New Paper: Stool Microbiota and Vaccine Responses of Infants

As part of getting my blogging groove back on, I thought I would talk about my part in this new paper. Together, Nazmul (the first author) and I analyzed the gut microbiota of a large cohort of infants in Bangladesh, paying extra attention to the bifidobacteria. Nazmul (and others) did a ton of work looking at the response to various vaccines in these infants. We found that the response to some vaccines was better in infants that had higher levels of bifidobacteria.

A couple of things of note about my contribution to this paper:

1) The correlations between vaccine response and the microbiota sometimes differed between species and subspecies of bifidobacteria, which means that A) not all bifidobacteria are equal, and B) that the effects can be correlated to a manageable set of genes. We were able to trace the effects down to subspecies level within the B. longum group thanks to a new method that I helped develop, which should be getting it's own paper soon.

2) The levels of bifidobacteria in these infants were really high compared to some other cohorts I have seen or studied myself. This was despite the high rate of c-section birth noted in the paper. I find this super interesting.

3) Parents, please vaccinate your kids so that stuff like this and this doesn't happen. Herd immunity is a real thing. When you choose not to vaccinate your child, you put other kids who can't get vaccinated for whatever reason (immunocompromised, etc.) or for whom vaccines don't work at risk. No matter what type of bacteria live in your child's gut, vaccination is almost assuredly better than no vaccination.

Anyway, I was glad to use my Bif-TRFLP technique on a new set of infants and be involved in this cool study. Grad school has given me the chance to collaborate on projects with a lot of great people on interesting things. I'm glad Charles Stephensen got interested in gut microbes and started this collaboration with my advisor. I'm increasingly convinced that collaborations are the best way to do impactful research. It's so hard to be an expert in all the relevent aspects of today's unsolved problems.

New Paper: A Comparison of Two Probiotic Strains of Bifidobacteria in Premature Infants

I wanted to write a little about my small part in this paper. My work in this collaboration is one of the times when I have most felt that I was making a real-world impact. Mark Underwood, the lead author on this paper, is a neonatologist and assistant professor at the UC Davis Medical Center, where he practices medicine in the neonatal intensive care unit (NICU) and cares for premature infants ("premies"). He had a use for the tool that I developed in my Bif-TRFLP paper, so I got to participate in this cool study.

A premie and its tiny little feet
from https://www.ucdmc.ucdavis.edu/children/clinical_services/NICU/

One of the major issues that premies face early in life is necrotizing enterocolitis (NEC), which is thought to arise in part due to imbalance in the gut bacterial community. Premies have underdeveloped intestinal tracts that are extra prone to infections. Probiotics have often been used to try to prevent this life-threatening disease, at least some of the time successfully. The idea is that the good bacteria can help the immature gut resist colonization by pathogens by taking up all the space, eating all the "bacteria food," and producing antimicrobial metabolites. There has been a lot of debate about which strains of probiotics to use, and how best to use them. This paper tested a few different supplementation mixes and how they affected the microbial community in the gut of premies. It showed some interesting results about improving the diversity of the community, improving levels of beneficial bifidobacteria, and showed species-level differences in the efficacy of the intervention. Here is a link to the paper.

My part in this paper was to use my Bif-TRFLP technique to figure out which species of bifidobacteria were found in the guts of some of Mark's NICU infants: before, during, and after a variety of treatments. I discovered that B. infantis, a strain that is known to eat the oligosaccharides (sugars) found in breast milk, colonizes infants better than the B. lactis strain we tested. When given breast milk the B. infantis strain was the dominant bifidobacteria in the infants, even if they were given B. lactis and not B. infantis. 

This begs the question of how the babies that were given B. lactis ended up colonized by B. infantis instead. They take lots of precautions in the NICU to try to avoid spreading bacteria around the environment, and try to keep these fragile infants from being exposed to harmful bugs like those that cause NEC. (You can take a look at the set-up they have in this really cool virtual tour of the NICU.) This work seems to show that the B. infantis floating around the NICU (maybe from the infants inoculated with it, stray inoculum itself, or just normal environmental strains, who knows!) can outcompete the non-human-milk-adapted B. lactis strain as long as they are given breast milk. The environmental B. infantis probably gets into the infant in much lower numbers than the comparatively massive B. lactis supplementation given to the study babies, so this is a remarkable finding.

This just goes to show the importance of strain specificity to an environment. Not all probiotics (or bacteria in general) are created equal, and they are not always well adapted to a given set of conditions. I really like being a microbial ecologist because it gives me the tools to answer questions like these. Evolution drives microbial community structures, and thinking about how that affects real world problems is a really rewarding exercise to me.

UPDATE- This work was profiled in the press. See here

New paper: Establishment of a Milk-Oriented Microbiota (MOM) in Early Life: How Babies Meet Their MOMs

A new paper just came out on which I am an author:

Establishment of a Milk-Oriented Microbiota (MOM) in Early Life: How Babies Meet Their MOMs. (Functional Food Reviews, Vol 5, No 1 (March), 2013: pp 3–12). Authors: Angela M. Zivkovic, PhD, Zachery T. Lewis, BS, J. Bruce German, PhD, David A. Mills, PhD

Link to the paper here if you have an institutional or other subscription.

I did not come up with the term "MOM" (Dave Mills did) but I thought it was brilliant, and I am glad to be part of the paper that coined the term. Its a good way to emphasize the importance of bacteria in helping a baby grow and thrive.

Little Johnny just found out he has TWO moms! (A Mom and a MOM.)
From http://www.flickr.com/photos/56323141@N00/2658949664

This paper is a review paper that talks about some of the latest research on how breast milk influences the microbes that live in babies. There are some components that help good bacteria grow (like the funky short sugar chains that good bacteria can eat) and some components that stop bad bacteria from growing (proteins that act like antibiotics, antibodies, and decoy molecules that fool pathogens into thinking they have attached to a cell and stop them from infecting us).

In this paper we talk about all the benefits that come from having a good mix of bacteria or "microbiota" in a baby. Associations have been found with the microbiota that include resistance to infection, reduced allergies, and reductions in other inflammatory conditions. There are even initial hints that autism might have a microbial component. This all suggests that having microbiota that doesn't cause inflammatory reactions early on in life might be important to educate our bodies about what is friend and what is foe.

The theory is that if the body has not-so-friendly bacteria in it early on, it seems to be hypersensitive to common allergens later in life. Bifidobacteria are very commonly found in breast-fed infants and seem to meet this non-inflammatory criteria. There is some evidence to suggest that they help calm the immune system down and keep the wrong things from getting to places where they might start triggering immune responses.

The "hygiene hypothesis" states that a lack of exposure to things that our distant ancestors commonly encountered ("dirty" things like feces and parasites and ... dirt) leads to our immune system overreacting to things that aren't really bad. As if it just gets bored and wants something to do, so it picks a fight with pollen or your cat's dander.

Felis catus, a common source of allergens. Sorry, I couldn't find an actual photo of one anywhere on the internet. Strange. I mean, I knew that very few people upload baby pictures, but it seems cats are even less common...

Some people think that if you have enough good bacteria around to keep the immune system busy monitoring harmless things it won't learn to react to the wrong things. With the recent explosion in pre-term and c-section births (both not nearly as survivable before modern medicine, and which are known to cause the baby to not get as healthy of a microbiota as easily) and the decline in breastfeeding, it seems possible that this could lead to at least some of the difference we observe in how many people in the "first-world" get allergies compared to how few people get them in the "third-world." Historically, mothers breast-fed their infants for a lot longer. They would continue to breast feed while weaning, a process which lasted a lot longer than it does now. The presence of the ingredients in breast milk and the bacteria they enrich might have helped keep the immune system from reacting to things like gluten and other common food allergens as they were introduced to the child.

C-section and pre-term births often cause altered microbiota profiles in the infant, which may have to do with problems in getting good microbiota from the mother. Shortly before this paper was published, but after it was submitted, Seth Bordenstein et al. came out with a really nice paper about how mothers pass on microbes to their infants across many species, not just humans (link here). You can go there for more details. I would have cited this paper it if it had been out.

One other point we made, which I though was important, was that diversity in an ecological community is not necessarily always a good thing. The common assumption I have seen many papers make is that a more diverse community is more stable and resistant to disturbances, and is always better. It may be that early on a more controlled community that is less diverse but maintained by specific inputs from the mother might be the better way to go for the overall health of the infant. A new Nature paper just came out on this subject, here.

Anyway, I thought we wrote a a nice overview paper if you are interested in learning about the benefits of babies being seeded with "good" microbes.

Conference Report: NIH "Human Microbiome Science: Vision for the Future" conference, Bethesda MD

I got back from this conference a couple a little while ago. I had the opportunity to present a poster of some of my work, and a chance to hear from some of the biggest names in the field of microbiome research. You should be able to watch individual talks as soon as they put them up here.

The idea behind this conference was to get feedback from scientists in the area about what the current state of our knowledge is, and to hear about what challenges and difficulties lie in the way of further progress. It was an impressive effort from the NIH people to figure out why they should be funding microbiome research and where the funding would do the most good. With the first phase of the Human Microbiome Project drawing to a close, it was a good chance to stop and organize and plan out what comes next.

I learned a lot about how NIH funding works, what the sub-institutes are, and what they fund. I got to meet a program officer and hear a talk from NIH Director Francis Collins, he of the Human Genome Project fame. I also got to hear talks from such luminaries as Rob Knight, Curtis Huttenhower (Nice guy!), Peter Turnbaugh, Ruth Ley, and Ed Yong (one of the best Twitter follows I ever made). My favorite talk was probably by Maria Gloria Dominguez Bello, who talked about the microbiomes of uncontacted indigenous tribes in Venezuela.

This was also my first time in Washington D.C.. I took the metro downtown one night to have dinner with my PhD advisor and his old PhD advisor (my grand-advisor?), Gary Dunny. Meeting him was a cool opportunity. I liked the atmosphere of the part of D.C. we went to.

I really think there is a bright future ahead in microbiome research, with discoveries just being made about the interactions of the microbiome with hormone regulation, autism development, new probiotics, immune system regulation and autoimmune disease, fecal transplants (So relatively unstudied! So exciting!), and obesity.

And who's to say scientists don't have a sense of humor! My advisor got a chuckle using this sign to talk about correlation vs. causation.

What order these go in makes for very different stories!

Another speaker used this video to talk about the seeking NIH funding in the current funding climate and overcoming challenges along the way. (The cheese is the funding, the grant applicant is the mouse)



I'll be speaking at two conferences between now and October, so this is not the end of conference season for me. It's nice to be able to do conferences at this stage of my PhD and talk about my data.