Interview with Dr. Ghannoum and TechNation Health
Many people know about the bacteria in our bodies, but did you know your body actually contains fungi? So how do those fungi actually impact your health?
Find out now! Listen to Dr. Ghannoum's interview with TechNation as he explains why it's important to learn how both bacteria and fungi work together in your gut to positively impact your health or how they can lead to disease.What about your body? How is your gut impacting your health? When you purchase a Probiotic Subscription, not only will you start balancing your total microbiome, but you get a personalized analysis of your gut’s microbiome using state of the art DNA sequencing technology. Find out how you can get your Probiotic Subscription now.
Dr. Gunn: Welcome to Technation Health, reimagining the future of health and healthcare with the emergence of new technologies. Today we hear about not the bacteria in your gut but rather fungus, or the plural of fungus, fungi, and how they actually work together. Dr. Mahmoud Ghannoum is a professor at Case Western Reserve University and University Hospitals Cleveland Medical Center. His research has been supported by NIH with over 25 million dollars in grants and he has published over 250 peer reviewed papers. I asked him, “In recent years we have come to appreciate that we have a microbiome in our gut, and the conversation has revolved around whether we have the right bacteria in our gut or the wrong bacteria. Why is this an incomplete picture?”
Dr. G: Because in our body we have both bacteria, fungi, as well as viruses, so when you look only at the bacteria, ignoring the fungi, you are really looking at half of the picture. What’s interesting having these bacteria and fungi together, they cooperate and work together in both health and disease. That’s why it’s very important to look at also the fungi in addition to the bacteria.
Dr. Gunn: now you’ve been working on this for over 30 years, you’ve gotten over 25 million dollars from NIH to discover all kinds of things about fungi, how do you determine the interaction between bacteria and fungi?
Dr. G: That’s a very good question. When we started our research we looked at the profile of what is in the gut of people with respect to bacteria as well as fungi. And then we looked at it in also Crohn’s disease patients and we found that there’s an increase not only of bacteria but also of the fungi, particularly candida tropicalis, one of the species of candida. So with that in mind we thought since both of them increase, bacteria and fungi increase in these patients, they must be working together. We went back to our culture collection, we have a large culture collection of organisms at the Center for Mycology, and we picked candida tropicalis, E.coli, and Serratia, which are the two bacteria which increased. We put them together because inside our gut the organisms are not free floating, they come together and form what is called digestive plaque or digestive biofilms. So when we put them in our experiments we noticed that they work together and they really start to form a very robust or thick digestive plaque. So our experiments which followed our observation from patients showed that they work together and this gave us the idea that we really need to study them together and understand how come they work together from the mechanistic point of view and that’s what we are doing now.
Dr. Gunn: Ok so that means that we have digestive plaque I guess lining our gut here. What difference does that make?
Dr. G: The difference is when you have digestive plaque in healthy situation it’s good because it tries to control and balance the bad bugs. The problem becomes when you have bad bugs, such as bad bacteria and the fungi and they come together and form this plaque. What happens is they become protected from not only our immune system but also antimicrobial agents like antibiotics for example. Bacteria in that plaque is protected by their matrix which forms the digestive plaque. So that’s why it is very important to break this down so that you are able to eliminate the bad bugs.
Dr. Gunn: So you could have the right antibiotic for the bacteria you’re going after and you can’t get it.
Dr. G: That is the futility of the case and this has been well established and not only in our gut, in general when microorganisms both bacteria or fungi form a plaque they become resistant to antimicrobial agents.
Dr. Gunn: now while you’re a professor at Case Western and you direct the Center of Medical Mycology at University Hospitals, you did spend part of your career at UCLA School of Medicine, and in fact you’re not an MD you are a PhD in dermatology.
Dr. G: Yes! This is a very interesting story cause usually fungal infections are put in the department of dermatology, why, because a lot of people have nail infections or they have athlete’s foot and that’s why conventional situation they always put that in dermatology. The interesting thing in UCLA while I was at UCLA, I was in the department of infectious diseases, so where it looks at more of the systemic infections so you have two faces of the coin. The superficial infections such as I said nail infections or an onychomycosis are dermatology but when we look at candida and systemic infections or oral thrush, it is in infectious diseases so we marry both.
Dr. Gunn: Now when you’re working with NIH, I know you do some volunteer work for them, what area are you working with them on?
Dr. G: At NIH I work mainly in infectious diseases. Why? Because Infectious diseases for example candida, can cause high mortality, it kills people so therefore the NIH wants to spend money to study candida. If I go and put the grant to study nail infections they’re going to tell me go home because this doesn’t kill patients, and that’s why the focus is on infectious diseases.
Dr. Gunn: You also have an MBA.
Dr. G: Yes. Because I work with the pharmaceutical industry, I help with their drug development. I work with various companies and for that I interacted with a lot of business people so it came to my mind you know what I really should do an MBA to try to understand how these people think, so that’s why I did it.
Dr. Gunn: I speak to so many research scientists they’re saying you know I see product here I see a product there and they either don’t have MBAs or, they’re just not, they have MBAs but they’re not sort of by personality suited. The other problem is it means if you’re really going to start a company it takes away from your research, the very thing that you did well. But you had the great foresight to have a son.
Dr. G: yes, certainly that’s where I’m very lucky because my son and I work together. He is the business brain even though I did MBA, believe me, he is the person who can think about it and keep me on check.
Dr. Gunn: So you can continue to be a professor, direct the center, but you and your son started up this business. But now let’s talk to you Afif.
Afif: Thanks for having me.
Dr. Gunn: Now Afif tell us about PathoBiohme.
Afif: so after my father came out with his study on Crohn’s patients and for the first time what they figured out was that while we known for a long time bacteria and fungi had some sort of relationship and it seemed that they were keeping each other in check. Really what my father discovered was that for the first time bacteria and fungi were working together to protect each other by creating digestive plaque, so he got literally thousands of people reaching out asking two questions. One: how do I actually figure out what’s in my gut and is there a probiotic you recommend. My background is as a biotech attorney so for years my father and I have been actually taking sort of his scientific prowess and my biotech background, and launching products and we sold products in about 27 thousand stores. So we looked and we said ok it’s kind of interesting there seems to be this gap because for a long time the role of fungi has really been ignored.
Dr. Gunn: We’ve been talking about probiotics. Is there such a thing as a pro-fungal?
Afif: so there are some probiotics that do have fungi in them. While a few do have fungi, the problem is that’s not what you need, you need a combination of both. So that’s the approach we took. We did two things, one, we created the first probiotic engineered to address not just bacteria and not just fungi but also digestive plaque. So we did that by combining bacteria and fungi and an enzyme that we knew was pretty powerful against plaque so that we could break down that digestive plaque and maintain the total microbiome of the gut.
Dr. Gunn: Now you do have this BIOHM which you can take once a day, but you also have which goes hand in hand or at least may be more important, this gut discovery kit. Now tell us about that and what you get from it.
Afif: Right, so one of the things that we found were that in this age were consumer genetic sequencing is becoming more common and there are a number of sites that will tell you about your heritage for example through your genetics. People wanted to know what is going on in my gut, and the problem that we found was that there was really no one looking at both bacteria and fungi. So what we did is we developed the BIOHM Gut Test, and through a sample we can actually analyze peoples bacteria and their fungi in their gut. . And then what we do is we use NIH’s human microbiome data on bacteria to show them what normal gut levels look like. But then, due to my father’s years and years of clinical research in fungi, we actually have a baseline of normal fungal flora that no one else has developed. So that was what we wanted to do, to allow consumers a way to really see what their entire gut microbiome picture looks like.
Dr. Gunn: So, now what could you see in terms of a fungal report that you could do, if you say either “I’m way below,” or “I’m way above” what I should be for a particular fungus?
Afif: Fantastic question. So, what we know about microbial balance is that it’s multifactorial. There’s actually four things, specifically, that can affect it. One is genetics. If some people are predisposed to microbial balance or imbalance, and obviously the extremes of that are conditions like Crohn’s, then diet is a giant factor in the balance of your microbiome. And part of that, as a subset is alcohol. We’ve actually seen with alcohol, and there’s studies showing that, with a glass of red wine being the exception, alcohol can really disrupt the balance. And then, oddly enough, stress can affect and lessen the diversity of your microbial balance. As a result, when people look and see if either if their bacteria or fungal levels are off, there are a number of things they can do. They can do—and obviously you can’t adjust your genetics—but what they can do is optimize some of the other things that are lifestyle related, for example, your diet. You can eat prebiotic-rich foods, prebiotic just means you’re giving a friendly environment for probiotic bacteria and fungi to exist. And that’s going to be from leafy green vegetables, avocado, sort of a Mediterranean style diet. The other thing you can do is, obviously, supplement your diet with a probiotic. And then manage the stress of everyday life, and even dad is religious about yoga. And I’m religious about thinking about exercise, so, you know, between the two of us we get it done.
Dr. Gunn: With all of the Gut Reports you’re getting, you’re getting a lot of data, anonymized, you’re getting a lot of data. You never got that kind of data in all these decades of studies you were doing. I mean, are you able to use that?
Dr. Ghannoum: You know what’s so important now, is the discoveries, as you said, with recent advances in technology, such as deep sequencing, as well as the bioinformatics. Doing this analysis is really giving us a lot of data which is very, very helpful and insightful, because if you are able to harness this information, you will be able to, for example, characterize: this is what people’s microbiome should be, fungal community, bacterial community, how we can control it, is it different people who are on different diets, for example, or geographic regions. So, this is very powerful data, and the good news is that we have a very strong team at Case Western Reserve University with bioinformatics backgrounds, who can help us put all this information together and dig deeper to try to understand, “What is the biological relevance, or the clinical relevance of these?” And this is a truly exciting time from that point of view, and definitely we can use this information.
Dr. Gunn: Now I saw a lot of the bacteria and I recognized it, and then I saw a whole lot of fungi that some of them I kind of knew, “Oh, anything that starts with Candida, do those.” And there were a whole lot of them, and how did you decide what to put in the analysis?
Dr. Ghannoum: That’s really a very good question. What we thought is, “Let’s look at the good fungus that we need in our body. What are the bad fungus and the ones that can cause problems?” And you mentioned Candida for an example. So, we selected those organisms that we know if they are up or down, they may affect the balance of your gut. For example, if you have a lot of Candida, or a growth of Candida, then that is not a very good sign. However, if you have Saccharomyces cerevisiae, which is a yeast, it is a good thing. So that will allow us to look at you or the profile of a person and say, “You know what, you have the right mix.” If you don’t have the right mix then it is possible to adjust that by either the use of probiotics or, as Afif mentioned my son, by adjusting your diet. So there are good ways to bring the balance back and restore.
Afif: So, the other thing we did when we selected the organisms to include in the Gut Report—you know if we listed all of them, you’re talking about probably hundreds and hundreds of species that we pick up and frankly, if you had spicy tacos you’d probably pick up some interesting species in a reading. So what we did was we really concentrated on what we call the core microbiome, and that is fungal and bacterial species that we found showing up in 20% of the population over and over, which indicated the really core organisms that had import in gut balance. The other thing that was fascinating, and we talk about how much data we’re picking up, well my father’s been studying and been doing very sophisticated global fungal clinical trials over the last decade, in the first six weeks we’ve been doing the BIOHM Gut Report we have more data than we’ve had on all those years.
Dr. Gunn: You know what really occurs to me, Dr. Ghannoum, is that, you know in the old days when you were out on the farm and you had a family, you tried to have as many people as possible. Hopefully a good mix of boys, you know, to work the farm. And now I think, if you’re going to be a research scientist, you should have a good mix of kids that can grow up and get a profession that will help you.
Dr. Ghannoum: Haha! That’s true.
Dr. Gunn: Okay, I’m going to put that in my advice to young scientists.
Dr. Ghannoum: Thank you very much. I am so lucky that my son and I work together and we enjoy each other’s company.
Dr. Gunn: Well thanks for coming on. We appreciate it.
Dr. Ghannoum: Thank you. Thank you very much for having us.
Afif: Thank you so much.
Dr. Gunn: Dr. Mahmoud Ghannoum is a professor at Case Western Reserve University and director for the Center for Medical Mycology. His son, Afif Ghannoum, is CEO BIOHM Health LLC and a contributor to Forbes.com. More information is available at BIOHMHealth.com. For Tech Nation Health, I’m Moira Gunn.
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