Our personal ecosystems

Imperial’s FemTech and Microbiome societies hosted a panel on Thursday, November 27, about female health and the gut and vaginal microbiome. The microbiome refers to the collection of microbes that reside in the human body.

Who was there?

Elvira Zelva, Lead Design Engineer at Daye, who is developing an at-home tampon screen for the vaginal microbiome.

Imogen Wolsey, Development Manager at Symprove, who sells a unique water-based bacterial supplement.

Sophie Stephens, Clinical Medical Research PhD at Imperial and Co-Founder of PHLYXR, which is developing a non-hormonal lubricant which can reduce the transmission of sexually transmitted diseases. The lubricant is designed to match the vaginal microbiome’s pH and can also act as a contraceptive.

Marie-Laure Provost, Founder of Fermenti, which develops innovative fermented foods sold at Whole Foods and Planet Organic stores across London.

Dr Belen Gimeno Molina, Postdoctoral Researcher at Imperial, who is studying microbial-host interactions as they relate to infection and inflammation in preterm birth.

Dr Julia Craggs, Medical Director at Aeva, which aims to integrate health data using AI to create a health companion that sees the full picture.

What is a healthy microbiome?

Overall, the panel concluded that there is no one healthy microbiome, that probiotics can’t heal you, and that the microbiome is not the full picture.
Stephens explained that while researchers have a somewhat clear picture of vaginal health - a healthy vaginal microbiome is, somewhat counterintuitively, not particularly diverse, and dominated by Lactobacillus bacteria - they are still unable to define a healthy microbiome. She also noted that a perfect model doesn’t and won’t ever exist.

“The concept of health must also be expanded to how they respond when things go wrong: functional resilience,” added Craggs, explaining that it is helpful to see how the microbiome can bounce back after, for instance, a round of antibiotics.
“We are full of microbes: sometimes they win, sometimes we do, sometimes we both can,” added Provost.

The microbiome has far-reaching effects on health. For instance, it can play a role in susceptibility to HPV-driven cancer and has a bidirectional relationship with hormones.

Stress is another crucial factor to keep in mind, as stress hormones can decrease good bacteria numbers and increase gut permeability which increases risk of infection. As the gut brain axis relates to stress, vagus nerve stimulation, such as through deep, belly breaths, can be a helpful tool, noted Provost.

Challenges in microbiome research

The speakers noted that there are a few key challenges in researching and tailoring health care to the microbiome, such as funding, visibility, and tight regulations. Another question to tackle is how to best model microbiome data. Some researchers prefer using organoids, which are more biologically relevant than an in vitro study. However, organoids are expensive and difficult to create and maintain, as well as somewhat unpredictable and not fully understood.

Provost and Wolsey added that Fermenti and Symprove both obtained data using the Simulator of Human Intestinal Microbial Ecosystem (SHIME) gut model, which is one of the few gut models that simulates the entire gastrointestinal tract, from stomach to colon. SHIME is cheaper than running a full clinical trial and can test microbiota’s ability to survive in the stomach acid but cannot provide information about the quality of the bacteria.

The future of microbiome research

The panellists hoped to see a more holistic approach to human health in the future, a hope that is uniquely envisioned by Aeva’s model of personalized health. Cragg noted that wellness and medicine are more interconnected that most people think. Molina is working on a clinical trial focusing on how changing the microbiome can modulate the immune response, which is now progressing to phase II.