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Gut Health in the era of the Human Gut Microbiota: from metaphor to biovalue

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Abstract

The human intestinal ecosystem, previously called the gut microflora is now known as the Human Gut Microbiota (HGM). Microbiome research has emphasized the potential role of this ecosystem in human homeostasis, offering unexpected opportunities in therapeutics, far beyond digestive diseases. It has also highlighted ethical, social and commercial concerns related to the gut microbiota. As diet factors are accepted to be the major regulator of the gut microbiota, the modulation of its composition, either by antibiotics or by food intake, should be regarded as a fascinating tool for improving the human health. Scientists, the food industry, consumers and policymakers alike are involved in this new field of nutrition. Defining how knowledge about the HGM is being translated into public perception has never been addressed before. This raises the question of metaphors associated with the HGM, and how they could be used to improve public understanding, and to influence individual decision-making on healthcare policy. This article suggests that a meeting of stakeholders from the social sciences, basic research and the food industry, taking an epistemological approach to the HGM, is needed to foster close, innovative partnerships that will help shape public perception and enable novel behavioural interventions that would benefit public health.

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References

  • Asch, D.A., and K.G. Volpp. 2012. What business are we in? The emergence of health as the business of health care. New England Journal of Medicine 367: 888–889.

    Article  Google Scholar 

  • Atun, R., F.M. Knaul, Y. Akachi, and J. Frenk. 2012. Innovative financing for health: What is truly innovative ? Lancet 380: 2044–2049.

    Article  Google Scholar 

  • Bachelard, G. 2004. La poétique de l’espace, 215. Paris: Quadrige/PUF.

    Google Scholar 

  • Bachelard, G. 1967. La formation de l’esprit scientifique. Contribution à une psychanalyse de la connaissance objective. Paris: Librairie philosophique J. VRIN, 5e édition. Collection : Bibliothèque des textes philosophiques, 257 p.

  • Baker, S.R., and L. Partyka. 2012. Relative importance of metaphor in radiology versus other medical specialties. Radiographics 32: 235–240.

    Article  Google Scholar 

  • Bapteste, E., and J. Dupré. 2013. Towards a processual microbial ontology. Biology and Philosophy 28: 379–404.

    Article  Google Scholar 

  • Baranyi, A., T. Krauseneck, and H.-B. Rothenhäusler. 2013. Overall mental distress and health-related quality of life after solid-organ transplantation: Results from a retrospective follow-up study. Health and Quality of Life Outcomes 11: 15. doi:10.1186/1477-7525-11-15.

    Article  Google Scholar 

  • Becker, A.E., and A. Kleinman. 2013. Mental health and the global agenda. New England Journal of Medicine 369: 66–73.

    Article  Google Scholar 

  • Bischoff, S.C. 2011. Gut health: A new objective in medicine? BMC Medicine 9: 24. doi:10.1186/1741-7015-9-24.

    Article  Google Scholar 

  • Blaser, M. 2011. Stop the killing of the beneficial bacteria. Science 476: 393–394.

    Google Scholar 

  • Blue, G. 2010. Food, publics, science. Public Understanding of Science 19: 147–154.

    Article  Google Scholar 

  • Brandt, L.J. 2013. American journal of gastroenterology lecture: Intestinal microbiota and the role of fecal microbiota transplant (FMT) in treatment of C. difficile infection. American Journal of Gastroenterology 108: 177–185.

    Article  Google Scholar 

  • Brinich, M.A., M.B. Mercer, and R.R. Sharp. 2013. An analysis of online messages about probiotics. BMC Gastroenterology 13: 5. doi:10.1186/1471-230X-13-5.

    Article  Google Scholar 

  • Casazza, K., K.R. Fontaine, A. Astrup, et al. 2013. Myths, presumptions, and facts about obesity. New England Journal of Medicine 368: 446–454.

    Article  Google Scholar 

  • Claesson, M.J., I.B. Jefferty, S. Conde, et al. 2012. Gut microbiota composition correlates with diet and health in the elderly. Nature 488: 178–184.

    Article  Google Scholar 

  • Clayton, E.W. 2003. Ethical, legal, and social implications of genomic medicine. New England Journal of Medicine 349: 562–569.

    Article  Google Scholar 

  • Cummings, J.H., J.M. Antoine, F. Azpiroz, et al. 2004. PASSCLAIM: Gut Health and immunity. European Journal of Nutrition 43(Suppl 2): II118–II173.

    Google Scholar 

  • Dagognet, F., F. Guery, and O. Marcel. 1989. “Mort et résurrection du paysage ?”, in Mort du paysage ?. Champ vallon: Philosophie et esthétique du paysage. 240 p.

    Google Scholar 

  • Dinan, T.G., Stanton, C., and J.F. Cryan. 2013. Psychobiotics: A novel class of psychotropic. Biological Psychiatry. doi: 10.1016/j.biopsych.2013.05.001.

  • Eden, S. 2011. Food labels as boundary objects: How consumers make sense of organic and functional foods. Public Understanding of Science 20: 179–194.

    Article  Google Scholar 

  • El-Matary, W., R. Simpson, and N. Rickett-Burns. 2012. Fecal microbiota transplantation: Are we opening a can of worms? Gastroenterology 143: e19. doi:10.1053/j.gastro.2012.04.055.

    Article  Google Scholar 

  • Ezzati, M., and E. Riboli. 2013. Behavioral and dietary risk factors for noncommunicable diseases. New England Journal of Medicine 369: 954–964.

    Article  Google Scholar 

  • Fineberg, H.V., and D.J. Hunter. 2013. A global view of health: An unfolding series. New England Journal of Medicine 368: 78–79.

    Article  Google Scholar 

  • Finegold, S.M., D. Molitoris, Y. Song, et al. 2002. Gastrointestinal microflora studies in late-onset autism. Clinical Infectious Diseases 35(Suppl 1): S6–S16.

    Article  Google Scholar 

  • Flegal, K.M., B.K. Kit, H. Orpana, and B.I. Graubard. 2013. Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. Journal of the American Medical Association 309: 71–82.

    Article  Google Scholar 

  • Foster, J.A., and K.A. McVey Neufeld. 2013. Gut-brain axis: How the microbiome influence anxiety and depression. Trends in Neuroscience. doi:10.1016/j.tins.2013.01.005.

  • Fox Keller, E. 1995. Refiguring life: Metaphors of twentieth-century biology. Columbia University Press, 134 p.

  • Garraud, O., and J–.J. Lefrère. 2013. Are there still myths in –or associated with- transfusion ? Blood Transfusion 11: 148–150.

    Google Scholar 

  • Goffette, J., and J. Simon. 2012. “The internal environment: Claude Bernard’s concept and its representation in Fantastic Voyage (R. Fleisher)”, pp. 187–205, In: Landers Matthew Munoz Brian (ed.): Anatomy and the organization of knowledge, 1500–1850, London, Pickering Chatto.

  • Gordon, J.I., Dewey, K., Mills, D.A., and R.M. Medzhitov. 2013. The human gut microbiota and undernutrition. Science Translational Medicine 4:137ps12. doi: 10.1126/scitranslmed.3004347.

  • Grad, F.P. 2002. The preamble of the Constitution of the World Health Organization. Bulletin of the World Health Organization 80: 981–984.

    Google Scholar 

  • Greenhalgh, T., and S. Wieringa. 2011. Is it time to drop the “knowledge translation” metaphor ? A critical literature review. Journal of the Royal Society of Medicine 104: 501–509.

    Article  Google Scholar 

  • Hansson, M.G. 2009. Ethics and biobanks. British Journal of Cancer 100: 8–12.

    Article  Google Scholar 

  • Hawkes, C., and K. Buse. 2011. Public health sector and food industry interaction: It’s time to clarify the term “partnership” and be honest about underlying interests. European Journal of Public Health 21: 400–403.

    Article  Google Scholar 

  • Hawkins, A.K., and K.C. O’Doherty. 2011. “Who owns your poop ?”: Insights regarding the intersection of human microbiome research and the ELSI aspects of biobanking and related studies. BMC Medical Genomics 4: 72. doi:10.1186/1755-8794-4-72.

    Article  Google Scholar 

  • Hoffmann, C., Risti, R., Heschi, L., Stelzer, D., and M. Maier. 2013. Antibiotics and their effects: What do patients know and what is their source of information? The European Journal of Public Aug 19.

  • Hudson, K.L. 2011. Genomics, health care, and society. New England Journal of Medicine 365: 1033–1041.

    Article  Google Scholar 

  • Hunter, D.J., and S. Reddy. 2013. Noncommunicable diseases. New England Journal of Medicine 369: 1336–1343.

    Article  Google Scholar 

  • Jacka, F.N., A. Mykletun, and M. Berk. 2012. Moving towards a population health approach to the primary prevention of common mental disorders. BMC Medicine 10: 149. doi:10.1186/1741-7015-10-149.

    Article  Google Scholar 

  • Janes, C.R., K.K. Corbett, J.H. Jones, and J. Trostle. 2012. Emerging infectious diseases: The role of social sciences. Lancet 380: 884–886.

    Article  Google Scholar 

  • Jones, D.S., S.H. Podolsky, and J.A. Greene. 2012. The burden of disease and the changing task of medicine. New England Journal of Medicine 366: 2333–2338.

    Article  Google Scholar 

  • Kahn, S.A., R. Gorawara-Bhat, and D.T. Rubin. 2012. Fecal bacteriotherapy for ulcerative colitis: Patients are ready, are we? Inflammatory Bowel Diseases 18: 676–684.

    Article  Google Scholar 

  • Kau, A.L., P.P. Ahern, N.W. Griffin, A.L. Goodman, and J.L. Gordon. 2012. Human nutrition, the gut microbiome, and immune system: Envisioning the future. Nature 474: 327–336.

    Article  Google Scholar 

  • Kelly, C.P. 2013. Fecal microbiota transplantation – An old therapy comes of age. New England Journal of Medicine 368: 474–475.

    Article  Google Scholar 

  • Kent, J., A. Faulkner, I. Geesink, and D. Fitzpatrick. 2006. Culturing cells, reproducing and regulating the self. Body & Society 12: 1–23.

    Article  Google Scholar 

  • Klingler, C. 2009. Notre seconde réserve de gènes. La Recherche 430: 31.

    Google Scholar 

  • Lagier, J.C., M. Million, P. Hugon, F. Armougom, and D. Raoult. 2012. Human gut microbiota: Repertoire and variations. Frontiers in Cellular and Infection Microbiology 2: 136. doi:10.3389/fcimb.2012.00136.

    Article  Google Scholar 

  • Lemon, K.P., Armitage, G.C., Relman, D.A., and M.A. Fischbach. 2012. Microbiota-targeted therapies: An ecological perspective. Science Translational Medicine 4: 137vr5.

  • Levy, R.L., E.A. Finch, M.D. Crowell, N.J. Talley, and R.W. Jeffery. 2007. Behavioral intervention for the treatment of obesity and effectiveness data. American Journal of Gastroenterology 102: 2314–2321.

    Article  Google Scholar 

  • Lewis, K.H., and M.B. Rosenthal. 2011. Individual responsibility or a policy solution – Cap and trade for the U.S. diet ? New England Journal of Medicine 365: 1561–1563.

    Article  Google Scholar 

  • Lizé, A., McKay, R., and Z. Lewis. 2012. Gut microbiota and kin recognition. Trends in Ecology and Evolution http://dx.doi.org/10.1016/j.tree.2012.10.013.

  • Maurice, C.F., H.J. Haiser, and P.J. Turnbaugh. 2013. Xenobiotics shape the physiology and gene expression of the active human gut microbiome. Cell 152: 39–50.

    Article  Google Scholar 

  • McDonald, D., Y. Vazquez-Baeza, W.A. Walters, J.G. Caporaso, and R. Knight. 2013. From molecules to dynamic biological communities. Biology and Philosophy 28: 241–259.

    Article  Google Scholar 

  • McMahon, A., P. Williams, and L.C. Tapsell. 2010. Reviewing the meaning of wellbeing and wellness and their implications for food choice. Perspectives in Public Health 130: 282–286.

    Article  Google Scholar 

  • Mercer, M.B., M.A. Brinich, G. Geller, et al. 2012. How patients view probiotics: Findings from a multicentre study of patients with inflammatory bowel disease and irritable bowel syndrome. Journal of Clinical Gastroenterology 46: 138–144.

    Article  Google Scholar 

  • Merleau-Ponty, M. 1993. Phénoménologie de la perception [1945]. Paris: Gallimard. 531 p.

    Google Scholar 

  • Millar, M. 2012. Constraining the use of antibiotics: Applying Scanlon’s contractualism. Journal of Medical Ethics 38: 465–469.

    Article  Google Scholar 

  • Mitchell, R. 2010. National biobanks: Clinical labor, risk production and the creation of biovalue. Science, Technology and Human Values 35: 330–355. doi:10.1177/0162243909340267.

    Article  Google Scholar 

  • Mordini, E. 2007. Technology and fear: Is wonder the key ? Trends in Biotechnology 25: 544–546.

    Article  Google Scholar 

  • Moschen, A.R., V. Wieser, and H. Tilg. 2012. Dietary factors: Major regulators of the gut microbiota. Gut and Liver 6: 411–416.

    Article  Google Scholar 

  • Mouton, L. 2010. The contribution of philosophy to immunology. Presse Médicale 39: 745–746.

    Article  Google Scholar 

  • Murphy, E.F., P.D. Cotter, A. Hogan, et al. 2013. Divergent metabolic outcomes arising from targeted manipulation of the gut microbiota in diet-induced obesity. Gut 62: 220–226.

    Article  Google Scholar 

  • Nancy, J.L. 2000. Le regard du portrait. Paris: Galilée. 90 p.

    Google Scholar 

  • Nerlich, B., R. Dingwall, and D.D. Clarke. 2002. The book of life: How the human genome project was revealed to the public. Health: An interdisciplinary journal for the social study of health, illness and medicine 6: 445–469.

    Google Scholar 

  • Nerlich, B., and I. Hellsten. 2004. Genomics: Shifts in metaphorical landscape between 2000 and 2003. New Genetics and Society 23: 255–268.

    Article  Google Scholar 

  • Nerlich, B., and I. Hellsten. 2009. Beyond the human genome: Microbes, metaphors and what it means to be human in an interconnected post-genomic world. New Genetics and Society 28: 19–36.

    Article  Google Scholar 

  • Norris, V., F. Molina, and A.T. Gewirtz. 2012. Hypothesis: Bacteria control host appetites. Journal of Bacteriology 195: 411–416.

    Article  Google Scholar 

  • O’Malley, M.A., and J. Dupré. 2007. Size doesn’t matter: Towards a more inclusive philosophy of biology. Biology and Philosophy 22: 155–191.

    Article  Google Scholar 

  • O’Malley, M.A. 2013. Philosophy and the microbe: A balancing act. Biology and Philosophy 28: 153–159.

    Article  Google Scholar 

  • Otis, L. 2008. Going with your gut: Some thoughts on language and the body. Lancet 372: 798–799.

    Article  Google Scholar 

  • Pérez-Cobas, A.E., M.J. Gosalbes, A. Friedrichs, et al. 2013. Gut microbiota disturbance during antibiotic therapy: A multi-omic approach. Gut 62: 1591–1601.

    Article  Google Scholar 

  • Persson, I. 2013. Could it be permissible to prevent the existence of morally enhanced people? Journal of Medical Ethics 38: 692–693.

    Article  Google Scholar 

  • Petrof, E.O., E.C. Claud, G.B. Gloor, and E. Allen-Vercoe. 2013. Microbial ecosystems therapeutics: A new paradigm in medicine ? Beneficial Microbes 4: 53–65.

    Article  Google Scholar 

  • Podolsky, S.H. 2012. Metchnikoff and the microbiome. Lancet 380: 1810–1811.

    Article  Google Scholar 

  • Pradeu, T., and E.L. Cooper. 2012. The danger theory: 20 years later. Frontiers in Immunology 3: doi: 10.3389/fimmu.2012.00287.

  • Robbins, A., and M. Nestle. 2012. Obesity as collateral damage: A call for papers on the obesity epidemic. Journal of Public Health Policy 32: 143–145.

    Article  Google Scholar 

  • Saavedra, J.M., and A.M. Dattilo. 2012. Early development of intestinal microbiota: Implications for future health. Gastroenterology Clinics of North America 41: 717–731.

    Article  Google Scholar 

  • Sacchini, D., G.M. Liumbruno, G. Bruno, et al. 2013. Ethical and deontological issues in transfusion medicine. Blood Transfusion 11: 14–25.

    Google Scholar 

  • Sanchez-Villegas, A., and M.A. Martinez-Gonzalez. 2013. Diet, a new target to prevent depression ? BMC Medicine 11: 3. doi:10.1186/1741-7015-11-3.

    Article  Google Scholar 

  • Selgelid, M.J. 2013. Moderate eugenics and human enhancement. Medicine Health Care and Philosophy Jun 1.

  • Sgard, A. 2010. “Une éthique du paysage est-elle souhaitable ?”, VertigO: La revue électronique en sciences de l’environnement [Online], Volume 10 Numéro 1 I avril 2010. URL : http://vertigo.revues.org/9472; doi : 10.4000/vertigo.9472.

  • Slashinski, M.J., S.A. McCurdy, L.S. Achenbaum, S.N. Whitney, and A.L. McGuire. 2012. “Snake-oil”, “quack medicine”, and “industrially cultured organisms”: Biovalue and the commercialization of human microbiome research. BMC Medical Ethics 13: 28. doi:10.1186/1472-6939-13-28.

    Article  Google Scholar 

  • Steinbrook, R. 2006. Imposing personal responsibility for health. New England Journal of Medicine 355: 753–756.

    Article  Google Scholar 

  • Stuckler, D., and M. Nestle. 2012. Big food, food systems, and Global Health. PLoS Medicine 9(6): e1001242. doi:10.1371/journal.pmed.1001242.

    Article  Google Scholar 

  • Suleski, J., and M. Ibaraki. 2010. Scientists are talking, but mostly to each other: A quantitative analysis of research represented in mass media. Public Understanding of Science 19: 115–125.

    Article  Google Scholar 

  • Svalastog, A.L. 2010. Gene myths in public perceptions. Public Understanding of Science 21: 478–494.

    Article  Google Scholar 

  • Tamayo, C. 2008. Clinical research on probiotics: The interface between science and regulation. Clinical Infectious Diseases 46(Suppl 2): S101–S103.

    Article  Google Scholar 

  • Tennison, M.N. 2012. Moral transhumanism: The next step. Journal of Medicine and Philosophy 37: 405–416.

    Article  Google Scholar 

  • Tosh, P.K., and L.C. McDonald. 2012. Infection control in the multidrug-resistant era: Tending the human microbiome. Clinical Infectious Diseases 54: 707–713.

    Article  Google Scholar 

  • Trehan, I., H.S. Goldbach, L.N. LaGrone, et al. 2013. Antibiotics as part of the management of severe acute malnutrition. New England Journal of Medicine 368: 425–435.

    Article  Google Scholar 

  • Tremaroli, V., and F. Bäckhed. 2012. Functional interactions between the gut microbiota and host metabolism. Nature 489: 242–249.

    Article  Google Scholar 

  • Triggle, D.J. 2012. Nous sommes tous des bactéries: Implications for medicine, pharmacology and public health. Biochemical Pharmacology 84: 1543–1550.

    Article  Google Scholar 

  • Umetsu, D.T. 2012. Early exposure to germs and the Hygiene Hypothesis. Cell Research 22: 1210–1211.

    Article  Google Scholar 

  • van de Weele, C. 2008. How to do with metaphor ? Introduction to the issue. Configurations 16: 1–10.

    Article  Google Scholar 

  • Waldby, C. 2002. Stem cells, tissue cultures and the production of biovalue. Health: An Interdisciplinary Journal for the Social Study of Health. Illness and Medicine 6: 305–323.

    Google Scholar 

  • Waters, A.E., T. Contente-Cuomo, J. Buchhagen, et al. 2011. Multidrug-Resistant Staphylococcus aureus in US Meat and Poultry. Clinical Infectious Diseases 52: 1227–1230.

    Article  Google Scholar 

  • Zarraonaindia, I., D.P. Smith, and J.A. Gilbert. 2013. Beyond the genome: Community-level analysis of the microbial world. Biology and Philosophy 28: 261–282.

    Article  Google Scholar 

  • Zimmer, C. 2011. Our microbiomes, ourselves. Review December: The New York times - Sunday. 3.

    Google Scholar 

  • Zinken, J., Hellsten, I., and B. Nerlich. 2008. Discourse metaphors. In R. Dirven, R. Franck, T. Ziemke, and J. Zlatev (Eds), Body, language, and mind. Volume 2: Social situatedness. Berlin: Mouton de Gruyter, 441 p.

  • Zipursky, J.S., T.I. Sidorsky, C.A. Freedman, M.N. Sidorsky, and K.B. Kirkland. 2012. Patient attitudes towards the use of fecal microbiota transplantation in the treatment of recurrent Clostridium difficile infection. Clinical Infectious Diseases 55: 1652–1658.

    Article  Google Scholar 

  • Zwart, H. 2009. From utopia to science: Challenges of personalized genomics information for health management and health enhancement. Medicine Studies 1: 155–166.

    Article  Google Scholar 

  • Zwart, H. 2010. Towards an eco-centric view of human existence: Implications of genomics for the environmental zone. Genomics, Society and Policy 6: 40–55.

    Article  Google Scholar 

  • Zwart, H. 2012. On decoding and rewriting genomes: A psychoanalytical reading of a scientific revolution. Medicine, Health Care and Philosophy 15: 337–346.

    Article  Google Scholar 

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Acknowledgments

The authors are grateful to Koren Wolman-Tardy and Victoria Paykar for their helpful assistance. The authors also thank the anonymous reviewers for the journal for their shrewd and constructive comments on the paper.

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Authors and Affiliations

  1. Service de Gastroentérologie, Clinique Mutualiste, 107 rue Trarieux, 69003, Lyon, France

    Vincent Baty

  2. Faculté de Philosophie, Université Lyon, 3 Jean Moulin, Lyon, France

    Vincent Baty, Catherine Dekeuwer & Gérard Carret

  3. Centre Christophe Mérieux, biomérieux, Grenoble, France

    Bruno Mougin

  4. Laboratoire de Bactériologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    Gérard Carret

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  1. Vincent Baty
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Baty, V., Mougin, B., Dekeuwer, C. et al. Gut Health in the era of the Human Gut Microbiota: from metaphor to biovalue. Med Health Care and Philos 17, 579–597 (2014). https://doi.org/10.1007/s11019-014-9552-2

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