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Microbiome and Inflammatory Bowel Disease IBD

Human Microbiome for IBD treatment

Courtesy of : ondineblog.com

There’s a lot of recent talk about something called the human microbiome. I read a very interesting article by Chris Iliades, MD that was reviewed by Farrokh Sohrabi. They say that the human microbiome has now become one of the most researched medical subject. Those of us who have been advocating use of probiotics for years and years now, have been well aware of the importance of probiotics and microbiota to a healthy digestive tract. Finally, allopatic medical research is catching up, and their findings could lead to a revolution in human health. For those suffering with crohns and colitis, i.e. Inflammatory Bowel Disease (IBD), this microbiome research could hold the key to future successful treatment and even prevention.

Keith Sultan, MD, assistant professor at Hofstra North Shore-LIJ School of Medicine and gastroenterologist at North Shore University Hospital in Manhasset, N.Y. tells us that the human microbiome is all the microbes that normally live inside the human digestive system and he says that for doctors who treat Inflammatory Bowel Disease, the big interest is in bacteria that live inside the colon and small intestine. He thinks that these bacteria may be the key to controlling the condition (IBD).

He goes on to explain how everyone has zillions of microbes living inside their digestive tract. These microbes, collectively known as the microbiome, help the body digest their food, also produce vitamins, prevent digestive tract infections, and also control the immune system. Now the research is showing that a healthy balance of these microbes is essential for maintaining good health. So, when the balance of the microbiome gets upset, it is called dysbiosis. Researchers now think that its dysbiosis that may be the trigger for both Crohn’s disease and ulcerative colitis. This would mean that by preventing dysbiosis it could be possible to control Inflammatory Bowel Disease IBD, known to affect more than a million Americans.

The Journal Genome Medicine published a review of microbiome research in 2013. They found the human microbiome to be an important in the lifelong role of maintaining health. The bacteria in the microbiome have been closely linked to a lot of autoimmune and inflammatory diseases, including IBD. Now the next step is to profiling the microbiome through the study of microbial genes so that we may look towards new kinds of treatment. The Probiotic Symposium that I attended in San Antonio, Texas in November of 2013, also provided new research in this field.

The American Association for the Advancement of Science sponsored a symposium on the microbiome in 2012. The researches spoke about the discovery of the 4 million or more genes in the microbiome and predicted that this research may lead to a revolution in treatment of infections, malnutrition, diabetes, obesity, as well as Inflammatory Bowel Disease  IBD. The big leap i.e. the ability to do gene sequencing for all the different bacteria in the microbiome rather than the old inefficient way they had to learn about it was by doing bacterial cultures.

Sultan says that the current thinking is that people with Inflammatory Bowel Disease IBD inherit genes that predispose them to the disease but not everybody with the genes gets the disease. It’s something in the environment that has to trigger the genes to cause disease. More and more its pointing to bacteria in the microbiome that are a major trigger.

Many studies have shown that people with IBD tend to have dysbiosis, having less of the friendly bacteria and more types of bacteria that cause gut inflammation. But what comes first, the chicken or the egg. Does IBD cause the dysbiosis that leads to gut inflammation or does dysbiosis trigger Inflammatory Bowel Disease IBD? This is still the one of the big question that remains to be answered. My sense is that both conditions exist. I think that its not a matter of either/or, but both possibilities, sometimes the IBD will trigger the dysbiosis and other times the dysbiosis will lead to IBD. I look forward to watching as the research conclusions develop.

I attended a dinner sponsored by the Crohn’s & Colitis Foundation of America a few weeks ago. I learned about the research they are sponsoring to help understand the role the microbiome plays in IBD. It’s called the Microbiome Initiative. They started in 2008. The researchers have already completed the collection of DNA data from the microbiomes of people without IBD and now they are collecting data from the microbiomes of people that do have IBD. They are looking to identify the changes in the microbiome that occur during IBD flare ups and also when they are in remission.

“The dream scenario would be that we discover which bacteria trigger IBD and eliminate them,” he says. “That could cure IBD.” But he says that a more complicated relationship is more likely. “The links between the microbiome and IBD are probably part of the puzzle,” he says. “What we learn may allow us to customize treatment for each patient with IBD based on their own genes and the genes of their microbiome.”

We already know that people may inherit 169 genes that can predispose them to having IBD. And it’s also known that bacteria inside the digestive tracts of people with IBD are different from bacteria of people without IBD. Now we will rely on the experts to start ‘putting the puzzle together’, he says. He knows that there is a lot of time and money being spent on profiling the microbiome. His opinion is that there is too much going on for there not to be some big breakthroughs in the near future.

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Dr. Pamela Nathan DHM January 8, 2014