In your gut right now, there are trillions of tiny organisms at work, influencing how you feel, how you sleep and even the diseases you might get in the future.
The gut microbiome is the collection of bacteria, fungi and viruses living in our digestive system. Research has shown that it plays a part in many different conditions, and so it could offer new ways to treat diseases.
It is a fast-growing but still under-researched area. Nine years ago, when Bowel Research UK funded its first project on the gut microbiome, research on this topic was seen as in its infancy. To date we have funded six projects looking at this area. Here we look at some of the microbiome research projects we have funded in more depth.
Using the microbiome to tailor bowel cancer treatment
Dr James Kinross is a Consultant Colorectal Surgeon at Imperial College London and Bowel Research UK’s microbiome expert. His research, funded by Bowel Research UK, showed bowel cancer patients with lots of certain types of gut bacteria on the surface of their tumours (e.g. Fusobacterium nucleatum and Granulicatella adiacens) were 40% less likely to have their bowel cancer return. By contrast, patients with lots of other types of bacteria (e.g. Faecalibacterium prausnitzii and Ruminococcus gnavus) were 26% more likely to suffer a recurrence of their cancer after surgery.
If these findings are backed up by larger studies, in the future patients with a less favourable tumour microbiome might be treated more aggressively with chemotherapy or monitored more closely after surgery.
Find out more here.
Can the microbiome predict who will get complications from Crohn’s Disease?
Professor Richard Brady is a consultant colorectal surgeon at The Newcastle Upon Tyne Hospitals NHS Foundation Trust. Bowel Research UK funded his study into perianal fistulas, where a tunnel forms in the body to connect the end of the bowel to the skin near the anus, often following an infection. When this happens in some people with Crohn’s disease, it can cause leakage of stool and incontinence.
Richard and his team wanted to create a detailed map of the gut bacteria. They found evidence that bacteria in the fistula tunnel may be different in patients with Crohn’s disease compared to those who have fistulas that are not associated with Crohn’s disease, suggesting that there could be a different way to identify and treat this specific condition. This research has led to a further study, called CHARM, to test this trend in a bigger group of people. If these links are confirmed, it could open doors to research on new treatments for perianal fistulas from Crohn’s disease.
Find out more here.
Mapping the microbiome’s role in causing IBD and managing symptoms
Inflammatory Bowel Disease (IBD) affects around 300,000 people in the UK and it can take the form of ulcerative colitis or Crohn’s disease. Despite the number of people affected and the often-debilitating symptoms, we know relatively little about what causes the disease and there is no cure.
Dr Franklin Nobrega at the University of Southampton and his team are using Bowel Research UK funding to create a map of gut bacteriophages – viruses that infect and grow within bacteria that are part of our gut microbiomes. Early studies have suggested that they may play a role in the development of IBD. By creating a comprehensive map of these viruses, the team hope to more definitively explain what role they play, and this could lead to new options for treating or preventing IBD.
Find out more here.
Understanding the role of the microbiome in a neglected type of Crohn’s disease
Crohn’s disease is caused by the immune system overreacting to the microbiome, but doctors don’t yet know what causes skin inflammation that some people get with the disease. Genital Crohn’s disease is an under-reported and often unrecognised form of Crohn’s disease that causes painful swelling and damage to the skin around the genitals, back passage and groin. This can result in people being unable to work, exercise or have an active sex life. Previous research has shown that young women are disproportionately affected and can get debilitating symptoms for years before they are diagnosed.
Laura Hancock and her team at the University of Manchester are looking at a unique collection of skin samples from recently diagnosed patients to study the types of bacteria on the swollen and ulcerated genital skin. By doing this, they will be able to identify potentially harmful bacteria involved in this condition developing and understand which treatments are most likely to be effective.
Find out more here.
Using the microbiome to predict whether bowel cancer will spread to the peritoneum
The peritoneum is the lining surrounding the abdominal organs. When bowel cancer spreads to the peritoneum (colorectal cancer with peritoneal metastases, or CRPM), it is very difficult to treat, which is why there’s an urgent need to understand what causes CRPM and how best to treat it.
Meera Patel and her team at the Christie NHS Foundation Trust in Manchester are building on early research that suggests the microbiome may play a role. They are looking at the presence of specific gut bacteria in CRPM patients to highlight the ones most likely to cause the disease to develop. This could lead to new ways to identify patients sooner when the disease may be easier to treat, new targeted treatments or even prevention.
Find out more here.
Help fund our future microbiome research
Microbiome research is still a neglected niche. That’s why Bowel Research UK is appealing for donations to create a ring-fenced pot of £250,000 for researchers to apply for PhDs or small grants for research on the gut microbiome. Click here to donate and help fund future microbiome breakthroughs.