Strategic Research Area OUH
The strategic research area “Personalized microbiota therapy in clinical medicine” establishes a multidisciplinary team at Oslo University Hospital, which will plan, coordinate and perform human trials of microbiota therapy. Clinical medicine based on stratification or modification of gut microbial composition requires gastroenterologists, infectious disease specialists, microbiologist and specialists in the individual diseases. Recently funded trials in primary C. difficile colitis, systemic sclerosis, HIV infection and cardiovascular disease highlight the potential and the need for a joint research strategy to enable rapid clinical translation and improved patient care within many fields, including inflammatory and infectious diseases as well as immune therapy for cancer.
The human gut microbiota, the total microbial content of the gastrointestinal tract, has a major impact on human health. The research groups included in the Strategic Reseach Area Project have contributed to seminal studies performing basic characterization of the disease-associated gut microbiota in multiple chronic inflammatory diseases and immunodeficiencies, and several proof-of-concept interventions targeting the microbiota, including the first trial of fecal microbiota transplantation in primary C. difficile colitis. It is demonstrated beyond doubt that disease-associated gut microbiota alterations exist. In experimental models, multiple conditions can be treated by modulating the gut microbiota, while data on how to modify the microbiota to improve disease management in humans are still lacking. One key observation is that inter-individual differences in gut microbiota composition are substantial, meaning that 1) gut microbiota medicine must be personalized, i.e. adapted to the individual, and 2) true personalized medicine must take gut microbiota into account.
Shared expertise, common methodology and analytical strategies are important to facilitate clinical implementation. This could be defined as the basic skills of the strategic area partners (Figure). These basic skills will be applied on the clinical problems, which are the expertise and topics of the groups and departments participating in this application, creating a circle of synergy.
Genomics and Metagenomic Research Group
Project Leader: Johannes Hov Microbiota Research Complete microbiota profiling pipeline (lab and bioinformatics).
Department of Gastroenterology
Project Leader: Asle W. Medhus Endoscopy and FMT experience (clinical C. difficile treatment) IBD-studies, probiotic interventions IBD research group (Marte Lie Høivik).
Section of Gastroenterology
Project Leaders: Knut Lundin and Kjetil Garborg Endoscopy and practical FMT expertise Microbiota profiling in non-responsive celiac disease and FODMAP vs gluten sensitivity
Clinical Effectiveness Research
Project Leaders: Michael Bretthauer and Kjetil Garborg Experience with clinical trials including FMT studies Trials of FMT as primary C. difficile treatment
Clinical Microbiology and Microbiota Medicine
Project Leader: Marius Trøseid Clinical mircrobiota reaserch Leader of Regional network in Microbiota Science (ReMicS)
Chronic Infections Research Group
Project Leaders: Dag Henrik Reikvam and Anne Ma Dyrhol Riise Large-volume of clinical C. difficile treatments Studies focusing on microbial modulation of chronic infection e.g. HIV, hepatitis B and tuberculosis Infectious risk assessments expertise Running a small-scale microbiology lab with expertise in preparation of donor feces for FMT
Department of Microbiology
Project Leaders: Jørgen Bjørnholt, Tone Tønjum, Karianne Gammelsrud and Fredrik Müller Know-how and routine microbiology diagnostics in OUS on fecal samples National reference function on C. difficile Hosts the research network “Turning the Tide of Antimicrobial resistance” (TTA), aims include metagenomic analysis and treatment of antibiotic resistance, and establishment of biobank of specimens for fecal microbiota transplantation (autologous) Microbiological control of germfree mice in the Gnotobiotic Lab at OUS
Project Leader: Åslaug Helland Immune therapy in lung cancer Planned study including microbiota profiling in immune therapy, potential for FMT from responders
Project Leader: Øyvind Molberg FMT studies in systemic sclerosis
Project Leaders: Lars Gullestad and Ingebjørg Seljeflot Extensive cardiology research experience Ongoing clinical intervention in heart failure and planned in acute coronary syndromes