A Bacteria That Guards Your Gut Lining with Colleen Cutcliffe, Ph. D.

You're listening to the Human Upgrade with Dave Asprey. What got you from your glucose control formula into looking at Akkermansia?

Well, first, starting with glucose control, I, I think that's a really important thing to focus in on all the health benefits. And actually, there's been some recent evidence coming out that going after these neurodegenerative diseases, things like Alzheimer's that we've always thought about, how do you target the brain, might really have a strong relationship to glucose control. And in fact, some of the really big pharma companies are starting to invest in clinical trials where they're using diabetes drugs to try to treat Alzheimer's disease. And so I think when you think about the gut bacteria and its role in glucose control, it's just a big opportunity to bring back these bugs that we've always had and lost along the way in order to help us metabolize sugars. And one of those important bugs is Akkermansia. And this strain has been studied for quite some time in the academic realm. Well, say quite some time, really the last decade or so. And what we're finding is that when you think about your gut lining, it's sort of like a fence. And so when I first bought my house, I have this wooden fence in the backyard. It was beautiful, shiny. All the planks are really solid, kept all the bad stuff out and the good stuff in. And what happens over time is that, you know, with weather and snow and rain, a of lot, those planks can start to wear out and become thinner and then sometimes fall down. And if you're not repairing those planks, you're going to end up with a really vulnerable system. And so your gut lining is just like that. It's like a fence. And so what Akkermansia does for a living is it's the guy that comes in and checks your fence and makes sure that all of your planks are sturdy and repaints things when it's needed and puts new planks in when needed. And so what we have discovered, and we as sort of the entire scientific community, is that when you are low in Akkermansia or some people have undetectable levels, it's missing. You have all kinds of problems. And it starts, for us, it started with understanding its role in glucose control, but it goes a lot farther than that, Dave. It goes into inflammation, immune response, GI distress, and probably also it's a big part of the gut brain connection. And so it's a really, really fundamental keystone strain in our microbiome.

So what this stuff does is it eats the mucus that lines the gut. Right. And that's important. And I wanted to point out too, there are questions we're going to get into about fasting, about maybe if you have no mucus, what's it going to do long term fasting. The other thing, though, this was only discovered in 2004. This is the year that smartphones came out. I had some weird HTC thing with a round thing on it. I've always been the guy who buys the latest smartphone. So we didn't have them before that. This is a very, very new discovery in the history of biology. So before that, every single recommendation ever made in medicine was ignoring the fact that there are bacteria that affect the lining of your gut, that keeps food and bacterial toxins out of your blood. So all of a sudden we have this new tool and we've had it for less than 20 years and we've learned a few things. What percentage of the things we need to know about Akkermansia do we know today?

Well, I would start by saying we've always had Akkermansia, we just didn't know about it. It's only recently that we discovered it, its existence.

It's always been there.

Yeah.

Just every recommendation we've ever made was, oh, yeah, that'll work. Without knowing that it was in the system doing stuff that really mattered.

That's exactly, exactly. Oh, man. What do we know? We know almost nothing. As with any new emerging science or health field, we like to think we know a lot of stuff and we're learning a ton of. So we know a lot more than we did before. But I think there's still a world of things to learn. Including, in what circumstances is Akkermansia reducing your mucin layer and in what circumstances is it increasing your mucin layer? Because it really is emerging as a regulator of that. And so how does it interact with other strains? How does it sense or know what your mucin layer looks like? How does it know when you're changing your diet just in a different environment, and how does it respond to that? And, and then, you know, probably most importantly, how does it get depleted? And, and why does it get depleted?

Are you more likely to have leaky gut if you don't have Akkermansia?

The idea of leaky gut is really, this is really centered around the gut lining and an insufficient gut lining. And so it's very much tied to the exact role of Akkermansia. And it has been shown that people who have ibs, GI issues, leaky gut, they are lower in Akkermansia levels. And you know, there's a variety of different microbiome testing labs out there right now. And what you'll find is that these microbiome testing groups are starting to call out Akkermansia as one of the keystone strains. And so if you're low in Akkermansia, you can find that out by taking a microbiome test and then understand, you know, what your levels are.

How easy is it to turn Akkermansia into a probiotic? I know there are some species that just die, you really, really can't take them. We're on the scale of, oh, we should all be smearing this everywhere. Is this one.

Akkermansia is a diva. Akkermansia is very hard to grow, very hard to cultivate. And it starts from the fact that it is located in an anaerobic environment. So where it's situated, there is no oxygen. So first you have to figure out, how do I manufacture something in an entirely closed system where not a single molecule of oxygen can get in? So that's the first thing. But the second thing to know about Akkermansia is not only is it sitting in an anaerobic environment, it's actually housed right up against your gut lining. So it lives on this mucin layer. And that means that it's not just living in a culture, like when you think about brewing beer, it's not living in a culture media like that. It's actually attached to something. And so here in the US you actually cannot grow a strain and sell a probiotic strain that has been grown in anything that has a meat based product in it. But your mucin layer is effectively a meat based product. So how do you take this thing that grows in an anaerobic environment, attached to a meat byproduct, and try to grow it in a vegetable based environment out here in the world where outside of our guts, where there's oxygen present. And that's made it really challenging to understand how to grow Akkermansia. But once we figured out some of those key things on how to grow it, we've really been able to scale it up and include it in a variety of different settings where we can now test what happens when you give Akkermansia back.