
(Image: Eye Of Science/Science Photo Library)
鈥淭HE average adult human is, in essence, a 10-meter-long tube.鈥 So began a 2005 special issue of the journal Science dedicated to the gut and its microbial inhabitants.
At that time, it was becoming clear how influential those microbes are on our health and well-being. At first, the focus was on obesity and inflammatory bowel disease. But the list has since grown to include diabetes, cancer, immune disorders and even mental illness. It is getting hard to find health problems that aren鈥檛 in some way linked to gut microbes (see 鈥Inside story on gut health: Why it鈥檚 time to take control鈥).
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That is both good and bad news. Gut microbiomes are flexible and potentially open to manipulation. Understanding the interactions between them and our health would open up many therapeutic avenues.
But the complexity of the relationship makes disentangling it difficult. A decade ago, there was optimistic talk of using gut bugs to cure obesity. We鈥檙e still waiting.
There are dangers too. Faecal transplants are growing in popularity as a quick fix for an 鈥渦nhealthy鈥 microbiome. There is solid evidence that they work for a specific infection. But some are also recommending them for conditions when the evidence is thin or non-existent. As a 快猫短视频 investigation reveals, a number of clinics are seeing unexpected side effects (see 鈥Doctors call for faecal transplant regulation as concerns mount鈥).
It is easy to understand the appeal of faecal transplants. Yuck factor notwithstanding, they have an aura of naturalness and holism that many people find attractive. But that is no substitute for clinical trials.
The case for using gut bugs to cure diseases is as strong as it was in 2005, and conventional medicine is on the case (see 鈥Smart probiotics: Wiring friendly bacteria to take out disease鈥). But the route from concept to clinic is long and hard. The US and Canada have taken the prudent step of regulating faecal transplants. The rest of the world should follow suit, lest the procedure becomes an unregulated cure-all that ends up squandering the great promise in that 10 metres of tubing.
This article appeared in print under the headline 鈥淕ut reactions鈥