The microbiome received a whole lotta love at the recent International Association for the Study of Pain (IASP) 16th World Congress on Pain, with Professor John Cryan presenting one of the most tweeted plenaries of the event (and I’m sure it wasn’t just because it gave everyone a free pass to use the poo emoji 💩!)
But a recent Comment in Nature Microbiology from Olesen and Alm sounds a sober, cautionary note on the excitement building around the complex microworld way, way down inside our guts – Dysbiosis is not an answer (open access)
“Dysbiosis, an imbalance in the microbiota, has been a major organizing concept in microbiome science. Here, we discuss how the balance concept, a holdover from prescientific thought, is irrelevant to — and may even distract from — useful microbiome research
Now, with modern DNA sequencing technology, we know our digestive systems are actually filled with mostly invisible microorganisms that respond to our diet. We have found that altering diet, ingesting probiotics, and wholesale replacement of the microbial community can improve our health. A common explanation for the effectiveness of these therapies is that they ameliorate ‘dysbiosis’, an imbalance in the microbiota
The word ‘imbalance’ is crucial, because it implies a dysfunction of some complex set of processes, that is, that dysbiosis causes disease. This is not implausible; there is accumulating evidence of how imbalances in the microbial ecology of the gut or in the host immune system could cause disease. However, at the moment, the concept of balance is supported by evidence from only a few model systems and model interactions.
…This ambiguity in definition [of dysbiosis] means that any measured difference in microbial composition, whether the cause or effect of disease, can be called dysbiosis. It is a ‘mechanism-free’ cause of disease to which we can retreat when plausible mechanistic explanations are discounted.”
The important critique from Olesen and Alm is not a denial of microbiome-gut-brain interactions (far from it), but rather a critique of sloppy, simplistic thinking associated with facile arguments based on superficial notions of balance that fail to recognise the deep and dynamic complexity of the system, and play free and loose with notions of causation.
Of course the microbiome-gut-brain axis isn’t the only topic that suffers from this oversimplification and is perhaps in need of some cooling – a bit of back to schooling on notions of causation and careful, reasoned logical thinking is always a healthy thing.
THE 2017 NOI CALENDAR IS SHAPING UP, HERE ARE THE CONFIRMED DATES
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