Microbiome: Meet your multitude

The health and wellbeing of each of us depends upon a number of vast communities of microbes that live in our gut, on our skin and in our sensory and reproductive organs.

This article was originally published in the third edition of Mewburn Ellis Forward — a biannual publication that celebrates the best of innovation and exploration.

It is estimated that there are more individual microorganisms living in and on the human body than there are human cells in the body. This means that – by cell count – everyone is more microbe than human.

This microbial community is referred to as the ‘microbiota’ and includes many types of bacteria, viruses, fungi and other microorganisms. Strictly speaking (and confusingly), the term ‘microbiome’ refers to the genomes of all the microbes of the microbiota, but it can also be used to refer to the microbiota itself.

Building up this microscopic community begins at birth, once the baby exits the womb’s sterile environment. It is at once a common feature of the population and completely personal: the kind and amount of microorganisms you carry is influenced by your environment, your pets – even your left and right hand will host different collections.

Behind the scenes

Studies have shown that an imbalance in the microbiome is an underlying cause of many diseases, including allergy, obesity and cancer (although some reports question whether abnormalities of the microbiome precede or are the consequence of disease). In any case, the mechanism by which a healthy microbiome supports health, and by which microbial imbalances cause disease, is not yet fully understood. Studies of the human gut microbiome have revealed a complex network of interactions between the microbial communities and immune cells in and around the gut. These interactions appear to be necessary to prevent damaging inflammatory reactions against innocuous targets, such as the constituents of the food we eat and of the human body itself. Therefore, treating the gut microbiome is increasingly seen as a way of curing or preventing inflammatory and allergic disease.

The latest figures available (at 2017) showed around a hundred new companies formed and more than half a billion dollars invested in targeting the microbiome, with some of these initiatives aimed at solving crucial health issues. A handful of microbiome-targeting treatments are in the final phase of clinical trials. These include products containing live microbes and live bacterial spores (for example, Rebiotix’s RBX2660 and Seres’s SER-109, respectively, both of which target C. difficile), and non-digestible sugars designed to stimulate certain microbial reactions (such as Ritter Pharmaceutical’s RP-G28, a treatment for lactose intolerance). Further treatments are ready to enter the final phase, such as Prota’s products combining live biotherapeutics with specific food antigens for treating an array of food allergies.

Room for novelty

As with any new treatment, it is absolutely essential to establish a strong IP position before undertaking the massive cost of clinically validating a microbiomebased treatment. While at first glance it might seem hard to build a strong patent portfolio in this field because the active therapeutic ingredients may be either naturally occurring or well known, this is not necessarily the case if the therapeutic use is new and innovative. With new observations indicating a link between an absence of certain gut bacteria and depression, and the potential for personalised mental health interventions, the study of these unique personal communities looks set to continue to drive novel discoveries.

You can read more about the gut microbiome, and metabolism of known drug molecules, in our blog Personalizing medicine based on gut reaction.