Really interesting and exciting talk. But when he talks about being 'a long way from home' and describes the 'normal' gut bacteria profile, I wonder whether he's taken into account the finding that in humans there are 3 distinct 'enterotypes' (or types of ecosystems), which have been compared to blood groups:
http://healthland.time.com/2011/04/21/you-know-your-blood-type-but-whats-your-gut-bug-type/
The German research claims 3 enterotypes, based on whether
Bacteroides,
Prevotella, or
Ruminococcus are dominant. Bacteroides and Prevotella are both of phylum bacteriodetes, but Ruminococcus is a Firmicute.
Whereas he describes his profile as 'far from home' because it is dominated by red (firmicutes) rather than blue (bacteroidetes), and seems to assume that a bacteriodetes-dominated profile would be normal, in contrast the German research suggests that a firmucute-dominated profile (which his profile is) is actually one of 3 valid enterotypes. Since he shows a pie chart for the average Crohn's patient indicating a fimicute-dominated profile, it may well be that a firmicute-dominated profile is the type most prone to various forms of inflammatory bowel diseases, but it's far from clear that a bacteroides-dominated profile is the 'right' or 'healthy' or 'normal' one, as he appears to assume.
I think he's very probably right that we are now beginning to transition to a new age of medicine which will be based on individual data, particularly on the microbiome and genome, with personalised treatments and detailed tracking of data being the new paradigm...that change is incredibly disruptive because it runs contrary to the entire traditional model of evidence-based generic treatments using large trials to prove efficacy, but that revolution does appear to be under way and Andreas Kogelnik talked about this at the Invest in ME conference yesterday.
But the double-edged sword of this new paradigm is that while we now have the capacity to gather this vast amount of data, we actually know next to nothing yet about what that data
really means - we're only just beginning to analyze it - and the 'individualised medicine' paradigm is also going to have to challenge our instinctive assumptions that we are all basically the same - human - and that the 'correct' biology can be defined by averaging the biology of healthy adults.
On the face of it, the contrast between how he's interpreting those red and blue slices in the pie chart, and what the German research says about enterotypes, appears to be a case of making a false assumption about the 'average' distribution automatically being the 'right' or 'good' or 'healthy' distribution. Then again, maybe he's right and perhaps the firmicute-dominated type is indeed a damaged ('mass extinction') state rather than being one of three 'valid' types. This is certainly a very exciting area of research to watch.