What is the gut microbiome?

So the gut microbiome is the organisms that live inside our digestive tract, and they could be bacteria, fungi and other microorganisms as well.

We have about 30 trillion human cells, but actually almost 38 trillion microbial cells. So we are actually more microbiome than human in some ways.

Well, when we're talking about microbiome, we're typically talking about gut microbiome, and that's all the bacteria that are in your gut. And we typically measure them by sequencing stool.

The gut microbiome represents a very diverse community of bacteria, fungi, viruses that live in our intestine.

Actually, if you think about the entire microbiome that lives on our bodies, on our skin, in our nares, inside our mouth, and in our gut, the number of cells this represents is many fold more than the number of cells in our own body, the number of genes that it represents that are represented there or expressed there is many fold more than our own genes.

So this is a very complex and diverse ecological community that co-exists with us and helps support our own immune health. Our cardiovascular health, our metabolism.

can have effects on obesity and diabetes. And also we're finding on cancer progression as well as cancer response to therapeutics such as immune therapies. And in our own investigation and perhaps even myeloma directed therapies.

Is everyone's gut microbiome the same or different?

Does it vary from time to time.

Similar to DNA, which is unique for every person, the microbiome is also unique for every person.

There are a number of factors associated with this, such as diet, location of where you live, environmental factors, the genotype or the genetic makeup of a person and hygiene. So there are multiple factors, even antibiotics and things that could affect the microbiome.

What is a good microbiome?

It's difficult to specifically define what is a good microbiome and what is not

We have identified that microbial diversity. So in other words, a microbiome that has many different bacterial subtypes in it, is beneficial in terms of progression free survival times after stem cell transplant and so diminished diversity. In other words, a microbial injury presumably related to the therapy is something that results in inferior survival times after transplant.

Similarly, we have found that among those that have MRD negativity meaning no residual myeloma detectable after initial therapy, that there are specific microbial features or bacteria that seem to be more abundant in that scenario. And conversely, bacteria are more abundant in association with MRD positivity.

Exactly how all of this works it's something that we're actively pursuing