SlideShare ist ein Scribd-Unternehmen logo
1 von 41
Human Microbiome in Health and Disease
Shivanshu Bajaj
M.Pharmacy (Pharmacology)
SPER , Jamia Hamdard
CONTENT
1) Introduction
2) Categorization of microbiota
3) Human microbiome project
4) Analytical techniques
5) Classification of microbiome
6) Anatomical areas
7) Role of microbiome in human health
8) Role of microbiome in human diseases
9) References
INTRODUCTION
The human microbiota/microbiome is the aggregate of microorganisms
that resides on or within any of a number of human tissues and biofluids
It includes –
Skin Mammary glands
Placenta Seminal fluid
Uterus Ovarian follicles
Lung Saliva
Oral mucosa Conjunctiva
Biliary gland Gastrointestinal tracts.
 Microbiota include bacteria, archaea, fungi, protists and viruses.
 Though micro-animals can also live on the human body, they are
typically excluded from this definition.
 The human microbiome refers specifically to the collective genomes of
resident microorganisms.
Categorization of Microbiome-
1. Commensal – they co-exist without harming the host
2. Mutualistic – both host and microbe are benefited
3. Non-pathogenic – they harm the host by producing metabolites. For ex :-
metabolites produced, like trimethylamine, which the human body
converts to trimethylamine N-oxide via FMO3-mediated oxidation
Relative numbers-
In 2014, the American Academy of Microbiology published that approximately 37.2
trillion microbial cell, meaning that the ratio of microbial-to-human cells, if the
original estimate of 100 trillion bacterial cell, is closer to 3:1
Human Microbiome Project –
The Human Microbiome Project (HMP) was a United States National Institutes of
Health (NIH) research initiative to improve understanding of the microbial
flora involved in human health and disease. Launched in 2007, the first phase
(HMP1) focused on identifying and characterizing human microbial flora. The
second phase, known as the Integrative Human Microbiome Project (iHMP)
launched in 2014 with the aim of generating resources to characterize
the microbiome and elucidating the roles of microbes in health and disease states.
Phase One (2007-2014)
The HMP1 included research efforts from many institutions.The
HMP1 set the following goals:
• Develop a reference set of microbial genome sequences and to
perform preliminary characterization of the human microbiome
• Explore the relationship between disease and changes in the
human microbiome
• Develop new technologies and tools for computational analysis
• Establish a resource repository
• Study the ethical, legal, and social implications of human
microbiome research
Phase Two (2014-2016)
In 2014, the NIH launched the second phase of the project, known
as the Integrative Human Microbiome Project (iHMP). The goal of
the iHMP was to produce resources to create a complete
characterization of the human microbiome, with a focus on
understanding the presence of microbiota in health and disease
states. The project mission, as stated by the NIH, was as follows:
The iHMP will create integrated longitudinal datasets of biological
properties from both the microbiome and host from three different
cohort studies of microbiome-associated conditions using multiple
"omics" technologies.
Achievements-
• Development of new database systems allowing efficient organization, storage,
access, search and annotation of massive amounts of data. These include IMG,
the Integrated Microbial Genomes database. Genomes Online Database(GOLD),
for monitoring the status of genomic and metagenomic projects worldwide and
their associated metadata.
• Development of tools for comparative analysis that facilitate the recognition of
common patterns, major themes and trends in complex data sets.
• Development of new methods and systems for assembly of massive sequence
data sets. Novel algorithms have been developed for improving the quality and
utility of draft genome sequences.
• Assembly of a catalog of sequenced reference genomes of pure bacterial strains
from multiple body sites, against which metagenomic results can be compared.
• Establishment of the Data Analysis and Coordination Center (DACC), which serves
as the central repository for all HMP data.
Study –
The problem of elucidating the human microbiome is essentially identifying
the members of a microbial community which includes bacteria,
eukaryotes, and viruses. This is done primarily using DNA-based studies,
though RNA, protein and metabolite based studies are also performed.
Studies can be performed using different techniques –
I. Shotgun Sequencing
a) Collection of sample and DNA extraction
b) Preparation of library and sequencing
c) Metagenome assembly
d) Contig binning
II. Marker gene analysis
III. Phylogenetic analysis
Classification of Microbiome –
1) Bacteria
a) Firmicutes
b) Bacteroidetes
c) Proteobacteria
d) Verrumicrobia
e) Actinobacteria
f) Fusobacteria
g) Cyanobacteria
2) Archaea
a) Methanogen
3) Fungi
a) Yeast
b) Candida
c) Malassezia
4) Viruses
a) Bacteriophages
BACTERIA
Class Sub-class Type Present at Benefits Disease
Firmicutes bacillus and
clostridium
Gram +ve Gut flora energy
resorption
diabetes and
obesity
Bacteroidetes
(opportunistic
pathogen)
Chlorobi, Fibro
bacteres
Gram-ve symbiotic
species in GIT
metabolic
conversions of
complex sugar
and proteins
obesity and irrit
able bowel
syndrome.
type1 and type-
2 diabetes
Proteobacteria Escherichia, Sal
monella, Vibrio,
Helicobacter, Y
ersinia, Legione
llales
Gram-ve Gut ,placenta,
lower tract
Metabolism
and in placenta
Inflammation in
women lower
tract
Archaea
Class Sub-class Type Present at Benefits Disease
Methanogen Methanobrevi
bacter smithii
Hydrogen
metabolizer
Human gut Microbial
fermentation
and yield
energy
Obesity
CVS problem
Type-2 diab
Colon cancer
Methanosph
aera
stadtmanae
Hydrogen
metabolizer
Human gut Convert
methanol to
methane
-
Fungus
Class Sub-class Type Present at Benefits Disease
Yeast Ascomycota
and
Basidiomycot
a
Commensal
and single
celled
GIT Balance flaura
Gut activity
Opportunistic
infection
Candida C. Albicans
C.ascalaphida
rum
C. Amphixiae
Commensal Vagina
Skin
Genitals
GIT
GUT
Glucose and
maltose to gas
and acid
Fungal infection
Opportunistic
infection
Anatomical areas
Skin
• A study of twenty skin sites on each of ten healthy humans found 205
identified genera in nineteen bacterial phyla, with most sequences assigned
to four phyla :-
Actinobacteria (51.8%), Firmicutes (24.4%), Proteobacteria (16.5%),
and Bacteroidetes (6.3%).
• A large number of fungal genera are present on healthy human skin, with
some variability by region of the body; however, during pathological
conditions, certain genera tend to dominate in the affected region. For
example, Malassezia is dominant in atopic dermatitis and Acremonium is
dominant on dandruff-afflicted scalps.
Conjunctiva
• A small number of bacteria and fungi are normally present in
the conjunctiva. Classes of bacteria include Gram-positive cocci
(e.g., Staphylococcus and Streptococcus ) and Gram-negative rods and
cocci (e.g., Haemophilus and Neisseria ) are present.
• Fungal genera include Candida, Aspergillus, and Penicillium.
• The lachrymal glands continuously secrete, keeping the conjunctiva
moist, while intermittent blinking lubricates the conjunctiva and washes
away foreign material. Tears contain bactericides such as lysozyme, so
that microorganisms have difficulty in surviving the lysozyme and settling
on the epithelial surfaces.
GUT
• In humans the composition of gut flora is established during birth.
• Birth by Cesarean section or vaginal delivery also influences the gut's
microbial composition.
• Babies born through the vaginal canal have non-pathogenic, beneficial gut
microbiota similar to those found in the mother. However, the gut
microbiota of babies delivered by C-section harbors more pathogenic
bacteria such as Escherichia coli and Staphylococcus and it takes longer to
develop non-pathogenic, beneficial gut microbiota
Urethra and bladder
The genitourinary system appears to have a microbiota which
is an unexpected finding in light of the long-standing use of
standard clinical microbiological culture methods to
detect bacteria in urine when people show signs of a urinary
tract infection.
As of 2017, sequencing methods were used to identify these
microorganisms to determine if there are differences in
microbiota between people with urinary tract problems and
those who are healthy
Vagina
• Vaginal microbiota refers to those species and genera that colonize the vagina. These
organisms play an important role in protecting against infections and maintaining vaginal
health..
• The most abundant vaginal microorganisms found in premenopausal women are from
the genus Lactobacillus, which suppress pathogens by producing hydrogen peroxide and
lactic acid.
• Bacterial species composition and ratios vary depending on the stage of the menstrual
cycle.
• Ethnicity also influences vaginal flora. The occurrence of hydrogen peroxide-producing
lactobacilli is lower in African American women and vaginal pH is higher.
• Other influential factors such as sexual intercourse and antibiotics have been linked to
the loss of lactobacilli.[
• Changes in the normal, healthy vaginal microbiota is an indication of infections, such
as candidiasis or bacterial vaginosis. Candida albicans inhibits the growth
of Lactobacillus species, while Lactobacillus species which produce hydrogen peroxide
inhibit the growth and virulence of Candida albicans in both the vagina and the gut.
Role of microbiota in Human Health
1. Symbiotic relationship: Interaction between two different
organisms living in close physical association, typically to
the advantage of both).
2. Shaping and maintaining immunity –
 Innate immunity
 Adaptive immunity
Gut Microbiota in Health- innate
immunity
• Produce pathogen associated
Molecular patterns (PAMPs) and
metabolic by products and
regulate intestinal immune
responses
• PAMPs are recognized by pattern
recognition receptor (PRR)-
bearing cells of the innate
immune system and many
epithelial cells
Gut Microbiota
in Health:
Adaptive
immune system
• Microbiota stimulation
leads to B cell switch to
IgA, regulatory T cell
induction, T cell
differentiation to Th17
Protective function (barrier effect)
• Compete and adhere to the attachment sites in the
brush border of intestinal epithelial.
• Compete for available nutrients.
• Produce antimicrobial (bacteriocins).
All of this will prevent attachment and subsequent entry of
pathogenic bacteria into the epithelial cells
Role of microbiota in
Disease
Density ,
diversity,and activity
of gut bacteria
Age ,
genetics ,
stress ,
physiological
processes ,
anatomical
structure and
physiology of
digestive
tract
Diet ,
prebiotics
,probiotics ,
antibiotic
usage , illness ,
lifestyle , living
environment
Health
Diseases
External influence
Internal host
properties
Dysbiosis: Proposed mechanisms leading to disease
• Genetic and environmental factors induce impaired barrier
function
• Overgrowth of pathogenic bacteria; inhibition of protective
bacteria
• Translocation of bacteria and bacterial products
• Immune activation and proinflammatory cytokine production
• Chronic inflammation leads to tissue destruction and
complications
• Leaky gut hypothesis
1) Gastric diseases
a) Gastric cancer
b) Gastritis
c) Ulcer
d) Ulcerative colitis
e) Crohns disease
2) Liver disease
a) Non-alcoholic liver disease
b) Non-alcoholic steatohepatitis
3) Neurodegenerative disease
a) Alzheimer due to oxidative stress
b) Parkinson
4) Metabolic disorder
a) Obesity
b) Diabetes
Dysbiosis and diseases
• Diseases of the GUT
– Malabsorption syndrome
– Malignancies: Colorectal cancer
– Inflammatory Bowl disease (IBD)
– Irritable Bowl syndrome
– Diarrheal diseases
– Clostridium Difficile Infection (CDI)
• Non-mucosal diseases
– Obesity and metabolic syndrome
– Malignancies: liver cancer, breast cancer
– Complications of liver cirrhosis
– Allergic conditions
– Autoimmune disorders (T1DM, arthritis etc)
– Abnormalities of the gut-brain axis- Autism and
other neurological disorders
– Obesity and other metabolic disorders
– Chronic fatigue syndrome
Malabsorption syndrome
• In health: The bacterial growth is restricted in the upper small bowel under the
influence of acid and motility.
• Factors predisposing to bacterial overgrowth:
Surgical, anatomical, motor (scleroderma & DM), hypochlohydra (atrophic gastritis, post
gastrectomy)
• Consequences of bacterial overgrowth:
– Fat malabsorption due to:
• Bacteria deconjugation of bile acids which allows free bile acids to be
reabsorped decrease luminal bile acid concentration ---limit micelle
formation.
• Patchy mucosal damage by bacteria or toxic effects of FFA
– CHO and protein malabsorption due to mucosal damage or
bacterial metabolism of these nutrients.
– B12 malabsorption: B12 is utilized by the bacteria, in contrast
bacteria produces folic acid.
GIT malignancies: Colorectal cancer
Colonic bacteria may initiate cancer through:
1- Production of carcinogens from diets rich in meat and fat (nitroso
compounds).
2- Elevation in damage to DNA of colonic cells by dietary carcinogens
(heterocyclic aromatic amines found in cooked meat).
3- Abnormalities in repair can lead to neoplastic transformations
4-Microbial metabolism can produce by-products toxic to epithelium;
5- Disproportionate pro-inflammatory signalling at the GIT mucosa, leads to
increased sloughing and repair of epithelium, which can ultimately lead to
neoplasia and malignancy.
6-Certain microbial species can have direct or indirect (through host cell
activation) cytotoxic effects on cells
From Next time Don’t feel Lonely….cause you have some friends inside
you to take care of yourself……
REFERENCE
1. Human Microbiome and Its Association With Health and Diseases, ASMAA A.
ALTHANI,1,2 HANY E. MAREI, DOI: 10.1002/jcp.25284
2. The human microbiome in health and disease : hype or hope , Gwen Falony,
Doris Vandeputte , International Journal of Clinical and Laboratory Medicine
3. Sherwood, Linda; Willey, Joanne; Woolverton, Christopher (2013). Prescott's
Microbiology (9th ed.). New York: McGraw Hill. pp. 713–721.
4. "NIH Human Microbiome Project defines normal bacterial makeup of the body".
NIH News. 13 June 2012.
5. H Human Microbiome Working Group (2009). "The NIH Human Microbiome
Project". Genome Res. 19 (12): 2317–2323. doi:10.1101/gr.096651

Weitere ähnliche Inhalte

Was ist angesagt?

Gut microbiome slideshare
Gut microbiome slideshareGut microbiome slideshare
Gut microbiome slidesharemonaDubey3
 
Understanding Our Microbiome: The Natural Symbiosis
Understanding Our Microbiome: The Natural SymbiosisUnderstanding Our Microbiome: The Natural Symbiosis
Understanding Our Microbiome: The Natural SymbiosisKumaraguru Veerasamy
 
Human Microbiome Project (HMP)
Human Microbiome Project (HMP)Human Microbiome Project (HMP)
Human Microbiome Project (HMP)christina163032
 
Gut microbiota in health and disease
Gut microbiota in health and disease Gut microbiota in health and disease
Gut microbiota in health and disease Asma AlQahtani
 
Presentation gut microbiota
Presentation gut microbiotaPresentation gut microbiota
Presentation gut microbiotaRadhikaMenon31
 
Gut microbiota
Gut microbiotaGut microbiota
Gut microbiotaSaurav Das
 
Human nutrition, gut microbiome and immune system
Human nutrition, gut microbiome and immune system Human nutrition, gut microbiome and immune system
Human nutrition, gut microbiome and immune system S'eclairer
 
Bacterial toxin and its harmful effect
Bacterial toxin and its harmful effectBacterial toxin and its harmful effect
Bacterial toxin and its harmful effectRaNa MB
 
Microbiome, gut function and immunity final
Microbiome, gut function and immunity finalMicrobiome, gut function and immunity final
Microbiome, gut function and immunity finalElla Allred
 
Microbial habitats
Microbial habitatsMicrobial habitats
Microbial habitatsMicrobiology
 
Microbiota Dysbiosis
Microbiota DysbiosisMicrobiota Dysbiosis
Microbiota Dysbiosisfathi neana
 
Methanogens by kk sahu
Methanogens by kk sahu Methanogens by kk sahu
Methanogens by kk sahu KAUSHAL SAHU
 
Gut microbiome and host health
Gut microbiome and host health  Gut microbiome and host health
Gut microbiome and host health SANTHANAKUMARV
 

Was ist angesagt? (20)

HMP PPT
HMP  PPTHMP  PPT
HMP PPT
 
Gut microbiome slideshare
Gut microbiome slideshareGut microbiome slideshare
Gut microbiome slideshare
 
Understanding Our Microbiome: The Natural Symbiosis
Understanding Our Microbiome: The Natural SymbiosisUnderstanding Our Microbiome: The Natural Symbiosis
Understanding Our Microbiome: The Natural Symbiosis
 
Human Microbiome Project (HMP)
Human Microbiome Project (HMP)Human Microbiome Project (HMP)
Human Microbiome Project (HMP)
 
Gut microbiota in health and disease
Gut microbiota in health and disease Gut microbiota in health and disease
Gut microbiota in health and disease
 
Gut flora and health
Gut flora and healthGut flora and health
Gut flora and health
 
Presentation gut microbiota
Presentation gut microbiotaPresentation gut microbiota
Presentation gut microbiota
 
Probiotics and their therapeutic role.
Probiotics and their therapeutic role.Probiotics and their therapeutic role.
Probiotics and their therapeutic role.
 
Gut microbiota
Gut microbiotaGut microbiota
Gut microbiota
 
Human nutrition, gut microbiome and immune system
Human nutrition, gut microbiome and immune system Human nutrition, gut microbiome and immune system
Human nutrition, gut microbiome and immune system
 
Bacterial toxin and its harmful effect
Bacterial toxin and its harmful effectBacterial toxin and its harmful effect
Bacterial toxin and its harmful effect
 
Microbial Ecology
Microbial EcologyMicrobial Ecology
Microbial Ecology
 
Microbiome, gut function and immunity final
Microbiome, gut function and immunity finalMicrobiome, gut function and immunity final
Microbiome, gut function and immunity final
 
Microbial habitats
Microbial habitatsMicrobial habitats
Microbial habitats
 
Microbiota Dysbiosis
Microbiota DysbiosisMicrobiota Dysbiosis
Microbiota Dysbiosis
 
INDUSTRIAL IMPORTANT MICROBES .pptx
INDUSTRIAL IMPORTANT MICROBES .pptxINDUSTRIAL IMPORTANT MICROBES .pptx
INDUSTRIAL IMPORTANT MICROBES .pptx
 
Methanogens by kk sahu
Methanogens by kk sahu Methanogens by kk sahu
Methanogens by kk sahu
 
Gut microbiome and host health
Gut microbiome and host health  Gut microbiome and host health
Gut microbiome and host health
 
Lecture 09 (3 4-2021) euks
Lecture 09 (3 4-2021) euksLecture 09 (3 4-2021) euks
Lecture 09 (3 4-2021) euks
 
Probiotics
ProbioticsProbiotics
Probiotics
 

Ähnlich wie Human microbiome in health and disease

Microbiology Medical Subject Department Development - www.biomed.fit
Microbiology Medical Subject Department Development - www.biomed.fitMicrobiology Medical Subject Department Development - www.biomed.fit
Microbiology Medical Subject Department Development - www.biomed.fitBiomed Fit
 
Biology-Report.pptx
Biology-Report.pptxBiology-Report.pptx
Biology-Report.pptxlevi0417
 
Major fields of Microbiology.pptx
Major fields of Microbiology.pptxMajor fields of Microbiology.pptx
Major fields of Microbiology.pptxjibrilmoisak
 
MBB611 Microbiome signature and application
MBB611 Microbiome signature and applicationMBB611 Microbiome signature and application
MBB611 Microbiome signature and applicationBARAKA NGINGO
 
Concepts of Microbiology.pptx
Concepts of Microbiology.pptxConcepts of Microbiology.pptx
Concepts of Microbiology.pptxBhoj Raj Singh
 
Bacterial cultures in food
Bacterial cultures in foodBacterial cultures in food
Bacterial cultures in foodssusere49174
 
Food Microbiology.pdf
Food Microbiology.pdfFood Microbiology.pdf
Food Microbiology.pdfSumanRiaz5
 
Class 2, Scope & History Microbiology.pptx
Class 2, Scope & History Microbiology.pptxClass 2, Scope & History Microbiology.pptx
Class 2, Scope & History Microbiology.pptxyadavshubham8902
 
Rishi human microbiome
Rishi human microbiomeRishi human microbiome
Rishi human microbiomerashmiakula
 
Chapter10 microfarid
Chapter10 microfaridChapter10 microfarid
Chapter10 microfaridfarid121272
 
KBS_Human Microbiome.ppt
KBS_Human Microbiome.pptKBS_Human Microbiome.ppt
KBS_Human Microbiome.pptvenwen
 
clinical microbiology
clinical microbiologyclinical microbiology
clinical microbiologyElijahKamani
 
1 Introduction to Microbiology.pptx
1 Introduction to Microbiology.pptx1 Introduction to Microbiology.pptx
1 Introduction to Microbiology.pptxIshikaRoy32
 

Ähnlich wie Human microbiome in health and disease (20)

human microbiome project new.pptx
human microbiome project new.pptxhuman microbiome project new.pptx
human microbiome project new.pptx
 
Microbiology Medical Subject Department Development - www.biomed.fit
Microbiology Medical Subject Department Development - www.biomed.fitMicrobiology Medical Subject Department Development - www.biomed.fit
Microbiology Medical Subject Department Development - www.biomed.fit
 
Biology-Report.pptx
Biology-Report.pptxBiology-Report.pptx
Biology-Report.pptx
 
Major fields of Microbiology.pptx
Major fields of Microbiology.pptxMajor fields of Microbiology.pptx
Major fields of Microbiology.pptx
 
MBB611 Microbiome signature and application
MBB611 Microbiome signature and applicationMBB611 Microbiome signature and application
MBB611 Microbiome signature and application
 
Normal microflora
Normal microflora Normal microflora
Normal microflora
 
Concepts of Microbiology.pptx
Concepts of Microbiology.pptxConcepts of Microbiology.pptx
Concepts of Microbiology.pptx
 
Human Microbiome.pptx
Human Microbiome.pptxHuman Microbiome.pptx
Human Microbiome.pptx
 
Bacterial cultures in food
Bacterial cultures in foodBacterial cultures in food
Bacterial cultures in food
 
Food Microbiology.pdf
Food Microbiology.pdfFood Microbiology.pdf
Food Microbiology.pdf
 
Pros And Cons Of Microorganisms
Pros And Cons Of MicroorganismsPros And Cons Of Microorganisms
Pros And Cons Of Microorganisms
 
Class 2, Scope & History Microbiology.pptx
Class 2, Scope & History Microbiology.pptxClass 2, Scope & History Microbiology.pptx
Class 2, Scope & History Microbiology.pptx
 
An Unknown Disease Caused By Microorganisms
An Unknown Disease Caused By MicroorganismsAn Unknown Disease Caused By Microorganisms
An Unknown Disease Caused By Microorganisms
 
Rishi human microbiome
Rishi human microbiomeRishi human microbiome
Rishi human microbiome
 
Human Gut Mycobiota
Human Gut MycobiotaHuman Gut Mycobiota
Human Gut Mycobiota
 
Microbiome Profiling of Bacteria, Fungi AND Archaea
Microbiome Profiling of Bacteria, Fungi AND ArchaeaMicrobiome Profiling of Bacteria, Fungi AND Archaea
Microbiome Profiling of Bacteria, Fungi AND Archaea
 
Chapter10 microfarid
Chapter10 microfaridChapter10 microfarid
Chapter10 microfarid
 
KBS_Human Microbiome.ppt
KBS_Human Microbiome.pptKBS_Human Microbiome.ppt
KBS_Human Microbiome.ppt
 
clinical microbiology
clinical microbiologyclinical microbiology
clinical microbiology
 
1 Introduction to Microbiology.pptx
1 Introduction to Microbiology.pptx1 Introduction to Microbiology.pptx
1 Introduction to Microbiology.pptx
 

Kürzlich hochgeladen

Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...narwatsonia7
 
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...saminamagar
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.MiadAlsulami
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Servicesonalikaur4
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...Miss joya
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girlsnehamumbai
 
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service JaipurHigh Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipurparulsinha
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...narwatsonia7
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...narwatsonia7
 

Kürzlich hochgeladen (20)

Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
 
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
 
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service JaipurHigh Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
 

Human microbiome in health and disease

  • 1. Human Microbiome in Health and Disease Shivanshu Bajaj M.Pharmacy (Pharmacology) SPER , Jamia Hamdard
  • 2. CONTENT 1) Introduction 2) Categorization of microbiota 3) Human microbiome project 4) Analytical techniques 5) Classification of microbiome 6) Anatomical areas 7) Role of microbiome in human health 8) Role of microbiome in human diseases 9) References
  • 3. INTRODUCTION The human microbiota/microbiome is the aggregate of microorganisms that resides on or within any of a number of human tissues and biofluids It includes – Skin Mammary glands Placenta Seminal fluid Uterus Ovarian follicles Lung Saliva Oral mucosa Conjunctiva Biliary gland Gastrointestinal tracts.
  • 4.  Microbiota include bacteria, archaea, fungi, protists and viruses.  Though micro-animals can also live on the human body, they are typically excluded from this definition.  The human microbiome refers specifically to the collective genomes of resident microorganisms. Categorization of Microbiome- 1. Commensal – they co-exist without harming the host 2. Mutualistic – both host and microbe are benefited 3. Non-pathogenic – they harm the host by producing metabolites. For ex :- metabolites produced, like trimethylamine, which the human body converts to trimethylamine N-oxide via FMO3-mediated oxidation
  • 5.
  • 6. Relative numbers- In 2014, the American Academy of Microbiology published that approximately 37.2 trillion microbial cell, meaning that the ratio of microbial-to-human cells, if the original estimate of 100 trillion bacterial cell, is closer to 3:1 Human Microbiome Project – The Human Microbiome Project (HMP) was a United States National Institutes of Health (NIH) research initiative to improve understanding of the microbial flora involved in human health and disease. Launched in 2007, the first phase (HMP1) focused on identifying and characterizing human microbial flora. The second phase, known as the Integrative Human Microbiome Project (iHMP) launched in 2014 with the aim of generating resources to characterize the microbiome and elucidating the roles of microbes in health and disease states.
  • 7. Phase One (2007-2014) The HMP1 included research efforts from many institutions.The HMP1 set the following goals: • Develop a reference set of microbial genome sequences and to perform preliminary characterization of the human microbiome • Explore the relationship between disease and changes in the human microbiome • Develop new technologies and tools for computational analysis • Establish a resource repository • Study the ethical, legal, and social implications of human microbiome research
  • 8. Phase Two (2014-2016) In 2014, the NIH launched the second phase of the project, known as the Integrative Human Microbiome Project (iHMP). The goal of the iHMP was to produce resources to create a complete characterization of the human microbiome, with a focus on understanding the presence of microbiota in health and disease states. The project mission, as stated by the NIH, was as follows: The iHMP will create integrated longitudinal datasets of biological properties from both the microbiome and host from three different cohort studies of microbiome-associated conditions using multiple "omics" technologies.
  • 9. Achievements- • Development of new database systems allowing efficient organization, storage, access, search and annotation of massive amounts of data. These include IMG, the Integrated Microbial Genomes database. Genomes Online Database(GOLD), for monitoring the status of genomic and metagenomic projects worldwide and their associated metadata. • Development of tools for comparative analysis that facilitate the recognition of common patterns, major themes and trends in complex data sets. • Development of new methods and systems for assembly of massive sequence data sets. Novel algorithms have been developed for improving the quality and utility of draft genome sequences. • Assembly of a catalog of sequenced reference genomes of pure bacterial strains from multiple body sites, against which metagenomic results can be compared. • Establishment of the Data Analysis and Coordination Center (DACC), which serves as the central repository for all HMP data.
  • 10. Study – The problem of elucidating the human microbiome is essentially identifying the members of a microbial community which includes bacteria, eukaryotes, and viruses. This is done primarily using DNA-based studies, though RNA, protein and metabolite based studies are also performed. Studies can be performed using different techniques – I. Shotgun Sequencing a) Collection of sample and DNA extraction b) Preparation of library and sequencing c) Metagenome assembly d) Contig binning II. Marker gene analysis III. Phylogenetic analysis
  • 11.
  • 12. Classification of Microbiome – 1) Bacteria a) Firmicutes b) Bacteroidetes c) Proteobacteria d) Verrumicrobia e) Actinobacteria f) Fusobacteria g) Cyanobacteria 2) Archaea a) Methanogen 3) Fungi a) Yeast b) Candida c) Malassezia 4) Viruses a) Bacteriophages
  • 13. BACTERIA Class Sub-class Type Present at Benefits Disease Firmicutes bacillus and clostridium Gram +ve Gut flora energy resorption diabetes and obesity Bacteroidetes (opportunistic pathogen) Chlorobi, Fibro bacteres Gram-ve symbiotic species in GIT metabolic conversions of complex sugar and proteins obesity and irrit able bowel syndrome. type1 and type- 2 diabetes Proteobacteria Escherichia, Sal monella, Vibrio, Helicobacter, Y ersinia, Legione llales Gram-ve Gut ,placenta, lower tract Metabolism and in placenta Inflammation in women lower tract
  • 14. Archaea Class Sub-class Type Present at Benefits Disease Methanogen Methanobrevi bacter smithii Hydrogen metabolizer Human gut Microbial fermentation and yield energy Obesity CVS problem Type-2 diab Colon cancer Methanosph aera stadtmanae Hydrogen metabolizer Human gut Convert methanol to methane -
  • 15. Fungus Class Sub-class Type Present at Benefits Disease Yeast Ascomycota and Basidiomycot a Commensal and single celled GIT Balance flaura Gut activity Opportunistic infection Candida C. Albicans C.ascalaphida rum C. Amphixiae Commensal Vagina Skin Genitals GIT GUT Glucose and maltose to gas and acid Fungal infection Opportunistic infection
  • 16. Anatomical areas Skin • A study of twenty skin sites on each of ten healthy humans found 205 identified genera in nineteen bacterial phyla, with most sequences assigned to four phyla :- Actinobacteria (51.8%), Firmicutes (24.4%), Proteobacteria (16.5%), and Bacteroidetes (6.3%). • A large number of fungal genera are present on healthy human skin, with some variability by region of the body; however, during pathological conditions, certain genera tend to dominate in the affected region. For example, Malassezia is dominant in atopic dermatitis and Acremonium is dominant on dandruff-afflicted scalps.
  • 17. Conjunctiva • A small number of bacteria and fungi are normally present in the conjunctiva. Classes of bacteria include Gram-positive cocci (e.g., Staphylococcus and Streptococcus ) and Gram-negative rods and cocci (e.g., Haemophilus and Neisseria ) are present. • Fungal genera include Candida, Aspergillus, and Penicillium. • The lachrymal glands continuously secrete, keeping the conjunctiva moist, while intermittent blinking lubricates the conjunctiva and washes away foreign material. Tears contain bactericides such as lysozyme, so that microorganisms have difficulty in surviving the lysozyme and settling on the epithelial surfaces.
  • 18. GUT • In humans the composition of gut flora is established during birth. • Birth by Cesarean section or vaginal delivery also influences the gut's microbial composition. • Babies born through the vaginal canal have non-pathogenic, beneficial gut microbiota similar to those found in the mother. However, the gut microbiota of babies delivered by C-section harbors more pathogenic bacteria such as Escherichia coli and Staphylococcus and it takes longer to develop non-pathogenic, beneficial gut microbiota
  • 19. Urethra and bladder The genitourinary system appears to have a microbiota which is an unexpected finding in light of the long-standing use of standard clinical microbiological culture methods to detect bacteria in urine when people show signs of a urinary tract infection. As of 2017, sequencing methods were used to identify these microorganisms to determine if there are differences in microbiota between people with urinary tract problems and those who are healthy
  • 20. Vagina • Vaginal microbiota refers to those species and genera that colonize the vagina. These organisms play an important role in protecting against infections and maintaining vaginal health.. • The most abundant vaginal microorganisms found in premenopausal women are from the genus Lactobacillus, which suppress pathogens by producing hydrogen peroxide and lactic acid. • Bacterial species composition and ratios vary depending on the stage of the menstrual cycle. • Ethnicity also influences vaginal flora. The occurrence of hydrogen peroxide-producing lactobacilli is lower in African American women and vaginal pH is higher. • Other influential factors such as sexual intercourse and antibiotics have been linked to the loss of lactobacilli.[ • Changes in the normal, healthy vaginal microbiota is an indication of infections, such as candidiasis or bacterial vaginosis. Candida albicans inhibits the growth of Lactobacillus species, while Lactobacillus species which produce hydrogen peroxide inhibit the growth and virulence of Candida albicans in both the vagina and the gut.
  • 21. Role of microbiota in Human Health 1. Symbiotic relationship: Interaction between two different organisms living in close physical association, typically to the advantage of both). 2. Shaping and maintaining immunity –  Innate immunity  Adaptive immunity
  • 22.
  • 23. Gut Microbiota in Health- innate immunity • Produce pathogen associated Molecular patterns (PAMPs) and metabolic by products and regulate intestinal immune responses • PAMPs are recognized by pattern recognition receptor (PRR)- bearing cells of the innate immune system and many epithelial cells
  • 24. Gut Microbiota in Health: Adaptive immune system • Microbiota stimulation leads to B cell switch to IgA, regulatory T cell induction, T cell differentiation to Th17
  • 25. Protective function (barrier effect) • Compete and adhere to the attachment sites in the brush border of intestinal epithelial. • Compete for available nutrients. • Produce antimicrobial (bacteriocins). All of this will prevent attachment and subsequent entry of pathogenic bacteria into the epithelial cells
  • 26.
  • 27. Role of microbiota in Disease
  • 28. Density , diversity,and activity of gut bacteria Age , genetics , stress , physiological processes , anatomical structure and physiology of digestive tract Diet , prebiotics ,probiotics , antibiotic usage , illness , lifestyle , living environment Health Diseases External influence Internal host properties
  • 29.
  • 30. Dysbiosis: Proposed mechanisms leading to disease • Genetic and environmental factors induce impaired barrier function • Overgrowth of pathogenic bacteria; inhibition of protective bacteria • Translocation of bacteria and bacterial products • Immune activation and proinflammatory cytokine production • Chronic inflammation leads to tissue destruction and complications • Leaky gut hypothesis
  • 31.
  • 32.
  • 33. 1) Gastric diseases a) Gastric cancer b) Gastritis c) Ulcer d) Ulcerative colitis e) Crohns disease 2) Liver disease a) Non-alcoholic liver disease b) Non-alcoholic steatohepatitis 3) Neurodegenerative disease a) Alzheimer due to oxidative stress b) Parkinson 4) Metabolic disorder a) Obesity b) Diabetes
  • 34. Dysbiosis and diseases • Diseases of the GUT – Malabsorption syndrome – Malignancies: Colorectal cancer – Inflammatory Bowl disease (IBD) – Irritable Bowl syndrome – Diarrheal diseases – Clostridium Difficile Infection (CDI) • Non-mucosal diseases – Obesity and metabolic syndrome – Malignancies: liver cancer, breast cancer – Complications of liver cirrhosis – Allergic conditions – Autoimmune disorders (T1DM, arthritis etc) – Abnormalities of the gut-brain axis- Autism and other neurological disorders – Obesity and other metabolic disorders – Chronic fatigue syndrome
  • 35. Malabsorption syndrome • In health: The bacterial growth is restricted in the upper small bowel under the influence of acid and motility. • Factors predisposing to bacterial overgrowth: Surgical, anatomical, motor (scleroderma & DM), hypochlohydra (atrophic gastritis, post gastrectomy) • Consequences of bacterial overgrowth: – Fat malabsorption due to: • Bacteria deconjugation of bile acids which allows free bile acids to be reabsorped decrease luminal bile acid concentration ---limit micelle formation. • Patchy mucosal damage by bacteria or toxic effects of FFA – CHO and protein malabsorption due to mucosal damage or bacterial metabolism of these nutrients. – B12 malabsorption: B12 is utilized by the bacteria, in contrast bacteria produces folic acid.
  • 36. GIT malignancies: Colorectal cancer Colonic bacteria may initiate cancer through: 1- Production of carcinogens from diets rich in meat and fat (nitroso compounds). 2- Elevation in damage to DNA of colonic cells by dietary carcinogens (heterocyclic aromatic amines found in cooked meat). 3- Abnormalities in repair can lead to neoplastic transformations 4-Microbial metabolism can produce by-products toxic to epithelium; 5- Disproportionate pro-inflammatory signalling at the GIT mucosa, leads to increased sloughing and repair of epithelium, which can ultimately lead to neoplasia and malignancy. 6-Certain microbial species can have direct or indirect (through host cell activation) cytotoxic effects on cells
  • 37.
  • 38.
  • 39.
  • 40. From Next time Don’t feel Lonely….cause you have some friends inside you to take care of yourself……
  • 41. REFERENCE 1. Human Microbiome and Its Association With Health and Diseases, ASMAA A. ALTHANI,1,2 HANY E. MAREI, DOI: 10.1002/jcp.25284 2. The human microbiome in health and disease : hype or hope , Gwen Falony, Doris Vandeputte , International Journal of Clinical and Laboratory Medicine 3. Sherwood, Linda; Willey, Joanne; Woolverton, Christopher (2013). Prescott's Microbiology (9th ed.). New York: McGraw Hill. pp. 713–721. 4. "NIH Human Microbiome Project defines normal bacterial makeup of the body". NIH News. 13 June 2012. 5. H Human Microbiome Working Group (2009). "The NIH Human Microbiome Project". Genome Res. 19 (12): 2317–2323. doi:10.1101/gr.096651