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Ground-breaking research on the microbiome — the collection of bacteria, fungi, and other microbes that live in the gut, on the skin, and within other human tissues — is creating new ways to treat disease. What started as a “bugs as drugs” approach to treatment is expanding to embrace the use of small molecules, biologics, phages, and engineered bacteria to modify the microbiome and prevent or alter disease progression.

Initially focused on the gastrointestinal tract, which was the origin of this burgeoning new field, manipulating the microbiome is now being viewed as a way to treat cancer, neurologic diseases such as Alzheimer’s and Parkinson’s disease, metabolic diseases like type 2 diabetes, and more.


In an analysis of the field, my colleagues and I at Back Bay Life Science Advisors identified more than 200 microbiome programs progressing to, and through, the clinic (Figure 1). They are likely to continue moving forward despite recent news of the death of a patient participating in a clinical trial of fecal microbiota transplantation, one of the earliest types of microbiome-based treatments.

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