Impending Mental Health Issues During Coronavirus Disease 2019 – Time for Personalized Nutrition Based on the Gut Microbiota to Tide Over the Crisis?

 Coronavirus disease 2019 (COVID-19) is a major pandemic facing the world today caused by SARS-CoV-2 which has implications on our mental health as well. The uncertain future, fear of job loss, lockdown and negative news all around have taken a heavy toll on the mental health of individuals from across the world. Stress and anxiety can affect the COVID-19 patients even more. Recent study suggests COVID-19 infection may lead to post-traumatic stress disorder (PTSD). Certain prebiotics and probiotics have been shown to have anxiolytic effect through gut microbiota modulation. Incidentally, preliminary report also suggests a differential microbial profile in COVID-19 patients as compared to healthy individuals. Gut microbiota’s role in anxiety and depression is well studied. The importance of the “gut-brain” axis has been implicated in overall mental health. It is known that diet, environmental factors and genetics play an important role in shaping gut microbiota. Trials may be initiated to study if personalized diet and supplementation based on individual’s gut microbiome profile may improve the general mental well-being of people prone to anxiety during this pandemic. Also, COVID-19 patients may be provided personalized nutritional therapy based on their gut microbiota profile to see if PTSD and anxiety symptoms can be alleviated.

For more details read my paper published in Frontiers in Neuroscience

https://www.frontiersin.org/articles/10.3389/fnins.2021.831193/full

Microbiome Domain – A journey and perspective from India

 

Our journey in the microbiome domain started in 2015. We had launched our company, Leucine Rich Bio pvt ltd. in the Silicon Valley of India, Bengaluru in the late half of 2014. We integrated our expertise in genomics, systems biology, molecular biology, information technology and bioinformatics to build a robust system that could address the challenges of the microbiome domain. We curated tons of research papers to build our own databases (Microbyte and Nutribyte) which contained information on the various aspects of the microbiota, their link to diseases, nutrients in food etc. Next challenge was to develop algorithms and matrices that would take the raw data from next generation sequencing machines as input and provide an actionable output in the form of a report utilizing the data from our in-house databases. That’s how South Asia’s first microbiome test, BugSpeaks was launched in mid-2018. Also, in early 2021, we launched India’s first gut microbiome data-based nutraceutical line, Rychbiome. It gives us immense pride that we could become this region’s first microbiome company and in doing so also helped spread awareness on this very important aspect.

So, what have been our challenges? Well, microbiome domain is very complicated and it required a great mix of expertise from various quarters to pull this off. Running a deep science based startup in India has its challenges. Although in the last few years the startup ecosystem has evolved yet it has still miles to go for it to become mature like in the West. Then there was lack of awareness as this domain was new. Interestingly, people in general, in India know a lot about the importance of gut health as our ancient scriptures like Ayurveda emphasized on keeping the gut healthy. Most people in India eat a variety of fermented foods as part of their routine diet thereby taking care of their gut! however, the fact that one can now profile one’s gut microflora and based on that could take certain actionable steps to improve their health and wellness was very new to them. We also found a lack of interest from majority of the investment community in India. This may be again because this field was new and there were no yardsticks to compare us with. But I feel now things are changing and I hope investors in India can see the potential of this domain and how it can change the way healthcare functions!

So, what are the advantages that we have? First, India is very diverse. The gene pool, the food habits, the climate, everything adds tremendous value to the microbiome data. Secondly, India is rich source of skilled and talented workforce. We are already an IT major and we have tremendous skilled force in the biotechnology and life-science domains as well. Such combination is hard to find by and expensive in other parts of the world. 

Where do we see the microbiome space going? We feel this domain can revolutionize the healthcare paradigm. Currently it is more commonly associated with the wellness category but it has the potential to provide diagnostic, prognostic and therapeutic solutions in gastroenterology, oncology, mental health and women health!

We feel India is in the cusp of providing major breakthroughs in various fields and microbiome domain is no different provided the government and investor community support this space!

 This opinion piece was published in Express Healthcare -

https://www.expresshealthcare.in/blogs/guest-blogs-healthcare/microbiome-domain-a-journey-and-perspective-from-india/431244/

 

 

Gut microbiota and Covid-19- possible link and implications

Covid-19 is a major pandemic facing the world today caused by SARS-CoV-2 which has implications on our understanding of infectious diseases. Although, SARS-Cov-2 primarily causes lung infection through binding of ACE2 receptors present on the alveolar epithelial cells, yet it was recently reported that SARS-CoV-2 RNA was found in the faeces of infected patients. Interestingly, the intestinal epithelial cells particularly the enterocytes of the small intestine also express ACE2 receptors. Role of the gut microbiota in influencing lung diseases has been well articulated. It is also known that respiratory virus infection causes perturbations in the gut microbiota. Diet, environmental factors and genetics play an important role in shaping gut microbiota which can influence immunity. Gut microbiota diversity is decreased in old age and Covid-19 has been mainly fatal in elderly patients which again points to the role the gut microbiota may play in this disease. Improving gut microbiota profile by personalized nutrition and supplementation known to improve immunity can be one of the prophylactic ways by which the impact of this disease can be minimized in old people and immune-compromised patients. More trials may be initiated to see the effect of co-supplementation of personalized functional food including prebiotics/probiotics along with current therapies.

For more on this please read my review published in the peer reviewed journal - Virus Research

https://www.sciencedirect.com/science/article/pii/S0168170220304603

A new revolution in Life Science and Healthcare called “Microbiome”

Any new development in life science and healthcare starts with baby steps and slowly but surely takes the world by storm. Whether it is small molecule based, high-end genomics guided targeted cancer therapy or the immuno-checkpoint inhibitors which are taking cancer treatment to the next level of personalization and precision.

In the last decade one small buzz word has created quite a noise and is bringing hope that indeed wellness and personalized treatment is a possibility – enter the world of the “microbiome”. The term microbiome means the entire genome of the microbiota ecosystem. The advent of microbiome research parallels the advancement in next generation sequencing (NGS). Before NGS came into the picture, microbiology-based study could rely only on culturing microorganisms in the lab which had its own drawbacks. Now, with advanced sequencing technologies and smart algorithms it is possible to dissect the microbial ecosystem without the need to culture microorganisms in the lab.

Human intestine harbors the maximum number of commensal organisms which are into a delicate relationship with the host. It is therefore not a surprise that maximum gut microbiota based studies are published which look into how gut microbiota plays an important role in human health and wellness.

Do you know:-

Ø   Metagenomic sequencing of fecal samples has identified 3.3 × 10⁶ nonredundant  microbial genes from up to 1,150 different species, outnumbering human protein-coding genes by about 150-fold

Ø     Each person is estimated to host at least 160 different species 

Ø  In 2007, only 14 NIH grants contained the word “microbiome” in their titles or abstracts, and the number went up to 1,043 in 2017

Ø   More than 10000 papers published in the last 3 years on “gut microbiota”

With new studies and developments in the gut microbiome space, it would suffice to say-

“If eyes are the windows to the soul, then gut microbiome is the window to your health”

The industry has also taken a leaf and are dwelling into various aspects of the microbiome space. Companies like Leucine Rich Bio (India), Day Two (Israel), Viome (USA), UBiome (USA), Microba (Australia) etc. are taking the developments in the research to consumers directly by providing easy to use at home gut health tests. And there are companies like Enterome (France), Vedanta Bioscience (USA), Seres Therapeutics (USA) etc. that are looking into tapping the therapeutic potential of the microbiome and thus bringing new paradigms in treatment of various type of cancer, IBD, IBS etc.

Investors especially in the Western world have and are putting lot of faith in these new age companies. Most notably Seventure Partners that have funded a slew of microbiome companies in Europe and the US.

Although, lot many research and studies will be needed in future to validate the interesting leads that the microbiome domain throws up yet it is pertinent that all stakeholders especially clinicians and investors in Asia also support this with less skepticism and more openness as the success of the microbiome can lead to a new era of healthcare and wellness

 

Bug Therapy to treat Diabetes and obesity in future?

The long held notion of ‘junk DNA’ has been found to be incorrect (ENCODE project), similarly, characterizing the gut microbiota as bystanders in the intestinal tract is now being widely challenged (Osborn O, Olefsky JM (2012), Nature Med 18(3):363-374).

A recent paper in Proceedings of National Academy of Sciences (PNAS) adds muscle to the fact that a single species of bacteria (Akkermansia muciniphila) can modulate diet induced obesity in mice. A. muciniphila is a Gram-negative bacteria that constitutes 3–5% of the gut microbial community. The paper also highlights the various mechanisms by which this bacterium might exert its effect (Everard A et al. (2013), PNAS)

The study shows dramatic decrease in gut A.muciniphila in diet induced obese mice. On restoring the abundance of this strain in obese and diabetic mice it was found that viable A. muciniphila controls gut barrier function, fat mass storage, and glucose homeostasis via several mechanisms. This study identified an association of obesity with a decrease in mucus thickness that is characteristic of obesity and associated disorders. Interestingly, the authors found that A. muciniphila restored this mucus layer. Strikingly, viable A. muciniphila induces these effects, whereas heat-killed A. muciniphila did not protect the mice from diet-induced obesity and associated disorders. One of the other key findings was that treatment with this bacteria led to increase in acylglycerol levels more specifically 2-OG and 2-AG. Incidentally, 2-OG is known to stimulate intestinal L cells which lead to secretion of GLP-1 (Hansen KB, et al. (2011), J Clin Endocrinol Metab 96(9):E1409–E1417). GLP-1 is known to increase insulin secretion. Also, A. muciniphila treatment completely reversed diet-induced fasting hyperglycemia via a mechanism that was associated with a 40% reduction in hepatic glucose-6-phosphatase expression thereby suggesting a reduction in gluconeogenesis. Hence this association might point to how A. muciniphila exerts its effects on glucose homeostasis. 

Many bacteria (Lactobacilus spp, Bifidobacterium spp etc.) have been shown to have effect on fat mass development during diet induced obesity (Fåk F, Bäckhed F (2012), PLoS ONE 7(10):e46837). However, in this study the emphasis was to study the bacterial strain that is affected during obesity and type 2 diabetes in humans and rodents. It would be interesting to see how this development would enthuse the world of gut microbiome research and interest the pharmaceutical/biotech companies to invest in this field which would then pave the way for not only treatment but prevention of inflammatory, lifestyle and even mental diseases in the near future.