Preliminary microbiome results showed striking differences between MEBO/PATM community members with active condition compared to those who learned to control the condition.
Research study: Dynamics of the Gut Microbiota in Idiopathic Malodor Production
Before you decide whether to participate in this research study, you should review:
1. The purpose of the research study
2. The study procedures
3. How long your involvement in the research will last
4. Any procedures that are experimental
5. Any reasonably foreseeable risks, discomforts, and benefits of the research
6. Any potentially beneficial alternative procedures or treatments
7. How the confidentiality of your data will be maintained
8. The possibility of unforeseeable risks
9. Any added costs to you
10. What happens if you decide to stop participating
11. New findings that may affect your willingness to participate
12. How many people will be in the study
We are starting pre-screening our candidates to find qualified participants, based on prior test results and ability to accurately report information.
Participants will be asked to submit their samples to uBiome on as different days in terms of their well-being/mood/symptoms as possible. MEBO is a condition of ups and downs. One day you may be completely odor-free, the next day you may have severe odor episodes - called flares. Our participants will be asked to submit their first sample if they felt they experienced symptoms, or had a day or two different from average. Study participants will be asked to submit responses to our questionnaire about those days.
We will privately follow up with suggestions to improve their wellbeing.
Our new Life-quality Test questionnaire will provide a measure for severity of Metabolic Breath and Body Odor and PATM symptoms.
Here is the first version and we welcome all suggestions and ideas the community may have.
Human odors depend on many extrinsic (such as food or clothing) and intrinsic factors - localized or systemic.
In recent years, microbes responsible for localized malodors - bad breath caused by oral bacteria and axillary odor - have been mapped using next generation sequencing approaches. However, Intestinal microbes responsible for systemic malodor (whole-body and extraoral halitosis), remain to be identified.
Our preliminary analysis of culture-, PCR- and 16S-RNA-based data donated by MEBO and PATM community members show that there are no easy answers.
"Lower Firmicutes to get firm and cute," says a news headline. MEBO population is low in Firmicutes and higher in Bacteroidetes. In fact, the very low F/B ratio is just about the only thing in common across the population in the Genova PCR-based microbiome analyses. The figure above shows typical representatives of MEBO "sweet" (on the left) and "non-sweet" (on the right) groups, as defined in our previous posts, video presentations and reports.
uBiome data, including SmartGut and Explorer, shows that MEBO community doesn't really have too many smellier bacteria, and likely has lower trimethylamine-producing potential than the average population. Many odoriferous bacteria - such as Odoribacter (ammonia odor), B. crossotus (rancid butter) and Desulfovibrio piger (rotten eggs) are often low in numbers, in at least one of the tests for every participant. But the composition of "scent tones" differs from normal.
This phylogenetic tree shows some of the bacteria found in abnormal levels in the MEBO community (underlined). Other bacteria displayed were found to cause (red) or compensate for (green) halitosis and underarm odors. TMA- and/or sulfide-producers are shown in brown. Some of them - like Staphylococcus hominis - produce additional volatiles like thioalcohols responsible for the characteristic unpleasant body odor smell. As seen from the figure, many bacteria can be either good or bad smell-wise on species level. This means that our 16S-RNA-based data doesn't always have sufficient resolution and might not adequately uncover the odor-producing potential.
Our preliminary findings show that "sweet" group of MEBO community is high in Anaerotruncus colihominis - indole (fecal smell) producing bacteria that utilises sugars glucose and mannose. Everyone seems to be low in Ruminococcus albus - a primary cellulose degrader that produces hydrogen and sweet-smelling acetate. 60% are low in Oxalobacter formigenes. Many participants had higher levels of Proteobacteria - but everyone had their own species - such as E.coli, Citrobacter freundii, Enterobacter Cloacae, Klebsiella or Aggregatibacter. Butyric acid-producing Butyrivibrio crossotus was abnormal in all of our samples: either too high or (mostly) too low. We also observed cases when the gut microbiota was significantly unstable - similar to Crohn's disease (even when patients are in remission).
We owe much of our general good health to the results of bacterial wars when the "good" species are destroying the "bad" invaders. Could it be that systemic malodor arises from bacterial wars that have no real purpose? Our research is only just beginning.
Science explains why some people smell worse than others despite keeping themselves squeaky clean.
The body is crawling with microbes that have evolved with the person, depending on the innate metabolism, history of infections, microbiome swaps, diet and lifestyle.
The body's ecosystem of microorganisms can increase the risk for dangerous diseases for which we have unreserved levels of sympathy. It can also lead to unlikable conditions such as unpredictable and embarrassing outbursts of odor emitting through the pores - odor so bad it ruins social lives and careers.
There is no cure for conditions responsible for odorous microbiomes. A rare disease TMAU (Trimethylaminuria) - an inborn error of choline metabolism that leads to the excessive excretion of foul-smelling trimethylamine (TMA) in the sweat and breath - can sometimes be managed by unhealthy diet very low in choline. A purely-microbiome-caused case of armpit odor may be fixed by microbial transplantation. But research is still in its early stages and is mostly unfunded.
Our community-led clinical trial was the first study attempting to find what is in common among individuals suffering from odor unexplained by known medical conditions such as TMAU.
We have demonstrated that symptoms described by participants are real - as they correlate with a number of laboratory tests. We have also proposed that there are at least two groups of participants with different genetics/medical histories (hence different microbiomes) that may require different types of treatments.
Unfortunately publishing these results is very difficult - with no funding to cover publication fees and no "sex appeal" to get support from peers. (The article was submitted to the Journal of Participatory Medicine in February, but peer-reviewers still have not returned their reviews)
The preprint is now available at bioRxiv and raw results at Mendeley. Study results will be also available on the clinical trials site.
We hope that the scientific community will look into our findings and support the underserved by their attention. Any comments or suggestions would be of great help!
Irene S. Gabashvili (2017). Community-led research discovers links between elusive symptoms and clinical tests BiorXiv DOI: 10.1101/139014