The Microbiome: Linking Bacteria, Health, and Disease

Robert C. Rickert, PhD; Scott Peterson, PhD


June 19, 2013

Editorial Collaboration

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In This Article

Applications for Clinical Practice

Dr. Rickert: What's the potential for integrating your research into the clinic, and what do you think some of the obstacles might be?

Dr. Peterson: One of the most exciting stories that I've heard in a very long time represented an event that took place in a hospital. A woman who had a serious Clostridium difficile infection had lost many, many pounds and was very close to death. Because she was in such a critical state, her clinician decided to try something radical, which was a fecal microbiome transplantation.[3] He took the fecal microbiome from her husband and implanted it into her colon. Remarkably, whereas antibiotic treatment completely failed in this particular patient, the microbiome transplantation allowed the woman to recover within days to a state of health. She was literally near death and within 48 hours was showing a remarkable improvement in her state, just as a result of this microbiome transplant.

That's one example. I think the critical nature of that particular case allowed the clinician to take this radical approach, but with so many diseases of the gut, such as Crohn disease, inflammatory bowel disease, and irritable bowel disease -- all of these seem to me to be practical applications for a similar type of treatment. The list can go beyond the gut as well.

The idea that this would gain acceptance as a routine practice and get US Food and Drug Administration (FDA) approval is the challenge. Of course, it will require animal model testing and all sorts of things that clinicians as well as basic scientists are used to engaging in. It's a process.

With respect to the sort of therapeutic compound approach that I referred to previously, that's another mechanism where I can imagine the microbiome basic research programs entering into clinical practice. If my notion is correct, then there will be lots of drug-like molecules that are produced by the microbiome. The difficulty is, again, the complexity of the microbiome -- there are hundreds and hundreds of species living in a particular environment.

We need to develop methods and mechanisms for identifying which microbes are producing therapeutic compounds -- those that can improve human health or help to maintain human health, in the same way that we think of vitamins and herbal remedies helping to sustain human health. Then we can learn to recognize those molecules and find ways of harvesting them from the particular bacteria that produce them in the first place.

Dr. Rickert: So a challenge for the future would be to identify some of those natural products that would have these abilities?

Dr. Peterson: Exactly. Very typically in science nowadays, as you start to become interested in a field, you open your eyes and realize that there are people already out there who have a head start and who have been studying natural compounds. All of the things are in place for this to take off. It's not a grassroots effort in that respect. It's a matter of connecting the right sets of expertise, and we're in a fantastic place in time to be able to do that and make good on that idea.

Dr. Rickert: As you can see, the work being done in the laboratory today is a first step in bringing new treatments to the clinic. Thank you for joining us today. I hope you'll join us for additional programs in the Developments to Watch series on Medscape.