Health & Fitness

The gut and its bacteria a growing focus of research

















Future therapies might target the microbes rather than the patient. For example, some gut bacteria produce an enzyme called beta-glucuronidase. Unfortunately this enzyme interacts with a chemotherapy drug called CPT-11, causing diarrhea that can be so severe some patients must stop taking the medication. In 2010, a team of researchers figured out how to block this enzyme in mice, thus preventing the diarrhea.

The growing understanding of the microbiome will undoubtedly lead to new treatments, but it may also inspire physicians to rethink how they use existing ones. Many widely prescribed antibiotics kill beneficial bugs as well as pathogens. With helpful bacteria out of the way, harmful germs such as C. difficile can move in.

Infection with C. difficile is "the clearest example of a bad outcome of using antibiotics," says Dr. Alex Khoruts, a gastroenterologist at the University of Minnesota. "This infection has essentially assumed epidemic proportions in the last decade."

Physicians may eventually be able to modify the microbiome to prevent the infection from taking hold. Fischbach envisions a future in which patients required to take a long course of antibiotics will also receive a dose of probiotics to replace the microbes wiped out by the pills. The goal would be to "repopulate the community in a way that helps dictate who's there instead of just leaving the coast clear for any actor — good or bad."

Copyright © 2014, Los Angeles Times
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