New insights into the latest microbiome research from Berlin
Scientific Summary Microbiome Discovery and Development Congress June 7th-8th2018, Berlin
MyMicrobiome visited Berlin at the beginning of June. We heard a lot of interesting talks on the status of microbiome development in different research fields which I’d like to summarize for you here.
One main topic was the fecal microbiota transplantation (FMT), represented by three different companies (Finch therapeutics, MAAT Pharma and Enterobiotix).
A further main topic was the skin microbiome, represented by L’Oréal, Sbiomedic and Origimm.
I learned a lot from an interesting talk about the vaginal microbiome from Osel Inc. and there were many more exciting topics such as immune regulation, regulatory issues and analytical methods related to the microbiome.
FMT – Fecal microbiota transplantation
Fecal microbiota transplantation (FMT) is a therapy against dysbiosis, in particular against C. difficile infection, and is becoming more and more popular. FMT is validated as a therapeutic option for C. difficile infection with 90% efficacy. Still there is uncertainty about how to regulate FMT.
Although FMT works very well, stool transplantation can also be dangerous if the sample has not been adequately examined before transplantation. But there are some institutions and scientists who make sure that stool transplants are clean (if one can even say ‘clean’ ;)). For example, there is the OpenBiome FMT database with more than 30,000 stool samples that have been analyzed and provided to doctors and scientists so far. Some companies are venturing into the challenging task of collecting and processing FMT in a manner that is safe and meets certain criteria, allowing for regulatory approval.
MAAT Pharma was the first company in Europe to set up good manufacturing practice (GMP) production for FMT. They collect stool samples from different donors, increasing the microbial diversity of the product. The quality criteria of the final product are bacterial diversity and purity (free from pathogenic germs). Because cancer treatments severely affect the microbiome, MAAT Pharma develops products for the restoration of the microbiome in cancer therapy.
A US company, Finch Therapeutics, has developed an FMT capsule for the treatment of C. difficile infections. Finch has access to the OpenBiome database, with more than 35,000 treated C. difficile patients and a cure rate of 90%.
Another company in Europe producing FMT is Enterobiotix in England. They work on a dosage form, which is easy to apply. In addition, the goal of Enterobiotix is to preserve the microbiome of healthy humans to help in later problems, e. g. after antibiotic administration, restore the microbiome with their own microbes.
An interesting article about fecal microbiota transplantation: https://www.sciencenews.org/blog/scicurious/fecal-transplants-regulation.
Overall FMT is a very successful therapy for distinct issues concerning the gut. We are lucky that there are companies who take FMT to the next level and make this therapy accessible for the people who need it.
About the skin microbiome
L’Oréal found that during aging, the skins microbial diversity increases and the proportion of Cutibacterium acnes (formerly Propionibacterium acnes) decreases. This is a very interesting finding since one paradigm is: the higher the bacterial diversity, the better! It seems like C. acnes is a gatekeeper during skin aging. After the menopause the skin secretes less sebum which is a nutrient for C. acnes and which also correlates with dry skin in aged people.
Sbiomedic also states that not only the skins microbial diversity, but the right balance between the right bacteria is the key to healthy skin. Sbiomedic is focussing on Acnes vulgaris and found that the major skin commensal Cutibacterium acnes is behaving different in Acnes skin and in healthy skin. Genetically these bacteria are identical, but a certain chemical compound of the skins sebum is being metabolized differently on Acne compared to healthy skin. The metabolite that results from the Acne forming C. acnes induces a viscous cycle of higher sebum production of the skin and thus pimples can grow and the bad C. acnes bacteria are further nurished… Sbiomedic is working on clinical studies in which they replace the bad with the good C. acnes bacteria. First results seemed to be successful!
Osel Inc. gave a very interesting talk about the vaginal microbiome. In contrast to most other microbiomes, a high diversity of the vaginal microbiome is correlated with disease. The vaginal microbiome is very specialized with Lactobacilli dominating a healthy microflora. Especially the bacterium Lactobacillus crispatus seems to be the healthiest bacterium and is dominant in women worldwide. L. crispatus produces lactic acid to keep the pH low and high amounts of H2O2 to fight adverse microbes. A low abundance of L. crispatus is correlated with higher risk of HIV infection, Bacterial Vaginosis, Urinary Tract infection and even Infertility! Even preterm birth may be protected with the enhancement of L. crispatus. Of course Osel Inc. created a product with L. crispatus cultureswhich is undergoing various clinical trials at the moment (Bacterial Vaginosis, Urinary Tract Infections and In Vitro Fertilization). We are looking forward to the results of the clinical studies!
Some presentations were given about the principle problems that we are facing when analyzing the microbiome. At the moment the fastest and easiest way of analysis is 16S rRNA analysis, which looks at a part of the bacterial RNA translational machine (Ribosome). This analysis in most cases only gives us the genus level but not the species level (e. g. we find the genus Lactobacillus but not the species Lactobacillus crispatus). The species level can be found with whole genome sequencing (metagenomics), which is way more time consuming and expensive. But not only that, some bacteria might be present in your microbiome, but they are not active… so you would have to look at the bacteria’s metabolic activity. This way of analysis is called metabolomics and is looking at the products (metabolites) of your microbiome and not at the bacteria themselves. One further advantage of metabolomics is the fact that we don’t necessarily need specific bacteria in our microbiome but we need specific functions of the bacteria in our microbiome, metabolomics do have a look at the function! In the long term, metagenomics and metabolomics will become the standard analytical methods of the microbiome.