Trust Your Gut

Second Annual Targeting the Microbiome September 20-21, 2016 Bonnie Feldman DDS, MBA @DrBonnie360

Your Autoimmunity Connection

Data and Digital Tools for the Microbiome: An Emerging Field in Autoimmune Disease

Trust Your Gut

+1.310.666.5312

drbonnie360@gmail.com

www.drbonnie360.com

@DrBonnie360

www.facebook.com/YourAutoimmunityConnection

Bonnie Feldman, DDS, MBA DrBonnie360’s mission is to create a digitally connected world of personalized care for autoimmune patients. We consult with start-up companies and entrepreneurs who are bringing new products and services that will improve research, diagnosis, and treatment for autoimmunity

The Road to Today

2008

2012

2015

2016

The NIH Human Microbiome Project is established

Public Curiosity Ignites

Scientific American publishes an interactive human

microbiome infographic

Microbiome exhibit opens to the public

The Secret World Inside You

The White House announces the National Microbiome Intiative

Advances in research begin to

show connections to autoimmunity

@DrBonnie360

AnInvisibleEpidemic

@DrBonnie360

~50 Million Americans have an autoimmune disease

DOUBLED

< 6% of NIH Funding goes to Autoimmunity

Source: http://bit.ly/1m0ttsl http://bit.ly/1B57pNb

incidence rate in children under 10 with IBD

in other words,

More than Cancer + Heart Disease combined

1 in 6 Americans Population of 25 states!

Is Your Gut Fr iend or Foe?

The Gut is Where

It’s At

Brain-Gut Axis

DOI:10.1038/nrn3346 @DrBonnie360

DOI:10.1038/ajgsup.2012.4 @DrBonnie360

Location Matters

Changing with Age

DOI:10.1038/nm.4142 @DrBonnie360

Oral Diseases 26 APR 2016 DOI: 10.1111/odi.12472 http://onlinelibrary.wiley.com/doi/10.1111/odi.12472/full#odi12472-fig-0002

CLINICAL PRESENTATION

@DrBonnie360

Triggering Autoimmunity

DOI:10.1038/ni.2611 @DrBonnie360

When Things

Go Wrong

The Leaky Gut

The Leaky Gut in Celiac Disease

DOI:10.3390/nu7085314

DOI:10.1038/nrgastro.2015.34 @DrBonnie360

A Life Balance

Inflammatory Bowel Disease

DOI:10.1038/ajgsup.2012.4 @DrBonnie360

Diversity Matters

Inflammatory Bowel Disease

DOI:10.1038/nrrheum.2011.121 @DrBonnie360

Beyond the Gut

Dysbiosis May Affect Other

Areas

Rheumatoid Arthritis

Beyond the Gut

Dysbiosis &

Rheumatoid Arthritis

DOI:10.1038/nm.3916 @DrBonnie360

Beyond the Gut

Dysbiosis &

Lupus

@DrBonnie360DOI:10.1128/mBio.01548-14

Beyond the Gut Microbe Composition & Multiple Sclerosis

@DrBonnie360DOI:10.1038/ncomms12015

DOI:10.1016/j.imlet.2014.08.017 @DrBonnie360

The Oral Microbiome

Dental Caries &

Periodontal Disease

Caring for your Microbiome Your Personal Microbial Garden

A

Tailor-Made

Personalizing Nutrition

DOI:10.111/nyas.13118 @DrBonnie360

DOI:10.1016/j.cell.2015.11.001 @DrBonnie360

Tailor-Made

Personalizing Nutrition

CompanyIndicaKonWhatHow

OpenBiome

TherapeuKc-Oral&

FecalTransplant

NonprofitStoolBank&ResearchPla5ormeliminatespracKcal

barrierstoFecalMicrobiotaTransplants(FMT)&provide

tailoredfecalmicrobiota

preparaKonstobioinformaKcs/

analyKcalservices

-DonorSelecKon;characterizewith

molecularbiomarkers,cross-secKonaldata,

&staKsKcaltoolstopredictwhichdonors

arewellsuited.

-MaintenanceTherapy;oralcapsulesto

deliver&explorelong-termmanagementof

chronicdiseases

uBiome CrowdsourcedDatabase Equipindividualswiththetools

neededtolearnaboutbacteria

withintheirbodies

-Sendsamplekits&surveystocollect

microbiomesforanalysis.

-UseNIHhumanmicrobiomeprojectto

sequenceDNA&IDeachstrain

-Comparewithlibrary&compileresults

Tailor-Made Global Crowdscience for the Microbiome

DOI:10.1038/nbt.2548 @DrBonnie360

Tailor- Made

Medicines From

Microbiota

CompanyIndicaKonWhatHow

AOBiome TherapeuKc-Topical

Skin

Advancethescienceof

AmmoniaOxidizingBacteria(AOB)torestoretheskin’s

microbiome

-TopicaltherapeuKc&consumer

productofAOBtoreintroduce

Nitrosomonastoskin’sbacterialflora&

restoreNitricOxidebalance

Enterome DiagnosKcs&

TherapeuKc

InflammatoryBowel

Disease-Crohn’s&

UlceraKveColiKs

QuanDtaDveMetagenomicsPla5orm(QMP)&FuncDonalMetagenomicsPla5orm(FMP)tosupport

personalizedmedicinefor

microbiome-relateddiseases

-QMPusestotalfecalbacterialgeneto

characterizepersonalmetagenome

withdiseasephenotype&ID

biomarkers

-FMPscreengenomic/metagenomic

librariesfordis&devofnewdrugs/

targets

MiomicsBio-

TherapeuKcs

TherapeuKc-Oral

Autoimmune

Disease-RA&MS

Oralbiologicalstorebalance

amicrobiotatowardsa

standardmicrobiota.

-ResearchGIinhabitancommensal

CompanyIndicaKonWhatHow

Osel TherapeuKc-Topical

Women’sHealth

“LiveBiotherapeuDcProducts”(LBP)focusingonwomen’shealth(GU&GI)

-Libraryofproprietaryhumanbacterial

strains

-ScreeningmethodstoIDstrainsw/

uniqueprotecKveproperKes

-ProducestablehighqualityLBPfrom

selectedstrains

SecondGenome TherapeuKc-Oral

Crohn’sDisease

MicrobiomeModulaDngDiscoveryPla5orm(MMDP)

IDkeymicrobialcommunity

members/acKviKes/

metabolites&assayfor

modulatorypotenKalagainst

hosttargets

-Measure&IDchangesinthemicrobial

communitycomposiKon/funcKon/

signalinginhealthordiseasedstatesw/

MMDP

-GeneraKon&evalofsmallmolecules/

pepKdebiologic/bacterialstrainsthat

modulatemicrobe-microbe&microbe-

humaninteracKons

SeresTherapeuKcs TherapeuKc-Topical

Dysbiosis,UlceraKve

ColiKs

PropritaryMicrobiomeTherapeuDcsPla5orm(PMTP)&EcobioDcdrugstoreestablishahealthy

microbiome

-ComputaKonalapproaches&PMTPto

IDorganismal/funcKonalnetworksof

microbialcommuniKes,&determine

whichorganismsworktogetherbest

withdiseasemicrobiometorestore

funcKon

CompanyIndicaKonWhatHow

Synlogic TherapeuKc

RareGeneKc

MetabolicDisorders

&IBD

SyntheDcBioDcsengineeredprobioKcbacteria

-Plahormthatengineersnewmetabolic

funcKonintothemicrobiome

VedantaBiosciences TherapeuKc

Autoimmune

Modulatepathwaysof

interacKonbetweenhuman

microbiome&hostimmune

sys.Toinducetolerance&

restoreintesKnal

homeostasis

-Studymucosalimmunologyto

producedrugbasedonaproprietary

consorKaofpotentregulatoryTcell-

inducingClostridiumbacteria

WholeBiome

DiagnosKcs&

TherapeuKc

Metabolic

Syndrome

Proprietarydiscoverypla5ormfortargetedequilibraKonofthe

microbiome.Focuson

metabolicsyndrome

-TargetnovelsymbioKcfuncKonality

inherentinthehuman-microbial

interfacewithamicrobiomediagnosKc

discoveryplahorm

•  Autoimmune Disease: An Invisible Epidemic http://bit.ly/1m0ttsl

•  The Serious Health Concern All 20-somethings Should Know About http://bit.ly/R9cEgp

•  Decoding Autoimmunity – a Summary of the State of the Art http://bit.ly/1knzaAQ

•  The Lonely Voices of Autoimmune Disease via Youtube http://bit.ly/X41mMv

•  Believe It or Not – The Real Voices of Autoimmunity http://bit.ly/20xRCXO

Your Autoimmunity Exploration

Exploring The Microbiome Lifeline

•  Fasano, Alessio. “Leaky Gut and Autoimmune Diseases.” Clinical Reviews in Allergy & Immunology 42.1 (2012) : 71–8. <http://www.ncbi.nlm.nih.gov/pubmed/22109896>.

•  Gomez, Andres, David Luckey, and Veena Taneja. “The Gut Microbiome in Autoimmunity: Sex Matters.”Clinical Immunology 159.2 (2015) : 154–162. <http://www.sciencedirect.com/science/article/pii/S1521661615001576>.

•  Kamdar, K et al. “Genetic and Metabolic Signals during Acute Enteric Bacterial Infection Alter the Microbiota and Drive Progression to Chronic Inflammatory Disease.” Cell Host & Microbe 19.1 (2016) : 21-31. <http://www.cell.com/cell-host-microbe/pdfExtended/S1931-3128(15)00498-9>.

•  McLean, Mairi et al. “Does the Microbiota Play a Role in the Pathogenesis of Autoimmune Diseases?” Gut

64.2 (2014) : gutjnl–2014–308514. <http://gut.bmj.com/content/early/2014/11/28/gutjnl-2014-308514>.

•  Waldor, Matthew et al. “Where next for Microbiome Research?” PLoS Biology 13.1 (2015) : e1002050. <http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002050>.

•  Wu, Hao, Valentina Tremaroli, and Fredrik Bäckhed. “Linking Microbiota to Human Diseases: A Systems Biology Perspective.” Trends in Endocrinology & Metabolism 26.12 (2015) : 758-770. <http://www.cell.com/trends/endocrinology-metabolism/abstract/S1043-2760(15)00194-0>.

Autoimmunity and the Microbiome

@DrBonnie360

The Microbiome and Inflammatory Bowel Disease

•  De Souza, Heitor, and Claudio Fiocchi. “Immunopathogenesis of IBD: Current State of the Art.” Nature Reviews Gastroenterology & Hepatology (2015) : 13-27 <http://www.ncbi.nlm.nih.gov/pubmed/26627550>.

•  Sartor, R. Balfour. “The Intestinal Microbiota in Inflammatory Bowel Disease.” Nestle Nutrition Institute Workshop Series 79 (2014) : 29–39.<https://uncch.pure.elsevier.com/en/publications/the-intestinal-microbiota-in-inflammatory-bowel-diseases>.

  •  Sartor, RB, and SK Mazmanian. “Intestinal Microbes in Inflammatory Bowel Diseases.” The

American Journal of Gastroenterology … (2012) : 15-21. <http://www.nature.com/ajgsup/journal/v1/n1/abs/ajgsup20124a.html>.

•  Wlodarska, Marta, Aleksandar Kostic, and Ramnik Xavier. “An Integrative View of Microbiome-Host Interactions in Inflammatory Bowel Diseases.” Cell Host & Microbe 17.5 (2015) : 577-591. <http://www.cell.com/cell-host-microbe/abstract/S1931-3128(15)00166-3>.

@DrBonnie360

The Microbiome and Periodontal Disease

•  Costalonga, M, and MC Herzberg. “The Oral Microbiome and the Immunobiology of Periodontal Disease and Caries.” Immunology Letters 162.2 (2014) : 22-38. <http://www.sciencedirect.com/science/article/pii/S0165247814001874>.

Rheumatoid Arthritis

Systemic Lupus Erythematosus

•  Scher, JU, and SB Abramson. “The Microbiome and Rheumatoid Arthritis.” Nature Reviews Rheumatology 7 (2011) : 569-578. <http://www.nature.com/nrrheum/journal/v7/n10/abs/nrrheum.2011.121.html>.

•  Mu, Q, H Zhang, and XM Luo. “SLE: Another Autoimmune Disorder Influenced by Microbes and Diet?” Frontiers in Immunology (2015) : n. pag. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663251/>.

@DrBonnie360

Prevention – Diet, Food, & Nutrition

•  Tilg, H, and AR Moschen. “Food, Immunity, and the Microbiome.” Gastroenterology 148.6 (2015) : 1107-1119. <http://www.sciencedirect.com/science/article/pii/S0016508515000128>.

•  Zeevi et al. “Personalized Nutrition by Prediction of Glycemic Responses.” Cell. 163.5 (2015) : 1079-1094. <http://www.cell.com/abstract/S0092-8674(15)01481-6>.

•  Zmora, N et al. “Taking It Personally: Personalized Utilization of the Human Microbiome in Health and Disease.” Cell Host & Microbe 19.1 (2016) : 12-20. <http://www.cell.com/cell-host-microbe/pdf/S1931-3128(15)00508-9.pdf>.

Prevention – Prebiotics & Probiotics

•  Hemarajata, P, and J Versalovic. “Effects of Probiotics on Gut Microbiota: Mechanisms of Intestinal Immunomodulation and Neuromodulation.” Therapeutic Advances in Gastroenterology. (2012) : 39-51. <http://tag.sagepub.com/content/early/2012/09/24/1756283X12459294.abstract>.

•  Petschow, B et al. “Probiotics, Prebiotics, and the Host Microbiome: The Science of Translation.” Annals of the New York Academy of Sciences (2013) : 1-17. <http://onlinelibrary.wiley.com/doi/10.1111/nyas.12303/full>.

@DrBonnie360

•  2008=HumanMicrobiomeProject.hlp://hmpdacc.org/overview/about.php

•  2012=ScienKficAmerican,explorethehumanmicrobiome(interacKve)hlp://www.scienKficamerican.com/arKcle/microbiome-graphic-

explore-human-microbiome/

•  2015=AmericanMuseumofNaturalHistory

•  exhibit:TheSecretWorldInsideYouhlp://www.amnh.org/calendar/the-secret-world-inside-you

•  info:MeetyourMicrobiomehlp://www.amnh.org/explore/science-topics/health-and-our-microbiome/meet-your-microbiome

•  2016=hlps://www.whitehouse.gov/the-press-office/2016/05/12/fact-sheet-announcing-naKonal-microbiome-iniKaKve