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Good Bugs – Bad Bugs: The Role of the Microbiome on Human Health

Good Bugs – Bad Bugs: The Role of the Microbiome on Human Health. S Shahzad Mustafa, MD Rochester Regional Health System Clinical Assistant Professor of Medicine University of Rochester School of Medicine and Dentistry. Disclosures. Grants: Shire

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Good Bugs – Bad Bugs: The Role of the Microbiome on Human Health

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  1. Good Bugs – Bad Bugs: The Role of the Microbiome on Human Health S Shahzad Mustafa, MD Rochester Regional Health System Clinical Assistant Professor of Medicine University of Rochester School of Medicine and Dentistry

  2. Disclosures • Grants: Shire • Speaker’s Bureau: Genentech, Teva, Regeneron, Astrazenaca

  3. Outline • Establishment of the microbiome • Associations of dysbiosis and chronic illness • Potential therapeutic interventions

  4. Infectious Disease Versus Immune Disorders Bach. NEJM 2002; 347: 911.

  5. Chronic Illness Versus Socio-Economic Status Bach. NEJM 2002; 347: 911.

  6. Definition • Microbiome: the collection of all genomes of microbes (including bacteria, bacteriophage, fungi, protozoa, and viruses) in an ecosystem, particularly the collection living in and on the human body

  7. Increasing Interest Butto. JACI 2017; 139: 1092.

  8. Increasing Interest

  9. Microbiome By the Numbers • Humans harbor 100+ trillion bacteria • 90% of human cells are microbial • 100x more microbial genes as compared to human genes • Between individuals, 99% of human genome is similar, whereas < 20% of microbial genome is similar Lynch. NEJM 2016; 375(24): 2369.

  10. Establishment of the Microbiome Gensollen. JACI 2017; 139: 1084. Garn. JACI 2013; 131: 1465.

  11. Bacterial Dysbiosis Furuta. JACI 2017; 139: 1131.

  12. Early Maternal Effects Cho. Nat Rev Genet 2012; 13(4): 260.

  13. Obesity and Pregnancy Gohir. Peds Rev 2015; 77: 196.

  14. Factors Affecting Infant Gut Microbiome Sordillo. JACI 2017; 139: 482.

  15. Cesarean Section and Colonization of the Gut Stokholm. JACI 2016; 138: 881.

  16. Associations with Mode of Delivery Stockholm. JACI 2016; 138: 881.

  17. Intrapartum Antibiotics for GBS Stearns. Sci Rep 2017; 7: 16527.

  18. Source of Infant Gut Microbiome Pannaraj. JAMA Peds 2017; 17: 647.

  19. Farming and Microbial Diversity Ege. NEJM 2011; 364: 701.

  20. Farming Protects Against Asthma Ege. NEJM 2011; 364: 701.

  21. Microbial Exposure and Asthma Ege. NEJM 2011; 364: 701.

  22. Farming Decreases Atopy Alfven. Allergy 2006; 61: 414.

  23. Cats and Dogs Fujomura. JACI 2010; 126: 410.

  24. Immune Development Lee. JACI 2018; 141: 1310.

  25. Intra-Individual Diversity Cho. Nat Rev Genet 2012; 13(4): 260.

  26. Microbial Signatures in Chronic Illness Butto. JACI 2017; 139: 1092.

  27. Microbial Signatures Harris. PloS One 2015. 10: e128346. Marri. JACI 2013; 131: 346.

  28. Complex Interplay Renz. JACI 2017; 140: 24.

  29. Potential Mechanisms – Food Allergy Plunkett. J Immunol 2017; 198: 581.

  30. Gut-CNS Axis Haas. Immunol 2018; 154: 230.

  31. Potential Therapy West. JACI 2015; 135: 3.

  32. C-Section and Vaginal Swab Dominguez-Bello. Nat Med 2016; 22: 250

  33. Therapeutic Approaches West. JACI 2015; 135: 3.

  34. Probiotics in Ulcerative Colitis Rembacken. Lancet 1999; 354: 635.

  35. Fiber and Chronic Illness Park. Arch Int Med 2011; 171(12): 1061.

  36. Dietary Effects David. Nature 2014; 505(7484): 559.

  37. Fecal Microbiota Transplantation Smits. Gastroenterology 2013; 145: 946.

  38. Fecal Transplant in C. Difficile Kassam. Am J Gastro 2013; 108: 500.

  39. Fecal Transplant in UC Costello. Ail Pharm Ther 2017; 46: 213.

  40. Fecal Transplant and Insulin Resistance • 9 males with metabolic syndrome received fecal transplant from a lean donor or reinfusion of own feces • Measured insulin sensitivity at 6 weeks Vrieze. Gastro 2012; 143: 913.

  41. Summary • The human microbiome is diverse and established at a young age • There are numerous ways to alter the microbiome • Many associations between dysbiosis and human illness • Extensive research being done at manipulating the microbiome to treat chronic illness

  42. Thank You shahzad.mustafa@rochesterregional.org shahzad_mustafa@urmc.rochester.edu

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