Lynn’s Review
I will be as amazed as you, if I manage to write up a simple review of today’s talk by: Dr James Kinross FRCS PhD, Colorectal Surgeon and Consultant Surgeon at Imperial College London.
My brain is ready to explode! What a joy to have a specialist with so much knowledge at his finger-tips to impart!
There is no way that I can give every detail, as James practically told us the contents of his book: “DARK MATTER.” I can, instead, recommend it as a good read and write about what his talk, and his book, meant to me…
Place yourself high up in space. Look down upon planet Earth and reflect upon its biosphere, everything is connected; everything is communicating and everything plays its part in maintaining the balance required to sustain life. Of all these entities, on Planet Earth, the most numerous are the microbes; there are twenty-three billion tons of bacteria under the ground alone, and two thousand species of bacteria have been described in the human gut, where one hundred trillion bacteria reside at any one time, (roughly equivalent to the same number of cells that make us human) and these, at last, are being recognised. They are neither good nor bad. They respond to the treatment they receive. If treated well, they will do us good, and if neglected or mistreated, we, our fragile biosphere, will become ill. Just as Dark Matter in the Universe holds everything together and Dark Energy appears to pull it apart. It works because of balance.
In the 1900s pathogens were our enemy, causing such things as pneumonia, cholera and tuberculosis. Mental health problems were minimal and cancer may have presented in old age.
Today, we are blighted by non-infectious disease such as: cancer, cardiovascular conditions, obesity, diabetes, allergies, and also mental health issues.
James explains that our gut microbes, which work symbiotically within us, have been placed under stress, so leading to an epidemic of non-infectious diseases. Helicobactor pylori is a case in point. It has been around in the gut for at least 58,000 years, and it can offer some protection from infection and may play a part in controlling hunger. Maternal Pylori also protects against asthma in the offspring, but in a gut where the microbes present are under stress, it can cause ulcers and cancers.
It was Barry Marshall who helped open a new chapter on microbiome research. He and his associate Robin Warren believed that gastric ulcers were not caused by acidity in the stomach. Barry, who grew up in a household open to experimentation, consumed two petri dishes of the bacteria to prove their theory, that Pylori, present in the gut, could cause disease, and fourteen days later he developed gastritis. Scientists now became more interested in this concept, and a new field of research on the role of microbes began.
Antibiotics are used to wipe out Pylori in patients who have gastric ulcers, and since the early 1900s there has been a decline in the presence of this microbe. Today, just half of the global population carries H. pylori. It is also, resistant to many antibiotics. Attempting to wipe it out may have been the only option, but now balance in the microbiome of the gut is coming into consideration. Any drug which disturbs the status of the gut will lead to stress amongst the microbes within it.
James likened our microbial composition to the rainforest or the coral reef, where the clown fish nestle in symbiosis with the sea anemone, and the various species living in these habitats keep each other in check. Bacteroides thetaiotaomicron, lives within the tentacle like villi in the gut, nourishing the gut and maintaining its health. It’s able to camouflage itself so that it can’t be confused with a pathogen. This relationship is so important to our survival, that it has been encoded into our DNA.
Diversity is threatened when rainforest habitats are chopped down or pollution enters the sea. In the same way, we need diversity in our gut to keep the microbes in check. These microbes consist of: viruses, bacteria, fungi, phage, archaea, helminths and protozoa and they form the dynamic communities of human microbiomes. When kept in check there is balance. Destroying one form or another can have the same impact as polluting the seas or chopping down rainforests. Diet, lifestyle, environment and medication, (particularly, but not solely antibiotics) will all impact this diversity.
Although 23,000 genes code us, at a genetic level we are only about 1% human; the other 99% comprise of genes from the microbes within and upon us. The microbiome evolves with us, responding to environmental changes. A new-born baby needs to receive symbiotic bacteria for its future health, and the process of birth and the giving of mother’s milk and nursing are what create this. Ill health or the giving of antibiotics at this stage can decimate ecosystems from which the gut may not recover. The maternal microbiome is also important for the foetus. The consequences of disrupting the microbiome during pregnancy is significant. The mother is the conductor of this orchestra of microbes through her diet, lifestyle and biological functions –some of which may be beyond her control.
Microbial diversity is changing and appears to be in decline throughout the biosphere. We have lost 30%-40% of our microbiome over the years and have maybe gained more microbes which cause imbalance.
There is an interaction between gut and brain. Bacteria shape our sensitivity to pain in a sex dependent way. Women are programmed to experience pain differently, they are also more likely to experience irritable bowel syndrome. Gut microbes can communicate with the brain through the manufacture of neurotransmitters like serotonin which affects mood, sleep, appetite and cognitive functions; through hormones in the endocrine system, and through the immune system. The gut and the brain grow together and disruptions to the microbiome will impact brain development.
A microbiome is a community of microorganisms found living together, and one exists in every area of our body, not just in our gut. Our oral microbiome has changed as our diet has changed. Since we began farming and consuming cereal grains, Streptococcus mutans began to dominate the oral microbiome and we developed dental caries and dental plaque. Toothpaste, fluoride and fillings have also had an impact on the oral microbiome, and its diversity has decreased. One bacterium which has responded to the western diet: Fusobacterium nucleatum, is commonly found in cancers throughout the body.
A Bacteriophage is a virus, and there are probably 100 million species in existence. It is used in Russia to replace antibiotics. It is now being considered for use more widely, as antibiotic resistance increases. An example is in the case of Bacterium Euterococcus, found in the microbiome of alcoholics. This bacterium, produces a toxin which damages the liver, causing alcoholic hepatitis. Transplanting faeces from alcoholics into germ-free mice, will produce phage to target Bacterium Enterococcus.
When administered to the patient, the phage invades the bacteria and kills or inactivates it. Phage treatment is individualised, as different phage affect different bacteria.
Faecal microbiota transplant is a novel treatment, faeces from healthy donors, show positive effect in a number of conditions, such as: addiction, allergies and chemotherapy induced peripheral neuropathy. In the future, it will become a precision therapy, and maybe we will be storing our own microbiomes in times of health, for use at times of disease.
I’m sure that I’ve become carried away now. I’ve found this all so interesting that I could add everything from James’ book. I’ll end by summing up his notes on diet, remembering that eating plastic shouldn’t be part of it, but nevertheless, frighteningly, we generally consume a credit card sized amount of plastic each month:
We live in a society full of nutritional extremes, and we don’t fully understand how food relates to/can cause disease, but an emphasis on the consumption of vegetables, legumes, beans, nuts, seeds, fruit, oils, wholegrains, with small or moderate amounts of meat, fish, eggs, dairy and red wine (more of that-in moderation- rather than fizzy drinks) is currently suggested.
Moderation appears to be the key, together with the social enjoyment of sharing home-cooking. When asked about pro and prebiotics, James thinks that an individualised approach, when prescribed, is the answer, but failing that, Kefir may be useful; although exercise and a balanced diet work well together, to care for your gut and gut-brain.
P.s from me… Of course many outside influences, which appear to be beyond our control are also affecting our microbiomes. We can only do our best, but I’ve become the typical characterisation of an older person who writes letters to attempt to influence change that I consider to be detrimental to the future of our biosphere.
1) https://profiles.imperial.ac.uk/j.kinross
2) https://nihrecord.nih.gov/2022/04/15/scientists-reveal-good-bad-and-ugly-h-pylori
3) https://www.nobelprize.org/prizes/medicine/2005/marshall/biographical/
4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043356/