Good bacteria on the way to curing diabetes

Our intestines contain more than a kilo of bacteria. Most of them are found in the large intestine where they break down roughage and foreign bodies that our cells cannot handle. Almost all of these bacteria belong to one of two specific groups that do not make us ill in the same way as many other bacteria do. These “good bacteria” were therefore of little interest to microbiologists conducting research. “I think it’s crazy that everyone was focusing on the same pathogenic bacteria. I wanted to study normal processes. Not much had been done in the area,” says Fredrik Bäckhed, a professor at the University of Gothenburg.

He began studying this in 2003 when he travelled to one of the few labs focusing on non-pathogenic intestinal bacteria at Washington University in St. Louis in Missouri. That was right after he gained his PhD.

Since then he has been able to prove that there are links between bacteria in the intestines and obesity and metabolic diseases. People with type 2 diabetes, for example, have fewer bacteria that can produce butyric acid, but more of other types of bacteria that can contribute to diabetes by breaking down a common amino acid in a different way.

In St. Louis he was part of a team that made the first ground-breaking discovery: a mouse that lacked certain bacteria became obese. This made it possible for them to connect the bacteria to metabolic disease. When he came back to Sweden he wanted to continue studying this link. He moved to Gothenburg.

The IVA Actuellt interview is conducted via Zoom. Fredrik Bäckhed is working from home when he suddenly apologizes and dashes off. He was out on his boat emptying lobster traps in the morning. He had been boiling some crabs that were also caught in the traps, and now they are ready.

“I started fishing last year. We live just a few minutes’ walk from the sea. It only takes 10 minutes by boat to the traps”, he says.

The reason he moved to Gothenburg was, however, the Wallenberg Laboratory, a translational research centre where research is based on problems discovered in health care.

“The university rents space on one floor of the hospital. I can work with physicians and go from molecules to people and from people to molecules. This has been an important stage in my research and carrier and it’s also very enjoyable. Being able to help improve people’s lives has in some way become a realistic goal”, says Bäckhed.

Working with doctors gave him access to samples from patients with type 2 diabetes or in the preliminary stages of the disease. He was able to identify a change in the bacterial composition in their intestines, but also discovered that the composition was affected by a drug the patients were given. This discovery was the start of a new, comprehensive study.

“We sent letters to 25,000 healthy Gothenburg residents and asked them to come to the clinic. More than 5,000 showed up and gave samples. Tests showed that some had type 2 diabetes or were in the preliminary stages of the disease without realising it. They were not receiving any medication but the bacterial composition in their gut was also altered, which indicated that this was a contributing factor in the disease progression”.

Bäckhed and his colleagues are now attempting to develop a treatment based on this discovery. The hypothesis is that type 2 diabetes will be cured by introducing bacteria that can produce butyric acid, which the patients have lower levels of.

“We have studied healthy volunteers and hope to be able to start a new study next year in patients in the preliminary stages of type 2 diabetes”, he says.

He has been working on this in cooperation with Chalmers University of Technology professor Jens Nielsen. The bacteria will be produced, but they need to be encapsulated to be able to survive outside the oxygen-free environment of the intestines where they normally live. The two researchers jointly formed the company Metabogen to develop the product.

“The study involving 5,000 Gothenburg residents also that showed that people with diabetes have more of the bacteria that contribute to diabetes by breaking down a common amino acid in a different way. Finding a treatment based on preventing this breakdown process is another, longer-term goal”, says Bäckhed.

Today, intestinal bacteria is a hot topic and a lot of people are interested in it. Popular science books such a “Gut - the inside story of our body’s most under-rated organ” are big sellers. Bäckhed often gives lectures on the subject for patient organisations and the adult educational association Folkuniversitetet.

“We need to focus our time and energy on informing the public, to be the antithesis of people who we hear from a lot but who are only interested in selling products that have not been scientifically tested. We have a responsibility as researchers at Swedish universities financed by tax revenue to communicate the knowledge we gain in publicly funded studies”, he says.

FREDRIK BÄCKHED

Age: 47

Education: Degree in Biology, Linköping University, 1997. PhD in Infection Biology, Karolinska Institutet (KI), 2002.

Career: Post doc at Washington University in St. Louis 2003–2006. Professor in Microbiology at Novo Nordisk Foundation Center for Basic Metabolic Research at Copenhagen University from 2011. Adjunct Professor at Oslo University 2013–2015. Professor in Molecular Medicine at the University of Gothenburg from 2013. Director of Wallenberg Laboratory for Cardiovascular and Metabolic Research 2012–2020. Guest lecturer at the University of Hawaii at Manoa, Hawaii, 2018–2019.

Distinctions: Ingvar Carlsson Award, Erik K Fernström Prize, Göran Gustafsson Prize, Torsten Söderberg Professorial Chair in Medicine, ERC Consolidator Award, Wallenberg Scholar. Member of the Young Academy of Sweden 2011–2016. KVA and IVA fellow.

GOLD MEDAL

Professor Fredrik Bäckhed for his outstanding microbiological research on the connection between the bacterial flora in the intestines and human metabolism and health, combined with the development of production technology to produce intestinal bacteria and methods for new treatments, and actively communicating this knowledge to the public.

PHOTO: THOMAS JOHANSSON

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