Wednesday, January 17, 2024

Microbiomes: The middle road to understanding


     "Western" medicine is excellent on the mechanics of the body -- replacing a hip, changing out a lens for the eye, insert a replacement cochlea, add an artificial replacement limb, and so forth. When it comes to working with the biochemistry of the body, it is more hit-and-miss and many discoveries have been serendipitous findings rather than the tail end of a focused search. Some aspects of interactions have been investigated and understood but, still, more from the point of view of mechanics -- receptacle points, chemical reactions, and enzymal subsystems.

     "Eastern" medicine has a longer history of treating the body, mind, and functioning as a holistic system -- recognizing that the mind (whatever that is), soul (whatever that is), and body all interact to make us live, react, and process life the way that we do. There is a tradition of building up longtime knowledge of the effects of various herbs, foods, and other substances with the way the body works. The manner in which such substances interact with the body are subsumed into spiritual, and traditional, teachings which often use words without specific "western" definitions.

     All approaches, and knowledge, can be of benefit.  Divisions between areas of knowledge are only useful for classification. "Western" medicine is becoming more interesting in energy aspects, such as chi. "Eastern" medicine is more allowing of the uses for engineering aspects of treating bodily ailments. Perhaps at some point, no divisions or classification will shine out.

     One area of development which is more in the "middle" of such development is research into the microbiomes of the body. As a recent "Gates Notes" blog indicated, a large percentage of our bodies are actually cells not directly part of the body. Most of such are beneficial and many are symbiotic. His blog emphasizes uses of pro- and prebiotics to help the microbiome in their tasks and provide a better symbiosis with the body. There are also books on microbiomes, a major tome of which is "I Contain Multitudes" by Ed Yong.

     Gates' blog emphasizes the role of the microbiome as applied to treatment of malnutrition. My own older blog on microbiomes (perhaps of interest to read, from May 25, 2015) covers some of the various important microbiomes -- including that on the skin which can provide a first point of defense for intruders into the body as well as the effect of the microbiomes may play with systemic diseases such as diabetes and asthma.

     I point out that a large problem with the transformation of our microbiomes is that manipulation can be very difficult to achieve. The upper digestive tract -- which should be the most direct route to the environment of the lower digestive tract, acting as a home for a major microbiome -- destroys most of any pre- or probiotics that try to enter via the route of ingestion. Substitution from the other direction (not necessarily for the squeamish) works much better but has the problem of being more of a "mallet" approach where it is not a manipulation but, rather, an attempt to conquer the old microbiome by a newer, hopefully healthier, microbiome.

     One side-effect of being aware of the existence of the microbiomes on, and inside, our bodies is that it has become much more obvious that it is wrong to say "kill all the bacteria" or "stop all the viruses". In fact, although antibiotics have been literal lifesavers to prevent major harm from bad bacteria, antibiotics may also contribute to more general illnesses (diabetes, arthritis, cancer, etc.) as a result of killing off helpful good bacteria.

     Note that there will never be ONE general population of microbiomes because each environment supports different situations. Someone who has rice as their principal food will support different creatures in their microbiome than someone who has wheat bread as their dominant food (and even different for those who have cola soft drinks as THEIR dominant calorie intake). A person living in near constant heat will have a different skin microbiome than someone who lives (or, with climate change, lived) in sub-freezing temperatures year-round.

     One of our challenges in this investigation is inventories. Just what viruses and bacteria are present in, and on, our bodies? What are their side-effects from living? What helps the good ones (which are typically dominant)? What hinders the specific bad ones (the methods we have do not discriminate well between beneficial inhabitants and those that are bad). We are aware that traditional uses of antibiotics are losing their usefulness as bacteria adapt to resist the medicines. Knowledge of our microbiomes will require us to understand well enough to tailor medicines against specific creatures rather than "all" creatures.

     After inventories -- knowing what, and what they do -- we need methods of manipulation. Pre-, pro-, and regular biotics might be encapsulated such that they only become vulnerable after the digestive process has completed its task of breaking down food into components. "Good" cultures could be maintained outside of the body and used to supplement existing microbiomes.

     Whatever emphasis is taken, our bodies ARE indeed houses for many. Some religious scriptures may refer to our bodies as temples and occupational spaces for the gods. We need good neighbors within our bodies as well as in the outside world between people. Finding methods of understanding these interior worlds of interacting cells may be as difficult as understanding of the outer world but both can be of great benefit and worth the effort;

To Waste or to Waist: That is the question

       As is true of many people growing up in the US, I was encouraged to always clean my plate (encouraged is putting it mildly -- I remem...