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Session Recap: “Trust Your Gut” – Therapeutic Opportunities from the Microbiome

February 10, 2015
Tuesday at the BIO CEO & Investor Conference kicked off with a Therapeutic Workshop titled, “Trust Your Gut” – Therapeutic Opportunities from the Microbiome. The panel was moderated by Mark Breidenbach, PhD, Equity Research Group, H.C. Wainwright & Co.

The panelists were:

  • Martin J. Blaser, MD, Muriel and George Singer Professor of Medicine, Professor of Microbiology, Director, Human Microbiome Program, New York University Langone Medical Center

  • Karim Dabbagh, PhD, Chief Scientific Officer, Second Genome

  • Michael Elliott, MBBS, PhD, Vice President of Immunology Scientific Innovation, Johnson & Johnson Innovation, Boston

  • Eric de La Fortelle, Venture Partner, Seventure Partners

  • Jeffrey Riley, CEO & President, Synthetic Biologics

Breidenbach opened the panel with an introduction into the current state of microbiome research and funding. The microbiome can be viewed as an extension of the human genome and has the potential to revolutionize the way we view human health. Each person’s individual microbiome may affect how one responds to drugs, how active or overactive one’s immune system is, and how well one can tolerate treatments. Preserving the diversity of the microbiome has become the focus of several biotech startups. Over $170 million has been raised in VC funding in the field, and it hasn’t escaped the attention of big pharma, either.

Blaser spoke to the question of the relationship of the microbiome to human health. While there is a lot of excitement in the field, our knowledge of this relationship is just beginning. The microbiome could offer insight into why different people have different reactions to diseases and treatments. What we do know, Blaser explained, is that a healthy microbiome is one that is diverse and contains a large number of organisms. We know it is malleable and can be affected by a changing diet and by illness.

Blaser is particularly interested in the question of how antibiotics affect the microbiome. “We used to think that we would bounce back after taking antibiotics,” he explained. “We now know that they have potentially life long effects on the microbiome. As a class, these drugs are tremendously important in medicine, so we need to know what affect they have on our gut health. In the future, we will take into account people’s microbiome ecosystem to create individualized approaches to therapy.”

Mark asks, “Is microbiome medicine diagnostic in nature or does it hold more potential in the development of new treatment options for patients?” Johnson & Johnson Innovation’s Elliott answered that there is a strong relationship between the microbiome and gut mucosal immunity, and that he is interested particularly in the potential for the development of preventative medicines. If we can understand how the microbiome forms in childhood, it may be possible to manipulate a person’s microbiome early in life to prevent illness in adulthood.

Second Genome’s Dabbagh was confident in the promise of this emerging field. He said that the recent research regarding fecal transplants to treat obesity already proves that the microbiome can transfer traits. La Fortelle explains that as an investor, he is interested in whether microbiome could even affect psychiatric diseases, and there is research into the gut-brain relationship.

Riley discussed his company’s research into the microbiome. He explored the question of whether the proliferation of one type of gut bacteria could create excess methane, thus slowing digestion and causing disease. His company has a drug in phase two that would treat this condition. He pointed out that the microbiome does not just exist in our guts, but also in our nasal passages and on our skin. Humans have coevolved for thousands of years with the bacteria and funguses that make up the microbiome, but we are just now starting to understand their role in our health.

Blaser pointed out that one third of children are born by caesarian section, thus missing out on the microbiome development that comes from natural childbirth. In addition, children are exposed to 10 courses of antibiotics on average by the age of 10. Thus, changes to the way infants are delivered and to the ways we treat diseases are likely having significant effects on the microbiome.

Karim pointed out that it has been observed in that there have been cases where one twin in a set will develop a pathology, while the other does not. This suggests genetics alone is not a sufficient explanation, and understanding the functionality of the microbiome will be important to forming a more complete picture of human health. We have the tools to understand this now; “the time is right” for this research, he said.

Blaser warned that there is a growing concern that antibiotics might lead to the extinction of certain gut flora before we are able to fully understand the role they play in our health. As antibiotic resistance becomes of increasing concern, we may need focus on creating narrow spectrum antibiotics in the future.​