Gastroenterologist believes valid gut biomarkers are on horizon

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A prominent gastroenterologist who operates a gene sequencing lab said the large and growing sets of data in gut health are going a long way toward answering some of the basic questions in the field.

Dr Sabine Hazan, MD, who continues in private practice, is also founder of Ventura, CA-based Progenabiome,  a state-of-the-art genetic research sequencing laboratory with next-generation whole genome shotgun sequencing capabilities on-site.  She also conducts clinical trials under a separate entity.

Eye opening case studies

While dealing with gut issues is the bread and butter of her medical practice, Dr Hazan said some of anecdotal evidence she gathered from her patients led her to conclude that there was a great deal to be learned from the gut makeup of individual patients, and new genetic tools were making it possible to start drawing up some broader conclusions.  Some of the first results came from cases in which patients had been treated with fecal transplants, which has been an accepted therapy for troublesome Clostridium difficile infections for a number of years.

“The case that really blew my mind was a patient of mine who had Alzheimers and C. diff and I did a fecal transplant on him. Six months later he remembered his daughter’s date of birth,” Dr Hazan said.

Dr Hazan said another case report she found eye opening appeared in 2017 in the American College of Gastroenterology Journal.  Two C. diff patients who exhibited alopecia universalis, or the complete loss of all body hair, were treated with fecal transplants and in both cases the patients reported new hair growth after the treatments.

Gut health research, both in the pharmaceutical realm as well as with nutritional products such as dietary fibers and supplements such as probiotics, has been hampered by a lack of biomarkers.

Dr Hazan said her frustrations with the testing of stools she sent out to labs as part of her medical practice and her research led her to bring the testing in house.  Some of the tests she sent out in previous years can back with varying results, which led her to lose some trust in the process.

Biomarkers could help study of probioitics

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Dr Sabine Hazan

 Dr Hazan said her goal, which she believes will be achievable with additional data, is to parse out some of these for specific conditions.

“It’s complex because you have to look at the individual and the individual’s gut and you cannot compare two individuals. My interest is finding the biomarkers associated with the microbiome effects in autism, in Alzheimers, Parkinson's, obesity even,” she said.

That will also help determine which probiotic products might benefit given patients.  The field is still so new, she said, that the reasons why some individuals might respond to these product and others don’t is still not well understood.  And she said claims for some products seem to have advanced beyond the scientific backing.

“Technology speeds like lightning,” she said. “I’m on the medical side trying to understand these therapies.  We are trying to validate what’s real from what’s not real.”

“It’s important to first have a baseline of a patient to understand whether the probiotic is working for an individual patient,” Dr Hazan said.

Matching up probiotics with effects on validated biomarkers would go a long way toward reassuring clinicians like her about the effects of these products, Dr Hazan said.

“I think more research on probiotics needs to be done by independent laborites.  I’m looking for research that is valid, verified and reproducible.  In the probiotic world we do see many studies that are lied that, that have a placebo control,” she said.