PPP Reading C06

The Human Microbiome

Over the past few decades, medical researchers have begun to shine a light on a largely
uncharted and complex world: the human gut. In a dizzying number of studies, the gut
microbiome has been linked to clinical fields beyond gastroenterology, including
immunology, oncology and diabetes. Estimates of how many microbes the human gut plays
host to vary considerably, some as high as 400 trillion. It was once thought that microbes
outnumber cells in the body by 10 to 1. However, this factoid was recently exposed to have

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been erroneously calculated in an earlier study.

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The microbiome is composed primarily of bacteria but also archaea (single-cell organisms),
fungi, viruses, and protozoa, and its delicate ecologic balance has given rise to the theory

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that modern hygienic practices (e.g. overuse of antibiotics, improved sanitation) have been
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detrimental to health by reducing exposure to bacteria on which humans thrived for
millennia. Isolated hunter-gatherer tribes in South America actually have considerably more
diverse microbiomes than people in industrialized societies. In an ironic twist, the very
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same progress that may be hurting us has also given us the means to unravel the reasons
why – and potentially intervene to correct it.
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The first theories of the microbiome's role in maintaining health were proposed by
Metchnikoff (1845-1916). A Russian scientist working in Louis Pasteur's laboratory,
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Metchnikoff won a Nobel Prize in 1908 for helping to pioneer cellular and humoral
immunology. Late in his life, Metchnikoff embarked on a personal quest to research methods
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of staving off senility and other markers of aging. Noticing that some economically-
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disadvantaged people nonetheless experienced longer lives, he studied their diet and
lifestyle choices. This led to his theory that aging-related illnesses were the result of
phagocytes being transformed from protective to destructive via bacteria in the colon. He
believed that regular consumption of lactic acid bacteria in fermented dairy products would
reverse this action and promote longevity, perhaps the first instance in which probiotics (the
practice of introducing microorganisms for their health benefits) were offered as a medical
solution.

In the first decade of the present century, multiple studies appeared in quick succession that
would reshape our concept of the gut microbiome's role in health and illness. One of the first
crucial discoveries came in a 2005 gene-sequencing study of colonic samples from healthy
subjects. It noted that a majority of newly-discovered microorganisms had little overlap from
patient to patient and there were slight differences from place to place. A comparative study

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 PPP Reading C06

then determined that lean and obese subjects had different groupings of microbes present in
their gut, and that an obese person’s profile changed upon weight loss on a lower-calorie
diet, giving tangible evidence of the value of even moderate adjustments to eating habits.

One of the most interesting recent findings has been that the microbiome communicates with
the brain indirectly (via hormones or the immune system) and directly (via neurotransmitters
in the gut), and has been linked to several neurologic conditions. Autism spectrum disorders
have a potential association with changes in the gut microbiome, while the inflammatory-

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state changes noted in schizophrenia and bipolar disorder indicate a similar link. This
connectivity has inspired new treatments for psychological and neurologic conditions.
Participants given probiotics were shown to experience a reduction in aggressive thoughts,

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and probiotics were observed to decrease stress in those undergoing laryngeal cancer
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surgery. Another study observed that long-term, broad-spectrum antibiotics decreased
plaques that contribute to Alzheimer’s disease.

It should be noted that the overwhelming attention given to the microbiome has not been
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without critics. A review in the journal Nature expressed this concern: ‘The hype surrounding
microbiome research is dangerous, for individuals who might make ill-informed decisions,
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and for the scientific enterprise, which needs to develop better experimental methods to
generate hypotheses and evaluate conclusions.’ The article's author also referenced
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companies that, similar to those conducting individual human genetic profiling, offer to
provide a microbial portrait using fecal samples, and expressed concern about the varying
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and imprecise results that can come from such an analysis. The research community must
consider the question of whether the tools pivotal to this research – the use of germ-free
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laboratory mice – truly reflect the real-world diversity of the human microbiome.

If the microbiome was a largely undiscovered territory twenty years ago, it is now awash with
pioneers. I believe more discoveries are to come. These will draw more researchers looking
to produce crucial interventions, as well as healthcare companies hoping to convert that
work into healthy returns. While clinicians await proven therapeutic options, they can take
steps to positively affect patients' microbiomes, beginning with dietary and lifestyle
recommendations. Although these involve re-iterating current recommendations, they now
come with new robust data to back up their utility. Such established strategies include
shifting patients toward fiber-rich diets, and promoting immunity and intestinal health by
modifying sleep patterns.

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 PPP Reading C06

1 What do we learn about the human gut in the first paragraph?

A A widely accepted statistic was the result of a mistake.
B Studies so far have lacked sufficient focus to be helpful.
C It contains more microbes than was previously calculated.
D Different microbes are understood to cause different diseases.

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2 What is the ironic twist that is referred to in the second paragraph?

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A Scientists are now focusing their research on only one continent.
B Being too concerned about cleanliness has caused new problems.

io e C The cause and potential solution to the problem are both found in modern practices.
ut en D Traditional societies understand more about gut health than modern ones.

3 What do we learn about Metchnikoff’s research into dementia?

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A It was overshadowed by Pasteur’s achievements.

B The timing of it was of particular relevance to him.
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C The significance of it was acknowledged within his lifetime.

D It allowed him to return to his earlier work in the field of immunology.
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4 What does this action in the third paragraph refer to?

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A the fermentation of lactic acid

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B the effect of bacteria on phagocytes

C the pursuit of a diet which is rich in bacteria
D the addition of bacteria to some dairy products

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 PPP Reading C06

5 One conclusion of the gut microbiome research mentioned in the fourth paragraph
was that
A previously unknown microbes were found only in people from remote
communities.
B obese people who started restrictive diets soon had similar microbes to thin
people.
C radical dietary changes were essential in order to achieve any observable

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benefits.

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D organisms in the gut varied widely, partly according to where individuals live.

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6
ut en What did the studies described in the fifth paragraph find?
A Both probiotics and antibiotics can have positive effects on mental wellbeing.
B Various types of probiotics are needed according to the type of neurological
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condition.
C Antibiotics might one day help to calm psychiatric inpatients who are agitated
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or angry.
D The way that bacteria in the gut act on hormones differs from how they act on
neurotransmitters.
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7 What warning is given in the sixth paragraph?

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A Using mice which are kept in sterile lab conditions is unsustainable.

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B Research effort is being unnecessarily directed towards the microbiome.

C Medical researchers are making a mistake in not sharing their results freely.
D Certain profiling tests produce results which are too unreliable to be helpful.

8 What is the writer’s suggestion to clinicians in the final paragraph?

A to wait for further evidence before deciding what to tell patients
B to direct patients to make radical changes in how they live
C to use facts and figures to support their advice to patients
D to avoid referring patients to commercial organisations

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 PPP Reading C06

Key
1 A
2 C
3 B
4 B

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5 D
6 A

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7ut en D
8 C
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N

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