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The future of the gut microbiome

A microbiologist describes the remarkable symbiotic, and sometimes adversarial, relationship between humans and the trillions of bacteria inhabiting our gastrointestinal tracts.
Illustration of probiotic bacteria in a circle.
The bacteria living in and on our bodies impacts everything from our physical and mental health to our sleep. | iStock/verodika

Guest KC Huang is many things: A bioengineer. A microbiologist. An inventor. But mostly he’s an expert on the ecology of the human gut. He and his collaborators have developed a device that can sample bacterial DNA and create a living map of the gut microbiome from mouth to … ah, well … you know. Every step of the way, he says, we play host to trillions of guests we know very little about. It’s time we got to know them, Huang tells host Russ Altman on this episode of Stanford Engineering’s The Future of Everything podcast.

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[00:00:00] KC Huang: We are filled with trillions of microorganisms that impact us in ways we haven't even begun to think about yet. And all of these microorganisms play a really intimate role in our health, in our everyday lives, but also can cause disease. They can impact how we think, how we sleep. And so they represent both [00:00:30] an intimate part of ourselves but also a really interesting opportunity to engineer ourselves in new ways for the future.

[00:00:44] Russ Altman: This is Stanford Engineering's The Future of Everything, and I'm your host, Russ Altman. If you enjoy the podcast, please subscribe or follow it wherever you listen to podcasts. It'll help our audience grow, and it'll make sure that you never miss an episode.

Today, KC Huang will tell us about the gut microbiome. [00:01:00] There are trillions of bacteria living in our gut, all the way from our mouth, yes, to our anus. And those bacteria make molecules and have other processes that can affect our health in important ways. They are affected by our diet, they are affected by our exercise, and in turn, they can affect inflammatory disease and even our mental health. It's the future of the gut microbiome.

Before we jump into this episode, please rate and review it. It'll help people understand what we're all about, and it'll also help them [00:01:30] discover the show.

So the gut microbiome is the set of bacteria that are living in our gut. All the way from the mouth to the end of the pipe in the anus, we have bacteria growing. It's easy to collect poop at the end of the day and at the end of the trail, but there's a lot that goes on between the time that we ingest something and when it exits. And we have previously not been able to [00:02:00] sample that material as it goes through the bowel.

Well, KC Huang is a professor of bioengineering and microbiology and immunology at Stanford University. And he and coworkers have invented a device that allows us to sample what's going on in our bowel from the beginning to the end under really good control. They can sequence the DNA. They can look for the molecules that are being secreted by the bacteria, and therefore they can create a map of what KC calls the ecosystem.

[00:02:30] KC, you study the gut microbiome among many other things. What is the gut microbiome, and why should we care about it?

[00:02:37] KC Huang: Great question. I would say the simplest way to think about it is that we are, uh, filled with trillions of microorganisms that impact us in ways we haven't even begun to think about yet. And all of these microorganisms play a really intimate role in our health, [00:03:00] in our everyday lives, but also can cause disease. They can, uh, impact how we think, um, how we sleep. And so they represent both an intimate part of ourselves, but also a really interesting opportunity to engineer ourselves in new ways for the future. And so that's why I've become so fascinated in thinking about these as new tuning knobs for our everyday lives. [00:03:30]

[00:03:30] Russ Altman: Great. So, trillions of bacteria, that causes pause right there, and I presume that when we're talking about the gut microbiome, we're talking about the bacteria that are living in our, in our bowels, in our stomach, small intestine, large intestine, esophagus, the whole ball of wax.

[00:03:48] KC Huang: You know, since you're a doctor, Russ, one of my clinical collaborators corrected me. I wrote that there are trillions of microorganisms living inside of us. And he actually [00:04:00] pointed out that our gut microbiome is living on us, not in us. Because essentially there is just a tunnel. We're like a mountain. There's a tunnel going from, you know, mouth to anus and that's outside our body. And so there is, I think it's actually a really important way to think about it. Because it's not like our cells inside of us that we think of as being part of the factory. We're really like talking to [00:04:30] these trillions of microorganisms that are at this boundary at this interface. And so we're kind of both, you know, cautiously engaging with them as allies, but also, you know, realizing that we could be at war at any point.

[00:04:44] Russ Altman: I love this. I love this. And yes, we are really nothing but a big tube with a lot of decorations. So there you go. Uh, and that's what they teach us in medical school.

So, okay, so, uh, and actually as an extension of what you're saying, that means that the other part of the surface, there's many surfaces, [00:05:00] there's our skin, and I'm presuming and I think I know that there's a lot of bacteria on our skin, there's a lot of bacterial in our oropharynx, in the insides of our, uh, our breathing mechanisms. So yeah, so that, so, but as I understand it, you have focused, um, at least recently on the gut microbiome.

[00:05:19] KC Huang: Yes, exactly.

[00:05:20] Russ Altman: So as a scientist and engineer, what are the challenges in studying that? I know we have ample access to the final product, if you will.

[00:05:29] KC Huang: Yeah.

[00:05:29] Russ Altman: But [00:05:30] I'm guessing that you have questions beyond just what comes out at the very end.

[00:05:34] KC Huang: You know, what strikes me as ironic is that our most recent work actually has come full circle to how I got interested in the gut microbiome in first place. I, 10 years ago, I knew nothing about the microbiome, but I made all sorts of wild and incorrect assumptions about what everyone else knew. And one of the things that I assumed was that, you know, [00:06:00] everyone was talking about this ecosystem and every other ecosystem that I know about on the planet, one of the first things people do is they map it because it seems so important to know where are the trees and where are the mammals and how do they spatially organize so they can take advantage of everything that ecosystem has to offer. And that really was a huge black box for the gut microbiome field. And so one of the first things we did [00:06:30] was to develop some computational tools so that you could start to quantify who was doing what and where and when.

But, um, what we started to realize was that this was even more important to understand, not just in model organisms like mice, but in humans, because, you know, there is such a pressing need for therapies to deal with gut disorders like Crohn's and IBD and IBS. You know, it's amazing how often people come.

[00:06:57] Russ Altman: IBD is Inflammatory Bowel Disease. [00:07:00] IBS is Irritable Bowel Syndrome.

[00:07:01] KC Huang: Exactly. Sorry. Thank you. And, um, you know, people come to me all the time and ask, you know, when is the solution going to be here? And I have to say, you know, I'm afraid we're, you know, we're like at the tip of the iceberg in terms of just understanding what is going on. And part of the real challenge is, as you say, that, um, we have an amazing amount of data for all the downstream effluent of our gut. Because [00:07:30] poop is something we can collect. We can study, you know, until kingdom come, but if you want to go a little bit upstream and start understanding, you know, who is inside our gut and what they're doing. It's incredibly challenging and laborious, and hence data has been very limited.

In fact, most of the time, you know, if you get to a certain age as a man, you start to become well acquainted with the inside of your [00:08:00] bowels through very uncomfortable exams where really you're completely cleared out first. And so almost everything we know about the bowels has been in a non healthy, non digestive state of the mice.

[00:08:17] Russ Altman: It's like you burn down the forest and then say, okay, now let's go explore the forest.

[00:08:21] KC Huang: Yeah, exactly.

[00:08:23] Russ Altman: Okay, so let me go back though, because you said a couple of things that I just want to, as a preliminary. So you're referring to [00:08:30] plural, uh, plural type of bacteria. So I think, uh, everybody gets that this ecosystem is not made only of one bacteria. It's not like there is the one bacteria type that lives in your bowel. So what do we know? Are we talking about five or 10 different species? Hundreds? Thousands? Even more? So paint a little picture for this ecosystem. And I know that it's still a frontier in many ways.

[00:08:53] KC Huang: Yeah, I think it, you know, I think the number of hundreds to thousands is what people will quote but it's [00:09:00] kind of similar to the way people argue about how many different cell types do we have in our body and you'll get a different answer depending on who you ask, maybe what time of day you ask them and I think for the same reason that really when it comes to a functional characterization of who exactly is there. Tiny differences is in the genomes can make an enormous difference. And remember that unlike any other ecosystem on the planet, [00:09:30] this is a set of trillion, a trillion bacteria that are literally squashed together like sardines in a can. And as a result, they engage in horizontal gene transfer at rates that are unparalleled, you know.

[00:09:45] Russ Altman: And so when you say horizontal gene transfer, you mean that one bacteria is literally lending or giving its genes to the one next door, even if they're not the same species. Uh, so there's a lot of sharing of materials between [00:10:00] these bacteria.

[00:10:01] KC Huang: And, you know, one of the ways you see that coming to the forefront is in antibiotic resistance. that, you know, it is undeniable that this is just a melting pot for the exchange of genes like antimicrobial resistance genes, but also for many other functions. There's, you know, great examples of bacteria that have acquired the ability to process the polysaccharides in seaweed, and that happened [00:10:30] first in Japanese populations, because of the fact that there is this selective pressure. You know, you have this available nutrient, someone is going to learn how to eat it. And that happened through horizontal gene transfer.

[00:10:45] Russ Altman: Okay, so good. So that gives us a state of we're talking about a lot of bacteria. They're closely packed, they're exchanging information all the time. The other thing that you said quickly, and I don't want to lose it, is that this is not just important for like the quality of your bowel movements, [00:11:00] which by the way, as a physician, the one thing that's really has always intrigued me is you can ask most people, how's your poop? And they know exactly how to answer that question. Everybody knows what a good poop is and they, and by inference, they also know if there's something going on that is not normal. And so, uh, that's just a side conversation, a side comment about things that I've observed talking to patients.

But you said brain function, diet, exercise, and then you also referred to antibiotics and other [00:11:30] drugs, but tell me how, like, and I guess, again, I understand these are frontiers, but. How does the bacteria in my bowel affect my brain function? That's just kind of a showstopper.

[00:11:40] KC Huang: Yeah, I mean, I think once you really start to think about it, you should switch it into how could they possibly not affect your brain?

[00:11:49] Russ Altman: Okay.

[00:11:50] KC Huang: You know after you eat lunch, you know, you probably feel sleepy I do and that's because you know, your brain is a processing [00:12:00] plant for metabolites, chemicals that are all over your body. And the amazing thing about the gut ecosystem is that not just that you have trillions of bacteria there and that they're closely packed. But there is a constant impetus for growth and motion and activity, right? Because it's also where all the food is going.

[00:12:21] Russ Altman: Right.

[00:12:22] KC Huang: So there is the fuel for the bacteria to grow, to make things. And so I think even more than just saying there are a thousand [00:12:30] types of bacteria in your gut. It's, uh, the more staggering number is how many different unique genes are represented by those bacteria and hence how many different types of proteins, small molecules can be made. And that's in the millions in any given, uh, in any given microbiome that, you know, yours or mine. And so amongst those millions of metabolites that are being produced, it's kind of a given that you're going to [00:13:00] have effectors that change brain function and, you know, bacteria themselves will make metabolites that have been shown to modulate sleep patterns in model organisms and mice. It's really that, you know, we're constantly talking to our environment and they are part of the environment. That's how I think about it.

[00:13:19] Russ Altman: Got it. Okay. So that really is good. And then I think just to kind of, to boil it down, yes, it makes perfect sense as you described it, that we have these bacteria, they're eating, they're creating these molecules [00:13:30] just as a byproduct. Those molecules, even though as you said, they're not really inside our cells, those molecules can get into our bloodstream, go to different parts of our body, and therefore modulate themselves how we're thinking. What about exercise? You said exercise has an effect. Is the exercise affecting the bacteria or is the bacteria affecting our ability to exercise? Or probably is it going in both directions?

[00:13:52] KC Huang: It's a great question. There's a lot of recent studies about this. Um, actually let me go back one step

[00:13:58] Russ Altman: Yep.

[00:13:58] KC Huang: To return to [00:14:00] what's inside of us because for many years I've been so fascinated with trying to get a closer look inside and in a really funny way, um, we started to realize that humans are actually the best experimental model organism for this because mice are so small. So even though, you know, we can do amazing experiments that they've been hugely useful for understanding they've got microbiome, actually going into [00:14:30] the small intestines of mice is incredibly difficult and there's just not very much material there either.

[00:14:36] Russ Altman: Right.

[00:14:36] KC Huang: So, um, recently we published a paper that was really one of the most exciting things. We have worked on because it was an engineering project that opened up so many new doors. We collaborated with a guy named Dari Shalon, who is a sort of serial inventor. He was one of the inventors of the DNA [00:15:00] microarray and that you know, uh, know and love well.

And, um, when he, uh, started to get interested in the gut, he realized that we are kind of making things too complicated. There are companies that will sell you for a thousand dollars, some device that will go in and make some measurements inside your gut, but, you know, they've got a lot of electronics, there's things that can go wrong, they're big and bulky. And [00:15:30] most importantly, they're too expensive to really deploy at a scale that lets you start to probe over time and over many people. And so we helped Dari develop this device which is sort of elegant in its simplicity. All it is, is a tiny bladder that basically has a time delay before it opens in a different part of your gut. And then it has a one way valve. It sucks up material and then closes off so [00:16:00] that you can collect that when you go poop.

[00:16:01] Russ Altman: Huh.

[00:16:02] KC Huang: The next day.

[00:16:02] Russ Altman: Huh.

[00:16:03] KC Huang: And the beautiful thing is that it's collecting what's there. And so you don't have to decide what kind of measurements you're going to do until you've got the material. And we've been able to use this. So, we can look at the proteins, look at the bacteria, look at the metabolites, and it's utterly fascinating because every single thing we look at, when we compare it to what we find in poop, it's totally different. And so what that means is that [00:16:30] even if poop has been useful in trying to say, tell apart, you know, what, how are these disease cohorts different from these healthy cohorts? We're not looking at what we think matters the most.

[00:16:42] Russ Altman: Right. Okay, so this is great. So this little floating bladder, uh, can get a sample of poop, if you will. Now I have to think about time, not distance. So I was thinking about, you know, we're three feet down the colon, we're seven feet down the colon. Now it's about we're ten minutes down the colon, we're thirty minutes down the colon. [00:17:00] But these give me measurements of the poop as it's forming and as it's living its life and therefore you can tell me well up at the top I'm seeing these thousand bacteria but over at the bottom I'm seeing these thousand and they're different or they're they're the same but they're acting different or all and the other thing you just said it's very powerful is it's not just about getting the DNA you can also get things like the small molecules that they're secreting um and so now I want to go back because you answered you went on this diversion when I asked you about exercise.

[00:17:29] KC Huang: Yeah.

[00:17:29] Russ Altman: [00:17:30] So you Tell me why you did that.

[00:17:31] KC Huang: So one of the things we are using this device for now is to study how exercise affects the microbiome. And there are many aspects to that question, but one we've been very fascinated in is temperature.

[00:17:47] Russ Altman: Huh.

[00:17:47] KC Huang: Because temperature is actually this fascinating tool that the body uses to fight off disease.

[00:17:55] Russ Altman: That's why we get fevers, I would guess. I know that, actually.

[00:17:58] KC Huang: In fact, pre [00:18:00] antibiotic discovery, uh, if you got syphilis, do you know what the primary there were two primary treatments. There was basically giving you poison with like cyanide.

[00:18:11] Russ Altman: Yes.

[00:18:12] KC Huang: Do you know what the other was?

[00:18:13] Russ Altman: I do not know that.

[00:18:15] KC Huang: They would give you malaria.

[00:18:17] Russ Altman: Oh

[00:18:18] KC Huang: The malaria would give you a very high fever that would help to clear the syphilis and then you probably drop 30- 40 pounds but they know how to clear the malaria afterwards and So it was it actually led [00:18:30] to the Nobel Prize In 1927 in medicine, it was for what's called pyro therapy.

[00:18:36] Russ Altman: Pyro therapy.

[00:18:36] KC Huang: Basically you would just put people in a big oven. It was like an oven with a hole for the head so you don't heat the head too much, and then they just heat you up to about 106 degrees.

[00:18:46] Russ Altman: And the bacteria don't like that. Syphilis is a bacteria, so it either dies or becomes disabled.

[00:18:52] KC Huang: Exactly. And when you do heavy exercise, it turns out your body temperature rises by about two degrees Celsius. Actually, [00:19:00] probably even more, but in our IRB, we're not allowed to push people, blow on people.

[00:19:04] Russ Altman: So IRB is the human subjects of people, and they don't want you to heat up your patients too much.

[00:19:10] KC Huang: Exactly. But I'm pretty sure, like, when I go on a really hard run, you know, my body temperature is temporarily going upside down.

[00:19:16] Russ Altman: I totally agree. In fact, I have, um, without any scientific documentation, I have observed that when I feel a cold coming on, sometimes going for a run or doing excessive exercise [00:19:30] seems to thwart off an infection. And I have no proof of that except what you just said.

[00:19:35] KC Huang: You know, and there's been a whole slew of recent studies that are trying to explore this interface because, you know, first of all, we and bacteria, you know, just very sensitive to these temperature fluctuations. But also, probably we've all experienced that heavy exercise messes with our gastrointestinal system. And so one of the things we're collaborating with, uh, [00:20:00] Sean Spencer, who's a GI fellow at Stanford, who has been really interested in how fermented foods can both affect the immune system, may also be important for recovery. Um, so, you know, it's a really interesting interface for thinking about, you know, how to remain healthy as, you know, you're sort of reflecting on, but I think one of the tools that will be so important is to be able to not just sample what's in there, but actually be able to sample as it's [00:20:30] happening, right? Cause the great thing about these capsule devices that we have is that

[00:20:34] Russ Altman: you can just keep swallowing them. You can just keep swallowing them.

[00:20:37] KC Huang: You can say, I want to pick up. Material at 2 pm. Not, I'm gonna wait until my next bowel movement, which may be three, four days from now.

[00:20:46] Russ Altman: Right.

This is The Future of Everything with Russ Altman. More with KC Huang next.[00:21:00]

Welcome back to The Future of Everything. I'm speaking with KC Huang from Stanford University.

In the last segment, KC told us about all the ways in which we're trying to understand the bacteria that grow in our gut. How we can measure them, how we can understand their interactions with one another, and with our physiology.

In this next segment, he will tell us about how we can see opportunities for engineering the microbiome to improve health. He has lots of ideas and he thinks that a lot of the action will be in [00:21:30] the small intestine.

In the last segment, KC, we talked a lot about the microbiome, what it looks like, what we're learning about it, how you're measuring it. But we didn't talk at all about once we have some more knowledge about the microbiome, how are we going to use that knowledge to influence health? Wellness or whatever. So tell me what are you seeing as the, um, exciting applications of the knowledge that you're generating?

[00:21:55] KC Huang: Yeah, you know, I taught a class with several [00:22:00] colleagues a few years ago called, uh, the microbiota in human health. And one of the things that we had the students do on the very first day was to fill in a survey, basically to get a sense of what they knew and most of them didn't know much. So the last two questions in the survey were, do you on a scale of one to 10, how much do you think microbiome based therapies will be a part of health care in the future? And the next question was when is this [00:22:30] actually going to be a reality? And then after 10 weeks of them reading what we thought of as the best papers in the field we gave them the same survey again. And uniformly, they were much more confident that microbiome therapies were going to be an integral part of healthcare, and uniformly, they were convinced that this was way further off in the future than...

[00:22:54] Russ Altman: Got it.

[00:22:54] KC Huang: ...they thought at the beginning.

And I think it's really striking commentary on [00:23:00] the state of the field. It's, there's a huge amount of excitement, there's a huge amount of energy and money both in academia and outside. But there's still this lack of fundamental understanding that is leading to the same sort of engineering paradigms that you see here in Silicon Valley, where, you know, we count on things like Moore's Law to push progress forward.

But I think, for me [00:23:30] personally, coming at this as a complete outsider, you know, I'm trained as a theoretical physicist. And even though, you know, we now do experimental wet lab work in microbial ecology, I still have this, uh, different way of thinking, and I think it's really important to try and apply that to a field like this.

And I think one of the things that has been missing is a perspective of [00:24:00] embracing the complexity of the ecosystem. You know, their reductionist science has gotten us so far that I think people tend to think, okay, we started with E coli as a model bacterium. And now that we're interested in the microbiome, let's see what happens if we have two species or three species or four species.

But I think the problem there is that when you have two or three species, every single way that they talk to each other is important. If you have a thousand species, there's [00:24:30] no way that every single arrow matters.

[00:24:33] Russ Altman: Right.

[00:24:34] KC Huang: It's just too much for establishing stability and robustness in any complex system. And that's why, you know, if you talk to a cosmologist, you know, they might say, Oh yeah, I developed computational models of the formation of the universe. And, you know, that's at a scale that, like, as biologists, we're like, wow, you know, okay, that sounds harder than just, you know, understanding humans.

[00:24:59] Russ Altman: I study [00:25:00] a thousand bacteria in the duodenum.

[00:25:02] KC Huang: But, you know, of course, the reason why you can actually make a model for a universe is because you just identify the most important two or three variables. And so that's a perspective we started to take for thinking about consortia of dozens or even hundreds of species where we say, let's just identify the one thing that is most important to these bacteria and then figure out how that [00:25:30] dictates who's going to be there and how they assemble.

[00:25:33] Russ Altman: Yeah, I can see that. And especially if you're right about those variables, I mean, it'll be a little bit of trial and error, but if you're right. Then that gives you a much more powerful knob to turn with respect to therapeutics and other applications. Cause you say, no, no, no, I don't have to change a thousand bacteria with genetic engineering of all a thousand of them. I just need to do something so that this variable goes up or goes down.

[00:25:56] KC Huang: Exactly. And I think you [00:26:00] and actually any of the listeners can probably guess. That's what the most important variable is for...

[00:26:06] Russ Altman: wow.

[00:26:06] KC Huang: ...bacteria in the gut microbiome. What do you think they care most about?

[00:26:11] Russ Altman: Uh, well, I think you gave a clue before. You said that's where all the food is.

[00:26:14] KC Huang: Exactly.

[00:26:14] Russ Altman: And I think for bacteria, it's like money. Money is to humans as food is to bacteria.

[00:26:20] KC Huang: Exactly. So go where the food is, you know, we've just finished a project where we took that hypothesis to its logical [00:26:30] conclusion. We said, if nutrients are what they care most about, then we should be able to predict almost every interaction by understanding who is eating what. And then we measured the nutrient consumption landscape of every species in the consortium. We were able to then say, okay, you know, this nutrient is being eaten by species 2,7 and 14. And this one is being eaten by 4, 8, [00:27:00] 11, and 36. And once we knew that competition landscape, we could actually build a model that successfully predicted the assembly of literally any subset of those species together.

[00:27:13] Russ Altman: Does that also mean that if you know that a species is eating X, that you can toggle the level of that species by providing more X or less X?

[00:27:21] KC Huang: Yes. And that has been done and it's a beautiful, it's actually one of the, uh, strategies is being used by a company for putting in engineered [00:27:30] bacteria into a human boosting their levels. But then also being able to take the bacterium away when you don't want it anymore. Once you've dealt with the problem.

[00:27:40] Russ Altman: And so listen, we have, we only have a couple of minutes left and this is a totally unfair question because you're still trying to figure this all out. But as a betting person, let's, I'm going to call you a betting person without actually knowing if you're a betting person.

What are the disease, the diseases or the disease areas that you think are [00:28:00] likely to be the ones that will be most influenced by an ability to manipulate the microbiome? Well, so I know you're making bets here and you're not ready to perhaps, uh, lay your life down on it. But I would really be interested in knowing what you know, which diseases look like they are diseases of the microbiome.

[00:28:19] KC Huang: Yeah. You know, now that we've started to learn so much about the small intestine, I'm becoming more and more convinced that small intestinal diseases are...

[00:28:28] Russ Altman: huh.

[00:28:29] KC Huang: ...where to go [00:28:30] because you've gone right to the source, you know, things like Crohn's are a direct interaction between the bacteria and the host, um, where we know that there are certain species that are starting to take over that shouldn't be there. And so our ability to start to design fecal microbiota transplants, consortia bacteria that you can put into someone's body and allow that to start to reconfigure the [00:29:00] microbiome that is there. I think that is the frontier.

[00:29:04] Russ Altman: So let me just ask you about that, if I could. Uh, is it the case, how do, can we tell the difference between there's a disease in the colon and the bacteria are growing to take advantage of the disease. But the bacteria are not causing the disease. They're just taking advantage of the breakdown of the barriers and the inflammation. Or do we know that actually that bacteria are participating in the pathogenesis, in the development of the disease from the [00:29:30] very start?

[00:29:31] KC Huang: I mean, I think you answered that question before when you said, you know, there's got to be some give and take in both directions. And, you know, we see that so often, even in sort of healthy states. One of my colleagues works on diet and the microbiome, trying to understand the role of fiber. And, you know, he's put forth the idea now that, um, eating too much fiber. may be problematic because [00:30:00] we no longer have all the bacteria that are supposed to be there to help us digest the fiber.

[00:30:05] Russ Altman: Ah.

[00:30:06] KC Huang: And so it becomes a question of, are the solutions or the problems, one of the presence of the bacteria, of the absence of bacteria that should have been there in the first place. Are they the host responding to that presence or absence? Probably the answer is all of the above, but I think the most exciting thing, the thing I want to leave the listeners with is that, [00:30:30] um, you know, there's going to be a frontier for, you know, human health, where we can engineer our genomes. But that is far off in the future, the microbiome is part of our genome in some ways, and we can engineer that now, and so every bit of understanding that we acquire is something that can be deployed in a very strategic and immediate way because we do that every day anyway, you know when you [00:31:00] eat broccoli you are engineering your microbiome. You just don't know exactly how yet.

[00:31:06] Russ Altman: Thanks to KC Huang. That was the future of the gut microbiome You have been listening to The Future of Everything podcast with Russ Altman.

If you enjoy the podcast, please follow and subscribe to it Also, please rate and review and tell all your friends so that nobody is ever surprised by the future of anything.

We have more than 200 interviews in our archive. Check those out because I think you'll find a lot of good stuff. [00:31:30] You can connect with me on Twitter @RBAltman or on threads @RussBAltman. And you can follow Stanford Engineering on Twitter @StanfordENG.

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