Big Idea 2015: Medicine, Wellbeing, and the Microbiome

In this series of posts, Influencers and members predict the ideas and trends that will shape 2015. Read all the stories here and write your own (please include the hashtag #BigIdeas2015 in the body of your post).

Deepak Chopra, MD and Rudolph E. Tanzi, PhD, Co-chairs, The Self Directed Biological Transformation Research Initiative

In the coming year we expect major breakthroughs in the microbiome, the community of microorganisms that inhabit the human body. Some have dubbed the microbiome a newly discovered organ, others an ecosystem. The potential for using the microbiome is potentially enormous. It's long been known that microorganisms populate the skin and gut, and that digestion requires them. Only since the revolution of DNA sequencing technology, i.e. used on the human genome, however, has our knowledge of the microbiome exploded.

By sequencing the DNA of the microorganisms that are unique to each person, the following findings are beginning to assume major importance:

• Although it only weighs 1-3% of our body weight, the microbiome contains a vast number of cells. By some estimates the body has between 35 and 100 trillion cells with only 1 in 10 belonging to tissues and organs and the rest belonging to the microbiome.
• The microbiome is a complete, dynamic, ever-changing ecology, with genetic variations according to which niche in the body is being populated. On the skin alone each bodily area has a differing local microbiome.
• Our personal human genome also determines the composition of our microbiome, which in turn can influence metabolism and propensity for weight gain.
• This varying ecosystem isn't populated by foreign invaders and pathogens but by colonies closely connected to human evolution.
• The microbiome interfaces between the human body and the outside world in complex ways, but the gist is that human DNA has evolved in cooperation with microbial DNA. This fact is more important than the interactions that cause diseases created by invading bacteria and viruses.
• The organelles in our cells that provide energy like a battery, called mitochondria, were once bacteria inhabiting our cells and were adapted for use by them. Mitochondria actually have their own genomes inherited from the mother without change.
• Some of the most archaic microorganisms on Earth survive today in our microbiome.
• The microbiome has a major impact on every person's state of disease and wellness.

The last point will have profound consequences, we believe, in the upcoming year and for decades to come. A poor microbiome (only now being defined and analyzed) seems to be implicated in a wide range of disorders. Some of these, such as chronic obesity and various gastrointestinal disorders, seem to be directly connected to the microorganisms in the gut. But other connections are not so self-evident, such as how the microbiome may affect autoimmune disorders, asthma, eczema, type 1 diabetes, certain cancers, and even depression and anxiety.

The first stage of exploring this connection involves DNA sequencing of the microbiome, identifying the population of microorganisms, and studying their chemical output in relation to health and disease. Research is flourishing at this stage, thanks to quicker and cheaper genome typing.

The second stage is to understand the differences in the microbiome that are associated with each disease and conversely, to identify what makes for an optimal healthy microbiome. Rapid progress is being made in determining which microbes contribute to obesity. Some researchers feel that modern diets, polluted air and water, and environmental chemicals have distorted the microbiomes of many populations around the world.

The third stage consists of treatments, both on the disease side and the side of wellbeing. Probiotics--supplements that improve the state of a person's microbiome--open up a huge area of potential benefits, from increased immunity to disease to slowing down or reversing the aging process. Another growing area involves fecal microbiota transplantation (or stool transplant), in which fecal bacteria from a healthy individual are transplanted into an infirm recipient. This has been used, for example, on patients with severe gastrointestinal infections that are resistant to antibiotics, e.g. C. difficile. This technique is also being tried on ulcerative colitis.

The two of us are deeply engaged in following and contributing to the expanding horizon of microbiome studies. In an upcoming book we are co-authoring, Super Genes, we will present the latest findings as well as a lifestyle program devoted to what we call Self-Directed Biological Transformation: the ability of each person to consciously intervene in their own biological processes, including the expression of their genes. You can't change the genes you were born with, but you can profoundly affect your genetic profile on a daily basis, making choices that directly influence the expression of your genes and the DNA of your microbiome.

It would appear that the genome and the microbiome cross-talk, a conversation that has been continuing for billions of years with no signs of stopping. In fact, the conversation continues to evolve. Just recently an article in the prestigious journal Nature reported that even our thoughts can affect the expression of genes. (Link: http://www.nature.com/ncomms/2014/141111/ncomms6392/pdf/ncomms6392.pdf ) We are well on our way to a unified theory of biology that will merge body and environment, brain and mind, genome and microbiome. To us, this is the most exciting and potentially rewarding field that's opened up in modern medicine.

Photo credit: Jon Berkeley/SPL

Deepak Chopra, MD is the author of more than 80 books with twenty-two New York Times bestsellers. He serves as the founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing. His latest book is The Future of God.

Dr. Rudolph Tanzi is the Joseph P. and Rose F. Kennedy Professor of Neurology at Harvard University and Vice-Chair of Neurology at Mass General Hospital. Dr. Tanzi leads the Cure Alzheimer's Fund Alzheimer’s Genome Project, has published over 460 research articles, and co-authored the New York Times Bestseller, “Super Brain” with Dr. Deepak Chopra. He has also played keyboards with Joe Perry and Aerosmith.