According to Cabreiro, the effect of drugs like metformin on and through the microbiome is still largely unknown, even in the case of cancer chemotherapies, which were often developed in the 1960s and 1970s. “Some substances are only activated by certain bacteria in the intestine. The individual composition of the microbiome could therefore explain, among other things, why these drugs are more effective in some people than in others,” says the researcher.
Even tumours have their own microbiomes, the composition of which might be crucial for selecting the right treatment: some microbes inhibit the active ingredient, while others enhance its effect. In colorectal cancer, for example, assessing the tumour’s specific microbial composition is particularly important when selecting a treatment.
Colleagues of Filipe Cabreiro’s in Heidelberg have recently even made a discovery about how antidepressants and antipsychotic drugs work. The antidepressant duloxetine, they found, causes confusion in the gut microbiome: certain bacteria absorb the drug because it resembles a molecule they can use in their metabolism. On the one hand, this reduces the amount of drug available for the host. On the other, the metabolites produced by these bacteria then reshape the overall structure of the microbiome. Cabreiro: “This is the reason why drugs such as the neuroleptic risperidone are associated with weight gain. It took us long to understand that what we are seeing is an interaction with the microbiome.”
Outnumbered by microbes
Bart Thomma believes that influencing the microbiome is crucial to breeding drought- and disease-resistant plants. Besides genetic modification, a cocktail of microbes that act against certain pathogens or compensate for nutrient deficiencies and stress in plants could be developed in the future. “We are gaining a better understanding of how the microbiome changes in response to stress or disease, and how metabolism and the microbiome influence each other,” says the biologist.
However, Thomma identifies another understudied topic in the long shared history of living creatures: interactions among microorganisms may be even more important than interactions between individual microbes and the host. Throughout evolutionary history, bacteria, fungi, algae, and protozoa have interacted with each other for much longer, forging beneficial alliances and developing joint survival strategies. From an evolutionary perspective, the microbes’ cooperation with plants and animals is but the blink of an eye. Thomma: “As organisms, we may be larger and more complex, but microbes outnumber us and are much older.”
When he thinks about the co-evolution of animal holobionts, Filipe Cabreiro clearly sees the advantages: “Without the enzymes produced by certain microorganisms, plants would be indigestible to us. Most animals – and we humans – would not even exist.” Seeing it that way, the few years they subtract from our lifespan seem like an acceptable price to pay.