Rambam: Fighting the Rise in Inflammatory Bowel Disease with the Microbiome
August 7, 2023 – Israel’s inflammatory bowel disease cases have surged in recent years, associated with changes in lifestyle and eating habits. Researchers at Rambam Health Care Campus (Rambam), in Haifa, Israel, are fighting this alarming trend with the microbiome.
According to Israel’s Knesset Health Committee, inflammatory bowel disease (IBD) in Israel has significantly risen by 250% since 2005. This alarming rise has been associated with our current lifestyle and eating habits. As a result, microbiome physician-scientists at Rambam have been studying the biological connection between processed foods and IBD incidence.
Dr. Hagai Bar-Yosef is an attending physician at Rambam’s Gastroenterological Institute and a specialist in transplanting intestinal bacteria. He shares, “The growing consumption of processed foods among the general public in Israel, can be a leading cause in the increased rate of bowel inflammation. We are researching the biological connection between processed foods and inflammatory bowel diseases. The connecting factor between nutrition and these diseases is through the microbiome.”
Microbiomes are communities of organisms such as viruses, bacteria, and fungi. Some reside in our intestines and play an important role in different metabolic processes. Using the microbiome to treat IBD is becoming more popular worldwide. This is done by transplanting intestinal bacteria. Bar-Yosef explains, “Human waste is collected from a healthy human donor and then using fecal microbiota transplantation (FMT) process of it is introduced into a patient’s gastrointestinal tract” He continues, “Many patients in Israel have suffered from returning bacterial Clostridium infections that are resistant to antibiotic treatment. Israeli hospitals are transplanting microbiomes from fecal content into these patients, with a 90% success rate in treating the infection. This is extraordinary, considering the failed antibiotic treatments in the past.”
Researchers are now investigating the microbiome’s ability to deal with different medical challenges that develop in our bodies. “We have found that patients with ulcerative colitis and Crohn’s disease have damaged microbiomes.” Says Bar-Yosef, “In Crohn’s, for example, unfriendly bacteria appear in connection with the return of the disease. With ulcerative colitis, studies have shown that being treated with microbiome transplantation can lead to remission of the disease. These treatments are still being researched.” According to Bar-Yosef, a current study is establishing a connection between the microbiome and various fields of medicine based on the scientific link between the microbiome in the intestinal area and different patient conditions. “Research results confirm that abdominal distention or a swollen intestine occurs in multiple conditions: obesity, infections, autism, and others. These are only part of the different possibilities for considering microbiome transfer treatment. Our research is aimed at restoring the microbiome balance and allowing this equilibrium to organically influence the disease or health of the patient.”
Dr. Milana Pitashny, who heads the Clinical and Research Microbiome Center at Rambam adds, “Whether for research or treatment, the use of human microbiomes is possible thanks to volunteers who are willing to contribute their human waste. Together with our international research partners and local leading scientists, we accumulate the ‘good’ microorganisms from the donor’s digestive system in suitable sizes, and we are improving the treatment for the Clostridium bacteria.”
Pitashny explains that some of the improved treatment options include a swallowable capsule, or directly into the digestive system through a colonoscopy or enema. The latter options are the accepted treatment in patients with a recurring Clostridium infection when antibiotics are not effective. She adds that Rambam is making a therapeutic powder that is encapsulated and taken orally.
“We are also working on developing methods for diagnosing and tracking patients known to have changes in their microbiomes,” Pitashny concludes, “We are trying to make doctors more aware. The microbiome is a treasure waiting to be discovered.”
Photo: (L- R) Dr. Haggai Bar Yosef and Dr. Milana Pitashny
Photography: Rambam HCC