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Of Men And Microbes

Who are you?

WRITER: RICHARD T. BOSSHARDT, M.D., FACS

Who are we, really?

On the surface, the question seems simple, but as with so many things in life, dig a little deeper and it becomes progressively more complex. The question has been asked in various ways, within different contexts, over the ages and can have a multitude of answers.

In the context of science and, more specifically, biology, the question becomes very interesting, especially when you narrow it down further to the field of medicine. We are a very complex organism comprised of a functionally interdependent collection of organ systems. The organ systems are composed of interdependent organs. These, in turn, are composed of tissues and the tissues are made of populations of different cells.

Many researchers have attempted to calculate the number of cells that make up the human body and the numbers are all over the place. Of course, the number will vary with something like size of the body but for convention, we often refer to a typical adult as weighing about 154 pounds. Using various methods of calculating there seems to be at least some general agreement among scientists that the number is around 37 trillion cells for said typical adult.

Put these all together and you have, well, you … or me … or someone else. Even that, however, fails to encompass who we are. When we die, those systems, and organs, and tissues, and cells do not all cease to function immediately. Long after we cease to be, according to legal and medical criteria, these continue to work for various periods of time, up to hours after we die. However, something vital is missing. Some call it our life force, some our spirit, some consciousness. Whatever it is, it imbues our physical bodies with what, for lack of a better term, we call “life”.

The question of who we are becomes a tad more complicated when you consider that we live in an environment teeming with microbial organisms. Some are friendly, some are neutral and some are dangerous, a source of infection, disease and death. Over millennia, we have adapted to live in relative harmony with our microscopic neighbors. The population of microbes that live on and in our bodies, called our microbiome, is vast. As with counting human cells, an accurate count is impossible, but it is generally agreed that we harbor 10 times more microorganisms than we do human cells, so from a strictly numbers perspective we are more bacterial than human.

I find that fascinating. However, this would be a bit

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0 0000 0 000 5 00 0 of interesting but otherwise useless trivia if it weren’t for the very real implications to our health. Our health depends on the microbes we harbor. In fact, you could say they are critical to our health. Doctors have known this for years. If our microbiome is disturbed the result is often illness, or worse. Just ask anyone who has ever experienced an intestinal infection with Clostridium difficil, commonly referred to as C. diff.

C. diff. is just one of the nearly 1,000 different species of bacteria found in our gut. C. diff is a pathogen, a disease-causing bacteria whose numbers are kept in check by the presence of other bacteria in our gut that outcompete it. When we take antibiotics, these can kill off enough of the beneficial bacteria to allow C. diff to multiply and damage the lining of our intestines, producing a severe colitis with abdominal pain, fever and bloody diarrhea. Patients get very sick; some die. One of the treatments for antibiotic-induced colitis is to give people probiotics, which are formulations containing large quantities of beneficial bacteria to help repopulate the gut and restore its normal microbial status.

Ever since Antonie van Leeuwenhoek peered through the lens of his primitive microscope and saw the first microorganisms one constant theme in human history has been has been a single-minded focus — some would say obsession — with distancing ourselves from our microbial past. We have developed antibiotics, antiseptics and countless processes to destroy bacteria around and in us. We treat cattle with antibiotics then pasteurize the milk they produce. We bathe and wash with antibacterial soaps. We wipe down our environment with disinfectants. In spite of these measures some say because of them we have not only failed to conquer the microbial kingdom, we have more health issues than ever due to the side effects of this misguided effort.

One of those issues is the rise of asthma, eczema, hay fever and other allergic disorders, which have increased by 1 percent every year since 1980. This has given rise to the hygiene hypothesis proposed by epidemiologist Dr. David P. Strachan. It is his contention that our obsession with hygiene has deprived children from exposure to enough bacteria, viruses and fungi in the environment to stimulate the development of a strong, effective immune system. This is also known as the microbial deprivation hypothesis.

Many researchers say what we need in our environment is not fewer microbes but more. A host of chronic illnesses ranging from cancer to heart disease have been linked, at least in part, to inflammation in our bodies.

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(1632-1723) one byproduct of the concern about our over-sanitized environment. Advocates actively seek out live food and fermented foods, things like sauerkraut, kimchi and yogurt that all are teeming with bacteria. Foods are prepared in such a way that the microbes are not killed. Some of these foods cannot be produced commercially or sold legally in the U.S. because their preparation does not conform to federal standards of hygiene. In France, for example, you can eat cheeses made from raw milk and containing live cultures of fungi and/or bacteria that cannot be sold in the U.S. because of supposed health risks. These don’t seem to be bothering French consumers much at all.

As a physician, I am not advocating we completely abandon modern sanitation measures, stop using antibiotics and let our children play in sewers. As with so much of life, I think we need to strike the right balance between protecting ourselves from bad bacteria, viruses and germs and the injudicious use of antibiotics and an obsession with cleanliness and sterility.

Inflammation is the result of a cascade of cellular changes that eventually turn healthy cells into sick ones. There is a growing body of evidence that some, if not most, of this inflammation is the result of alterations in our microbiome.

The raw food movement is

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