Disappearing microbiota and epidemic obesity

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Disappearing microbiota and epidemic obesity Martin J Blaser, MD Departments of Medicine and Microbiology New York University School of Medicine Langone Medical Center Department of Biology, NYU

Ancient Niche-specific Persistent Conserved Host-Specific EMBO Rep 2006; 7: 956-960. 2

10 14 microbial cells Who are we? + 10 13 human cells n GENOME MICROBIOME EMBO Rep 2006;7:956. Nature 2007;449:843. PNAS 2010; 107:6125. Metabolome 3

Biological questions related to the human microbiome 2. What are these microbes doing? 1. What is the identity of the microbes that populate their host? 4. What are the forces that maintain equilibrium among the populations? 3. How is the host responding to them? 5. What are the unique characteristics of each individual? PNAS 2010;107:6125.

Schematic of interaction between co-evolved colonizing microbe and host Signals Signals Nature 2007; 449:843-849. 5

Schematic of interaction between co-evolved colonizing microbe and host Signals Signals Robust Resilient Perturbation? Nature 2007; 449:843-849. 6

Relationships between co-evolved hosts and persistent microbes in a Nash equilibrium Space/timescale Founding microbial Founding reactive populations host cell populations Intra -host adaptation Intra - host adaptation M icroscopic A B B Intermicrobial Intercellular selection New populations/ N ew populations/ selection structure structure Mesoscopic F C Microbial transmission Secondary/tertiary tissue functions Host viability D M acroscopic H ost population structure E Nature 2007; 449:843-849.

The Disappearing Microbiota Hypothesis With changing human ecology beginning in the late 19 th century, there have been dramatic changes affecting the transmission and maintenance of the indigenous microbiota. These changed circumstances have affected the composition of our indigenous microbiota. The changed composition affects human physiology, and thus disease risk. EMBO Rep 2006; 7:956-60. Can Prev Res 2008; 1:308-311. Nature Rev Microbiol 2009; 7:887-94. 8

Examples of changes in human ecology that may affect microbial transmission Clean water Smaller families Caesarian section Formula feeding of infants Amalgam dental fillings Antibiotic use 9

The effect of maternal status on the resident microbiota of the next generation Representation of a conserved microbiota 100% Vertical acquisition Potential horizontal aquisition Nature Rev Microbiol 2009;7:887-94. 0 20 40 60 80 Time (years)

Obesity trends among US adults 1990 1999 2008 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30% Source: CDC Behavioral Risk Factor Surveillance System

Is epidemic obesity related to a disappearing microbiota? 1990 1999 2008 Source: CDC Behavioral Risk Factor Surveillance System Representation of a conserved microbiota 100% 0 20 40 60 80 Time (years) Vertical acquisition Potential horizontal aquisition

Use of antibiotics on the farm >50 years of antibiotic use for growth promotion Economically beneficial Low level exposure (subtherapeutic) is sufficient for effect Mechanism of action: uknown 14

Sub-therapeutic antibiotic treatment (STAT) used in agriculture for growth promotion of livestock Antibiotic Class Target Bambermycin Glycolipid Cell wall Virginiamycin* Streptogrammin Protein synthesis Avilamycin Orthosomycin Protein synthesis Bacitracin* Cyclic peptide Cell wall synthesis Monensin Ionophore Cell membrane Carbadox* Quinoxaline DNA Synthesis C57/B6 STAT Control Measure phenotypes Analyze microbiome Find relationships

Biological questions related to the human microbiome 1. What is the identity of the microbes that populate their host? Ilseung Cho 2. What are these microbes doing? 3. How is the host responding to them? Antibiotics as: -agents of change? -probes of physiology? Laurie Cox 16

Short chain fatty acid production in the large intestine SCFA 90-95% absorbed 10% of caloric intake 60% 25% Substrate for lipid and cholesterol synthesis 15% Inhibit cholesterol synthesis Pryde et. al. FEMS Microbiol Lett (2002) Energy for colonocytes anti-carcinogenic

A model of early life development Mesenchymal stem cell 1 Signals Diet/ Calories 2 Bone Muscle Fat Later

STAT Research Team Ilseung Cho Laurie Cox Shingo Yamanishi Zhan Gao Alex Alekseyenko Barbara Methe Jiri Zavadil Yael Nobel Mouse Care Minso Kim, John Hwang Mahak Jain, Doug Mahana, MRI Sungheon Kim Supported in part by 1UL1RR029893 from the National Center for Research Resources, T-R01DK090989, Diane Belfer Program for Human Microbial Ecology

Differences in the theoretical constructs of the hygiene and disappearing microbiota hypotheses Criterion Hygiene Disappearing microbiota Relevance of environmental exposures Farm animals High Nil Pets High Nil Soil and dirt High Nil Other children Moderate High Mother Nil High Father Nil Moderate Relevance of antibiotic use No High Ability to define critical players Difficult Definable Evolutionary basis? High

Posters at IHMC, Vancouver Shingo Yamanishi-Regulation of hepatic metabolism in mice exposted to sub-therapeutic antibiotic treatment (STAT). Laurie Cox-Cholesterol-lowering dietary fiber perturbs murine intestinal microbiota. Zhan Gao-E. coli strains from South American hunter-gatherers living in isolated villages.

Posters at IHMC, Vancouver Ilseung Cho-Variable recovery of the major phyla of the gut microbiome after colonoscopy bowel preparation. Proton pump inhibitors significantly alter the taxonomic composition and butyrate metabolic capacity of the colonic microbiome. Alex Alekseyenko-Analysis of high-throughput 16S community sequencing data in R.