Why pharma insiders are betting £100m on “the microbiome”

This may sound odd, but today I want to talk bout the investment opportunity found in the 100 trillion microbes that live on your skin, in your mouth and digestive tract, but in particular in your gut.

This may sound odd, but today I want to talk about the investment opportunity found in the 100 trillion microbes that live on your skin, in your mouth and digestive tract, but in particular in your gut.

Just before Christmas I noticed that the French group Seventure Partners has raised over £100m for a new fund, Health For Life, ‘the first investment vehicle in the world to anticipate the microbiome revolution in the fields of health and nutrition.’

Explains CEO Isabelle de Cremoux,

‘Since the bitechnology sector started in the 1980s, we are now witnessing the emergence of a new sector that will be as important as genomics… The microbiome revolution will have an impact in the veterinary and agricultural fields as well as in human healthcare… Worldwide pharmaceutical groups are increasingly interested in the microbiome field as a means of finding new ways to conduct research and to develop drugs with accompanying diagnostics, especially for infectious and gastrointestinal diseases…….’

Demonstrating that this is not just hype, the fund’s backers include Danone and Novartis.

So we need to take the microbiome seriously, and I have been doing my research. I have read Giula Enders’ surprise best-seller ‘Gut, The Inside Story of Our Body’s Most Under-Rated Organ’, which tells you more than you probably want to know about the journey taken by our digested food; and ‘The Diet Myth’ by Professor Tim Spector, a book that gives a balanced and evidence-based opinion of the risks and benefits of different diets. Spector is also the man behind the British Gut Project, in which I am a participant. Here he is collecting faecal samples (don’t ask!) in order to analyse the microbes of the gut.

Why this sudden interest in the microbiome? Simply this. Until recently we have assumed that those 100 trillion microbes live in peaceful co-existence with our bodies. They have no more effect on your health than the birds in the sky or the insects in the garden. But it seems that this is wrong. It seems that these microbes do interact with our bodies after all.

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Anxiety, autism and heart disease may start in the gut

Let me give you just two examples. Last year researchers at Oxford University gave prebiotics, which boost health bacteria in the gastrointestinal tract, to a group of volunteers. This appeared to make the volunteers less anxious and stressed.

Recently researchers at Cleveland Clinic have identified a compound that naturally occurs in the extra virgin olive oils, balsamic vinegars and grape seed oils of the Mediterranean diet. This prevents gut microbes from turning unhealthy foods into a cause of atherosclerosis (hardening of the arteries). Says Cleveland’s Stanley Hazen,

 ‘Many chronic diseases like atherosclerosis, obesity and diabetes are linked to gut microbes. This study….demonstrates the exciting possibility that we can prevent or retard the progression of diet-induced heart diseases starting in the gut.’

The state of the microbiome has been linked to many health conditions, including autism, autoimmune diseases like multiple sclerosis where the body’s immune system attacks healthy tissue, diabetes and obesity. The microbiome has also been implicated in neural conditions like depression and anxiety with the route of transmission being the vagus nerve that connects the gut to the brain. What else do we think that we know?

– Every time we take antibiotics we kill not only the harmful bacteria, but also bacteria that play a healthy role in the gut.

–  The gut microbes of Westerners are different to those found in the rest of the world, possibly owing to the higher consumption of processed sugars and carbohydrates in the Western diet. Microbes don’t like the emulsifiers, preservatives and artificial sweeteners in processed food, causing them to produce unusual chemicals and killing off friendly species.

– Obese individuals have a less diverse gut microbiome, and harbour excess microbes that signal the body to store energy as fat. When gut bacteria were transplanted from overweight mice to thin mice the latter put on weight

– Inflammatory bowel diseases like Crohn’s disease and Ulcerative colitis affect the intestines. Interactions between microbes and the cells that line the intestine appear to be important in inflammatory bowel disease.

– Type 2 diabetes is much more common today than it was few decades ago, and this may be due to a shift to a high-fat, high-sugar diet. Researchers in Amsterdam have shown that it may be possible to shift microbial communities back to a healthier state. Obese men with insulin resistance received microbes from thin, healthy men. After just six weeks, the obese men were more responsive to insulin, and their blood sugar levels dropped to healthier levels

– Allergies happen when the immune system over-reacts to something that is normally harmless. Allergies are rare in developing countries, but in the United States, rates of asthma and hay fever have tripled over the last 30 years. Our genes have not changed, so the increase must have something to do with the environment, quite possibly including our microbes.

These are just some of the theories that associate our microbiome with our state of health and some evidence of cause and effect. Recent years has seen an explosion of research into this area. Epidemiological studies look for connections between diet, the microbiome and health outcomes. Animal studies alter the microbiome of mice and report on the consequences. Now we are starting to see the formation of businesses that want to capitalise on some of the evidence.

How to fix a gut

If you want to change your microbiome you could change your diet. Studies have shown that populations who still live the life of hunter-gatherers, with a diet of fruit, nuts, meat and fish but no cereal, dairy or processed foods, have a more diverse and thus better gut microbiome. This is the basis of the Paleolithic Diet. Another strategy is to take probiotics – live bacteria and yeasts – that supplement your existing microbes; or else prebiotics, which are fibres that feed and cultivate your existing microbes.

If you really want to transform your gut flora with an instant fix, you could have a faecal transplant. Here microbes taken from the stool of a healthy individual are delivered into your own gut via an enema or a pill (colloquially known as a ‘crapsule’). This has been shown to be effective against clostridium difficile and clinics are now springing up all over the world. The Tay Clinic in Hertfordshire, for example, offers a course of five implant treatments over one week and five additional implants to take away with you for a price of c. £3,000.

Other fledgling companies, like ENTEROME, LNC, SERES THERAPEUTICS, AOBIOME and OPTIBIOTIX (AIM: OPTI) seek analyse and modulate the individual microbiome to achieve better health. It is this nascent field that is being backed by the Seventure Fund.

Does this all sound a little bit faddish? Anything that promises to improve health simply by eating has always attracted its fair share of cranks and there are already several ‘microbiome supplements’ on the market. We should be careful. The science is still in its infancy and while altering the microbiome might be good in some ways it could have unforeseen consequences.

For the pharmaceuticals industry the microbiome offers an interesting new channel for research with some definite attractions. Tackling diabetes, for instance, via the microbiome is something new and could possibly succeed where conventional treatment has failed. The approach is consistent with the trend towards personalised medicine. The microbiome of each person is different and one vision of the future would have this individually analysed and modulated. Finally, of course, the gut is quite accessible, and it could be easier and safer to alter its constitution than to take chemical drugs or indulge in cell therapy.

For me this is simply an area to keep an eye on. Possibly in the future it could throw up some investable companies but these are early days. For now I will favour the Mediterranean diet and live by the words of my grandmother –’a little bit of what you fancy does you good.’

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