By Tim Hoctor, Vice President, Life Science Solutions Services
Humans harbor trillions of microbes – known as the microbiome. The microbiome has a crucial role in our overall health, as illustrated by recent research; it can impact – and be impacted by – a wide array of diseases across human processes including immune, metabolic and neurological. The microbiome has the potential to transform preventative care and significantly reduce medical costs by enabling bespoke individual therapies.
Moreover, the combination of precision medicine and the microbiome is already advancing the field of oncology and is likely to benefit immunology and allergy fields. A recent study, published in Nature, found almost a quarter of drugs the authors tested hindered the growth of at least one bacterial species in the microbiome; fully understanding these interactions and whether this is in part what makes the drugs effective will lead to the development of more successful treatments.
In recent years there has been a lot of industry ‘buzz’ around the term microbiome and a huge amount of research hours has been spent trying to understand the field’s complexity, which has generated vast amounts of data. This research is made more difficult by the fact microbiomes grow and change with each individual throughout their lives. Decoding the microbiome will be an important facet of precision medicine, helping to find the areas of research it could complement and extend, and the ways it will help to improve all aspects of patient care. The crux of this will also be solving the data challenge – by removing obstacles to accessing and utilizing data to help realize the potential the microbiome offers to improving patient outcomes.
How decoding the microbiome will aid drug development
There is a wide array of diseases we don’t yet understand at a molecular level – from Alzheimer’s and Parkinson’s to food allergies – and the microbiome could hold the key to advancing treatments in these areas. Research indicates that a person’s microbiome is impacted throughout their life by diet and environmental factors. In order to take microbiome research into the clinic to potentially advance therapies, a deeper and more predictive understanding of microbiome-drug interactions is required to understand how the body metabolizes drugs, because this is a key element of both a drug’s effectiveness and the potential for adverse reactions. To achieve this understanding, researchers will need to be able to filter through an abundance of data to find a small nugget that offers insight, and specialized search tools will be essential.
Individuals vary widely in their responses to medicinal drugs, which can be both dangerous, and expensive for drug manufacturers if faced with delays from adverse effects. A classic example of the gut microbiome impacting a drug’s effectiveness is the first widely used antibiotic, prontosil, which was found to tackle infection from the bacterium Streptococcus pyogenes in mice, by microbiologist Gerhard Domagk. It was then later established that it is metabolized by gut bacteria to generate sulphanilamide, the active form of the drug.
In the last decade there has also been a rise in incidence of non-communicable diseases, which are often linked to changing demographics and dietary patterns. Diseases like cancer, diabetes and chronic respiratory diseases are now global, and the poor suffer most. These diseases all share risk factors of tobacco use, harmful use of alcohol, unhealthy diets, and physical inactivity – making them difficult to understand and fully prevent, not least because data on these diseases and the environmental factors are not typically clearly linked. However, the development and availability of high throughput ‘omics technologies have grown dramatically in the post-genomic era, meaning that microbial ecosystems can be studied more easily, and we can delve into these environmental factors.
Another area of research that stands to benefit from a better understanding of the microbiome is antibiotics – we are only just beginning to discover the ways antibiotics have reshaped the ecology of the microbiome over the past 80 years and the effects of these changes. Researchers have found there are long lasting consequences on the microbiome after taking antibiotics, for example one study by University College London shows a single course of antibiotics can change the composition of the oral and gut microbiomes for at least a year. Motivated by indiscriminate antibiotic use, researchers are now looking to find ways to be able to target specific species of bacteria, prevent antibiotics having a destructive effect on the microbiome, and rationally limit the use of antibiotic compounds. This will help to fight the rise of ‘superbugs’ which are antibiotic resistant.
Filtering out the ‘noise’
To advance new therapies across fields from oncology to allergy, and to develop personalized treatments, it is crucial for the microbiome to be explored further through comprehensive studies. As technology continues to develop, life science researchers will be able to conduct these larger scale studies and generate huge volumes of data, helping to increase our understanding around how to target change in human cells. Looking to the future, this research will also have a wider impact on regulations, which will need to evolve to accommodate the new information uncovered.
There will be intricate challenges for regulatory bodies and life science companies to overcome – for example, how to regulate donor Faecal Microbiota Transplantation for Clostridium Difficile infection, which is currently showing great promise. Finally, for all stakeholders to benefit from this research, scientists working in the area will all need access to centralized, harmonized and linked data, along with the latest research – so they are able to filter out the ‘noise’, make fast and informed decisions, and ultimately improve R&D research. For advancements to continue, it is essential we equip scientists with the best digital tools to manage this abundance of data, so they can focus their time on developing new avenues of research.