By Gail A. Hecht, MD, MS, AGAF, Loyola University Medical Center, chair of the AGA Center for Gut Microbiome Research and Education scientific advisory board.
AGA established its Center for Gut Microbiome Research and Education in 2012 as the microbiome was just beginning to explode in the scientific literature. I have been privileged to chair the center’s scientific advisory board over the last three years. As I enter my final few months in this role, I wanted to look ahead to the issues we’ve prioritized for 2019 — many of which build on our accomplishments in 2018.
DIET AND NUTRITION
More than ever before, clinicians and patients appreciate that what we eat can have an important impact on our digestive health and our gut microbes. Recognizing the need for a stronger evidence base, the NIH developed a nutrition research strategic plan, which AGA wrote in support of late last year. We will continue providing updates on the latest advances in the new year. In March, AGA will host the eighth annual Gut Microbiota for Health World Summit in Miami, Florida. This continues our long-standing collaboration with the European Society of Neurogastroenterology and Motility and the 2019 edition will focus on the interplay between what we eat and the microbes that live on and in us. Materials from the meeting will be made available through AGA’s educational platform, AGA University, later in the year.
PRO-, PRE- AND SYNBIOTICS
Last fall, the center published its first two scientific statements on several important clinical studies on the gut microbiome (read more here and here). We collaborated with AGA’s GI Patient Center to issue patient-friendly resources on probiotics. Probiotics will continue to be a key topic for AGA guidance in 2019. In the spring issue of this newsletter, look for the first of a four-part educational series on prebiotics and digestive health. AGA also continues to develop a technical review and clinical guideline on the role of probiotics in the management of GI disease. A “first look” can be found on AGA’s clinical guidelines page under “Upcoming Guidelines.”
As clinicians, we’ve experienced the growing popularity of direct-to-consumer genetic tests and questions from patients wanting to know what their results mean for existing or potential medical conditions. Inspired by discussions among clinicians within the AGA Community, scientific advisory board member Alexander Khoruts, MD, wrote a primer for clinicians on microbiome-based tests which was published recently; it was also disseminated through this newsletter and MedPage Today’s KevinMD.com. This issue will continue to be a challenge for researchers and clinicians as the research moves beyond correlation to causative relationships between our gut microbiome and human health and disease. The center will continue to provide guidance on this issue as the field evolves.
The FMT National Registry announced the enrollment of its first patient this time last year. As it continues to recruit new sites, the registry’s steering committee (under the leadership of AGA members Colleen Kelly, MD, Loren Laine, MD, AGAF, and Gary Wu, MD, AGAF) will begin looking at data to develop an interim publication on lessons learned from the earliest-enrolled patients. FMT, of course, is the just the beginning of a revolution in microbiome-based therapeutics. As new pharmaceuticals targeting the gut microbiome advance in clinical trials, the center will help prepare health care professionals for what this will mean for their patients and their practices.
2019 promises to be another banner year in gut microbiome research. AGA and its Center for Gut Microbiome Research and Education will continue to provide evidence-based information and guidance on one of the most exciting emerging areas of science and medicine.