Bugs as Drugs
LBP’s or Live Biotherapeutic Products is the new kid on the block when looking at how we can use our knowledge about our gut microbiome to develop a “bug drug” to help fight disease.
So what are LBP’s?
-They are a biological product
-They are designed specific for a particular disease or condition e.g. IBD
-They are not a vaccine, probiotic or a synbiotic
-They contain live microorganisms
-They may include genetically modified microorganisms or genetic material that has been modified
LBP’s will be living drugs taken orally with specific direct or indirect targets on cellular targets. They may possibly be used in conjunction with existing drug therapies (immune system related) to enhance outcomes. The possibilities are endless.
These LBP’s are not probiotics as they will be designed for a target in mind whereas probiotics at the moment are generally just hit and miss.
The traditional way of designing drugs will not be applicable with LBP’s as live microorganisms do not remain static and the variability between individual guts will have to be taken into consideration. Not an easy task!

Let’s look at an example where LBP’s could be used to target Inflammatory Bowel Disease (IBD). We know that the gut of someone with IBD has dysbiosis, reduced microbial diversity, a reduced amount of Clostridia cluster species, an overgrowth of Proteobacteria and immune mucosal dysregulation in our intestines.
Research has shown effective treatment of IBD using the correct strains and numbers of Clostridium bacterial strains to positively prevent and treat inflammation in IBD. This is very new research and there are already clinical trials underway. Very exciting stuff that will hopefully develop very quickly.
Reference:
Lamousé-Smith, E., Kelly, D., & Cremoux, I. D. Designing bugs as drugs: exploiting the gut microbiome. American Journal of Physiology-Gastrointestinal and Liver Physiology, 0(0), null. doi:10.1152/ajpgi.00381.2019