Clinical OMICS

NOV-DEC 2018

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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www.clinicalomics.com November/December 2018 Clinical OMICs 15 The microbiome has become a household word, in large part due to the increasing popularity of microbiome-based products and marketing. What do you think about all of the companies that are selling products based on the microbiome? Mazmanian: I am inherently skeptical about many of the claims currently made about the benefits of the microbiome. The assertion that a company can tell you what diet to eat to 'fix' your microbiome is sim- ply unsubstantiated. There is no way that anyone has enough information to be able to reshape your micro- biome in a meaningful and healthy way, that is tailored to you. We have no idea what healthy even is, as far as the microbiome is concerned and, since my micro- biome configuration is based on my genetics, diet, and life experiences, healthy for me is totally different from healthy for you. It is really the function of the microbiome that is important to understand and that is where we have the least amount of evidence. Not which bacteria are there in terms of genus and species and not even what is there in terms of genes. Rather, what are the molecules that are being made? We have some glimpses of that answer from fecal and serum metabo- lomics. These bacterially derived mole- cules are almost completely unstudied and do not look like anything else that has never been studied before. As we sit here today, we are much closer to knowing nothing than we are to knowing anything as far as function of the microbiome. Cataloging what bacteria are there has been done. But no one knows what that information is tell- ing us about biology. Do you change anything based on the skepticism that surrounds the microbiome field? Mazmanian: I don't change anything about the projects that we study in the lab based on microbiome skeptics. The skepticism is not an obstacle. In fact, it is balanced and maybe even outweighed by the optimism in the field. A lot of fields have not met the promises that they have made. The field of the microbiome is new—and there- fore exciting—and has a ton of potential. The hype and the claims that the companies make con- cerns me. Some people are making promises to society that will almost certainly not be kept. There are going to be consequences and backlash to that. If companies con- tinue to make claims to customers who pay hundreds of dollars for a product and nothing is received in return, they will think that the microbiome is just another fad. The long-term issue of too much hype may come back to really hurt the field. I know I can't control that. But, I do know that if we do the most rigorous and informative experiments, if we ask the right questions, if we translate the findings from mice to humans and show clinical efficacy in people, it will validate the field. For me, that is the blueprint that will uncover the microbiome as an avenue to understand health and disease and to leverage it to help people. This is going to take time. It will take 5 to 10 years. But, once we have those clinical wins, and if we can achieve the goals, that will be validation needed to believe that the microbiome can be harnessed to help people. In theory, by drugging the microbiome, you should be able to restore health." chombosan / Getty Images

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