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How gut microbes are joining the fight against cancer (nature.com)
164 points by digital55 on May 23, 2018 | hide | past | favorite | 26 comments



I got to know about microbiome sometimes last year.

Spent good amount of time on reading about it, some books I read:

* 10% Human: How Your Body’s Microbes Hold the Key to Health and Happiness (https://www.amazon.in/10-Human-Microbes-Health-Happiness/dp/...)

* Gut: The Inside Story of Our Body's Most Under-Rated Organ (https://www.amazon.in/gp/product/938528861X)

* Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain–for Life (https://www.amazon.in/dp/0316380105)

also watched the course on Coursera about Microbiome (https://www.coursera.org/learn/microbiome), it was an eye opener.


From that reading do you have any advice, what can we do to improve our gut and health ?


the simplest advice would be less sugar, more fiber (and probably some omega-3 PUFAs). i'll add sources when i get home.


* Less Sugar

* Less refined/junk food

* Limited use of antibiotics

* More greens

* Add curd/yogurt (in not allergic in your diet)

* More dry fruits, nuts


+1, might add this TED Talk by the author of "Gut"

https://www.youtube.com/watch?v=HNMQ_w7hXTA


nice. I was not aware, she had a TED talk.


If I had to read/watch just one of these, which one would recommend?


> It was an eye-opener for a lot of people who couldn’t see the clinical relevance of gut microbes

I've met a a number of people that think this way. As if the whole of the body's digestive and immune system serves no purpose simply because it's complex and we don't understand it well enough.


I worked as a sysadmin at DNA sequencing and analysis company for a while, and one of the things the boss was adamant about was how important in all factors the microbiome was, and he was repeatedly proven correct. For example, we were doing some work with a leading Chrons researcher... and doing microbiome sequencing was leading to some very promising progress. This happened in many fields, for example wound recovery biofilm.

I am very happy to have gotten the opportunity to work there, and sometimes I wish I hadn't left. My non-compete is finally up at least!


As someone with Crohn's disease, I follow a diet specifically designed to alter the microbiome. It is very effective in eliminating symptoms, though it does require very strict adherence, which can be very difficult.

The amazing thing is this diet (The Specific Carbohydrate Diet) has been successfully used by people for several decades. Unfortunately, despite recent progress in terms of scientific studies validating its effectiveness, many gastroenterologists still say that diet has little to no effect on Crohn's disease.

Fortunately, not everyone is in denial, and it is finally starting to gain acceptance in the medical and the research community.


I would caution you with attributing your good health with solely this diet rather than just paying attention to what you eat. I have UC and it only made me sicker and lose weight and nearly ended up in the hospital. I concluded that perhaps this diet is not for all IBD. Really great to hear you're doing well though.


One of the things that is so fascinating about the gut's response is that it varies so dramatically from individual to individual. The current diagnostic and restorative tools we have are extremely blunt.


SCD carries a lot of psuedoscience baggage so I don't blame doctors for not heeding its advice. It does seem to have a positive effect though. Hopefully one day we'll figure out exactly why it works (and doesn't work).


Is there any good research for dealing with biofilms inside the body? I know Acne and dental plaque are well known as is some links with arterial diseases, but I have not heard of much outside of that.


very anecdotal/personal and speculative. I was a SIBO sufferer for years. GP didn't really have a clue what it is. I thought candida, tried diet, remedies - with very moderate temporary success. Got actually diagnosed with SIBO - by breath test - only few months back. The GE was very pessimistic and skeptical about my prospects of getting rid of it. First round of antibiotic (Xifaxan) - very mild improvement (may be 30% based on a major symptom - gas generation). I pressed the GE for another round of some other antibiotic. With one more lecture on low chances to cure, he gave me another, a wide spectrum one - amoxicillin. This time it hardly budged a needle.

So, what to do? I remembered reading some research which connected the cases of low antibiotic efficiency with bacteria organization into biofilms. Given that both - Xifaxan, which acts mainly in the internal space of the intestine, and the amoxicillin, which acts from the blood, ie. from the inside of intestinal wall, didn't work well, it suggested to me that the bacteria is probably biofilmed upon and inside the mucous layer. So basically i needed to scrub clean the surface of my intestines. High skilled yoga practitioners do self-cleaning by chewing on a length of cloth and passing it that way through the body - well, now i understood why they would do it :) Not having yoga skills and thinking engineering way - i needed something like a laxative which would be sucking the water through and off the intestinal walls (i.e. washing the biofilms/colonies off the walls and down) and would start doing it right in the upper small intestine (the breath test shown that i had the bacterial overgrowth starting in the upper small intestine). The first Google search brought it right away - salt water flush. Once i saw it, i didn't even have the patience to go to store for the recommended pink Himalayan salt as it was pretty obvious that salt(ie. NaCl) itself is the key here as the salt acts exactly the way i needed. I just rushed to the kitchen (i got so tired of SIBO for all those years) and used the regular one. 3 hours later the effect on the SIBO was stronger than that from a round of antibiotic. That week i repeated it 4 more times (with the recommended pink Hymalayan salt as actually it tastes better :). For several weeks after - 1-2 times/week. Last week didn't have to do it at all. SIBO is known to have high return rate, and i'm absolutely not bothered by it as the procedure can easily be repeated if/when it becomes needed and not that bacteria can develop resistance to it.


Don't have anything near this bad, but anecdotally I've felt alot better/cleaner less 'clogged' stomach wise after drinking lemon water (like 1oz lemon juice+water, no sugar) regularly and eating pickles - I had a similar 'cleaning the gut' theory.


oh, yes, acidic stuff, like vinegar dressed salads and straight supplementation with HCl (stomach acid), have helped me to somewhat soothe the condition during those years. From what i read, my understanding is that in normally healthy gut the "good" bacteria do maintain slightly acidic environment which prevents the "bad" bacteria overpopulation and biofilm formation.


Very cool. This belongs in a medical journal!


Honestly I don't know. I figure scihub would be a good place to start looking though.


How is acne related To biofilm?



Our knowledge of medicine still seems to be an an early stage. For instance, we still seem to be discovering large organs in the body. I feel that way about other fields too -- geology only had its fundamental theory widely accepted less than 100 years ago. We're still unsure of the number of planets in the solar system, even. In short, it's an exciting time to be alive, with a lot of theories yet to be discovered in science. Nearly all of the low-hanging fruit have been found now, but there's a lot to we will yet learn from the complex parts that we don't understand well enough.


Tangentially : I'm currently reading a book about microbes and microbiomes in general.

https://www.goodreads.com/book/show/27213168-i-contain-multi...

I've found it to be pretty interesting and accessible if the subject interests you.


Thanks That looks good and I am researching this (just as a hobby) at the moment myself


Is this Kurzgesagt video relevant? https://youtube.com/watch?v=YI3tsmFsrOg


was just reading about one of the companies mentioned, Evelo, this morning. their IPO prospectus mentions a few other potential benefits of using "bugs as drugs", rather than traditional biologics or small molecules, including 1) can alter multiple biological pathways, as opposed to one target per drug w small or large molecules, 2) cheaper to optimize the product (don't have to do extensive medicinal chem or antibody optimization, just need to pick the right naturally occurring bug) and 3) potential for microbes to be safer (ppl have been eating these for a long time). a nice side effect of a safer treatment is that you can use them in less sick patients, thus increasing your market size

i can see 1) being true. 2) potentially is true, though i don't have the expertise to evaluate this. however, some companeis are genetically engineering microbes to increase effectiveness, which would add to the time requried to "optimize" the microbe. for 3), ive heard differing opinions. "the tox is in the dose", so even if ppl have ingested a microbe without harm, if you increase the amount of microbe who knows what will happen.

nonetheless, their approach is interesting. the idea is that circulating immune cells (dendritic cells and macrophages) "sample" the gut microbiome by sticking tendrils through the intestinal wall. they collect antigens from the gut and then migrate to regional lymph nodes (basins with a bunch of immune cells) and interact with t cells and other immune cells, changing how they function. they have a platform where they screen a bunch of different microbe strains in culture with dendritic cells (and maybe other cells) and then measure what cytokines and other chemicals the dendritic cells secrete / express. they select microbes that have the ideal "immunophenotype" to use as therapies. they then validate these in animal models of disease, and have some really impressive preliminary results (summary of data in the IPO prospectus)

of course, as the article states, the big question is whether this will work in people. there's conflicting evidence as to what particular strain is most implicated in a particular cancer. and we also don't really know if just hitting one strain is enough to do anything. part of what makes evelo interesting is that they think theyve found a specific immunological mechanism for their microbes role in disease, which makes it easier to measure whether its working in early studies (ie you can measure circulating cytokine and immune cell populations as a proxy for whether the cancer is getting better). however, theres no way to know without doing the human studies. this phenomenon applies to all types of drugs however, and is the reason why drug r&d is so expensive: you never know if something works until you test in humans, and thats really expensive




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