Microbiota in Health and Medicine
The human body is colonized by highly specialized and organized microbial communities along all its surfaces.
These microbial communities, called the body’s ‘microbiota’, are integral to human physiology and health. In fact, the composition of the human microbiota is unique to humans and our microbiota is considered part of the human body. Microbiota plays important roles in energy metabolism; it is critical to the development and maintenance of the immune system; it may even participate in neural development and affect our behavior!
Research suggests that exposure to antibiotics and altered diet over the last century in our society may have altered the composition and activity of microbiota and contributed to emergence of many common health problems, including obesity, diabetes, allergies, autoimmunity, and many others. It is now clear that microbiota, just like any other part of the body, can become sick (a state called ‘dysbiosis’) and require restorative treatment.
- Develop effective and practical restorative microbiota therapies.
- Conduct mechanistic research to understand microbiota-host interactions and discover strategies to nurture and maintain healthy microbiota.
- Educate patients, physicians, and the general public on our best understanding of microbiota science in health and medicine.
We consider any treatment that protect or heal microbiota to be ‘microbiota therapeutics’. This field is a new frontier in medicine, although the idea is not entirely novel. Many scientists dating back all the way to Louis Pasteur and Ilya Metchnikoff have recognized the importance of human microbiota. However, understanding was very limited and only relatively recently the complexity of human microbiota and its symbiotic relationships with the human host have been appreciated. Thus, early attempts at ‘microbiota therapeutics’ with select microbes that were termed ‘probiotics’ have been largely ineffective.
A new approach, which involves implanting an entire microbial community from a healthy donor into a sick patient, emerged as a spectacularly successful treatment for Clostridium difficile infection that cannot be cleared with any other standard therapies like antibiotics. This treatment came to be known as ‘fecal microbiota transplantation’ or FMT. Although this terminology sounds rather strange, the process is not exactly what it sounds. Our group has developed a way to separate the microbial communities from stool and keep them frozen. This solves most of the esthetic concerns associated with this treatment and the streamlined process of healthy microbiota preparation has allowed access to FMT to thousands of patients. Given the importance of microbiota in human health and our very limited understanding of what constitutes healthy microbiota, it is critical that every effort is made to select the healthiest donors. We have achieved that by building a robust donor program.
We are constantly working to develop next-generation microbiota therapeutics. This includes preparation of encapsulated preparation of microbiota that can be easily taken orally. We remain humble before Nature and appreciate that we are naïve to its many secrets. Therefore, we currently try to make the preparations of the entire microbial communities with minimal disruption. Of course, we are keenly interested in how FMTs work and believe that someday it will be possible to make ‘synthetic’ microbial communities based on mechanistic understanding. It is also possible that these insights will enable development of more conventional small chemical drugs. This field is still very much in its infancy, but the power of this microbiota therapeutics has already been established.
Clostridium difficile infection is one of the common causes of diarrhea associated with the use of antibiotics. It affects approximately 500,000 people in the US every year. Traditionally, C. difficile infection has been a problem primarily for older adults receiving care either in a hospital or at a nursing home facility. However, more recently the infection is commonly acquired in the community and also affects younger people. The incidence of C. difficile infection has increased significantly over the past two decades. Moreover, it often causes more severe illness, possibly leading to death. Mortality attributed to C. difficile infection by the Centers for Disease Control is conservatively ~ 30,000 per year in the U.S. However, it may be a contributor to premature mortality in at least 100,000 patients in the U.S. every year.
Approximately 280 patients with refractory C. difficile infection were treated at the University between 2009 and 2014. These
patients failed all antibiotic treatments to eradicate the infection. They recovered after Fecal Microbiota Transplantation (FMT). [Read More…]
Obesity and Metabolic Syndrome
Intestinal microbiota participate in all aspects of energy metabolism: intake, harvest, storage, and distribution. Our society‘s exposure to antibiotics and processed foods may have altered the composition of microbiota, which might be contributing to the epidemics of obesity and diabetes. In fact, it is known that obese individuals have less diverse microbiota that has altered functionality. Therefore, we think it is possible that the altered microbiota is one reason for why it is so difficult to address metabolic problems with diet and exercise alone. We are now directly testing this question in an interventional clinical trial where we use a restorative approach to change the functionality of microbiota in pre-diabetics, NCT02730962. [Review the clinical trail online or download our brochure…]
Additional Treatment Areas
Microbiota Therapeutics has wide ranging applications for the treatment of a variety of health concerns including many currently under investigation at the University of Minnesota, including Blood and Marrow Transplantation (BMT), Cystic Fibrosis (CF), and Inflammatory Bowel Disease (IBD). [Read More…]
Donor recruitment remains an area of great need for the program. Potential donors undergo a rigorous qualifying examination, and are tested for infectious disease and other problems, e.g., diabetes. Donors have to be completely healthy, i.e., cannot be obese, take prescription medications, have food intolerances, have problems with autoimmunity or allergic/atopic disease. [Read More...]