26 Clinical OMICs November/December 2017 www.clinicalomics.com
W
e are all colonized by vast quantities of microorganisms. Until
recently, there has been little focus on how these microbes can help
us stay healthy. However, it has now been recognized that they can
provide us with a whole array of different benefits. In contrast, disruption of these
microbial communities, such as through excessive use of antibiotics, can actively
contribute to disease.
The quest to try to understand the human microbiome and to discover how
manipulating it in different ways could help prevent or treat disease has been
taken up by the research community with enthusiasm, with advances in technol-
ogy helping to power this search for knowledge.
There are several different microbiomes present in or on the human body such
as that of the skin, the mouth and the urogenital tract, but the largest and most
well characterized is the one found in the gut. Recent research has uncovered
associations between the gut microbiome and a number of diseases including
inflammatory bowel disease, diabetes, cancer, infections, and even neurologic
disorders.
While a lot of this research is still at an early stage, clinicians and researchers
are already finding ways to use their findings to help treat patients develop better
diagnostic tools for disease; and evaluate the efficacy of different therapies based
on the diversity and composition of a patient's gut microbiome.
Conquering Clostridium difficile
An early win for gut microbiome researchers was the use of fecal transplants from
healthy volunteers to treat patients with recurrent C. difficile infection—a condi-
tion that causes around 29,000 deaths per year in the United States alone.
The success of this somewhat unconventional treatment led to it cautiously
being recommended for severe or reoccurring C. difficile infections by both the
U.S. FDA and the U.K. National Institute for Health and Care Excellence. But,
there are restrictions on its wider use due to concerns about transplant regulation
and possible side effects (see "How Safe are Fecal Transplants" sidebar).
Mark Wilcox, M.D., professor, medical microbiology, University of Leeds,
March of the Microbes
Harnessing the Power
of the Human Microbiome to
Improve Health and Target Disease
NIAID,
National
Institutes
of
Health
Scanning electron micrograph of human
neutrophil ingesting MRSA (purple).
Helen Albert