‘Missing Microbes- How Killing Bacteria Creates Modern Plagues’ by Martin Blaser was published 3 years ago. While the jury’s still out on many claims regarding the microbiome, the broad message of this scintillating book is sound, timely and supremely relevant.
Bacteria have been the backbone of Blaser’s career for 40 years. He’s director of the Human Microbiome Program at New York University, served as the chair of medicine at NYU and was president of the Infectious Diseases Society of America. Fuelling the narrative of this book and to an extent, the author’s research and life, is the history and nature of our relationship with Helicobacter pylori.
Barry Marshall and Robin Warren became Nobel Prize winning legends when their clinical studies showed that eradicating H. pylori with antibiotics cured ulcers. Marshall gets credit for playing a strong, bold game when he took some H. pylori from the gut of an ailing patient, mixed it up in a broth, and downed it. He got sick, proved a point and dramatically changed the way the medical profession treats gastritis and ulcers.
Like most with a vested interest, Martin Blaser’s outlook was changed by Marshall and Warren’s work. By the mid-1990s, however, he ceased viewing H. pylori as an enemy of health and started to explore other possibilities.
“It was only when I let go of the dogma proclaiming ‘gastritis is bad’ that I was able to re-evaluate the biology of H.Pylori. Yes, H. pylori can be very harmful to some adults, but later we found that it may be very beneficial to many of our children.”
Blaser’s focus on H. pylori forms the backbone of Missing Microbes and is one of the book’s key strengths, creating an unsolved, rolling mystery at the core of a wider journey into our internal ecosystem. At one point, somewhat poetically, when discussing the gradual depletion of H. pylori, from our stomachs, he refers to it as a, “dance without a partner. And like the end of most long-term relationships, the effects are not just immediate or local; they are lifelong.”
He starts the book at the dawn of our planet’s relationship with microbes, those 3 billion years when bacteria were the sole inhabitants of the earth. From there, he charts the rise of the microbe, their co-evolution with other living organisms and the current battleground that is our overuse of antibiotics.
While tackling a range of big, complex topics and a timeline from the birth of earth to the present, Blaser excels in style; insightful, witty, sometimes spiky and persistently informative. He doesn’t refrain from technical language, but an enthusiasm and personal passion keep the book galloping along with page turning ease.
His hypothesis that overuse of antibiotics, c-sections and antiseptics are fuelling a rise in modern ills such as obesity, juvenile diabetes and asthma may not be new, but Blaser has a unique take on this topic.
The research Blaser discusses in relation to the microbiome and antibiotics is largely his own, performed in his laboratory, first at Vanderbilt University and after 2000, at New York University.
Doubt and heresy
His zeal, research and conviction that Helicobacter pylori are of some benefit to our health is both persuasive and engaging. It should be pointed out that he doesn’t invite the opinions of dissenting researchers or present conflicting evidence and admits to being a touch renegade in his thinking:
“My ideas about H. pylori – that they appear to be beneficial early in life for health and well-being but dangerous to health in later life- have not been well received by many of my colleagues. Just the opposite. Some have even labelled me as a heretic.”
He’s not shy of scepticism himself, dishing it out liberally for probiotics, prebiotics and synbiotics- as they’ve escaped well-conducted, blinded clinical trials and are probably susceptible to placebo effects.
“Manufacturers who make good money selling prebiotics are disinclined to pay for such studies.”
Missing Microbes manages a rare feat in that it balances compelling science with colourful, personal anecdote. This heady cocktail is a prime example of sci comms at its best, creating a gripping read that should engage scientists and lay readers alike.
Missing Microbes by Martin Blaser is published by Oneworld
Stewart Cumiskey (SfAM Press & Media Officer)
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