From microbial technology to microbiota medicine as a clinical discipline: Sustainable development goal

Abstract

Health and wellbeing are important components of the United Nations Sustainable Development Goals. Research on microbiota and human health is a burning question in achieving these goals. Global use of antibiotics and other drugs, the prevalence of the ultraprocessed foods in the Western diet, drastic changes in lifestyle and industrial development continue to damage both environmental and human microbiota (Marchesi et al., 2016). Numerous studies have shown that human microbiota plays an important role in disease profiles, from infections, inflammation, malnutrition to cancer, providing a new dimension for understanding medicine and life science. The recognition of the importance of the microbiome in health and disease, particularly in inflammation and immune function, has become one of the most significant scientific breakthroughs in the past decade. Targeting the human microbiome for diagnosis and treatment of diseases has led to a series of groundbreaking technologies, especially in microbiome sequencing, multiomics integration, and faecal microbiota transplantation (FMT), which are changing clinical practice. From the perspective of using microbial cells to treat diseases, probiotics and FMT are at two extremes. FMT being the most effective clinical technology fundamentally proves the importance of the microbiome in human health and disease. An analysis of global FMT clinical reports in the 10 years since the term ‘fecal microbiota transplantation’ was defined in 2011, FMT has been used to treat 85 diseases related to microbiome dysbiosis, which can be collectively referred to as microbiota dysbiosisrelated diseases (Wang et al., 2022). These diseases are related to dysbiosis and can be treated by microbiome reconstruction. In recent years, new technologies derived from FMT have emerged, mainly including washed microbiota transplantation (WMT) based on medical devices approved in China (Lu et al., 2022; Wang et al., 2022), faecal liquid enemas as drug approved in the United States (Khanna et al., 2022) and purified spores from faeces as drug approved in the United States (Feuerstadt et al., 2022). This rapidly increasing clinical evidence has broken through the boundaries of classical digestive system diseases, highlighting the transformative role of microbiometargeted technologies. Developing microbiomebased therapeutics is the driving force moving clinical medicine forward. How can we maximize the use of human microbiome to diagnose and treat individual diseases and promote human health? In fact, the number of patients who actually benefited from emerging microbiome technologies was far from the theoretical number of beneficiaries. If these microbiome technologies are allowed to develop freely according to the current form and promoted and developed according to the rules of technical commercialization, the entire field will face bottleneck constraints. The use of technical thinking, utilitarian behaviour and commercial activities may result in medical unfairness due to high costs. Additionally, excessive reliance on technology can lead to ethical and moral issues, which can create obstacles for the development of the field. To solve these bottleneck problems and avoid these potential traps, a scientific framework higher than the technology itself is needed to achieve sustainable development goals. However, in the existing clinical medicine discipline classification system, there is no discipline that can cover the above medical needs. Solving the emerging microbiomebased clinical medical problems is an important action to transform our world and achieve sustainable development goals. After Faming Zhang received the invitation from Juan Luis Ramos, the editor of Microbial Biotechnology in 2023 for contributing an article which highlights the potential contributions of microbes to achieving sustainable development goals in clinical medicine, the authors of this article prepared for this and held a dialogue and discussion on the theme of ‘From Microbial Technology to Microbiota Medicine: Sustainable Development Goals’ at the China Gut Conference (China National Convention Center, Beijing) on May 21, 2023 and then revised and formed this article. Received: 7 June 2023 | Accepted: 3 July 2023

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DOI

10.1111/1751-7915.14317

Journal

Microbial Biotechnology

Year

2023