Rutgers researchers are part of an international call for a microbiome moonshot, a massive, coordinated effort to pinpoint how certain microorganisms inside us drive chronic disease and how others can be harnessed for repair.
Antibiotics, cesarean births, infant formula and diets rich in heavily processed foods can change the microbes that live in and on our bodies. These trillions of microorganisms, collectively known as the human microbiome, help shape immunity and metabolism.
For years, Rutgers microbiologists Martin Blaser and Maria Gloria Dominguez-Bello , along with other leading microbiome researchers, have suspected that disruptions to those microbial communities may help explain the nearly simultaneous rise of chronic conditions such as obesity, asthma and food allergies. Evidence for those connections has increased , but proving (or disproving) a cause-and-effect relationship, rather than mere correlation, requires more research funding for large and lengthy controlled experiments in humans.
The U.S. Department of Health and Human Services isn’t committing extra money to microbiome research yet. Still, the steady flow of interesting study results was enough for the federal agency to invite Blaser, Dominguez-Bello and ten other top global researchers for a roundtable discussion aimed at designing an ambitious proposal for research and public education.
Their plan , outlined in Nature Medicine , identifies 10 priorities for testing the microbiome’s role in chronic disease and developing ways to protect or restore microbial functions that support health. The authors call for coordinated research and public education that places particular emphasis on pregnancy and early childhood.
The recommendations align with a stated priority of leadership at the Department of Health and Human Services. Secretary Robert F. Kennedy Jr. called for making microbiome research a national “moonshot” priority at a symposium in May, and the panel’s plan illustrates what such an effort would entail. Implementation would depend on getting funding for specific study and education proposals that emerge from and harmonize with the general plan.
“We hope to move quickly, with detailed proposals for particular studies and programs in this next fiscal year,” said Blaser, the commentary’s lead author and director of the Center for Advanced Biotechnology and Medicine at Rutgers .
Alongside the funding proposals Blaser hopes to see, the authors identify public education as a practical step. They recommend aligning microbiome and nutrition science with medical training and school nutrition education so that research can inform everyday decisions.
One of the most promising places to start, the authors argue, is the first 1,000 days, from pregnancy through a child’s second birthday. "The microbiome develops during this period, creating an opportunity to investigate whether protecting the initial development can improve health years later,” said Dominguez-Bello, the Henry Rutgers Professor of microbiome and health in the School of Environmental and Biological Sciences ’ Department of Biochemistry and Microbiology.
Antibiotics in infancy and cesarean delivery alter microbiome development and correlate with the development of metabolic and allergic conditions in later life. The authors propose studies that follow individuals from pregnancy through adolescence to see whether those microbiome disruptions cause later conditions and, if so, to test preventives.
All the recommendations in the plan fall into four general areas:
Its research priorities include standardized research methods globally, so study results can be shared and aggregated to reflect what’s happening outside the wealthy Western nations where most studies have taken place.
The most practical applications of microbiome research so far are two treatments for recurrent infections. The Food and Drug Administration has approved Rebyota and Vowst, products containing microbes derived from donated human stool, to prevent recurrent Clostridioides difficile infection in adults following antibiotic treatment for recurrent infection.
Cancer offers another important research direction: Gut microbes can influence how patients respond to immunotherapy. Scientists also are investigating connections between the gut and brain in Parkinson’s and Alzheimer’s diseases. Extending microbiome approaches to these conditions will require evidence specific to each disease.
The authors seek new standards for evaluating and approving microbiome treatments while maintaining safety standards. They also propose evaluating and reporting to consumers how medicines, food additives and environmental exposures affect the microbiome, and they identify public education as a practical step that can be taken almost immediately. They recommend bringing microbiome and nutrition science into medical training and school nutrition education so that research can inform everyday decisions.
“Altogether, I see this agenda as short-term as well as medium and long-term,” said Dominguez-Bello.
Nature Medicine
Commentary/editorial
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The human microbiome and chronic disease: ten strategic priorities for research and public health
23-Oct-2026
M.O. has served as an employee for the OpenBiome Foundation and a consultant for Vedanta Biosciences. S.K.M. is a founder and board member of Vertero Therapeutics and Nuanced Health. T.D.S. is a co-founder and equity holder in ZOE Ltd a gut health science company. N.S. is a founder of PreBiomics and a consultant for and board member of ZOE Ltd. The other authors declare no competing interests related to this work.