Saturday, 14 September 2013

The Next Science Fad?-The Microbiome

When we talk about science and how it follows science fashion, we often said jokingly that we have "flavours of the month" to reflect science thought. The question is- will this flavour leave a nasty taste in the mouth? 

Based on the debate about priorities in the last couple of days.
After I said in a comment "you may be asked to eat it", you asked what is "Faecal Transplantation".

This relates to the Microbiome or gut bacteria. You need a gut flora to aid digestion and so we see lots of adverts for nutriceuticals on "good bacteria"

There is growing interest in how gut bacteria can shape the immune response. There are many immunologists who are convinced that you are what you eat and this may be central in the development of MS.  So by changing the gut flora you may be able to alter autoimmunity. 

So there are lots of scientists doing the Human Microbiome Project and this aspect is popping up more and more in science meetings. 

So it is not long before the next step, which will be to modify the gut flora and see how this affects your MS. 

Remove the existing gut flora and replace it with a new one...such as that taken from Stools  (For the non-English speakers = number 2 in the dictionary meaning in this link. (Helen groans in Oz) but How appropriate:-) it is number 3 as well). So this would be faecal transplantation

Could this be the next Science fad or the next route for people out to make a buck. I'll put money on it. 





Smits LP, Bouter KE, de Vos WM, Borody TJ, Nieuwdorp M. Therapeutic Potential of Fecal Microbiota Transplantation. Gastroenterology. 2013 Sep 6. doi:pii: S0016-5085(13)01279-1. 10.1053/j.gastro.2013.08.058. [Epub ahead of print]

There has been growing interest in the use of faecal microbiota for treatment of chronic gastrointestinal infections and inflammatory bowel diseases. Lately, there has also been interest in its therapeutic potential for cardiometabolic, autoimmune, and other extra-intestinal (things that have nothing to do with the intestines) conditions that were not previously considered to be associated with the intestinal microbiota. Although it is not clear if changes in the microbiota cause these conditions, we review the most current and best methods for performing fecal microbiota transplantation and summarize clinical observations that have implicated the intestinal microbiota in various diseases. We also discuss case reports of fecal microbiota transplantations for different disorders, including Clostridium difficile infection, irritable bowel syndrome, inflammatory bowel diseases, insulin resistance, multiple sclerosis, and idiopathic thrombocytopenic purpura. There has been increasing focus on the interaction between the intestinal microbiome, obesity, and cardio-metabolic diseases-we explore these relationships and the potential roles of different microbial strains. We might someday be able to mine for intestinal bacterial strains that can be used in diagnosis or treatment of these diseases.

Berer K, Krishnamoorthy G. Commensal gut flora and brain autoimmunity: a love or hate affair? Acta Neuropathol. 2012;123(5):639-51. 

Multiple sclerosis (MS) and other chronic inflammatory autoimmune diseases represent major public health challenges in industrialised Western society. MS results from an autoimmune attack against myelin structures by self-reactive lymphocytes, which are normal components of the healthy immune repertoire. The nature of the triggers that convert the innocuous self-reactive lymphocytes into an autoaggressive phenotype is poorly understood. In the past, it was primarily suspected that pathogenic infections trigger MS. However, so far, none of the incriminated pathogenic microbes were firmly associated with the disease. A growing body of evidence in animal models of MS implicates the gut microbiota in the induction of central nervous system (CNS) autoimmunity. The mammalian gut harbors a diverse population of microbial organisms which are essential for our well being. There is an increasing understanding that the gut microbiota not only modulates the local immune functions but also affects the systemic immune system. We are only just beginning to understand the nature of the interactions of the gut microbiota with the host's immune system especially in the context of autoimmune diseases. 

It is easy to experiment and start with germ-free animals and add back bacteria, but the trick will be to start with bacteria, remove and then replace.

It is used to get rid of infections and clinics have been set up...

Be prepared to be grossed out (click and watch)

8 comments:

  1. maybe useful for patients on long-term antibiotics. You're not a proponent of the hygiene hypothesis?

    ReplyDelete
  2. that did ruin my breakfast experience. I thought haggis was unpalatable

    ReplyDelete
    Replies
    1. Haggis...Tell that to the Scots. Lung, oats and other bits...yum yum.

      However we will be sampling Scottish Hospitality again very soon and looking forward to it.

      Delete
  3. Tracy said

    Fecal transplants are not a laughing matter. They are a legitimate medical intervention, often effective in managing a whole range of digestive and non-digestive issues. LINK REMOVED

    I said
    Does it work for MS?

    ReplyDelete
    Replies
    1. Is this the New Aspirin for the 21st century.

      Let's see

      Delete
  4. In a previous posts comments, Prof G mentioned that we should test all these theories, no matter blue sky they are. Maybe we will get lucky. If so, then how to differentiate between a true science possibility and fads?

    Isn't 70% or so of the immune system in the digestive system? Who knows, maybe the black swan will turn out to be Number 2.... :)

    ReplyDelete
    Replies
    1. 'Who are you?'
      'The new Number Two.'
      'Who is Number One?'

      'You are Number Six.'

      'I am not a number - I am a free Man!' :-)

      The Prisoner :-)

      Delete
  5. Fear not. I am sure this is being tested, animals work has already been done, there was a Gordon Conference session of microbiome and demyelinating disease, so should appear soon.

    I expect people are planning clinical trials, as they are no doubt in every suspected autoimmune disease and it can be done as proper science seeking class I evidence.

    The question I posed was whether this will be the next fad for MSers?

    There are places that can do this procedure, not involving neurologists.

    Are MSers going to wait for the clinical trials or pay the money to some, possibly dodgy clinic (10 day holiday for new microbiome) and take a chance.

    If people (POOPers) are convinced it works, as they have paid for it, they spread the word on the internet, post a few videos on youtube and off we go again in the absence of class I evidence.

    Is the establishment ready to meet this challenge.

    ReplyDelete

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