Karolinska Institutet

Post image

Saving the Antibiotic for Future Generations

World Health Organization (WHO) has classified the global issue of antibiotic resistance as a major threat to public health. In just Europe alone, approximately 30,000 deaths per year occur from infections with resistant bacteria and this figure is expected to have doubled in the next ten years.

In some countries, when there is risk of infection of such bacteria, the risk alone is causation enough to cancel a scheduled operation. Should we just give up then or is there light at the end of the tunnel? Well, first of all, we must change our behavior and not use antibiotics unnecessarily. Antibiotics should, in principle, be used to save lives and not for banal viral infections or colds. But if we want to save the antibiotic for future generations, new alternative treatments for infections with resistant bacteria must also be tested. These such trials are what is currently ongoing at the Center for Translational Microbiome Research, CTMR.

An alternative that seems promising is to compete the resistant bacteria in the intestinal flora with a “good microbiome” i.e., good intestinal flora. Currently ongoing in the laboratory is an experiment where resistant bacteria are supplied with a disturbed intestinal flora in test tubes and we then add “healthy intestinal flora” from a healthy donor. It is the same principle used in so-called fecal transplantation (FMT) where patients with diarrhea caused by certain antibiotics are cured with a healthy donor intestinal flora. We hope to be able to identify healthy donors whose intestinal flora can, in the future, help to compete with resistant bacteria in the intestinal flora of people who unknowingly carry. In this way, we can also reduce the risk of spreading resistant bacteria outside the body.

Another way to kill disease-causing resistant bacteria is phage therapy. Here, target-seeking viruses are used to eliminate the desired bacteria, usually with great precision. Phage therapy has long existed as a treatment option in Georgia and other post-Soviet states, but when the antibiotic entered the scene about 60 years ago the technique has not developed or advanced, as many thought antibiotics were the solution to all infectious problems. Now the researchers are beginning to realize that phage can be a good alternative when antibiotics cannot be used. Phage therapy also has the advantage that it does not interfere with the intestinal flora, which has proven to be a problem in antibiotic treatment, where even “good” bacteria are eliminated as well.

At our center, several trials are now underway. One of which we use test tubes containing good intestinal flora, then we add resistant bacteria and lastly the phages that kill them. Our results show that the phages do not disturb the intestinal flora at all and that the number of resistant bacteria decreases markedly in the test tube. The next step is to transfer this principle to humans. Today, there are occasional reports of successful treatment in patients where antibiotics did not work and where the patient’s life was rescued thanks to phages who did the job instead. A combination of phages therapy as well as supplying a dose of good intestinal flora could also be tested in some patients.

If we can prevent the spread of resistant bacteria by changing our behavior while developing new alternative treatments for infections with resistant bacteria then hope is not out. Then future generations can also use antibiotics when needed, i.e., to save lives.

Lars Engstrand is a doctor and professor at Karolinska Institute and leads the work at the Center for Translational Microbiome Research. He has been studying microorganisms in the gastrointestinal tract for over 30 years and is one of the pioneers in studying the role of the gut flora in health and disease.

Share

Comment

Karolinska Institutet

Post image

A Mummy’s Diet

Two weeks ago I was on a visit to Bolzano in northern Italy. I was visiting as an expert on a scientific council to evaluate the research at the EURAC Institute for Mummy Research. In Bolzano is a museum which is home to the 5300-year-old iceman, Ötzi. Eight years ago he was thawed for just a few hours and I alongside other researchers were able to examine Ötzi.

Researchers from many different fields of research took a variety of samples from the stomach and intestines, among several other things. We have since collaborated with research colleagues in Italy, the United States, Germany and Austria to study the stomach contents of Ötzi and with new technologies, mapped residuals of proteins, fat and genetic material. We came to the conclusion that Ötzi was an omnivore who was well equipped for his hiking in the Alps for that time. He needed a lot of energy, and his diet contained a lot of fat that could be likened to today’s LCHF diet i.e., high fat and low carbohydrates. His last meal before he died consisted of red meat (mountain goat and deer), grains and some spices. He also cooked the food in a way that is similar to the smoking of meat.

In a few weeks, a state-of-the-art laboratory will be opened at EURAC to study mummies from different parts of the world. An important part is to ensure that the sample you are analyzing truly comes from the mummy itself and not from the environment. For example, in the study of intestinal flora, one must be very careful in the preparation of the sample so that no bacteria in the environment pollute the sample.

The new laboratory in Bolzano has specially designed premises to ensure this. In collaboration with us at the Center for Translational Microbiology, researchers at EURAC are working to map the intestinal flora of Ötzi with new impressive DNA technologies. The intention is to compare his intestinal flora with the intestinal flora of people today. We will also collaborate to study the stomach content and hence the diet of other well-preserved mummies from different parts of the world. There are mummies in Mexico, Peru, Switzerland, Egypt and China that are so well-preserved that the intestinal flora and perhaps dietary remnants can be mapped in the same way as Ötzi.

We hope to find out more about how people lived thousands of years ago. In addition, we can deepen our understanding of how intestinal flora looked with the diets of previous times . Who knows – we may have a Bronze Age diet on the Christmas table next year.

Lars Engstrand is a doctor and professor at the Karolinska Institute and heads the department at the Center for Translational Microbiology Research. He has studied microorganisms in the gastrointestinal tract for over 30 years and was one of the pioneers to study intestinal flora with new DNA techniques.

Share

Comment

Karolinska Institutet

Post image

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!

You’re more than welcome to follow us on Facebook and Instagram.

Share

Comment

CONNECT WITH US:

Karolinska Institutet

Post image

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?

You’re more than welcome to follow us on Facebook and Instagram.

Share

Comment