Curated Paper 1: Ayurveda and Metabolism

What is Ayurveda

Ayurveda, what is it? Its definition is as follows: The traditional Hindu system of medicine, which is based on the idea of balance in bodily systems and uses diet, herbal treatment, and yogic breathing. In the context of this course, I think Ayurveda is a perspective that can enhance the study of disease. We are only beginning to understand the complexity with which the human body operates. Studying disease with a holistic perspective is helpful, especially for health care providers. Humans are very complex and their health is affected by a multitude of factors. A patient’s stress from their job could be a bigger issue to their overall health than anything going on inside their body.  I am going into health care, specifically, I am going to be attending an osteopathic medical school next fall. One thing that attracted me to osteopathic medicine was the idea of holistic medicine. Behind every disease is a person with stress from family and work life and a lifetime of environmental and genetic factors that have affected them. As a health care provider, you are not only treating the disease but the entire person. 

 Your Gut and Mental Health- A Connection

It is estimated that nearly one-third of primary care physicians(PCPs) patients are mental health patients( Abed et.al 2010). I currently want to go into primary care, and thus am trying to gain a good understanding of mental health and the various diseases within the discipline. I have shadowed several primary care physicians and I can attest to the statistics found in the study listed above, whether it is a middle-aged woman feeling down for prolonged periods of time, for now, reason, or a suicidal teenager, PCPs see many mental health patients every day. I think it is particularly important to look at mental health issues with the perspective of Ayurveda. When I have been in exam rooms and listened to PCPs evaluate mental health patients they try to get a good understanding of all the factors in that person's life that are contributing to the issue. People and their emotions and feelings are very complex and I can think of very few circumstances where an imbalance of these two things are caused by any single factor. 

One factor that can affect mental health is the types and numbers of bacteria living in your gut. Kind of crazy, hu? In a paper titled The microbiome-gut-brain axis: from bowel to behavior by Cryan and O’Mahony, the authors outline the relationship between gut microbiota and behavior. Stress, anxiety, and diseases of the nervous system are all starting to be shown to be connected to imbalances in the microbiome. Mice models are the primary means by which we are conducting studies on the gut microbiome and its relationship to the brain. The conclusion of this paper was that more research needs to be done on the microbiome in order to effectively understand the gut-brain axis, but that this is a very promising and exciting new avenue of understanding human illness. Further studies will help to develop treatments of disorders that are a result of a miscommunication between the gut and the brain. 

New connections are being found every day and new factors are being shown to influence the development and progression of different diseases. The metabolic pathways of the human body are so interconnected and intricate that it is really surprising that new connections are being found every day! As I said in the opening of this post, I truly believe that learning about and treating disease with the perspective of balance is insightful and important! The rest of this post I would like to discuss the microbiome and it’s incredible connections to human health and wellbeing. 

The Microbiome and Its Connections

The microbiome truly is a fascinating phenomenon of the human body. The more research I see that is done on the microbiome, the more fascinated I become. The Microbiome has been linked to mental health (as we discussed above), sleep, the immune system, cardiovascular health, and cancer. First, we will discuss the link between the microbiome and sleep. 

The past year I have worked as a sleep technician conducting studies that were used to treat and diagnose sleep apnea and other sleep disorders. Sleep is such a fascinating phenomenon, I personally like to call it human death rehearsal. One specific study exploring this connection that I found particularly interesting used mice to explore the relationship between Odoribacter and the abundance of sleep(Bubier et al 2020). The study found a correlation of disease-related traits with underlying biomolecular and microbial characteristics. The gene QTL Micab7 on chromosome 7 is associated with the relative abundance of Odoribacter, and this study showed a relation between this gene and sleep as well as obesity. The methods in this study helped me to answer the question of how one would go about testing individual relationships between specific genes, microbes, and phenotypes. 

Another Interesting connection is between the microbiome and weight gain and weight loss.  A study titled Gut Microbiota from Twins Discordant for Obesity Modulate Metabolism in Mice, explored the relationship between weight gain/loss and the microbiome of mice. Groups of germ-free mice were cultured by fecal microbiota from an obese or lean mouse. The mice who were cultured with the microbiota of obese mice had a greater increase in body mass. These findings are extremely interesting. And the implications for medicine are the new use of fecal transplantation therapies being used to treat a wide range of diseases and disorders. 

The last connection we will discuss here is the connection between the immune system and the microbiome.  In the study, Microbiome and the immune system: from a healthy steady-state to allergy associated disruption,  A line in the abstract caught my eye. The authors stated that the microbiome and the immune system are constantly shaping each other. I had never thought about the microbiome in this way, but it is a balance between the immune system allowing certain good bacteria, and killing bad bacteria. The main focus of this paper was to discuss the connection between microbiome and allergies. Allergic diseases have increased in the last half-century. The authors say that many factors contributed to this. The paper outlines and explains many different interactions. One section I found particularly interesting was the connection between the skin microbiome and atopic dermatitis. I have read and researched what can happen when the gut microbiome gets disturbed, but I never thought about what can happen when imbalances of the skin microbiome occur. This paper outlines the specific interactions and imbalances in skin microbiota that can cause disease. I also found the section on allergic diseases of the airways intriguing. This paper mostly focuses on the role of the microbiome in severe asthma. I had never considered that an imbalance in the airway microbiota could cause asthma. This is an intriguing field of study for developing better treatments and maybe even cures for asthma in the future. 

There are many more studies outlining the various connections between the microbiome and the genesis and progression of various diseases and ailments, and new connections are being found every day! Connections have been shown between the microbiome and the heart (Peng et al 2018), brain development in young children (Wang et al 2018), and bowel disorders (Bhattarai et al 2017). The increasing amount of papers published on the microbiome is telling of the scientific communities interested in this idea of balance and connection. I personally am really excited to see more research on the microbiome and to use the information that is gained from this research to help give patients more holistic and effective care. 

 Abed Faghri, N. M., Boisvert, C. M., & Faghri, S. (2010). Understanding the expanding role of primary care physicians (PCPs) to primary psychiatric care physicians (PPCPs): enhancing the assessment and treatment of psychiatric conditions. Mental health in family medicine, 7(1), 17–25.

Bubier, J. A., Philip, V. M., Quince, C., Campbell, J., Zhou, Y., Vishnivetskaya, T., ... & Foster, C. M. (2020). A Microbe Associated with Sleep Revealed by a Novel Systems Genetic Analysis of the Microbiome in Collaborative Cross Mice. Genetics, 214(3), 719-733.

Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341(6150):1241214. doi:10.1126/science.1241214

Peng, J., Xiao, X., Hu, M., & Zhang, X. (2018). Interaction between gut microbiome and cardiovascular disease. Life sciences, 214, 153-157.

Wang, S., Harvey, L., Martin, R., van der Beek, E. M., Knol, J., Cryan, J. F., & Renes, I. B. (2018). Targeting the gut microbiota to influence brain development and function in early life. Neuroscience & Biobehavioral Reviews, 95, 191-201.