows that women who give birth by C-section tend to have fatter kids. Co-author of one study, Audrey Gaskins, was quoted as saying “Children born by vaginal delivery are primarily exposed to their mothers’ vaginal and gut microbes, whereas children born by caesarean are primarily exposed to bacteria on their mothers’ skin and whatever bacteria happen to be in the air in the operating room.” Similarly, a study in Gastroenterology looked at antibiotic exposure in early life and showed comparable issues with obesity. This reinforces the importance of managing the infant microbiome carefully.

The above treatments are fascinating, and potentially very profitable. But the story of the microbiome does not end in the gut. In July, a first of a new class of antibiotics was announced, lugdunin, based on the bacteria growing up people’s noses.

This is just the start. We have germs on every square inch of our bodies. This is a barely-explored world – and it’s one that will play a critical part in the future of medicine. You must not ignore this opportunity.

Best,

Andrew Lockley
Exponential Investor

Category: Genetics and Biotechnology

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