ReMicS
Regional Research Network
for Clinical Microbiota Science
The microbiota is a remarkably complex community, collectively containing at least 300 times as many genes as humans, and with each bacterium having the capacity to produce hundreds of different metabolites. An altered gut microbiota has been linked to several chronic disease states, including inflammatory bowel diseases, diabetes, obesity and cardiovascular disease (CVD). The underlying mechanisms, however, are not completely understood.
ReMicS is funded by the South-Eastern Norway Regional Health Authority and is a regional network for research on clinical microbiota medicine in multiple diseases involving multiple research groups. The purpose is to establish a multi-disciplinary network of scientific and clinical excellence in order to lay the foundation for clinical microbiota medicine, i.e. medical practice based on stratification or modification of gut microbial composition or function.
The ReMicS network allows allocation of resources to the development of methods and knowhow, combined with extensive translation and dissemination to the involved clinical partners. In addition to providing new knowledge on gut microbiota in different diseases, this will also build competence in the clinical departments. The geographical variation in gut microbiota underscores the importance of a regional and national knowledge basis. This will be accentuated by keeping an open door to new research groups entering the field during the funding period.
Selected ReMicS Projects and Aims
Microbiota signature related to treatment response
Microbiota signature related to PD-1 inhibition in lung cancer (Åslaug Helland) Microbiota signature related to treatment response and side effects of “biological treatment” for chronic auto-immune diseases (Øyvind Molberg)
Microbiota signatures as diagnostic and prognostic tool
Microbiota signature and related metabolites as diagnostic screening algorithm for anal cancer in HIV-infected individuals (Marius Trøseid), aiming to improve diagnostic accuracy of early stages of anal cancer and to reduce incidence of anal cancer in this high-risk group. Microbial functions as diagnostic and predictive biomarkers after liver transplantation (Johannes Hov). Microbiota signatures integrated as part of national screening program for colorectal cancer (Øyvind Holme and Trine Rounge).
Microbiota transplantation
Optimization of FMT (Michael Bretthauer). FMT for new indications, including systemic sclerosis, where gut symptoms, including anal incontinence are major clinical problems (Anna-Maria Hoffmann-Vold). In addition there is an interest in the role of FMT in patients with HIV infection (Dag Henrik Reikvam), and in Cesarean delivered infants (Merete Eggesbø).
Probiotics, prebiotics and nutritional strategies to target the gut microbiota
We have previously conducted trials with probiotic lactobacilli, reducing local and systemic inflammation during HIV infection. Next generation probiotics will probably target specific enzymatic pathways. As an example, the core groups are currently running the GutHeart trial, treating heart failure with the probiotic fungus S. boulardii to improve cardiac function, possibly through enhanced production of butyrate (Marius Trøseid and Johannes Hov). Nutritional/prebiotic intervention is also of significant interest, including prebiotics for glycemic control in type 2 diabetes (Anne-Marie Aas)., and personalized diet to reduce co-morbidities after colorectal cancer (Rune Blomhoff).
Surgical models
Gastric bypass for obesity provides an excellent human model for studying how profound changes in the architecture of the gut translates into changes in the gut microbiota and how microbiota changes are related to changes in cardiometabolic risk factors. In two ongoing studies of gastric bypass and sleeve gastrectomy, changes in gut microbiota composition and function are included as secondary objective (Jøran Hjelmesæth). Organ transplant provides a human model for studying how immunosuppression affects gut microbiota, and whether gut microbiota signature is related to complications after liver transplantation.
