Advertisement

Journal of General Internal Medicine

, Volume 27, Issue 12, pp 1704–1706 | Cite as

Time to Recognize Our Fellow Travellers

  • Travis B. Murdoch
  • Allan S. Detsky
Perspectives

Abstract

It is increasingly apparent that human health is reliant on our fellow travellers, the innumerable microorganisms that inhabit our bodies. This realization has led to the concept of the superorganism, which suggests that shared metabolic and signalling pathways are crucial for optimal existence of both host and commensal microflora. This commentary focuses on implications of this paradigm for personalized medicine and therapeutics. Study of the microbiome, the collection of microorganisms inhabiting the body, may identify disease-associated microbial profiles with pathophysiological and diagnostic value. As with genomics, companies will emerge offering direct to consumer microbiome analysis. Probiotics can potentially modulate the superorganism for therapeutic benefit. However, the probiotics industry will need to undergo a transformation, with increased focus on stringent manufacturing guidelines and high-quality clinical trials. Ultimately, we suggest that healthcare will move beyond its prevailing focus on human physiology, and embrace the superorganism as a paradigm to understand disease.

KEY WORDS

superorganism human microbiome probiotic 

Notes

Acknowledgments

The authors thank Dr. Ken Croitoru for his helpful comments on an earlier version of this manuscript.

Conflict of Interest

The authors declare that they do not have a conflict of interest and there was no source of funding for this paper.

References

  1. 1.
    Eberl G. A new vision of immunity: homeostasis of the superorganism. Mucosal Immunol. 2010;3:450–60.PubMedCrossRefGoogle Scholar
  2. 2.
    Poelstra K, Bakker WW, Klok PA, et al. A physiologic function for alkaline phosphatase: endotoxin detoxification. Lab Investig. 1997;76:319–27.PubMedGoogle Scholar
  3. 3.
    Li M, Al-Sarraf A, Sinclair G, Frohlich J. Fish odour syndrome. CMAJ. 2011;183:929–31.PubMedCrossRefGoogle Scholar
  4. 4.
    Bry L, Falk PG, Midtvedt T, Gordon JI. A model of host-microbial interactions in an open mammalian ecosystem. Science. 1996;273:1380–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Turnbaugh PJ, Ley RE, Mahowald MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444:1027–31.PubMedCrossRefGoogle Scholar
  6. 6.
    Wen L, Ley RE, Volchkov PY, et al. Innate immunity and intestinal microbiota in the development of Type 1 diabetes. Nature. 2008;455:1109–13.PubMedCrossRefGoogle Scholar
  7. 7.
    Grice EA, Kong HH, Conlan S, et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009;324:1190–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 2010;464:59–65.PubMedCrossRefGoogle Scholar
  9. 9.
    Laksman Z, Detsky AS. Personalized medicine: understanding probabilities and managing expectations. J Gen Intern Med. 2011;26:204–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Klein M, Sanders ME, Duong T, Young HA. Probiotics: from bench to market. Ann N Y Acad Sci. 2010;1212(Suppl 1):E1–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Shanahan F. Probiotics in perspective. Gastroenterology. 2010;139:1808–12.PubMedCrossRefGoogle Scholar
  12. 12.
    Deshpande G, Rao S, Patole S, Bulsara M. Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Pediatrics. 2010;125:921–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Besselink MGH, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;371:651–9.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  1. 1.Department of MedicineUniversity of TorontoTorontoCanada
  2. 2.Department of MedicineMount Sinai HospitalTorontoCanada
  3. 3.Department of Medicine, University Health NetworkUniversity of TorontoTorontoCanada
  4. 4.Zane Cohen Centre for Digestive DiseasesMount Sinai HospitalTorontoCanada
  5. 5.Institute for Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada

Personalised recommendations