THE GUT AND THE BRAIN: TCFD WEIGHS IN ON THE COMPLICATED RELATIONSHIP

It was Hippocrates (460-370 BC), the father of modern medicine, who first said that, “all disease begins in the gut” but it was not until much more recently that the connection between the microbiome – an ensemble of about a trillion organisms in the intestine – and the brain began to be studied in earnest. The New York Times reports that numerous studies have now shown “remarkable links” in the gut-brain axis, including evidence that it may play a role in a number of medical conditions including Alzheimer’s disease, Parkinson’s disease, Autism Spectrum Disorders (ASD), depression, and schizophrenia. The Center for Discovery is on the frontlines of this area of research, with a particular focus on the role gut microbiome abnormalities play in ASD and other complex conditions.

“Data is emerging rapidly about how the microbiome may affect certain diseases, and there are exciting findings,” says Dr. Kara Margolis, the lead researcher on Gastrointestinal Issues at The Center and an Associate Professor of Pediatrics at Columbia University and Pediatric Gastroenterologist at New York-Presbyterian/Columbia University Medical Center. “It is exciting to think that this community that might be causative of many diverse disease processes and may actually be manipulated to formulate novel therapeutic targets.” But Dr. Margolis says the research is in the early stages and there’s much we still don’t know. “We have identified only a small percentage of organisms in the gut,” says Dr. Margolis. “We still don’t know what that whole environment is or how each bacteria affect one another or an entire community. So, it’s challenging at this point to be able to really pinpoint one specific bug that’s going to be the cause or the cure for something without having a more complete understanding of the microbiome.”

Scientists from The Center are participating in the largest study to date examining the microbiome and metabolome in children with autism led by Baylor University and supported by Autism Speaks. Initial results are expected later this year. Current studies are trying to figure out a much more personalized approach to how the microbiome may affect autism specific behaviors as well as the different co-morbidities associated with autism including gastrointestinal problems.

In the meantime, there are things we do know more about. “One of the key ways that the microbiome can be manipulated is through diet,” says Dr. Margolis. TCFD has been at the forefront of understanding how important diet is in the overall health and treatment of complex disease. Healthy eating is a pillar of TCFD’s comprehensive approach to care known as the Health E6 Model. TCFD has long recognized that what we eat impacts a person’s vitality, sleep, ability to manage stress, and to learn. The mostly plant-based, whole food, high fiber diet that The Center champions through its Department of Nourishment Arts (DNA), is a hallmark of the program. Registered dietitians monitor each individual’s diet to ensure they are receiving proper nutrition appropriate for their age and individual need.

Dr. Margolis cautions about the use of probiotics to manipulate the microbiome. “Probiotics can have potential side effects like gas, bloating and diarrhea. For individuals with autism who are nonverbal that can be much harder to detect and the resulting abdominal discomfort can translate into other issues including aggression and self-injury.” Fecal transplantation is also being explored as a way to manipulate the microbiome. “By putting stool from a healthy donor into somebody who has a potential disease, you’re transferring more than one bacteria. You’re transferring a community made up of one trillion bacteria,” says Dr. Margolis, “We still do not know what the risk is of potentially transferring harmful health issues along with the more beneficial ones, including obesity, mood disorders or immune abnormalities.” Dr. Margolis says a lot more work needs to be done before this kind of intervention can be applied to humans.

For more information about The Center for Discovery’s research initiatives, please contact Bill Evans, VP for Development, at bevans@tcfd.org.

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