Dr's Casebook: A molecular Rosetta Stone may transform medicine

Dr Keith Souter writes: I was excited to read of research that is being done at the San Diego School of Medicine in the USA which promises to increase our understanding about the microbiome. In particular it could show us what the microbes in the bowel actually do and how they do it, and by extension how they can affect other parts of the body. Just look at the list above and it may seem puzzling to see how the gut microbes can link up with heart disease or asthma.

This new research, which is a study of the bile acids, which seem to have a much wider role than merely that of aids to digestion, may do just that. They give us an insight into the language of the gut microbes and how they communicate to affect distant organs of the body. Indeed, Dr Lee Hagey, one of the co-authors of this study has likened these new discoveries to a ‘molecular Rosetta stone.’

By that he means that the answer to the decipherment of that language has been in front of us all this time, there just had to be a clue to understand it. The Rosetta Stone gave scholars a means of deciphering the hieroglyphic of ancient Egypt.

Bile acids are made in the liver, and are stored in the gallbladder then released into the gut to help digestion. The microbes in the gut metabolise the bile acids and change them into thousands of other different molecules called secondary bile acids.

This scientific breakthrough shows that these secondary bile acids not only aid digestion, but they are molecules that help to regulate the immune system, and various metabolic processes including lipid and glucose metabolism. Thus, they explain how the gut microbes can have an effect on organs throughout the body, and will give greater understanding about diseases they are linked to. It is very exciting for the future of medicine.