Canada have induced remission in about 25 percent of patients – a success
rate equivalent to that seen with expensive drugs that target specific parts
of the immune system.
Herbert Gaisano and Johane Allard are part of the University of
Toronto Fecal Microbioata Transplantation Outcomes Program, and they
are involved in research to assess the role of the microbiome in obesity
and the potential of fecal transplants to treat patients with obesity. Taking
another approach, Emma Allen-Vercoe, an associate professor in microbiology at the University of Guelph, and her team are working to produce a defined multi-species probiotic – a synthetic stool treatment called
“RePOOPulate” – to overcome the challenges of using regular fecal transplants, which might contain unknown pathogens from donors.
“The stars have aligned,” says Dr. Finlay in an interview, to make Let
Them Eat Dirt a success. “If I’d written it five years ago, nobody would
have read it and five years from now there will be 50 other books on the
subject.” He says professional colleagues in this field have been very supportive and “love” the book. He points out that all of the information in
the book is based on peer-reviewed, published data.
But for all the excitement and potential being generated as a result of
gut microbiome research here and abroad, there is still a need to be cautious and moderate expectations. As Elisabeth Bik from the department
of medicine at Stanford University recently wrote in an article in the Yale
Journal of Biology and Medicine: “Disturbingly, the recent large amounts
of microbiome articles by popular science media and general news outlets have generated feelings of exaggerated excitement among the public
which has led to a belief that the microbiome is connected to all human
organs and diseases,” she writes. “Many of these proposed connections are
interesting hypotheses, some of which might turn out to be correct, but
most of these hypes are not, or only poorly, founded by scientific findings.”
She adds: “Microbiome research has brought us better understanding
but yet no clear cause or cure for complex gastrointestinal or other disorders
such as IBD, autism, or multiple sclerosis.” However, in the conclusion to
her article, Dr. Bik acknowledges the potential with microbiome research
by stating, “the microbiome is an important and intricate part of our physiology which appears to be disturbed in a wide range of disease conditions
(and) in some instances, microbiome studies have led to treatment options.”
For his part, Dr. Finlay, having spent more than a decade working in
the area, says he is gratified that the scientific community is now starting
to recognize the importance of the gut microbiome and its relevance to
many fields of medicine. “The time is right,” he says.
Canadian researchers are also involved in international collaborative
efforts involving the gut microbiome. Some of Dr. Moayyedi’s colleagues
at the Farncombe Family Digestive Health Research Institute at McMaster
are recipients of two of six recent grants awarded by the European-based
Joint Programming Initiative.
Elena Verdú is the principal Canadian investigator, along with partners
in France and the Netherlands, who have been funded to explore the effect
of diet and the microbiome on a protein, the aryl hydrocarbon receptor
(AhR), recently shown to be crucial for maintaining balance in how the intestines function. Mike Surette and Jennifer Stearns are co-investigators on
a grant led by McMaster colleague Eileen Hutton, with international partners, to look at the impact of introducing solid food and stopping breast-milk feeding on the gut microbiome of premature and term babies.
“I think we have some of the best investigators throughout the
world working on the microbiome,” says Dr. Ouellette. “Our strategy
[at CIHR] has been to create a strong research group and they are inter-
Canada is also attracting researchers from overseas to participate in
this area. Last summer, it was announced that Université Laval had been
awarded a $10-million Canada Excellence Research Chair in the Microbi-
ome-Endocannabinoidome Axis in Metabolic Health, to be held by Italian
biomolecular chemist Vincenzo Di Marzo.
unpalatable though it may seem, the poster child for
successful treatment approaches focusing on the gut microbiome has been fecal transplantation. According to Dr.
Ouellette, using fecal transplants to treat Clostridium difficile infection has been the most dramatic example of the
type of transitional medicine now being attempted as a result of gut microbiome research.
By taking stool samples from healthy individuals and using them to
“I think we have some of the best
treat patients infected with C. difficile, significant success has been shown
in displacing this bacteria with healthy bacteria and eradicating the infec-
tion, which in some cases can be life-threatening. “This was the first big
success,” says Dr. Ouellette. In their book, Drs. Finlay and Arietta declare:
“The simple act of delivering fecal microbes either through a nasal tube
to the gut or by enema, cures a potentially fatal disease.”
In Canada, fecal microbiota transplants have also been used with
some success to treat ulcerative colitis and obesity. Dr. Moayyedi says pre-
liminary small studies using fecal transplants to treat ulcerative colitis in
investigators throughout the world
working on the microbiome.”