Studies of the microbiome should be integral to future precision medicine initiatives, argue scientists from the University of Chicago in a new commentary published Nov. 1 in Trends in Pharmacological Sciences .
A growing body of research shows the microbiome--the community of bacteria, fungi, viruses and other microorganisms living in the body, mostly in the digestive tract--plays a crucial role in human health and disease. Because of its influence on disease states and response to treatments, write Thomas Kuntz, a PhD student in the Department of Chemistry, and Jack Gilbert, PhD, Faculty Director of the Microbiome Center, the microbiome should play a crucial role in the field of personalized medicine, which has been dominated thus far by genetics.
"Ultimately, the microbiome must become an integral part of precision medicine as a whole, since so much of human functioning and metabolism is dependent upon it," the authors write. "If this is to happen in the near future, as it hopefully should, we must better understand the microbiome and its interactions with the human and the environment via a concerted effort and conversation between researchers, clinicians, patients, the government, and most importantly, the broader community."
In his 2015 State of the Union, President Barack Obama announced the Precision Medicine Initiative, a far-reaching research effort to develop medical treatments tailored for an individual's unique genetic makeup, environment and lifestyle. Instead of relying on one-size-fits-all solutions designed to help the largest number of statistically average people, such treatments could leverage advances in genetic testing, molecular engineering and big data analysis to target diseases that are often unique to each patient.
Many early precision medicine projects have focused on genetic differences between individual patients, such as unique genetic mutations in a tumor. Kuntz and Gilbert suggest several key areas where microbiome research could complement and extend genetics-based, precision medicine efforts:
Because the human microbiome is incredibly complex and can rapidly change in an individual, it offers a prime opportunity for developing highly-personalized, precision treatments, the authors write.
"The time has come to include the microbiome and microbial responses in our assessments of health and disease," said Gilbert. "We should build an integrated database of all of these records to allow for appropriate meta-analyses, so that we can all benefit."
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Trends in Pharmacological Sciences