By Carrie Brodmerkel, Senior Director, Systems Pharmacology & Biomarkers, Janssen R&D
The microbiome gets a lot of press these days, from leading scientific journals such as Science publishing a special issue “Microbiota at Work” in April, 1 to articles about fecal microbiome transplants in major newspapers like the Washington Post.2 Many articles tout the need for a healthy gut microbiome and that the diversity of the gut microbiome is what maintains not just gut health but overall health. But for all of the hype, what do we really know about what a healthy microbiome looks like? What do we really know about the impact of the microbiome on health and disease? Is there a universal definition of a healthy microbiome or is it more likely that the each person has his or her own unique healthy gut microbiome?
A study published in 2015 in Science Advances studied the fecal, oral and skin microbiome of an Amerindian tribe, the Yanomami, who were completely isolated from the Western world.3 The researchers found that the Yanomami had the highest levels of human microbial diversity ever reported. They also don’t suffer from Western diseases like cardiovascular and metabolic disease or autoimmune and inflammatory diseases. Does this infer that gut microbial diversity equates to better health and less disease? That has not yet been proven and it may be that the microbiome in this tribe works in conjunction with a far different lifestyle and lack of chemical and pharmaceutical impacts and interventions to support a lack of disease. Still it drives the question of whether personalized cocktails of microbes will be needed to achieve optimal gut health for a given individual or group of individuals with similar microbiomes?
This collision of microbiome research and the precision medicine space, and the potential need for patient selection and personalization of microbiome therapies, will play out as microbial based therapeutics begin to hit the clinic. Evidence supporting this need already exists from fecal microbial transplant studies in C. difficile and inflammatory bowel disease where the response rates in an unselected population of patients leaves opportunity for improvement. Efforts to understand the functional effects of the microbes that inhabit the human gut and determining which promote health and which promote disease will be essential in unraveling the microbial communities necessary to promote health at the population or cohort level.
Hear more about Janssen’s efforts to define patient stratification strategies and personalized medicine in the age of microbial-based therapeutics at Arrowhead’s 3rd Annual Translational Microbiome Conference, being held April 12-13, 2017 in Boston, MA. For more information, visit: http://www.microbiomeconference.com.
1 Science Magazine April 2016 http://science.sciencemag.org/content/352/6285
Interestingly, despite their isolation and no known exposure to antibiotics, it was found that the tribe harbored bacteria that carried functional antibiotic resistance genes, including those that confer resistance to synthetic antibiotics and are syntenic with mobilization elements.