“There’s a huge need we must address,” McRae says. “Drugs that work for some patients don’t work for others. Other patients with IBD respond to treatment initially and then over time can lose response to a medicine. We have to get to the bottom of this mystery and the microbiome may play a role in this.”
Increased microbiome interest
There’s been an increase in research and journals related to microbiomes within the last 10 years, but McRae points to one of the reasons being a “rebranding” of the subject.1
“It was called bacteriology when I was in college, but it’s matured to a point where the industry has more confidence to help us understand its potential,” McRae says.
AbbVie is also exploring microbiome research. McRae is excited about the early direction of this focus area because it could lead to the development of a targeted therapy through the gastrointestinal tract by evaluating the impact of an individual’s diet, stress, immune system and metabolism on the bacteria in the gut.
Diversity in the gut
In a healthier gut, the bacteria metabolize dietary fiber to short chain fatty acids. Those fatty acids then communicate with epithelial cells and the immune system in your gut. In people with IBD, microbial diversity in the gut is reduced, leading to an imbalance called dysbiosis. The reduction in diversity in the gut microbiome negatively impacts immune regulation, as well as the function of the thin tissue that covers internal organs which can allow for more disease-causing bacteria to overgrow.
“Could we alter the gut microbiome to restore more normal immune regulation and reduce chronic inflammation for someone with IBD?” McRae ponders.