Missing Microbes Part IV: Epilogue

This is the conclusion of my four-part review of Missing Microbes, How the Overuse of Antibiotics is Fueling our Modern Plagues, by Dr. Martin Blaser, head of the Human Microbiome Research Project at New York University. Part I explained how the human body evolved to depend on the services of its resident bacteria species, collectively the microbiome. Part II detailed the significant negative health problems that can occur when some necessary bacteria are not present in the microbiome. Part III covered some of the potential solutions to these problems. In the first three parts of this series, I tried to hew closely to the material in Missing Microbes. Here in the epilogue, I am providing some extrapolations of my own on this fascinating and important subject.

Doctors and scientists have long known that the body’s resident bacteria performed important and helpful functions.   But now the work of Dr. Blaser and others is driving an important paradigm shift in which the human body and its microbiome are viewed and treated as a single organism. That paradigm shift might not sound particularly important at first, but the implications are quite significant. We know that many devastating diseases such as Down Syndrome and Cystic Fibrosis are caused when a person is born with a missing or damaged human gene. If we now consider the genes in our microbiome to be of equal importance as our own human genes, then the loss of some species of bacteria within our microbiome can and should be viewed as a problem equivalent to damaged or missing human genes. I expect this new paradigm to be a fundamental driver of medical research and innovation during this century.

If we continue our current antibiotic onslaught against our own microbiome, it could result in the extinction of some species of our resident bacteria since the human body is their only environment. To the extent that this occurs, and there is reason to believe that it already is, humanity as a whole becomes weaker and less able to survive future threats. There are ways that we can mitigate against this trend. Studies of the microbiome’s of residents of remote and isolated communities such as the mountains of Peru or New Guinea show that they have much greater diversity of bacteria than those from people in developed countries. Further these people tend not to be obese, or have asthma, or diabetes or any of the modern plagues discussed in Missing Microbes. The techniques already exist to harvest the bacteria from the feces of one person with a diverse microbiome and transfer it to the gastrointestinal tract of another with a deficient microbiome, often with dramatic positive impact on the recipient. This process is called a fecal transplant. It is not difficult to envision a scenario in which the bacteria from remote villagers are being harvested and then transferred into the wealthy in developed countries, albeit with a more palatable name for the procedure.

The section in Missing Microbes regarding C-sections got me thinking about advice commonly given to breastfeeding mothers.  If your research the benefits of breastfeeding, the most common claim is something to the effect of “breast feeding for the first six months reduces the incidence of asthma, diarrhea, and ear infections.” We now understand from works such as Missing Microbes that these benefits to the child accrue from the having bacteria in the breast milk colonize the gastrointestinal system of the child. We also know that swabbing the inside of the mouth of a newborn from a C-section with placenta and amniotic fluid just once right after birth provides life-long improved diversity in their microbiome. The data from these C-section studies suggests to me that the bulk of the benefit of breastfeeding, at least with regard to the health conditions reviewed in Missing Microbes, may very well be conveyed to the child during the first several feedings. While there are most certainly other benefits to continuing breast feeding for six or more months, if I am correct that tremendous benefits result even from only several feedings, this information should be made available to women many of whom are not able to meet the six month guidance

Several times while reading Missing Microbes, my thoughts turned to the plight of the honeybee. If you are a reader of Common Science®, I am going to presume that you are at least somewhat familiar with the worldwide mystery of the die-off of honeybees, known as Colony Collapse Disorder (CCD). There have been many studies of CCD over the years and many theories regarding the possible root cause or causes. It occurred to me that perhaps harm caused to the microbiomes of honeybees through the combined use of antibiotics and pesticides by beekeepers is the smoking gun in the CCD mystery. I emailed this theory to Dr. Blaser and he responded on the same day! He said that he thought the theory was quite plausible and more importantly that this was a testable hypothesis. He was not aware of anyone investigating this possibility but if in the end this theory turns out to be correct, please remember that you read it here first.

Thanks for sticking with me through this four-part series. As I suspect you can tell, I was powerfully impacted by this book. I have loved being a chemical engineer these last several decades, but from time to time I think, “Hey, I’m only 49, maybe it’s time to try something else”. (I’m not sure whether or not this is a mid-life crisis but at least I didn’t go buy a Harley.) In these moments, I think about heading back to school for a Ph.D. in a new subject after I get my children through college. Who knows, maybe Dr. Blaser needs a new student?

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