According to an article from the JAMA Network, the role of the human microbiome in our health is just beginning to be understood, and the manipulation of the human gut microbiome could one day play a major role in medicine. A growing field of research has come to recognize how the composition of the microbiome changes in different disease states and has even revealed its impact in diseases that do not appear to directly affect the digestive system.
The Human Microbiome and Fecal Microbiome Transplantation
The human microbiome comprises the immense community of microorganisms that survive within our bodies and in fact play important roles in its normal functioning. The greatest diversity of these organisms are found in the digestive tract, where a diverse array of bacterial species reside and play a role in digestion. In 2020, the primary method in which the microbiome is manipulated in order to treat illness is in a process called fecal microbiome transplantation (FMT). This procedure is used to treat gut infections involving the Clostridioides difficile bacterium. Research has found FMT to be far more effective than other approaches such as antibiotics and bowel lavage. While FMT has been proven effective, questions remain as to how the procedure actually works and what explains differences in patient response. There are also safety concerns to take into consideration.
Further Research and Treatment Efforts
Some studies have also attempted to use FMT to treat ulcerative colitis, but results so far have been varied. Further research has suggested that it may be easier to manipulate the microbiome in diseases with less microbiome complexity. The vagina, for example, also has its own microbiome, but it is far less diverse than that of the digestive tract. Regardless, infections of the vagina, known as bacterial vaginosis, can be difficult to treat with antibiotics. Antibiotic treatment often fails and recurrence is common. An experimental study of vaginal microbiome transplant as a treatment for patients with chronic disease produced encouraging results, with four of the five patients ultimately achieving long-term remission. However, three of the patients required repeated transplant procedures. This is another area where more study is necessary to understand how the operation works and what can make it more effective.
Other studies have shown that introducing a single strain of bacteria to the gut can change disease risk for newborns; another area of research involves how diet can impact the microbiome and its relationship to certain diseases.
There is little doubt that the gut microbiome can play a major role in the treatment of disease; however, much more research will be necessary before its impact can be fully deployed in medicine.
