Be skeptical of products and treatments for microbiome, experts say

Bara Vaida

About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in outlets that include the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico and The Washington Post.

Journalists and health providers should be skeptical about products and treatments related to the microbiome because researchers are still in the early days of understanding how it works and its connection to health.

Three scientists – Dr. Jeffrey Gordon, director the Washington University Center for Genome Sciences and Systems Biology, Dr. Lita Proctor, the National Institutes of Health’s former Human Microbiome Project coordinator, and Dr. Anna Seekatz, Clemson University assistant professor of biological sciences – all emphasized to reporters that researchers are far from unlocking the key to the body’s community of microbes.

“It’s important for patients and media, clinicians and researchers to not blindly follow the hype that sometimes gets written up about very specific studies” on the microbiome, Seekatz told journalists at a Aug. 22 webcast hosted by SciLine, the American Association for the Advancement of Science’s science information resource for media.

The microbiome is described as a collection of “good germs” that are now considered to be another major human organ. These microbes, which are a collection of bacteria, viruses and other microorganisms, live and interact with one another in communities. Their interaction among the group of microbes, or microbiota within the body is now understood by scientists to be a key function of health.

Microbe interaction, however, is extremely complex to study because “the number of interactions are literally astronomical,” said Gordon.

“How the parts of the microbiome function and interact … is the central challenge of the field,” said Gordon.

No one has the answer to exactly which microbes or which set of interactions of microbes are the ones associated with disease and health, therefore most therapeutic approaches to treating the microbiome are years away. Further, preclinical studies of the microbiome are occurring within laboratory mice and these studies may not translate to the human body, Gordon said.

Scientists hope eventually they will be able to unravel clues to which specific collections of microbes can be used and in what doses, to improve health, he said.

Some early studies have indicated that the microbiome could be responsible for leading people to gain or hold onto weight or might cause inflammatory digestive disorders, or attack the immune system. At the NIH, researchers are looking at the microbiome’s connection with more than 100 diseases, Proctor said. In 2007, the NIH launched the Human Microbiome Project, to describe and categorize the microbiome.

Early research has spawned lots of commercial ventures, like the sale of probiotics. But most probiotics “are fermented dairy products that aren’t very carefully regulated,” said Gordon.

“There is no absolute gold standard” for a health microbiome, said Gordon. He added that everyone’s microbiome is a little different. It is related to age, sex, diet, living environment and genetics. Therefore, a healthy microbiome looks a little different, depending on the person, adding to the level of complication in determining what makes a healthy microbiome.

The only proven treatment using the microbiome is connected to fecal transplants for reoccurring illness from Clostridium difficile. C. diff is a bacteria that causes symptoms from diarrhea to life-threatening inflammation of the colon. Evidence indicates that about 90% of people with severe C. diff can be healed if they receive a fecal transplant form someone healthy.

Seekatz said scientists, however, don’t understand exactly how a fecal transplant from a healthy donor heals the body. Fecal transplants also are not without risk. An individual recently died because they received a transplant from someone with an antibiotic-resistant bacteria.

For more detail of the discussion, watch the SciLine webcast here.

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