From Cancer to Alzheimer's Disease: Scientists Call for a Major International Human Microbiome Research Initiative

The microbiome is the collection of trillions of microorganisms that play a role in immune function and metabolism. Researchers suggest that changes in the microbiome may be associated with the rising prevalence of obesity, asthma and food allergies. Factors such as antibiotic use, cesarean delivery, formula feeding and diets high in heavily processed foods can influence the composition of microbial communities.

However, many of the associations identified so far do not prove that microbiome changes directly cause disease. Large-scale controlled studies with long-term follow-up are needed to establish causal relationships.

The authors outlined ten research priorities grouped into four areas: advancing the scientific foundations, developing clinical treatments, investigating the most promising opportunities and educating the public. They called for common research standards across countries so that findings could be compared and combined. Particular attention should be given to pregnancy and early childhood.

According to the researchers, one of the most critical periods is the first 1,000 days of life, from pregnancy through a child's second birthday. During this time, the microbiome develops rapidly. Scientists want to determine whether changes associated with factors such as antibiotic use in infancy or cesarean delivery can increase the risk of metabolic and allergic diseases later in life. To investigate this, they propose following children from pregnancy through adolescence and evaluating potential preventive interventions.

Some microbiome-based treatments are already in use. The US Food and Drug Administration (FDA) has approved Rebyota and Vowst, products containing microorganisms derived from donated human fecal material. They are used to prevent recurrent Clostridioides difficile infections in adults following antibiotic treatment.

Other promising research directions include investigating how gut microorganisms affect the effectiveness of cancer immunotherapy and exploring potential links between the gut and the brain in Parkinson's disease and Alzheimer's disease. However, the effectiveness of these approaches must be established separately for each condition.

The researchers also propose incorporating current knowledge about the microbiome and nutrition into medical education and school curricula. In addition, they recommend assessing how medications, dietary supplements and environmental factors affect the human body's microbial communities.