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Gut microbiome research moves toward prognostics, diagnostics, personalized medicine

Eugene B. Chang, MD, AGAF
Eugene B. Chang, MD, AGAF

Gut microbiome science is moving quickly from basic research and early trials toward an evolving clinical discipline. One of the keys to this progress is the recognition that the gut microbiome is as much an organ as the liver, pancreas, intestine or any other organ along the GI tract.

“Like most other organs, there’s an interconnectedness between the gut microbiome organ and the other organs of the body,” said Eugene B. Chang, MD, AGAF, the Martin Boyer professor of medicine and director of the Microbiome Medicine Program at the University of Chicago Knapp Center for Biomedical Discovery, IL. “There are multiple studies reporting relationships between perturbations of the gut microbiome underlying diseases that range from neurologic development disorders to autoimmune diseases, inflammatory bowel diseases and cardiovascular diseases.”

Dr. Chang will moderate Monday’s AGA symposium Microbiome Diagnostics, Prognostics and Personalized Medicine, which is sponsored by the AGA Center for Gut Microbiome Research and Education, for which he serves as chair-elect.

“Like other organs, you can’t live without your microbial organ and it can be transplanted from one individual to another,” Dr. Chang continued. “Things like Western diet, antibiotics or other perturbations that affect its membership and functions will have consequences on the rest of the body.”

It’s clear that the gut microbiome can be manipulated by diet, medications and other interventions, but the clinical utility of those manipulations is limited in large part by the lack of metrics. Clinicians need validated metrics to assess the health of the microbiome just as liver and pancreatic enzyme metrics help assess the health of those organs to guide diagnosis, risk assessment and individualized treatment.

“Microbiome metrics are important, if not essential, for the future of precision medicine,” Dr. Chang said. “If you’re going to tailor microbiome-based or targeted therapies to individual physiological variations, you have to know what defines a healthy microbiome in specific contexts. Within a few years, we’re going to see these kinds of metrics, biomarkers and diagnostics that can be predictive of a healthy or unhealthy state. Having this toolbox will guide the practicing physician to gauge the level and type of treatment for specific conditions and indications.”

The development of clear metrics also creates the potential for more accurate risk assessment and interventions to prevent disease. And as basic research unravels more of the intertwined pathways that link the gut microbiome and other organs, clinicians can expect new diagnostic, prognostic and therapeutic agents based on the microbes and microbial mediators that make up the microbiome.

“During this session, we will provide a crystal ball for the audience — a look at where we are going and what we can expect as gut microbiome research moves into clinical practice,” Dr. Chang said. “This symposium will show where and how the gut microbiome will benefit your practice.”

Please refer to the DDW Mobile App or the Program & Exhibits section in Monday’s issue for the time and location of this and other DDW® events.

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