There are trillions of bugs or microorganisms, mainly consisting of bacteria, living in and on our body. Their genetic contents make up our “microbiome."
The genes in the human microbiome far outnumber those in the human genome. This complex community of microorganisms has vital functions for our bodies including development of the immune system, fighting off bad bacteria and aiding digestion. Conversely, imbalance of the microbiome has been associated with a wide range of diseases, including gastrointestinal conditions such as necrotizing enterocolitis and inflammatory bowel disease, metabolic conditions including obesity, atopic conditions such as asthma and allergies, autoimmune disease and even developmental and neurological conditions.
At ITMI we are dedicated to the better understanding of how the human microbiome contributes to health and disease. Our ultimate goal is to reduce disease associated with microbiome imbalance.
See below for the current microbiome studies being conducted by ITMI. For additional information about any microbiome study, please contact Dr. Suchi Hourigan, director of microbiome research at ITMI, at 703-776-8489.
While Caesarean section (CS) delivery can be lifesaving for both new mothers and their babies, children born by CS have an approximately 50 percent increased risk of childhood obesity, along with asthma and allergies. It is believed that the risk of diseases associated with CS delivery may be due to the lack of mother-to-newborn transfer of beneficial vaginal microbes at birth, which are known to play a role in immune and metabolic development.
"Vaginal microbiome seeding,” the transfer of vaginal microbes from mother to baby, is a process that can restore the exposure of a CS-delivered newborn to their mother’s beneficial vaginal microbes. In a pilot study, vaginal microbiome seeding of CS- delivered newborns was associated with an increased abundance of bacteria typically missing or reduced in CS. However, this study was too small to determine effects on early childhood health outcomes such as obesity.
At the Inova Translational Medicine Institute (ITMI) we are conducting the first randomized controlled trial in vaginal microbiome seeding in newborns delivered by CS. ITMI will thoroughly document each baby’s health throughout his or her first three years of life to fully examine microbiome development and childhood health outcomes through regular stool samples and health screenings. If vaginal microbiome seeding is shown to decrease the risk of adverse childhood health outcomes in newborns born by CS, this could improve the health of our children and change the practice of obstetrics as we know it.
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The first few months and years of a child’s life are essential in shaping the intestinal microbiome which rapidly develops during this time, reaching a relative stability by toddlerhood that generally lasts into adulthood. Hence this early period may be critical for shaping future health and preventing the development of many diseases.
Even prior to birth, factors have been identified that may affect the early microbiome development. Premature infants are at increased risk of an imbalance in gut bacteria and delayed or disturbed gut colonization for many reasons including an immature gut and immune system, increased exposure to antibiotics and delayed feeding. They are also at increased risk of many disorders associated with gut bacteria imbalance compared to infants who are born full term.
At Inova Translational Medicine Institute (ITMI) we are conducting a longitudinal microbiome study of babies born prematurely and in the neonatal intensive care unit (NICU) and following then into early childhood to examine why and how disturbances in gut bacteria develop and how they may lead to early childhood health problems such as necrotizing enterocolitis, obesity and allergies. Using the latest technology, we hope to gain better insight into how disturbances of the microbiota cause disease, alter immune function and interact with the human genome. This knowledge is essential to enable future possible microbiota manipulation in childhood and prevention of disease.
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Clostridium difficile infection is an intestinal infection that can be life threatening. The incidence is increasing in children, and there is resistance to standard treatment with rising rates of recurrence. In resistant and recurrent cases, manipulation of the microbiome by FMT is an effective treatment. We are examining the intestinal microbiome in children before and after FMT to gain and better understanding of why this treatment is effective and also to improve FMT treatment in the future.
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Medications to suppress gastric acid are often used in children for conditions such as gastroesophageal reflux disease or GERD. We are learning more about potential side effects of these medications including Clostridium difficile infection and small bowel bacterial overgrowth which may be due to the underlying effect of these medications on the intestinal microbiome.
The microbiome of a child develops in the first few years of life and so young children may be particularly vulnerable to these medications. We are examining the gut microbiome of young children before and after using these medications. This will give insight into possible mechanisms for reported side effects and may give data to guide appropriate use of these commonly used medications in childhood.
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