Dr Yehuda Ringel, Allan Walker, and I have just completed editing a large textbook of 43 chapters that will be published by Elsevier, The Microbiota in Gastrointestinal Pathophysiology: Implications for Human Health, Prebiotics, Probiotics, and Dysbiosis. One of my colleagues, interested in the clinical aspects of the microbiome, asked where do you get a patient tested to study their microbiome? That was a good question. Most of the published data come from research and research laboratories, and they do not do clinical work. I researched the problem and found that there were few places that do clinical studies. One is called American Gut, and the other is called Ubiome. Dr Rob Knight published a paper in AGA Perspectives,1 and he points out in his brief paper that it is a little early to use these data clinically. He compares his paper with some clinical studies, but those references are sparse.
Another paper was just published in the Journal of Nutrition in which they studied the gastrointestinal flora of overweight pregnant women and related it to serum zonulin.2 They found that the richest composition of the microbiota can vary with the intake of food substances. Of course, this study is limited to overweight pregnant women, but it is a very important finding as they demonstrate that food intake can affect the clinical outcome.2 As we begin to learn more and more about the microbiota in various clinical states, the importance of food intake will become paramount.
A chapter in our book, which has not been published yet, from the laboratory of Dr Ian Carroll, points out the depth of determining the microbiota from mucosa to lumen.3 It will be essential that studies tell us from where they collected their specimens to compare the data and determine whether we can alter the clinical states by altering the prebiotics or probiotics or food substances.
It is very early in our understanding, but a very exciting time for us to begin to understand the pathophysiology and role of the intestinal microbiota.
1. Knight R. The gastroenterologist’s microbiome. AGA Perspect. 2016;12:26–27.
2. Mokkala K, Roytio H, Munukka E, et al.. Gut microbiota richness and composition and dietary intake of overweight pregnant women are related to serum zonulin concentration, a marker for intestinal permeability. J Nutr. 2016;1:1694–1700.
3. Ellermann M, Carr JS, Fodor AA, et al.Floch MH, Walker WA, Ringel Y. Characterizing and functionally defining the gut microbiota: methodology and implications. The Microbiota in Gastrointestinal Pathophysiology: Implications for Human Health, Prebiotics, Probiotics, and Dysbiosis
. Amsterdam, The Netherlands: Elsevier. (In press).