Advanced Microbiome Manipulation - 2023 Term

Course Outline in Detail

Week 1

Meet the Key Microbiome Players – The Good, the Bad, and the Ugly

Module 1 – Bifidobacterium

Module 2 – Lactobacillus

Module 3 – Akkermansia

Module 4 – Faecalibacterium

Module 5 – Key Butyrate Producers

Module 6 – Escherichia

Module 7 – Streptococcus

Module 8 – Bacteroides

Module 9 – Alistipes

Module 10 – Prevotella

Module 11 - The Classic Hydrogen Sulphide Producers – Bilophila and Desulfovibrio

Module 12 – Fusobacterium

Module 13 – The Methane Producers

In week 1, we’ll take a deep dive into the microbiome, getting into the nitty-gritty details on the key microbiome players. We’ll explore the key beneficial genera, main commensals, and the common pathobionts. For the beneficial genera, we’ll learn strategies to increase their populations, for the commensals, how to optimise their populations, and for the pathobionts, techniques and tools we can use to decrease their populations.

Week 2

Module 14 - In Depth Reviews of Different Microbiome Testing Options and Interpretation Walk Through.

This week we’ll delve into the testing approaches (and their technologies) that are available for clinicians to assess the health of the microbiome. We’ll look at the strengths and weaknesses of the different microbiota assessment techniques and the labs offering them. We’ll cover tests using culturing, 16s rRNA, PCR, and shotgun metagenomic technology. We’ll specifically detail the tests Dr Hawrelak uses in his clinical practice and walk through how he extracts and interprets the data from these different tests for his patients.

Week 3

Module 15 – Medicines and the Microbiome

Module 16 – Enhancing Microbiota Polyphenol Transformations.

Research over the past decade has clearly shown that antibiotics are not the only pharmaceutical agents that harm the GI microbiota. It is now known that a wide number of pharmaceutical agents negatively impact the composition of the microbiota. It is essential as clinicians to know which medications have this capacity, so we can know how to address this in our patients taking them. Module 16 will consider the ways in which we can enhance the conversion of polyphenols in our gastrointestinal tract so that we can receive greater benefit from their ingestion – keeping in mind that over 90% of ingested polyphenols reach the colon intact and that their microbiota conversion is generally essential for their beneficial actions.

Week 4

Module 17 - Endotoxemia – Addressing a Key Driver of Chronic Disease

Endotoxemia is a key driver of chronic disease that is seldom on the radar of healthcare practitioners. Research conducted over the past 15 years has begun to shed considerable light on the disease-causing capacity of bacterial endotoxins. In module 17, we’ll dive into endotoxemia, describing what endotoxins are, detail their origins in the GIT and discuss how they are key drivers in many different chronic diseases common in Western nations, including metabolic diseases, cardiovascular conditions, and neurological disorders. We’ll cover current ways of assessing our patients for endotoxemia and explore future testing possibilities. Lastly, we’ll detail the tools that practitioners can use to address endotoxemia, including dietary recommendations, specific probiotics, prebiotics, and herbal medicines that can effectively address their production and absorption in the GIT and enhance their clearance.

Week 5

Module 18 - The Mitochondrial-Microbiota Axis – Enhancing Mitochondrial Function

Healthy physiology of mitochondria is essential for human health, and their dysfunction is now considered a critical factor in a number of different conditions, such as type 2 diabetes, cancer, neurodegenerative, and cardiovascular diseases. The removal of damaged mitochondria (mitophagy) and the generation of new fully functional ones (mitochondrial biogenesis) are required to preserve both cellular and mitochondrial homeostasis. In module 18, we’ll cover the newly discovered mitochondria-microbiota axis and detail the ways in which the microbiota can alter the function of the body’s mitochondria. We’ll also highlight the tools and techniques we can use to enhance the mitochondria-microbiota axis to optimise mitochondrial function.

Week 6

Module 19 - The Role of the Microbiota in Cognitive Decline & Alzheimer’s Disease

The important role of the microbiome-gut-brain axis in the pathogenesis of cognitive decline and Alzheimer’s disease is becoming increasingly clear. Module 19 delves into the drivers of the dysfunction in the microbiome-gut-brain axis that contributes to cognitive decline and covers how we can use microbiota optimisation as an additional strategy to both prevent and treat cognitive decline and Alzheimer’s disease.

Week 7

Module 20 - The Microbiota and Mood Disorders - Depression & Anxiety

It has long been known that psychological stress could negatively impact the composition of the GIT microbiota. Research conducted over the past decade has shown, however, that alterations in the composition of the microbiota can actually change emotional behaviour and brain function. This bidirectional relationship is now being referred to as the Brain-Gut-Microbiota axis. In Module 20, we’ll be exploring in depth the mechanisms by which our microbes may modify our mood - specifically depression and anxiety. We'll examine which intestinal microbes and their metabolites may be involved, as well as emphasise treatment strategies aimed at improving the dysbiosis and gut dysfunction that underlies discordance in the microbiota-mood axis. We’ll also highlight specific prebiotic and probiotic interventions that can modify the stress response, decrease systematic inflammation, and lift the spirits.

Week 8

Module 21 - How to Harness the Microbiome for Enhancing Longevity and Healthy Aging

Module 22 – Metabolic Disease and the Microbiome

Aging and increased risk of chronic disease have invariably been linked in the minds of most Westerners. We know, however, that some people reach a ripe old age free of chronic disease and that chronological age and biological age do not necessarily correlate. In Module 21 we delve into the role of the microbiota in the aging process. We’ll discuss the microbiota changes typically seen with aging in Western nations, but interestingly, these dysbiotic changes are not observed in healthy older people. We’ll highlight the microbiota patterns seen in healthy centenarians and discuss strategies to preserve a youthful microbiota pattern as a way of delaying biological aging.

The rates of both metabolic syndrome and type 2 diabetes have escalated dramatically in Western nations over the past three decades. It is now estimated that a significant proportion of the population of Western nations suffer from Metabolic Syndrome or type 2 diabetes. Recent research has suggested a strong link between both of these conditions and dysbiosis in the GIT microbiota. In Module 22, we’ll provide an overview of what the growing body of research in this area has found and highlight treatment approaches that can beneficially modify the composition and functioning of the GIT microbiota and improve metabolic disease outcomes.

Week 9

Module 23 - The Role of Dysbiosis in Autistic Spectrum Disorders

Rates of autism spectrum disorders (ASD) have increased dramatically over the past 30 years. A growing body of evidence is suggesting a strong link between altered microbiota composition and ASD. Research has also found that changing the microbiome can significantly influence ASD presentations, such as mood, cognition, and GI symptoms. Module 23 covers the links between dysbiosis and ASD, highlights the most commonly seen dysbiotic patterns observed in ASD children (based upon the research and Dr Hawrelak’s clinical experience with this population), and delves into the tools that can be used to address these specific patterns.

Week 10

Module 24 - Optimising the Microbiota to Enhance Cancer Outcomes

Module 25 - Common Microbiota Patterns and How to Address Them – Proteobacteria Blooms, Bacteroides Overgrowth, Prevotella Overgrowth

Over the past few years, a growing body of evidence is suggesting that treatment outcomes in cancer patients are influenced by the composition of their GI ecosystem. With some ecosystem compositions associated with poorer outcomes and other patterns associated with enhanced survival and better treatment tolerability. In Module 24, we’ll highlight the recent research findings in this area with a view of enabling clinicians to optimise their patients’ ecosystems before (and during) conventional cancer treatment as a complementary approach to improve treatment outcomes. Our final lesson, Module 25, will cover some common dysbiotic patterns and using cases from Dr Hawrelak’s practice, show how they can be successfully addressed.