We’re pretty proud of modern medicine. We’ve accumulated a very intricate understanding of how our body works, what can go wrong with it, and what are options are for tinkering with it to improve its health. We’ve got all sorts of tests, treatments, and pills for it, with more on the way all the time.
However, there has been increasing awareness of the impact our microbiota has on our health, and I think modern medicine is reaching the point classical physics did when quantum physics came along.
Classical physics pictured the atom as kind of a miniature solar system, with well-defined particles revolving in definite orbits around the solid nucleus. In quantum physics, though, particles don’t have specific positions or exact orbits, combine/recombine, get entangled, and pop in and out of existence. At the quantum level everything is kind of fuzzy, but quantum theory itself is astoundingly predictive. We’re fooled into thinking our macro view of the universe is true, but our perceptions are wrong.
Two articles in Science illustrate how we’re still just scratching our understanding of their impact. The first, from Rodrigo Pérez Ortega, reports on two new studies.
The first study found that the genetic structure of gut microbiome was more predictive of health than one’s own genes. It was especially better for “complex” diseases that are attributed to both environmental and genetic factors. Gut microbes are impacted sooner by environmental factors and thus serve as better predictors for such diseases.
The second study found that a person’s microbiome could be used to predict their death 15 years later. Presence of a certain family of bacteria led to a 15% higher mortality rate in the next 15 years. Whether the bacteria are the cause of the mortality or a side effect of other factors is not clear.
The second article was a study from B.B. Finlay, et. alia, that speculated that so-called non-communicable diseases (NCD) might actually be communicable, via the microbiome. I.e., “we propose that some NCDs could have a microbial component and, if so, might be communicable via the microbiota.”
The authors looked at obesity, Type 2 diabetes, cardiovascular disease, and inflammatory bowel disease as possible examples. “These observations suggest that the microbiota could be a causal and transmissible element in certain diseases that have been traditionally classified as NCDs,” the authors conclude, further noting: “Additionally, only gut bacteria have been considered in this discussion, yet viruses and fungi may also contribute to NCDs, as well as microbiota at other body sites such as the skin and oral cavity.”
Their paper concludes:
These findings could serve as a solid framework for microbiome profiling in clinical risk prediction, paving the way towards clinical applications of human microbiome sequencing aimed at prediction, prevention, and treatment of disease.
Dr. Finlay says: “If our hypothesis is proven correct, it will rewrite the entire book on public health.”
Microbiome researcher Samuel Minot, PhD, who was not involved in the studies, is told Mr. Ortega, “I am hopeful and enthusiastic that the community will reach a point where we’re able to develop microbiome-based therapeutics and diagnostics. I think that this is within the realm of possibility.”
Professor Harry Sokol of the Paris Center for Microbiome Medicine agreed, telling Gut Microbiota for Health: “I am convinced that some microbiome-based tests will become biomarkers in many clinical situations in the future.”
There is much work going on in the field. For example, The Cleveland Clinic has the Center for Microbiome and Human Health, the Mayo Clinic has the Microbiome Program, Stanford has the Stanford Microbiome Therapies Initiative, UCSF has the Benoff Center for Microbiome Medicine, the University of Pittsburgh has the Center for Medicine and the Microbiome, and the University of Wisconsin has the Center for Microbiome Sciences & Therapeutics.
Still, it is too early to get overly excited. Everyone agrees more research is necessary. Timothy Caulfield, the Research Director of the Health Law Institute at the University of Alberta, warns: “Gut hype is everywhere.” He acknowledges that this is an exciting field with great promise, but cautions “it is still early days for microbiome research.”
Think of modern medicine, with its germ theory of disease and its understanding of our body’s biomechanics, as classical physics. See a germ, kill a germ. Monitor our bodily functions, test our blood, even sequence our genes; all the answers lie within us. Newton would approve.
Our recent discoveries about our microbiota are upending our notions about what disease is, what causes it, and how we should best deal with it. Our supposed precision in medicine is illusionary. Heisenberg would understand.
Modern medicine loves its antibiotics, despite the devastating impact they wreak on our microbiome. It is fascinated with our genome, despite the fact that our microbiota’s genes greatly outweigh our own, and have more diversity. Our microbiota change in ways that we don’t understand and, as yet, can’t even really track, much less predict the effect of.
We need the equivalent of a quantum theory of health.
I don’t mean literally applying quantum physics to healthcare, although, of course, we are a collection of quantum bits. I mean recognizing that our human-centric picture of health is much too narrow, and fails to predict what actually drives our health. I mean admitting that “our” health is really a consequence of “their” health, and that only figuring out how to incorporate both will yield us a true picture of health.
Modern medicine is in the stage physics was in the early part of the 20th century, when the concept of quanta was known but the consequences of it were yet to be discovered. Physics struggled for many years to accept quantum theory, and medicine will have a similar struggle to accept whatever the theory that fully incorporates microbiota will be.
Modern medicine has had its Newtons, maybe even its Einsteins, but now it needs a new generation of scientists to develop more accurate theories of our health, no matter how counter-intuitive they might be.
Welcome to a quantum theory of health.
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