David Relman, M.D., the Thomas C. and Joan M. Merigan Professor in the Departments of Medicine, and of Microbiology and Immunology at Stanford University, discusses the influence of the microbiome on health and disease.

Our microbiome – the community of trillions of bacteria in and on our bodies – and how they impact our health and disease was the focus of discussion at yesterday’s  afternoon’s plenary sessions at Individualizing Medicine 2017: Advancing Care Through Genomics, a conference sponsored by the Mayo Clinic Center for Individualized Medicine.

The microbiome as your personal landscape

David Relman, M.D. kicked off the afternoon sessions encouraging all health care providers in the audience to view themselves as park rangers, tasked with managing the microbiome landscape of their patients. That’s because research in this emerging field has demonstrated that a stable, healthy microbiome plays a role in maintaining our digestive and immune systems, but an unstable microbiome could lead to disease.

Dr. Relman, the Thomas C. and Joan M. Merigan Professor in the Departments of Medicine, and of Microbiology and Immunology at Stanford University, added that if we can understand the microbiome landscape, we can better anticipate or predict how it will respond to changes.

For example, he and his research team have examined links between the microbiome and premature births.  They found differences in the vaginal microbiomes of pregnant women, showing that women who go into preterm labor have some distinct bacterial differences that may impact a baby’s health and development. By considering these differences among many other factors that could lead to preterm labor, Dr. Relman hopes to develop a way to identify women at risk in order to prevent it or reduce any negative implications for the mother and baby.

Dr. Relman also discussed the importance of studying how medications like antibiotics or changes in our environment affect your microbiome. Understanding changes in the community of bacteria may shed light on ways to prevent disease and maintain or restore overall health.

Ignore your microbiome – and you ignore 99 percent of your system

Your body is made up of 22,000 genes that never change and 2 to 20 trillion microbial genes that are continually changing. In fact, each part of your body harbors a unique, diverse microbiome. Over the last decade, the microbiome has been linked to many diseases, including obesity, multiple sclerosis, Parkinson’s disease and depression.

All of these facts suggest you should not ignore your microbiome’s influence on your health, according to Rob Knight, Ph.D., director, Center for Microbiome Innovation, University of California, San Diego.

Dr. Knight explained that thus far researchers have unlocked many factors that influence the makeup of bacteria in your microbiome, including your age, your diet, how much sleep you get, your alcohol consumption and how frequently you exercise.

He added that the key to unlocking the importance of the microbiome is to not only understand why it changes, but also learn how to predict and control the changes to promote overall health.

So how will we use knowledge about our microbiome to manage our health in the future? Dr. Knight predicts in the next 10 years, researchers  will develop tools that serve as a “microbiome GPS” that combine genetic sequencing technology with artificial intelligence to provide you with immediate feedback. After providing a sample of bacteria, you would learn whether your microbiome was healthy or if you need to add some form of “good bacteria” to restore a stable bacterial community.

Inflammatory bowel diseases – how precision medicine may help improve care

Judy Cho, M.D.  addressed how an individual approach to chronic inflammatory bowel diseases holds promise for patients.  These diseases, which include Crohn’s disease and ulcerative colitis, affect 3 million Americans with ongoing, often painful symptoms. While new biological therapies have helped improve treatment for some, there is still a need for new, more effective therapies. Many patients require surgery and ongoing treatment with medications to manage their symptoms and to prevent the diseases from worsening.

Dr. Cho highlighted how testing has led to the discovery of genetic links to these conditions and the development of new, targeted therapies. Going forward, she believes genetic testing will also help identify biomarkers which can be used to help detect these conditions sooner and also direct patients to the right therapy. According to Dr. Cho, this approach may help patients achieve a complete remission from their condition, a new goal for providers.

In addition to focusing on the individual patient, Dr. Cho discussed the importance of looking at these diseases from the population perspective. For example, people with an Ashkenazi Jewish heritage, have a significantly higher risk of developing the disease. As Dr. Cho explained, if patients with this ancestry could be pre-emptively tested, more patients could be diagnosed and treated earlier, a critical step in reducing the health burden from these conditions.

The conference continues - more presentations and breakout sessions today

• See the schedule.
• Review the list of speakers.
• Learn about pre-conference and post-conference sessions.
• Follow the latest news related to the conference on the Center for Individualized Medicine blog, Facebook, LinkedIn or Twitter at @MayoClinicCIM. Use hashtag #CIMCon17.

Mayo Clinic Center for Individualized Medicine is hosting the conference with support from the Jackson Family Foundation.

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