We live in a time where medical technology is evolving faster than we can imagine. For that we have exceptional and dedicated scientists and researchers to thank. In 1990, the Human Genome Project spurred a revolution in biotechnology around the world, which paved the way for a completely new approach to healthcare called Personalized Medicine. In the late 1990s researchers began studying the role that intestinal microbes might play in the human immune system.1 Since then it has become the subject of great interest for researchers across disciplines. In 2008, the Human Microbiome Project was established, “with the mission of generating resources that would enable the comprehensive characterization of the human microbiome and analysis of its role in human health and disease.”2
First let’s talk about microbes. To put it plainly, microbes are microscopic organisms‐‐a living thing too small to be seen with the naked eye. They are categorized in six different life forms: Bacteria, archaea, fungi, protists, viruses, microscopic animals (e.g. arthropods, crustaceans, rotifers, mites), and microscopic plants (e.g. green algae). The human body is home to all of these different microbes, except for microscopic plants.3
Microbiome is defined as the collection or an ecological community of micro‐organisms that inhabit an environment creating a “mini‐ecosystem.” Our human microbiome consists of communities of symbiotic, commensal and pathogenic bacteria that share our body space and call it home.4 Joshua Lederberg PhD, the winner of the 1958 Nobel Prize for his discovery of how bacteria transfer genes5 came up with the term “microbiome.” His study emphasized the importance of microorganisms living in our bodies both in good health and disease.6
Until 2014, articles and publications noted that an average person’s microbiome (bacteria and microbes within the body) outnumbered their body’s cells ten to one. At a National Institute of Health lecture in 2005, David Relman, a microbiologist at Stanford, explained that human bodies were made up of 100 trillion microbes and 10 trillion cells – hence the ten to one ratio. This ratio has been cited by researchers in scientific journals, books, TED talks7 and continues to be noted on the Human Microbiome Project website.
So where did this ratio originate? In 1972 a microbiologist named Thomas Luckey made his calculations based on one gram of feces. His study was presented in a visionary symposium he organized that helped put intestinal microecology in motion.8
However, modern day scientists believe that this was a crude estimate that established itself as fact through repetition and decades of citations. More recently, a 2014 report issued by the AmericanSociety of Microbiology showed that the ratio of microbes to human cells is closer to three to one. Peter Turnbaugh, a University of California at San Francisco microbiologist, said that there is tremendous diversity and abundance making it a challenge to determine the absolute number. “The most important thing is that much of what makes us human—many of important aspects of health and the predisposition to disease and recovery—depends on metabolic activity of these microbes. I don’t think it’s all about numbers.”9
So why does this crude estimate continue to linger? Perhaps it’s the “wow” factor of the dramatic ratio, or people’s astonishment, much in the same way we react when we hear we only use 10% of our brains.
The communities of bacteria that make up our microbiome complement each other and are present on our skin, eyes and mouth, with the majority of it, of course, in our intestines. Some of these bacteria are known as commensal, which means they are just along for the ride while others are considered symbiotic. A third type, which is usually present in small numbers are pathogens—the disease‐causing microbes. In a healthy microbiome, these pathogens remain in check and their numbers remain small and manageable limiting any harmful effects. However, if this goes out of balance, the individual may suffer a disease.
Recent studies have shown that we have approximately 10,000 different microbial species that occupy our microbiome.10 These communities perform a variety of functions which are not only vital to our health and well‐being but also to our very own survival.
Our microbiome lays the groundwork in which our bodies judge whether or not something is friend or foe. It keeps balance, harmony and order among the communities making sure that pathogens are kept at bay, and at the same time ensuring that the host system doesn’t attack itself.
Our gastrointestinal tract (gut) microbiome is crucial in breaking down and absorbing the nutrients from the foods we eat. Without it, food would be indigestible and we would be unable to extract the important nutritional compounds our bodies need to function. In addition, they secrete beneficial chemicals as a natural part of their metabolic cycle.
Our microbiome begins at birth with our first exposure to these micro‐organisms through the birth canal, followed by nutrition from the mother’s milk or other sustenance such as baby formulas. This establishes the foundation on which we build our microbiome. A recent research study also indicated that the mode of delivery affects the diversity of gut microbiota during the first three years of an infant’s life, with natural birth being better than Caesarean section deliveries for microbiome development.
A healthy gut microbiota promotes a healthy development of the immune system, while an abnormal gut is considered to possibly cause gastrointestinal infections during the infancy.11 Our lifestyles, including our dietary choices and exposure to different environments throughout our lives, especially in the developing years, will cultivate an ecosystem that will play a significant role in the determination of our overall health for life.12
Although microbes are present on the skin, mouth, and eyes, their balanced presence in the gastrointestinal tract is most critical to our well‐being. Studies on the significance of the gut microbiome have led researchers to understand how small imbalances in our intestinal microbial populations can cause diseases. That same study also indicated that these imbalances can be restored and may possibly lead to cures. This new understanding could lead to better and more effective treatments that will kill only the harmful bacteria, unlike antibiotics which target both good and bad microbes.
Recent studies also indicate that human gut flora also plays an important role in the metabolism and efficacy of how pharmaceuticals are absorbed by our bodies.13
Some of the conditions that are likely to be affected by our microbes include:14
There are numerous other studies on the effect of the microbiome to specific diseases such as liver, metabolic and cardiovascular, and impaired bone mass and quality. 18 19 20
Healthcare is facing two significant challenges at this time:
With these two challenges the healthcare industry needs to assess several conditions.
The microbiome research over the last few decades has brought forward a completely new view of our human make‐up, which is affecting the direction of healthcare. The healthcare industry believes the solution to these challenges lies within our microbiome. New research data has spawned different techniques in medical approach as well as having the potential to thwart ongoing epidemics. This brings personalized medicine to its full potential and sets us on a path to sustainable healthcare.
Prebiotics are dietary fibers that purport to promote the growth of healthy bacteria in the digestive tract. Probiotics are live bacteria and yeast that can help balance your gut flora. There are many types of probiotic bacteria with purportedly different benefits. However most are classified into two groups: 24
Taking prebiotics/probiotics is just one facet of a healthy lifestyle. However, simply ingesting large quantities of these biotics won’t make you healthy if your lifestyle continues to include habits that damage gut bacteria.
For gut microflora to be healthy it needs a stable environment in which to grow and flourish. This means that the pH in the colon should be slightly acidic (lower than 7 pH),which will inhibit the growth of undesirable bacteria like Salmonella, Shigella, and E. Coli, and will promote the growth of healthy bacteria such as Lactobacillus.
The best way to accomplish this is through diet. Consider whole, unprocessed, unsweetened foods as well as traditionally fermented or cultured items. Reduce the intake of grains and sugar, and avoid genetically engineered ingredients, processed foods and pasteurized foods. Sugar promotes the growth of pathogenic yeast and other fungi and is also known to fuel cancer cells.
Published research since microbiome studies began in the late 1990s makes it clear that microbiomes are a fundamental component of human physiology. Changes in the microbiome can trigger changes in our bodies which could either result in a disease or improve our health. The ability to understand these mechanisms and the disease process is very important as we move towards better therapeutic interventions for everyone.
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1 Penders, J.; Stobberingh, E. E.; den Brandt, P. A.; Thijs, C. (2007). "The role of the intestinal microbiota in the development of atopic disorders." Allergy. Accessed September 2016. https://www.ncbi.nlm.nih.gov/pubmed/17711557
2 NIH Human Biome Project. Accessed September 2016. http://hmpdacc.org/overview/about.php
3 “What are Microbes?” Accessed September 2016. http://learn.genetics.utah.edu/content/microbiome/intro/
4 “Microbiome 101: Understanding Gut Microbiota.” Accessed September 2016, http://www.prescript‐assist.com/intestinal‐health/gut‐microbiome/
5 Adams, Amy. (February 6, 2008). “Geneticist Nobel laureate Joshua Lederberg dies at 82.” Stanford Report. Accessed September 2016. http://news.stanford.edu/news/2008/february6/medlederberg‐020608.html
6 Peterson, Jane; et al. (Dec 2009). “The NIH Human Microbiome.” Genome Research. Accessed September 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792171/
7 Smith, Peter Andrey. (September 14, 2014). “Is your body mostly microbes? Actually, we have no idea.” The Boston Globe. Accessed September 2016. https://www.bostonglobe.com/ideas/2014/09/13/your‐body‐mostly‐microbes‐actually‐haveidea/qlcoKot4wfUXecjeVaFKFN/story.html
8 Abbott, Alison. (January 8, 2016). “Scientist bust myth that our bodies have more bacteria than human cells.” Nature. Accessed September 2016. http://www.nature.com/news/scientists‐bustmyth‐that‐our‐bodies‐have‐more‐bacteria‐than‐human‐cells‐1.19136
9 Ibid 7
10 Ibid. 2
11 Rutayisire, E; Huang, K; Liu, Y; Tao, F. (July 30, 2016). BMC Gastroenterol. “The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants' life: a systematic review.” Accessed September 2016. http://www.ncbi.nlm.nih.gov/pubmed/27475754
12 Lim, ES; Wang, D; Holtz, LR. (October 24, 2016). Trends Microbiology. “The Bacterial Microbiome and Virome Milestones of Infant Development.” Accessed September, 2016. http://www.ncbi.nlm.nih.gov/pubmed/27353648
13 Jourova, L; Anzenbacher, P; Anzenbacherova, F. (September 2016). “Human gut microbiota plays a role in the metabolism of drugs.” Accessed September 2016. http://www.ncbi.nlm.nih.gov/pubmed/27485182
14 “The Microbiome and Disease.” Accessed September 2016. http://learn.genetics.utah.edu/conten/microbiome/
15 Ibid 14
16 Hernandez, CJ; Guss, JD; Luna, M; Goldring, SR. (September 2016). “Links Between the Microbiome and Bone.” Accessed September 2016. http://www.ncbi.nlm.nih.gov/pubmed/27317164
17 “Adult Obesity Facts.” CDC. Accessed September 2016. https://www.cdc.gov/obesity/data/adult.html18 Betrapally, NS; Gillevet, PM; Bajaj, JS. (July 2016). “Gut microbiome and liver disease.” Accessed September 2016. http://www.ncbi.nlm.nih.gov/pubmed/27477080
19 Meyers, KA; Bennett, BJ. (October 2016). “Diet and Gut Microbial Function in Metabolic and Cardiovascular Disease Risk.” Accessed September 2016. http://www.ncbi.nlm.nih.gov/pubmed/27541295
20 Ibid. 14
21 Bloom, D.E.; Cafiero, E.T.; Jané‐Llopis, E.; Abrahams‐Gessel, S.; Bloom, L.R.; Fathima, S.; Feigel, A.B.; Gaziano, T.; Mowafi,M.; Pandya, A.; et al. (September 2011). “The Global Economic Burden of Noncommunicable Diseases.” World Economic Forum; Geneva, Switzerland. Accessed September 2016.
22 Cantón, R.; Horcajada, J.P.; Oliver, A.; Garbajosa, P.R.; Vila, J. “Inappropriate use of antibiotics in hospitals: The complex relationship between antibiotic use and antimicrobial resistance.” Enferm. Infecc. Microbiol. Clin. Accessed September 2016. https://www.ncbi.nlm.nih.gov/pubmed/24129283
23 Hughes, D. (August 2014). “Selection and evolution of resistance to antimicrobial drugs.” IUBMB Life. Accessed September 2016. https://www.ncbi.nlm.nih.gov/pubmed/24933583
24 DiLonardo, Mary Jo. “What are Probiotics?” WebMD. Accessed September 2016. http://www.webmd.co/digestive‐disorders/features/what‐are‐probiotics