This article is more than 5 years old. Information may no longer be current.
The Microbiome: Key to Life, Medical Mystery or Simply Cool?
Click Here to Manage Email Alerts
This month, we revisited ongoing research in the field of the microbiome, and we were truly privileged to have gathered such an extraordinary group of investigators working in this field to provide updates on the many “hot areas” surrounding this topic since our last discussion in 2016. As then, I still like to say that the microbiome “entices us and frustrates us” in our effort to understand it.
The fascination comes from the belief that the microbiome is important to us as a species; regardless of the actual number — as this figure has been a source of widespread contention — humans are nonetheless significantly outnumbered by our microbial traveling partners. Even more intimately, we now recognize that approximately 8% to 10% of our genome is of viral origin (eg, endogenous retroviral elements), which have created a host-parasite co-evolutionary dynamic that affects everything from our integrated host defenses to our own behavior. Collectively, these observations are hard not to impress upon us the importance of the putative role microbes play in our collective biology.
The frustration of studying the microbiome has come from the abject failure to comprehend it, let alone manipulate it in some reductionist manner. Many of the studies enacted thus far have attempted to reduce our understanding of dysbiosis, focused instead on identifying organisms responsible for individual diseases and replacing them with a few of the erstwhile “friendly microorganisms” from a pill that we buy at the drugstore: Should we be puzzled or surprised that these studies have been largely unrevealing?
The study of the microbiome bears a striking resemblance — at least in terms of complexity and dedication of massive resources — to the study of the gene and the Human Genome Project, which after so many years and significant investment has, despite yielding copious amounts of observations and data, raised many more questions than it answered. Should we have expected anything less? Do we think that the multiple microbiome projects around the world will yield the answer? No; I think we are too smart for that. Most of us recognize that the work of science is far more often the act of placing our little pebbles on the pile iteratively in our goal to seek answers to the questions that matter.
I will close by giving some cautionary advice: I try to follow the current microbiome literature but am often dismayed by the oversell of limited amounts of data. If you agree, let me steer you to an informative and iconoclastic scientist, Jonathan A. Eisen, PhD, from the department of medical microbiology and immunology at the UC Davis School of Medicine. Known for his brutal honesty (Case in point, he refused to speak at one of my CME meetings because I did not have enough women on my faculty — He was right), Eisen has a thriving Twitter feed (@phylogenomics) which he often uses to puncture the hype surrounding microbiome research. He also is known for regularly giving out awards to “charlatans” who propose simplistic solutions to complex problems — I highly suggest checking him out. For now, be enticed, be frustrated and be wary!
If any of you are working in the microbiome space, please reach out to me by email to calabrl@ccf.org or to me on Twitter @LCalabreseDO.
- For more information:
- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
Disclosure: Calabrese reports serving as an investigator and a consultant to Horizon Pharmaceuticals.
Microbiome: Unraveling Truth from Hype
To read more about the current misleading and potentially dangerous overselling of the microbiome — or “Microbiomania” — visit Dr. Eisen’s “The Tree of Life” blog at phylogenomics.blogspot.com.