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Good germs to fight bad germs.
Penn Medicine researchers have singled out a bacterial enzyme behind an imbalance in the gut microbiome linked to Crohn's disease. The new study, published online this week in Science Translational Medicine, suggests that wiping out a significant portion of the bacteria in the gut microbiome, and then re-introducing a certain type of "good" bacteria that lacks this enzyme, known as urease, may be an effective approach to better treat these diseases.
"Because it's a single enzyme that is involved in this process, it might be a targetable solution," said the study's senior author, Gary D. Wu, MD, associate chief for research in the division of Gastroenterology at the Perelman School of Medicine at the University of Pennsylvania. "The idea would be that we could 'engineer' the composition of the microbiota in some way that lacks this particular one."
[...] In a series of human and mouse studies, the researchers discovered that a type of "bad" bacteria known as Proteobacteria feeding on urea, a waste product that can end up back in the colon, played an important role in the development of dysbiosis.
The "bad" bacteria, which harbor the urease enzyme, convert urea into ammonia (nitrogen metabolism), which is then reabsorbed by bacteria to make amino acids that are associated with dysbiosis in Crohn's disease. "Good" bacteria may not respond in a similar manner, and thus may serve as a potential therapeutic approach to engineer the microbiome into a healthier state and treat disease.
If the technique works, it could open the door to treating other conditions like obesity.
Josephine Ni, et al A role for bacterial urease in gut dysbiosis and Crohn's disease. Science Translational Medicine, 2017; 9 (416): eaah6888 DOI: 10.1126/scitranslmed.aah6888
(Score: 2) by Spamalope on Friday November 17 2017, @01:47AM (2 children)
This appears to work for people with compromised protein handling in the gut, whereas the transplant helps with a gut population problem in an otherwise healthy person (or possibly a person who can function as normal if they've got a bacteria strain they're not getting naturally where they live). It's cheating to engineer replacements that don't make the problem protein but otherwise perform the gut function we need.
I know someone who suffered lots of painful health consequences from the auto-immune side effects of crohns before finally having to have their colon removed. A really tragic situation. Something like this could be profoundly life altering in an awesome way.
(Score: 4, Interesting) by JoeMerchant on Friday November 17 2017, @02:17AM (1 child)
We also knew someone who was on the verge of a colostomy for Crohn's shortly before I got involved with the world of epilepsy. There the great travesty of medicine is the ketogenic diet - doctors will literally let families rot in epileptic hell, offering damaging lobotomies and not even suggest trying the ketogenic diet first. The ketogenic diet isn't a 100% cure, nothing is (though, if you don't mind the side effects, you can usually improve epilepsy with the lobotomy...) but it _is_ a 100% cure for some people, and it's a significant improvement in symptoms for at least 1/3, about the same as most epilepsy meds.
The world of medicine is seriously warped by the money factor. Something without a focused profit center, like a diet change, or a poop transplant, just doesn't get respect or adoption that a pharmaceutical or surgical procedure does.
This thing for Crohn's has been kicking around since 2004-ish, about the same time the gluten-free diet started really gaining mind-share. Any MD who offers a colostomy to a young person without at least trying both (gluten-free and flora transplant) first, multiple times, really should have their license stripped. "First, do no harm" seems to have fallen out of practice, and it needs to come back.
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Friday November 17 2017, @05:15AM
This kind of paranoia is ridiculous. The medical system has a lot of issues, but you don't think that health insurers would rather pay for a diet to solve things like this than the surgery? Precisely whose crack are you smoking?
Dietary changes are virtually always preferred by insurance when the medical evidence backs the treatment up. It's not something they have to pay for and even providing a few sessions to give the patient the necessary information is significantly cheaper than performing those surgeries that may or may not actually work and result in the risk of serious harm.
As far as doing no harm goes, doctors are supposed to make their recommendations on the basis of medical research. Just because you hear stories of something that people did and were successful does not mean that the treatment works, the people you hear from tend to be the ones for whom the effect was the most profound. For every one of them, there's other people who may not have been so lucky and without conducting proper medical testing, you don't have any way of knowing if it works and if it does work, whom it works best on.