The microbiome may be little known or understood outside scientific circles, but it is now thought to have a major impact on health. Defined as a vast collection of microbes, medical experts produce new evidence almost daily suggesting that the microbiome plays an essential role in our overall wellbeing. This plethora of research presents mouth-watering commercial opportunities in a number of fields and fast-moving companies are racing to bring new products to market.

HEALTHCARE

Gut instinct

Gut instinct

The microbiome may be little known or understood outside scientific circles, but it is now thought to have a major impact on health. Defined as a vast collection of microbes, medical experts produce new evidence almost daily suggesting that the microbiome plays an essential role in our overall wellbeing. This plethora of research presents mouth-watering commercial opportunities in a number of fields and fast-moving companies are racing to bring new products to market.

One of the most surprising scientific revelations of the past decade has been the outsized role that gut bacteria play in our health. The ecosystem – or microbiome – of bugs inhabiting this often-disparaged organ has huge implications for our physical and even emotional wellbeing. Scientists have been piecing together how imbalances in this microbiome can contribute to a staggering range of diseases from digestive ailments such as Crohn’s disease to seemingly unrelated conditions, such as multiple sclerosis, Parkinson’s disease, cancer and depression. 

This is making the gut bacteria a big deal for business, explains Dr Grégory Lambert, chief executive of French biotech firm TargEDys, which aims to harness bacteria to treat metabolic problems and eating disorders from binge eating to anorexia. 

“There has been a surge of interest in the microbiome across an array of industries, from biotechnology, food and supplements to information technology, digital app makers and publishing,” he says. “And as more products start to come to market, I would expect business interest in gut bacteria to continue increasing.” 

The growing public curiosity in the gut is already being fed by the publishing industry, with best-selling books by the likes of Giulia Enders (Gut: The Inside Story of Our Body's Most Underrated Organ) and Ed Yong (I Contain Multitudes: The Microbes Within Us and a Grander View of Life). A search for microbiome in the books section of Amazon now brings up more than 350 entries. The online retailer also features a burgeoning array of products related to intestinal health, from activated charcoal to aid digestion to foot rests that promote optimal posture while going to the toilet. 

 

HEALTHCARE
Lucrative markets

But the real business potential of the microbiome centres on companies with more specialised intellectual property. At present, more than 380 firms are raising capital in the microbiome area, says Isabelle de Cremoux, chief executive of Seventure, a venture capital group specialising in digital technologies and life sciences. Seventure has a particular interest in microbiome-based therapeutics and technologies at the intersection of health and nutrition. 

De Cremoux says: “While mapping the human genome was a huge advance, the advances in disease treatment arising from this have been slow to emerge, partly because you can’t change a person’s genome. The difference with the microbiome is that having sequenced it, you can change its composition – adding new strains, killing others and changing the interaction between the gut and the body.” 

But she warns there is a danger of hype. “Even if diseases can be understood, it does not mean we can correct the microbiome easily and many diseases are caused by many factors, so manipulating the microbiome alone might not prove sufficient,” she argues. That said, there is clear potential for smart firms to unlock large and lucrative markets. 

Powerful tool

First, consider diagnostics. A breakdown of the microbiome can provide clues as to what a patient is suffering from and how they will respond to certain drugs. As such, it is becoming a powerful tool for diagnosis and treatment. Ensuring that treatments are given only to patients who are likely to benefit has the potential to reduce both side-effects and medical costs.

Mapping the microbiome can also help to determine the best food choices for each individual. 

Several firms are starting to tap into this consumer market. DayTwo, an Israeli company, provides a meal plan that is customised for an individual’s unique microbiome to ensure optimal digestion and health. This can be especially useful for diabetics who need to manage glucose levels. MapMyGut, a UK company, also provides a nutrition app with personalised dietary advice. 

Several companies are also trying to manipulate the microbiome to treat or cure a wide range of diseases, either by creating traditional drugs or developing live organisms. 

 
Recolonising the gut

One of the most promising fields is that of restoring the gut flora of patients whose microbiome has been decimated by antibiotics or chemotherapy. MaaT Pharma, a French firm founded in 2014, is seeking to do this by taking a sample of the patient’s microbiome and using it to recolonise the gut after surgery or treatment. Alternatively, donors can be used to produce a very high-diversity microbiome. 

Such products are nearing fruition, says Hervé Affagard, the firm’s co-founder and chief executive officer. “Within 18 months we could have microbiome-based products on the market for the first time, with treatments that can be prescribed by doctors,” he says. MaaT Pharma will be launching Phase II trials – which assess the effectiveness of a product compared with existing treatments or a placebo – and many other companies will be doing the same over the next year-and-a-half. “There is a lot going on,” says Affagard.

An even more mouth-watering market is being eyed by TargEDys, which is aiming to provide solutions to weight-related conditions. In 2016, more than 1.9 billion adults worldwide were overweight, of which 650 million were obese, according to the World Health Organization, so the opportunity set is sizeable.

“We are developing products to harness gut bacteria to regulate satiety and appetite,” says Lambert. TargEDys has already proved the concept on animals and the company is aiming to release a supplement aimed at moderately overweight people in about 18 months. Assuming trials go well, this will be followed by a pharmaceutical product to control binge eating. 

“This is a problem for about 5 per cent of the population, who are subject to uncontrollable bouts of hunger in which many can almost empty an entire fridge, eating 1 or 2 kilos of food,” says Lambert. On the flipside of the dietary spectrum, the firm is exploring modes of boosting appetite for those whose calorie intake is inadequate, such as the elderly or anorexics. 

Tackling pathogens

Another approach is being taken by Paris-based Enterome. “We are seeking to eliminate harmful gut bacteria that are causing disease, while leaving the rest intact,” says chief executive Dr Pierre Belichard. “Such pathogenic bacteria get a freer rein because most people’s gut flora has been degraded by the antibiotics used in producing meat and fish.

”Belichard estimates that the diversity of gut bacteria declined by 30-50 per cent between the 1950s and 2000s. One of Enterome’s cancer-targeted projects is being conducted with pharmaceutical giant Bristol-Myers Squibb, a sign of blue-chip firms’ growing interest in the microbiome. 

Boost for IT sector

This burgeoning group of biotech start-ups is driving demand within the information technology sector too, as Lambert explains.

“Practical innovations in medicine would not be possible without advances in computational power, micro-processing, data storage and artificial intelligence,” he says. “In the analysis of the microbiome of a single individual, you can expect to find around 3 million genes and about 5,000 species. That is a huge amount of data and you need thousands of patients to start drawing solid conclusions and to identify correlations.” 

This is an expensive exercise. As a result, the IT industry stands to gain a great deal from this growth in research. CosmosID, for example, provides a web-based platform that enables microbiome firms to upload metagenomics files. It is also developing artificial intelligence routines to search for specific correlations. 

At a more basic level, food companies and restaurant chains are getting in on the act. Here, however, there is clearly a chance that some businesses will use the microbiome as a pure marketing tool or a pretext to charge inflated prices. 

“The standard of proof for effectiveness is obviously far lower,” points out de Cremoux. “Simply eating healthy food can be ‘microbiome friendly’, without the need for any fancy extras.” 

This would include a diet rich in vegetables and fermented food, like sauerkraut or yoghurt, which can promote a healthy microbiome, while overconsumption of meat can lead to an excess of sulphur-producing bacteria.

That said, some food companies are taking a greater interest in the science. Lambert cites Danish firm Chr. Hansen, a leading global supplier of probiotics, for demanding strong proof that products are useful before promoting them. The company also funds academic research into the field. In the UK, natural fast-food chain Leon Restaurants has worked with gut expert Dr Megan Rossi of King’s College London to produce a menu that promotes a healthy microbiome.

Entering the mainstream

Since 2010, when prestigious science journal Nature made the sequencing of the microbiome its cover page, there have been around 8,000 scientific publications on gut bacteria. The microbiome has thus entered the mainstream of scientific and medical research. Over the coming decade, the microbiome promises to go from being a marketing tool for yoghurt-makers and a niche for small biotech firms to a major source of revenue for drug makers, the IT firms that support them and a variety of ancillary industries 

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Microbiome Facts

1. The community of microorganisms that share our body outnumbers our own genes by 150 times, according to current estimates. 

2. Humans share around 99.3 per cent of their DNA with the rest of the species, but the overlap in microbiome DNA is just 10-30 per cent. 

3. There are about 100 trillion bacteria in or around the body. The average human has between 0.5kg to 1kg of bacteria living in their gut. 

4. A study conducted among infants showed that those who lacked diversity in gut bacteria were more likely to develop allergies, according to researchers in Copenhagen.  

5. Mice fed the bacterium Lactobacillus rhamnosus were less likely to suffer from anxiety and depression, according to research published in Proceedings of the National Academy of Sciences.

A search for microbiome in the books section of Amazon now brings up more than 350 entries”​

One of the most surprising scientific revelations of the past decade has been the outsized role that gut bacteria play in our health. The ecosystem – or microbiome – of bugs inhabiting this often-disparaged organ has huge implications for our physical and even emotional wellbeing. Scientists have been piecing together how imbalances in this microbiome can contribute to a staggering range of diseases from digestive ailments such as Crohn’s disease to seemingly unrelated conditions, such as multiple sclerosis, Parkinson’s disease, cancer and depression. 

This is making the gut bacteria a big deal for business, explains Dr Grégory Lambert, chief executive of French biotech firm TargEDys, which aims to harness bacteria to treat metabolic problems and eating disorders from binge eating to anorexia. 

“There has been a surge of interest in the microbiome across an array of industries, from biotechnology, food and supplements to information technology, digital app makers and publishing,” he says. “And as more products start to come to market, I would expect business interest in gut bacteria to continue increasing.” 

The growing public curiosity in the gut is already being fed by the publishing industry, with best-selling books by the likes of Giulia Enders (Gut: The Inside Story of Our Body's Most Underrated Organ) and Ed Yong (I Contain Multitudes: The Microbes Within Us and a Grander View of Life). A search for microbiome in the books section of Amazon now brings up more than 350 entries. The online retailer also features a burgeoning array of products related to intestinal health, from activated charcoal to aid digestion to foot rests that promote optimal posture while going to the toilet. 

In the analysis of the microbiome of a single individual, you can expect to find around 3 million genes and about 5,000 species. That is a huge amount of data”​

DayTwo, an Israeli company, provides a meal plan that is customised for an individual’s unique microbiome to ensure optimal digestion and health”​

A search for microbiome in the books section of Amazon now brings up more than 350 entries”​

Lucrative markets

But the real business potential of the microbiome centres on companies with more specialised intellectual property. At present, more than 380 firms are raising capital in the microbiome area, says Isabelle de Cremoux, chief executive of Seventure, a venture capital group specialising in digital technologies and life sciences. Seventure has a particular interest in microbiome-based therapeutics and technologies at the intersection of health and nutrition. 

De Cremoux says: “While mapping the human genome was a huge advance, the advances in disease treatment arising from this have been slow to emerge, partly because you can’t change a person’s genome. The difference with the microbiome is that having sequenced it, you can change its composition – adding new strains, killing others and changing the interaction between the gut and the body.” 

But she warns there is a danger of hype. “Even if diseases can be understood, it does not mean we can correct the microbiome easily and many diseases are caused by many factors, so manipulating the microbiome alone might not prove sufficient,” she argues. That said, there is clear potential for smart firms to unlock large and lucrative markets. 

Powerful tool

First, consider diagnostics. A breakdown of the microbiome can provide clues as to what a patient is suffering from and how they will respond to certain drugs. As such, it is becoming a powerful tool for diagnosis and treatment. Ensuring that treatments are given only to patients who are likely to benefit has the potential to reduce both side-effects and medical costs.

Mapping the microbiome can also help to determine the best food choices for each individual. 

Several firms are starting to tap into this consumer market. DayTwo, an Israeli company, provides a meal plan that is customised for an individual’s unique microbiome to ensure optimal digestion and health. This can be especially useful for diabetics who need to manage glucose levels. MapMyGut, a UK company, also provides a nutrition app with personalised dietary advice. 

Several companies are also trying to manipulate the microbiome to treat or cure a wide range of diseases, either by creating traditional drugs or developing live organisms. 

 

DayTwo, an Israeli company, provides a meal plan that is customised for an individual’s unique microbiome to ensure optimal digestion and health”​

Recolonising the gut

One of the most promising fields is that of restoring the gut flora of patients whose microbiome has been decimated by antibiotics or chemotherapy. MaaT Pharma, a French firm founded in 2014, is seeking to do this by taking a sample of the patient’s microbiome and using it to recolonise the gut after surgery or treatment. Alternatively, donors can be used to produce a very high-diversity microbiome. 

Such products are nearing fruition, says Hervé Affagard, the firm’s co-founder and chief executive officer. “Within 18 months we could have microbiome-based products on the market for the first time, with treatments that can be prescribed by doctors,” he says. MaaT Pharma will be launching Phase II trials – which assess the effectiveness of a product compared with existing treatments or a placebo – and many other companies will be doing the same over the next year-and-a-half. “There is a lot going on,” says Affagard.

An even more mouth-watering market is being eyed by TargEDys, which is aiming to provide solutions to weight-related conditions. In 2016, more than 1.9 billion adults worldwide were overweight, of which 650 million were obese, according to the World Health Organization, so the opportunity set is sizeable.

“We are developing products to harness gut bacteria to regulate satiety and appetite,” says Lambert. TargEDys has already proved the concept on animals and the company is aiming to release a supplement aimed at moderately overweight people in about 18 months. Assuming trials go well, this will be followed by a pharmaceutical product to control binge eating. 

“This is a problem for about 5 per cent of the population, who are subject to uncontrollable bouts of hunger in which many can almost empty an entire fridge, eating 1 or 2 kilos of food,” says Lambert. On the flipside of the dietary spectrum, the firm is exploring modes of boosting appetite for those whose calorie intake is inadequate, such as the elderly or anorexics. 

In the analysis of the microbiome of a single individual, you can expect to find around 3 million genes and about 5,000 species. That is a huge amount of data”​

Tackling pathogens

Another approach is being taken by Paris-based Enterome. “We are seeking to eliminate harmful gut bacteria that are causing disease, while leaving the rest intact,” says chief executive Dr Pierre Belichard. “Such pathogenic bacteria get a freer rein because most people’s gut flora has been degraded by the antibiotics used in producing meat and fish.

”Belichard estimates that the diversity of gut bacteria declined by 30-50 per cent between the 1950s and 2000s. One of Enterome’s cancer-targeted projects is being conducted with pharmaceutical giant Bristol-Myers Squibb, a sign of blue-chip firms’ growing interest in the microbiome. 

Microbiome Facts

1. The community of microorganisms that share our body outnumbers our own genes by 150 times, according to current estimates. 

2. Humans share around 99.3 per cent of their DNA with the rest of the species, but the overlap in microbiome DNA is just 10-30 per cent. 

3. There are about 100 trillion bacteria in or around the body. The average human has between 0.5kg to 1kg of bacteria living in their gut. 

4. A study conducted among infants showed that those who lacked diversity in gut bacteria were more likely to develop allergies, according to researchers in Copenhagen.  

5. Mice fed the bacterium Lactobacillus rhamnosus were less likely to suffer from anxiety and depression, according to research published in Proceedings of the National Academy of Sciences.

A breakdown of the microbiome can provide clues as to what a patient is suffering from and how they will respond to certain drugs. As such, it is becoming a powerful tool for diagnosis and treatment”​

Boost for IT sector

This burgeoning group of biotech start-ups is driving demand within the information technology sector too, as Lambert explains.

“Practical innovations in medicine would not be possible without advances in computational power, micro-processing, data storage and artificial intelligence,” he says. “In the analysis of the microbiome of a single individual, you can expect to find around 3 million genes and about 5,000 species. That is a huge amount of data and you need thousands of patients to start drawing solid conclusions and to identify correlations.” 

This is an expensive exercise. As a result, the IT industry stands to gain a great deal from this growth in research. CosmosID, for example, provides a web-based platform that enables microbiome firms to upload metagenomics files. It is also developing artificial intelligence routines to search for specific correlations. 

At a more basic level, food companies and restaurant chains are getting in on the act. Here, however, there is clearly a chance that some businesses will use the microbiome as a pure marketing tool or a pretext to charge inflated prices. 

“The standard of proof for effectiveness is obviously far lower,” points out de Cremoux. “Simply eating healthy food can be ‘microbiome friendly’, without the need for any fancy extras.” This would include a diet rich in vegetables and fermented food, like sauerkraut or yoghurt, which can promote a healthy microbiome, while overconsumption of meat can lead to an excess of sulphur-producing bacteria.

That said, some food companies are taking a greater interest in the science. Lambert cites Danish firm Chr. Hansen, a leading global supplier of probiotics, for demanding strong proof that products are useful before promoting them. The company also funds academic research into the field. In the UK, natural fast-food chain Leon Restaurants has worked with gut expert Dr Megan Rossi of King’s College London to produce a menu that promotes a healthy microbiome.

A breakdown of the microbiome can provide clues as to what a patient is suffering from and how they will respond to certain drugs. As such, it is becoming a powerful tool for diagnosis and treatment”​

Entering the mainstream

Since 2010, when prestigious science journal Nature made the sequencing of the microbiome its cover page, there have been around 8,000 scientific publications on gut bacteria. The microbiome has thus entered the mainstream of scientific and medical research. Over the coming decade, the microbiome promises to go from being a marketing tool for yoghurt-makers and a niche for small biotech firms to a major source of revenue for drug makers, the IT firms that support them and a variety of ancillary industries 

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Bridgepoint  |  The Point  |  November 2018  |  Issue 34