The Future is Bright for Probiotics

Posted 2nd December 2019 by Joshua Sewell

I am extremely sceptical of all claims about probiotics. For the last 10 years of running Probiotics.org, companies have been sending me questionable products with extraordinarily impossible to believe claims.

But, after Global Engage’s 4^th Probiotic & Prebiotics Congress, here’s what I strongly believe:

• There is a $40, 30-day supplement for newborns that can severely decrease the odds of allergies later in life.
• Food allergies are likely caused by being low in certain probiotic strains.

I’m going to briefly cover what I found interesting at this conference. In part 1 I will cover probiotics. In part 2, I will cover prebiotics, metabolites and drugs derived from probiotics.

Modulating a Newborn’s Inflammation Baseline With Using B Infantis + Breast Milk

Dr. Bruce German and Dr. David Kyle gave back-to-back keynote lectures on the relationship between infant health, breast milk and B infantis.

Together, they made a strong case that if a child is given breast milk, along with B infantis, the risk of allergies for the child is much lower. It seems that this combination, especially if administered to the infant soon after birth, reduces markers of inflammation.

Unfortunately, if B infantis is not present in the newborn’s intestines, then breast feeding does not have this strong anti-inflammatory effect (though it has other benefits over other formula alternatives).

Conversely, if B infantis is present, but a baby is not fed breast milk, then B infantis can’t aggressively colonize the infant’s intestines, and the infant’s chance of allergies will likely be much higher.

This work is based on multiple clinical studies that have well-powered statistics with seriously large clinical effects.

According to their talk, ~90% of infants at birth lack B infantis. Meaning that >9/10 infants today are lacking this vital probiotic species. Given the cost and efficacy of this treatment, I hope this is given to ~100% of infants in the USA.

I want to compliment both Bruce German and David Kyle on how well they constructed the narrative in their talks. The stories they told were compelling, the claims they made were back by data, and their B infantis product from Evivo seems to have a benefit-to-cost ratio that is as high as Mt. Everest is tall.

The Microbiome Relationship to Food Allergies

Azza A Gadir hosted a round table discussion on her work showing the relationship between food allergies (FA), and the microbiome.

In her research, she analyzed a group of children who had food allergies, and compared their microbiome to another group of children who didn’t seem to have food allergies.

The group of infants with FA had common deficiencies in some probiotic species compared to the non-FA children, implying a certain type of dysbiosis. By supplementing those lacking probiotic species, she could reverse food allergies in infants.

This worked in both a mouse infant model and human infants as well. In the mice, CRISPR was used to delete Myd88 or Rorc in Treg cells. Once Treg pathway was deleted, then mouse infants with FA no longer reversed FA with supplementation of those same probiotic species.

It’s really exciting that probiotic treatment can potentially help reverse food allergies. I am very excited by this line of research.

Microbiome Genetic Standardization Problem and FMT Metabolites

James Burgess of Finch Therapeutics hosted a fascinating round table on FMT and related subjects. James co-founded the OpenBiome, the largest FMT bank that has supported dozens of clinical trials

He shared with me that there was a small trial ~5 people with Cdiff who were given an FMT transplant, but the bacteria were removed from the FMT. In this study, there was no recurrence of Cdiff, pointing to a different MoA than the probiotic component for treating Cdiff with FMT.

This and other metabolite discussions completely blew me away. It seems like there is great potential for refining metabolites and then using them to treat many conditions.

He also shared with me that that genetic analysis of stool samples is not well standardized between labs. This is because different stool samples have genetically distinct sets of bacteria, which respond differently to the chemicals used for exposing genetic material in a sample. 

This non-standardization makes it difficult to replicate results within the same lab, and even more difficult to replicate results across different groups in different countries. So some clever standardization and reference results work needs to be done.

How To Preserve A Pristine Hunter/Gatherer Skin Microbiome – Studying Healthy People Rather Than Diseased People

This presentation resonated with me more than any other. The presenter, Larry Weiss, founder of Persona Biome, told a fascinating story about a) why we want to know the skin microbiome of our distant ancestors and b) how his company is attempting to preserve this data.

This presentation had an extremely strong narrative format. It gave an emotional account of how a son of this tribe, who had an Amazonian mother, but an American father, reconnected with his mother in the Amazon after not seeing her for 15 years.

To me, it sounds like the company is really trying to study healthy people – and mimic what makes people have healthy skin. The typical approach is to study diseased people and trying to cure them of that specific disease. I believe that if we can live correctly, and mimic what healthy people do, then we can prevent many diseases that are prevalent today. 

I’ve never said this before, but I look forward to the skincare products they bring to market!

Consumer Probiotic Marketing & Positioning (Alan Murray – GoodBelly CEO)

Alan gave an interesting talk about how to position a consumer probiotic product. History is littered with technically strong, effective products that were poorly positioned, and failed spectacularly. 

Poor marketing and positioning can destroy a scientifically solid product. Ultimately, a scientific consumer product won’t do much good if nobody buys it, or if the company is not financially viable. I really appreciated Alan’s talk because helps to keep us grounded in the commercial realities that make probiotic research possible.

Alan explained the risks of certain naming conventions that can capitalize on a short term trend, but ultimately pigeonhole the brand – and ruin its adaptability as tastes change. For example, if your brand is too specific/literal like “AcaiBerry” – then you may need a separate company to capitalize on new consumer trends. But a more abstract name like GoodBelly isn’t limited to probiotic juice products. It can gracefully expand to more product categories.

Alan also emphasized that marketing by population segment is vital. And that some consumer segments may have a higher lifetime customer value that could be 10x higher, even if that segment has a population size that is 10x smaller.

He also shared an interesting 2-D plot of brand positioning in the probiotic food space. The X-axis was the continuum between lifestyle marketing & medical marketing. The Y-axis ranged from approachable flavours down to exotic and difficult to approach flavours.

If you are interested in more effective marketing of your consumer product, Alan likely has sage advice. I believe he has positioned himself as the go-to person in probiotic food positioning & marketing.

Read the upcoming part 2 of my conference round up to learn about the interesting drug, prebiotic and metabolite research shared at this conference.

Evan Jerkunica founded Probiotics.org in 2009, where he takes a research-based approach to understanding the benefits and potential risks of probiotics.

The agenda for the 2020 Microbiome & Probiotics R&D and Business Collaboration Forum is now live. Click here to download it.

Tags: bacterial gut microbiome, gut microbiome, prebiotics, probiotics