Need for Prospective Cohort Studies to Establish Human Gut Microbiome Contributions to Disease Risk
+Author Affiliations
- Correspondence to: Volker Mai, PhD, MPH, 2055 Mowry Rd, Gainesville, FL 32610 (e-mail:vmai@ufl.edu).
In this issue of the Journal, Ahn et al. (1) report on associations between fecal microbiota composition and risk of colorectal cancer (CRC). Although gut microbiota contributes to the maintenance of human health, perturbations in normal microbiota composition have been correlated with various disease states (2). In this context, the work by Ahn et al. is exciting because it may provide insights into future ways to reduce the risk of CRC. At the same time, given the complexity of these biologic systems, caution must be exercised (and a lot more research done) before proceeding too far in promoting changes in microbiota as a prevention strategy for CRC. CRC occurrence is known to be influenced by host genetics, as well as factors such as obesity, nutrition, and exercise (3–5); given that these factors also influence microbiota (2), separation of cause and effect among all of these factors may become quite difficult. Coordinated international efforts have generated a wealth of new data on the diversity of human host–associated microbiota at various anatomic sites. These studies confirmed, even in healthy individuals, a large degree of intra- and interindividual variation in microbiota composition and, albeit to a lesser degree, microbial activities. Although recent work based on analyses of both 16S rRNA and shotgun metagenomic datasets suggests the existence of three distinct enterotypes (6), other studies suggest more of a continuous spectrum of microbiota composition (7,8). The wide range in microbiota composition and associated metabolic functions among individuals provides a rational for proposing the …
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