Karolinska Institutet

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Examining Bacterial Flora in the First Trimester of Pregnancy?

Ina Schuppe Koistinen is an associate professor and lecturer at the Karolinska Institute in Sweden. She also works at the Center for Translational Microbiology Research to study the role of bacterial flora in inflammatory bowel diseases and women’s health. In addition to research, she is passionate about yoga and guiding people to a healthier lifestyle. She is also an active artist.

Could a bacterial sample at the beginning of pregnancy predict if the child will be born prematurely or if the newborn mother will suffer from postpartum depression(PPD)? These are some of the questions that Ina will be shedding some light onto for us today.

Today, I am going to tell you about the Swedish Maternal Microbiome Project (SweMaMi) – Sweden’s most exciting research project in women’s health (in our opinion anyways) that investigates how the bacterial flora affects both mother and child during pregnancy. The SweMaMi study is conducted by our research team at the Karolinska Institute in collaboration with Söder Hospital in Stockholm. The goal is to reduce the number of pregnancy complications in the future, such as premature delivery.

In today’s medical community it is still unknown why some births start too early or why some women suffer from Preeclampsia or PPD. All of which can imply major health risks to the child and/or mother. Smaller studies on fewer than one hundred women have shown that an adverse bacterial flora in the vagina has led to premature births. Those who give birth prematurely tend to lack bacteria from the Lactobacillus family. However, a more detailed study is needed to prove this hypothesis. The aim of the SweMaMi study is therefore, to collect samples from 2,500 pregnant women to create a representative picture of pregnant women’s bacterial flora (in Sweden). Research has shown that a strong connection between the intestinal bacterial flora and the brain allows them to communicate with each other and in return, affect our mental health. Hence why we take bacterial samples from the mouth and the intestine as well as the vagina.

All women throughout all of Sweden can join. The study is aimed at women who have not yet reached week 19 of their pregnancy. During pregnancy, samples are taken on two occasions and questionnaires are collected about the women’s lifestyle, health, eating habits, illnesses, stress, bowel function and several other things. After the child has been born a concluding test is taken.

By mapping the bacterial flora in pregnant women and coupling that with the questionnaire responses, we want to understand if certain bacteria are associated with a higher risk of complications and which bacteria could potentially offer more protection. The goal is that healthcare would be able to detect women who are at risk by taking a simple bacterial sample early in the pregnancy and thereupon be able to take preventive action. I will update here and share the results with you eventually as we conclude the study.

Want to help reduce early premature births? Tell expecting mothers you know about our study. And if you are pregnant, don’t forget to eat a diet that promotes the good bacteria and sign up to join our study at www.swemami.se. You are also welcome to follow us on Facebook and Instagram: SweMaMi.

You can make a difference!

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Karolinska Institutet

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Food for Thought – Our Bacteria Are Also Controlled by Epigenetics

Louise Sjöholm has an undergraduate degree in molecular biology as well as a doctorate in depression genetics from the Karolinska Institute. For the last seven years, Louise has worked in the epigenetic field and researches the role of the gastrointestinal tract in relation to autoimmune diseases, i.e. diseases where the body’s own immune system attacks its own tissue. Furthermore, she seeks to broaden our understanding of the epigenetics of bacteria and what connections there are to health and disease.

In my previous post here at Food Pharmacy, I wrote about epigenetics, which to repeat is – the link between inheritance and the environment, in conjunction with their important role in both disease and health. Interestingly, there is more that is affected by the environment (through, for example, what we eat) than just our DNA. This also applies to the bacteria both within and upon our bodies and their genetic coding. They, just as we, are controlled by epigenetic mechanisms.

The epigenetics of bacteria and its connection to diseases is a relatively unexplored area. Quite odd seeing as that, we are in fact only “10% human” – the rest of us is actually made up of bacteria and other microorganisms. We are merely landlords. This, broken down means that, for each cell in our body there are nine times as many microbes in and on us!

There is research which shows that bacteria can actually affect our own epigenome. For example, studies have shown that, that is exactly how the stomach ulcer bacteria Helicobacter pylori works to induce stomach cancer: through epigenetic mechanisms that fight our defense against this bacteria. And even changes within bacterias own epigenomes could potentially contribute to various diseases, due to their basic functions being steered by epigenetic mechanics. Imagine for example, that bacterias production of serotonin, vitamin B12 and vitamin K become disrupted. Surprisingly, some bacterias ability to infect and make us sick (e.g., Escherichia coli, Salmonella and Vibrio) also seem to be partly controlled by epigenetic mechanisms.

My research attempts to, among other things, understand and investigate the epigenetic changes of bacteria, primarily DNA-methylation. This is to determine if there are connections to various diseases. I am developing a new method that can be used to study the most common epigenetic modification of bacteria: methylation of the DNA base A. I hope this new technique will serve as a first screening method and complement the other expensive and more time-consuming methods available. Thus, that we will then be able to understand more about the interaction between us and our bacteria, the tenants.

Perhaps it’s time for us epigeneticists to start studying the remaining 90% of what we call our body?

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Karolinska Institutet

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The Link Between Gut Bacteria and Cancer Treatment

Lars Engstrand is a physician and professor at Karolinska Institutet in Stockholm, and the director of Centre for Translational Microbiome Research (CTMR). For more than 30 years, he has been studying the microorganisms in the gastrointestinal tract, and he was one of the first to study the intestinal flora with new and powerful DNA techniques. In his spare time, Lars enjoys singing and is a member of the male choir Orphei Drängar.

Why do people with cancer respond differently to cancer treatment? In recent years, outcomes for cancer patients have improved thanks to so called immunotherapy, a type of treatment that engages the immune system to attack tumors. Immunotherapy has proven to be effective, and some say it is set to revolutionize the treatment of cancer. However, some patients respond better than others, and in around two-thirds of people, cancers are resistant to this type of treatment. For a while now, researchers have been trying to figure out why. Immunotherapies unleash the body’s immune system to fight cancer cells – why patients respond differently to this treatment remains a mystery.

New research is showing a link between a person’s gut microbiome and the effectiveness of cancer immunotherapy. It seems like the bacteria found in a patient’s digestive tract can in fact affect the outcome of the treatment. Understanding which patients will benefit from immunotherapy is a big challenge, and this research is a step towards identifying these people. Certain bacteria seem to boost the effectiveness of the treatment and, if we alter the composition of the microbiome, we may be able to influence the outcome of the treatment and help the body’s immune system fight the disease.

Clinical studies of how to improve responses to immunotherapy are underway. In some studies, cancer patients are given supplements of cultivated bacteria from people who have previously responded well to immunotherapy. In others, researchers are exploring the possibility of altering patients’ gut bacteria through microbiota transplants from people with strong responses to these therapies. All in the hopes of helping the immune system to recognize and better attack the cancer cells.

These are very early-stage studies. How some bacteria are able to trigger our immune system to fight the cancer is still unknown, and researchers from both America and Europe are looking for answers. Changing your eating habits is another way to affect the microbiome, and thereby influence the effectiveness of immunotherapy. But more research has to be done. However, a widely accepted hypothesis is that a good gut microbiome can join the fight against cancer.

Our group of scientists is exploring the gut microbiome in the healthy population, in hopes of understanding what makes up a healthy microbiome and how it affects the human body. In the future, this will help us evaluate the role of probiotic supplements in the treatment or prevention of various diseases.

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Karolinska Institutet

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Microbiome-Friendly Food Will Keep Your Vagina In A Good Mood

Ina Schuppe Koistinen is an Associate Professor and Alliance Director at the Centre for Translational Microbiome Research (CTMR), at Karolinska Institutet in Stockholm. Through her research, she is exploring the human microbiome and its connection to inflammatory bowel diseases and women’s health. She loves yoga and is passionate about helping others make healthy lifestyle choices. She is also an artist, specializing in watercolor painting.

Bacteria and other microorganisms are found everywhere within and on the surface of our bodies, such as in our intestines, on our skin and in our mouths. Most of them are good for our health. Earlier scientists thought that babies are born sterile but that may not be true. At delivery, the mover passes microbes onto the baby as the newborn passes through the birth canal. Babies born by C-section pick up microbes from the mother’s skin and the hospital environment. There are also bacteria in breast milk that will influence the newborn baby’s health and gut flora. Another type of bacteria that have significant implications for a women’s overall health is the vaginal flora. Despite its importance, surprisingly little is known about the composition of a healthy vaginal flora. Our researcher group is trying to get to the bottom of this.

Most women have a large amount of Lactobacillus bacteria in their vaginal tract. They help maintain a low vaginal pH, which creates an unfriendly environment for “bad” bacteria like Chlamydia, Gonorrhea and Gardnerella (that is associated with a smelly vaginal discharge and Bacterial Vaginosis). The fungus Candida can survive in a wide range of pH levels, but in a more alkaline environment that lacks Lactobacilli, Candida is more likely to overgrow and cause symptoms.

A healthy vaginal flora is made up of many different types of bacteria, the predominant bacteria being Lactobacillus. They are superheroes and play a key role in defending against infection. But how can you encourage lactobacilli to thrive in your vaginal microbiome? The answer is simple: lead a healthy lifestyle, eat a varied diet, exercise and practice safe sex. Another good tip is to combat vaginal dryness by avoiding soap that can affect the pH levels in the vagina and cause irritation.

Studies suggest that probiotic Lactobacillus has a beneficial effect on the vaginal microbiome. It’s a fascinating thought that these little bugs travel all the way from the intestines to the vaginal tract. Isn’t it incredible how these things work?

To define the composition of the vaginal microbiome in adult women, our group of scientists has initiated a number of large clinical studies, in collaboration with Uppsala University Hospital and Professor Matts Olovsson. The study is called VaMiGyn (Vaginal microbiome and gynecological health) and we investigate the relationship between changes in the vaginal flora and the development of cervical cancer.

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