Public health

Mail order microbiome tests are jumping the gun: expert


A mail order test that provides a comprehensive profile of an individual’s microbiome is being backed by one of Australia’s top medical researchers.

However another leading microbiome researcher says such tests are not yet ready for prime time.

The $349  ‘Microba’ test offered by a Queensland team including HPV pioneer Professor Ian Frazer uses metagenomics to sequence genes from the microorganisms in a faecal sample.

The ‘gut health check’ service, being promoted direct to consumers online, uses 16sRNA gene sequencing to deliver a comprehensive profile of all the micro-organisms present in the gut, including identification of potentially beneficial and problematic bacteria, fungi and parasites.

Microba says the results will inform the consumer of their microbiome diversity, identify bacteria commonly used as probiotics and the potential of their microbiome to digest nutrients and produce vitamins. People who order the test receive personalised dietary suggestions to promote a healthy microbiome.

The company emphasises that microbiome profiling is only intended to provide information about overall gut health. It will allow individuals to check the impact of antibiotics and probiotics, see if there is overgrowth of particular micro-organisms and to make dietary changes to promote a healthy microbiome.

“The information in your profile is meant for you to gain a better understanding of your personal microbiome and how it may change in response to lifestyle choices. It is not a diagnostic tool and cannot be used to diagnose or treat medical conditions,” its website says.

But a leading gastroenterologist warns that microbiome tests could generate anxiety for patients and extra work for doctors.

Professor El-Omar

Professor Emad El-Omar, director of the Microbiome Research Centre at St George & Sutherland Clinical School based at the University of New South Wales says the limited knowledge and evidence about the gut microbiome means that profiling tests still belong in the realm of research settings.

“As a gastroenterologist, I see many patients who present to me with such microbiome analyses done through commercial kits,” he tells the limbic. “The patients are baffled and in all of these cases, the management was not dependent on the analysis, other than giving the usual advice about healthy eating and living.”

Professor El-Omar says the while basic science behind the test is sound and it comes from a respectable group, “my view of all these tools as a scientist and a clinician and as someone who has worked in the microbiome field for 20 years is that we are jumping ahead of ourselves”.

“While the kit is able to catalogue, in very broad terms, the microbiota and what they do in one’s stool, any clinical correlations are speculative at this stage.”

The test would probably reveal whether the balance of “good” to “bad” bacteria is skewed, “but this means very little for an individual person in the absence of large, well designed, well controlled clinical trials,” he says.

“There are so many confounders that can impact on such a stool analysis, and one must really be very careful in interpreting the findings without the proper context of the background of the subject, their diet, exercise level, medications, co-morbid disease.”

“I view these products as excellent research tools that could and should now be used in large clinical trials. Until then, I do not think their use is helpful for the general public and they run the risk of creating unnecessary anxiety and extra work for the medical profession, most of whom do not understand the meaning of the findings.”

However, with a research boom into the area of the microbiome Professor El-Omar believes it won’t be long before such tests are ready for prime time.

“I would say that in the next five years, we may be ready to use such tools in our clinical practice, but not now.”

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