The role the microbiome plays in human disease, such as metabolic, gastrointestinal and neurological disorders, has been well-established. This has led to therapies that, just a few years ago, seemed radical, including fecal transplantation. Currently, several groups are working to design orally-administered “smart” bacteria that can perform deficient enzymatic roles in specific disease.
One example is a genetically-altered E. coli strain designed by Synlogic in Cambridge. This version of E. coli degrades ammonia into arginine in patients unable to regulate their nitrogen level. The strain has been designed to only work in the human gut by requiring low-oxygen, a condition in the gut, and thymidine, which is not found in high levels in the digestive tract. Other uses for “smart” bacteria include anti-cancer therapeutics and food treatment for phenylketonurics.