The Human Microbiome – what’s in it for you?
By Tracy Mac – Within one linear centimeter of your lower colon there lives and works more bacteria (about 100 billion) than all humans who have ever been born. Yet many people continue to assert that it is we who are in charge of the world.
Neil deGrasse Tyson American astrophysicist, science communicator.
In 2005, the Karolinska Institute in Stockholm awarded Australian physician Barry Marshall and his long time collaborator Robin Warren the Nobel Prize in Medicine for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease. Marshall found the bug and Australian Professor Thomas Borody, found the drug combination that killed it. The Marshall/Borody protocol is now standard medical practice worldwide for the treatment of stomach ulcers.
Since then, bacteria have been flavour-of-the-moment in the scientific community. Research teams and would-be Nobel Prize aspirants across the globe are investigating the role of the Human Microbiome, that community of microbiota – bacteria, viruses, phages – that live on our skin, our mucus membranes and in our gut.
So why are these bugs so important? Increasingly research is showing that each of these microbiota produce substances on which the human body relies for survival and good health. Links are being identified between the human microbiome and conditions as diverse as cancer, heart disease and autoimmune conditions. However correlation does not equal causation and more research needs to be done to establish what this means for medical practice. In the meantime, if there’s an illness to be cured you can bet there is a scientist somewhere that is researching its connection to a dysfunctional microbiome.
One of the more confronting manifestations of microbiome awareness is the use of fecal microbiota transplantion therapy to cure the vicious and fatal gut infection C difficile. C diff has been an increasing problem in hospitals and nursing homes around the world with the increasing use of anti-biotics and growing anti-biotic resistance. It is estimated to kill 14,000 people each year in the US alone. Fecal microbiota transplantation (FMT) has been around since 4th century China and was used in Western hospitals as recently as 1958, until the widespread use of anti-biotics became an easier option. In its modern day form FMT has been pioneered since 1995 by Australian Professor Thomas Borody of the Australian Centre for Digestive Diseases.
Earlier this year (2013) a study published in the respected New England Journal of Medicine showed FMT to have a 93% success rates in the treatment of C diff. The trial was stopped for ethical reasons as it was not believed fair on those patients in the placebo group (receiving antibiotics) to continue. Recent research has shown that it takes up to 4 months for the new microbiota to colonise the gut of a patient who has received a fecal transplant for C diff.
FMT is slowly gaining acceptance within the medical professions for treatment of C diff, although some caution that more research needs to be done to monitor long terms risks. This research cannot come fast enough for desperate patients who are doing FMT at home for C diff and a variety of other conditions for which FMT shows promise. FMT patient information and advocacy websites like The Power of Poop have sprung up to ensure that patients have accurate information about FMT before trying it and urging them to carry out the procedure safely, including having their donor tested by a doctor for blood borne and fecal pathogens.
In the last year over 1000 chronically ill patients have poured from the Power of Poop website into a private FMT facebook group to discuss everything from where to buy a suitable FMT enema bag, to the latest FMT research and where to find a FMT-friendly doctor. Lest you think this is a group of fruit-loops, a quick review of the facebook profiles of members will show normal people from all walks of life, united only by the fact that their gut microbiome has become unbalanced and needs fixing. In this group you won’t hear a snigger or sneer about poop, it is treated with deadly reverence.
So what does all this microbiome madness mean for you and I? We need to start thinking kindly of the bugs within. We need to start caring for that community of microbiota that keeps us well and healthy. We need to think twice before we feed our microbiota a standard Western diet or slaughter them with antibiotics. Most of all, we need to come to terms with the fact that we are more bug than human. For every one human cell, there are 10 microbiota living within our body, with most living in our gut. Indeed we are 10% human and 90% shit. We just don’t like it.