Dr Amine Zorgani on novel microbiome therapies and vaginal health

This episode is brought to you by Nourish Me Organics, your gut health superstore. Nourish Me Organics is the premier online store for all things gut health, including probiotics, prebiotics, natural health supplements, and home fermentation kits. So head to www.nourishmeorganics.com and use the code Happy Gut for 10% off. Join Kruban Govinda, a seasoned food scientist and gut health exper. In this episode, we explore the secrets to reproductive health success with Dr. Amin Zorghani.

Hey, guys, Crib. And Gavinda from the Gut Health Gurus podcast. I've got a background in food science, and today we have an absolute superstar in the world of the microbiome. I'm guessing maybe people who are just starting in the microbiome journey might not be familiar with Dr. Amin, but we're going to get into it. Dr. Amin Zoghani, welcome to the show.

Thank you so much. And I'm very delighted on this nice introduction and definitely my pleasure to be on your show. So thank you.

My absolute pleasure, Dr. Amin. And what I like to do at the start of the show is to get it straight from the horse's mouth. Who is Dr. Amin Zogani?

Oh, yeah, it's. It's been a journey, to be honest, to arrive where I am today, or at least the.

The.

The chair I'm sitting. I have a very, let's say, unorthodox career or path of growth. How did I come to Iraq to the microbiome? It's a long journey, but I can cut it short. I am an engineer by training. I've. I'm born in Algeria. It's in the north of Africa. For those who doesn't know, I've done my engineering degree there. More from a microbiology and biotech perspective, really trying to kind of understand how to build bioreactors for production of microbes. For instance, one of the first microbes I worked on was from the desert of the Sara in Africa. Like, literally those microbes that can resist to high salt concentrations. And my goal was there to understand how these microbes can actually live in places like that, Right. And I tried to understand from a molecular perspective the proteins that these bacteria produce. Maybe they have a specific formation or confirmation, as we say. It would look more from a bioinformatic perspective. Unfortunately, in Algeria, there was not that much of interest into bioinformatics or wavelength kind of technologies, so you had to move around the world. And I landed in France, where I did a PhD in microbiology. And this time, instead of actually loving microbes, I was rather hating microbes to say I was trying to find solutions, how to kind of find new antibiotics against specific microbes that can actually affect the health of neonates. That was literally the whole objective of my PhD. And I think the first month or so my PhD supervisor came to me and he said, listen, this is the future of health, of medicine. He came with a book and that book basically was about probiotics and prebiotics. Back then it was like in 2013, I had no idea what these stuff. I mean, I've heard the probiotics, but like I never worked on them. But I told him, listen, this is not my subject of research. He said, listen, take this and you will thank me after a few days. Later, I worked in the microbiome and I worked in different startups, from small to a little bit big. That was acquired and that was my journey on the microbiome. And probably we can go on it later. But yeah, my journey is a little bit different than. So I switched from actually someone who trying to kill microbes to someone to trying to preserve microbes. And yeah, that's what I'm doing today is literally trying to save microbes as much as I can because I believe they are the essence of our existence on all sorts of forms and they are the ones who basically keeping us healthy, not only us, but also anything around us. And I think we should do our best to keep some of the microbes good at least then.

So what an amazing journey and almost that, that step inward into discovering the microbiome, working on projects perhaps to kill off microbes, helophiles, I think what you were referring to. But then discovering that microbes are actually also beneficial for humanity. So I'd like to dig a little bit deeper. Amine, how about your passion? Where did you develop this passion for the microbiome? Because when I Look at your LinkedIn posts, I highly encourage people to follow you on LinkedIn and watch what you post, because I very closely follow you and you have this beautiful way of summarizing very complex microbiome research and then putting together a small little articles or LinkedIn summaries on the gist of the post and also inserting some of your insights into that. So where did this passion come from? Because clearly I can see you posting so much about it. So you're spending so much time in the microbiome, so there must be something that you love about it. So where did this passion come from?

It's a great question. And thank you for, for your encouragement as well. And I definitely follow your post and I also hardly encourage people to also follow yours as well. Honestly, I think if you're a microbiologist and you have at least discovered what the microbiome is, I actually can't understand how people can turn away from that. Honestly, because the minute you dig in is okay. It's impossible that someone can say okay, I'm not interested anymore because there is so much to learn. And although the first human microbiome project was launched on 2007, we still don't know that much, right? I mean what do we know? Like maybe 1, 2, 5%? I mean we have worked on the microbiome for so many years, rather say decades and we only have three approved microbiome based therapies that only came to the market just last year. So meaning that we have so much still to be done and even those therapies aren't that complex. We are talking about some stool from healthy people being given to some people who have CDI or Clostridium deficie infections. So it's not that complex. Literally taking stool from healthy donors and giving them this is what practiced for centuries like in from the yellow soup, in whatever like centuries in like probably 120 years ago. So it's not that complex. The technology we are already using and approving so meaning that what we still need to be done to get something, how to say technologically developed like I don't know, engineered microbes or single microbes that can literally target specific diseases or cancer cells and what sort of. We're still a long way to go. Meaning me and others still have to work so hard to find something novel or something at least meaningful that can save people's life. And I'm looking for that little idea somewhere and what I actually share. So when I actually share a paper or a post on LinkedIn, it's rather my ideas I'm sharing. Actually I'm trying to send in a hook to someone somewhere in the world that may be inspired. And I'm happy to say that few people got inspired and started some ideas because you know, you never know. So I say okay, if I don't share what I've learned today on my coach, usually when I do my post is in the evening. I might not inspire somebody. So I'd rather share it. And I hope to inspire at least one person with that post which enables me to be happier and at least I and the thing it to be a little bit more how to say like selfish because when I do share posts it also allows the post to engrave in my brain and I will never forget them afterwards. So it's a win win for you to get the post and for me to engrave them on my brain.

So I hear you. I hear you. Amy, Most people might not know is the reason why I started this podcast was also very self selfishly to learn from experts. So I think the motive, the motivation is very honorable because you are trying to summarize a very complex research paper into some very simple perhaps actionable steps for someone and then putting out to the world. So it's almost a win for you and then a win for the world. So it's, it's completely honorable and I, I applaud you for what you do. And so the the another little side note that I wanted to explore is in how did you go from engineering to microbiology? Because so many of my guests come from such interesting diverse spaces but find themselves completely enthralled in this microbiome space. So how did you make that transition?

Actually to be honest, was more or less planned in my brain. So as you said like earlier about the communication. So I believe that all scientists and this is the unfortunate things that we don't actually learn at university and I really encourage students or PhDs that really trying to get their steps through the PhD and to access industry. There are some key skills that we don't learn at the university. In my opinion, three of the most important skills that all PhD students should be learning today, not tomorrow. Number one is project management. Number two, communication. Number three, today is easier than yesterday is marketing. Because when you work in a startup or any company, either small or big, you have to manage projects accurately. So you have to kind of deliver them. You have to be able to clearly communicate your ideas. For some people who, I mean if you're speaking to CFO Chief Financial officer, I mean these people usually come from banking or like finance and stuff. And if they work in a startup of biotech, working in the microbiome, they very likely have no clue what microbes is or probably never seen a microbe in their lives. So if you start telling them about, I don't know, QPCR or very complicated wordings, metagenomics, we're going to do barcoding. He said, what are you talking about? So you have to have a language that is adapted to these people to enable them to see the essence of your work in the lab, to enable you to get the funding necessary for you to actually do your job, otherwise you will not be able to do so. And then when you've created something or you created an idea, you have to be able to market that idea properly. Like there is a difference between marketing and communication because marketing is more like you're trying to sell that stuff or communication, you try to inform about it. And, and for me to do the switch between engineering and microbiome actually. So in my PhD I've noticed that microbiome is something that is far beyond what I thought and I tried really to work towards that goal is to get into a startup where we can actually work and harness the microbiome. So I was in this startup in Ireland called Naritas. We were using artificial intelligence to trying to find peptides from plant proteins. The peptide is literally the small pieces of proteins, right? And these peptides, we're trying to identify them using artificial intelligence, not the chatgpt that we know today. This is literally was seven years ago and basically looking to the DNA of these plants, like plants like we're talking about potato or tomato or any plants, they do have proteins in them. Find the peptides, these little pieces of proteins that basically can have a beneficial effect. And one of my departments was basically finding the beneficial effect of peptides on the gut microbiome. So when you take the plant protein hydrolysis, you hydrolyze those proteins with enzymes, you drink it, they land on the gut and trying to see what is the impact on that. And honestly when I started working on that project, I've never looked behind because it's just a fascinating world and as I said, we are still on probably 5% of what we actually should be knowing on the microbiome. So there was likely the switch. And since then I was only looking for companies or startups, mostly interested in startups than companies, to be honest. Why this? Because there is a freedom of innovation, there is a fast pace, you can really execute, test, execute, test and execute. So yeah, and since then I'm still there for now 10 years.

That's incredible. Amy, I completely understand where you're coming from because it's almost. The microbiome is so. Is so undiscovered, for want of a better word. I mean, there's so much more to learn and from that learning comes the opportunities to develop technology, therapeutics. There's still so many problems to solve in the world, especially when it comes to health. So I completely understand and I'd be remiss if I didn't step backwards just a little bit before we move forward. You mentioned there were three areas that were being almost developed in the microbiome space. So you mentioned something around the fecal matter transplants. Now what were the other two? Because I think people will be fascinated to hear that.

Absolutely. So that is the conventional one that there is huge debates. I mean, at least for the ones who aren't from the microbiome space. I call them the disbelievers. So the first one is the huge debate is about the probiotics. So probiotics and all the biotics that comes with. Right, but mostly probiotics. So we have a lot of people from the space understanding the benefits of the probiotics. And by the way, not all the probiotics are the same. Not all probiotics do work. And there is also again, here we have the issue of communication and marketing. So there are a lot of probiotics being marketed as probiotics for. Funny. Just I open quote unquote here. Yesterday I was in the pharmacy. I had to get my new supply of probiotics. I couldn't get it from my usual supply side. Okay, whatever. I'm going to the pharmacy. Pharmacy. So I went in and hello. So I asked the guy, what probiotics do you guys have? He said, do you want it activated or inactivated? I said, ah, interesting. What do you mean about inactivated? He said, you know, killed probiotic. I said, okay. I said, man, do you know that a killed probiotic is not a probiotic? Because probiotic by definition is a live microbe. That is the definition of the isep, this international scientific association for probiotic and prebiotics. So I said, I said, why do you say that? I said, listen, I work on this space. I know what a probiotics is. And if it's killed, it's not a probiotic. I mean, you can call it definitely a postbiotic, but it is definitely not a probiotic. And this is a pharmacy. It is somebody who has a degree and like, you know, studied at university and so on. Meaning that today when you look into the marketing that is around probiotic is mostly wrong or at least people aren't really informed in the right way. And that's why we would find misinformation. And some people may be benefiting from taking probiotics. They wouldn't do so simply because they hear a lot of noise. Probiotics are not good or are just crap. And what sort of. So that's one. Probiotics are the easiest, the cheapest probably, and they're most of them, at least that you can find with the Strain meaning my name is Amines organi. That's my strain name. Like I'm different than yourself because we have a complete different background, different coming from and so on. So strain meaning you would find the name of the bacteria and behind that name you would find a number or like letters and what. So that's defines the strain. These trays find the strain that are clinically tested that can definitely help you. But this is, let's say the. This was practiced for so many years now and they're sold on the market and you can definitely find them in kefir or fermented foods and stuff with low amount, but you can definitely find them there. So this is the easy one. And then we go another level of complexity and we go more towards therapeutic application. And here we speak about live biotherapeutics abbreviation lbps. The LBPS are basically single strains to some extent. And we can also find consortia is basically a combination of different strains which are attended to treat like, meaning that we develop them specifically in the context of clinical therapeutic application, meaning that there is clinical trials that is developed specifically for those LBPs to target specific diseases that can find them in IBS develop into IBD or cancer and what. So there are a lot of companies working on that. So this is one strain or several strains together. And obviously there is not a single approved LPP today in the market. So because we're still in the research phase, there are a few in phase clinical 2, but none had made it to phase 3 or phase 4. And then we go another level of let's say complexity and less complexity. Why it's a complexity because we have a big consortium or a huge number of bacteria that we actually don't know how they interact together. And it's not that complex because it's just coming from the stool. So which we call them the fecal microbiota transplants, the fmt. So there is one strain or several strains of probiotics and there is LBPS is one strain or several strains, but this is for therapeutic application. And there is another strain which is the fecal microbiota transplantation. And here we what we try is to find healthy donors, people who usually aren't medicated, they eat well, they sleep well, they exercise and we run them through a battery of tests to assess the integrity of their microbiome or at least its complexity. And we also do say that there are some super donors. These people actually do have super microbiomes. So we get this tool, we analyze it to assess there is no Pathogens, There is no viruses, there is no Covid in the case when we are in the COVID period. And then we transfer them to people who aren't healthy, who are suffering from various diseases, going from Clostridium difficile infection, where we today have an approved product in the FDA and also in Australia, and to autism and many other diseases. The only one approved is Clostridium difficile infection, but none in the other areas. But I hope some will come together in the future for fmt. And there are in parallel to fmt, we do see other applications from human donors and this can include what we call today VMT vaginal microbiota transplantation. So we take also vaginal fluids from healthy women and we give them to women that suffering from bacterial vaginosis or in very. One of the best papers I've read last year is about a woman that was actually having bacterial vaginosis and also have recurrent pregnancy loss. So we have transferred, it was published in the Lancet, transferred vaginal fluid from a woman that was healthy to this woman. She got pregnant after five months. And it was one of the most amazing stories I've ever heard in my life.

So, wow, I'm giving goosebumps because I completely understand that. I have friends in this space who have been trying to conceive for many, many years, unsuccessfully. So when you talk about things like this, it makes me a little bit emotional. So thank you so much for sharing that amazing cutting edge research that's happening right now in the world of the microbiome. So we know we've had this one particular treatment that's approved for C. Difficile. So how, how does the. How did are these live? Therapeutic preparations administered.

So when we go to the fmt. So there are at least two versions of it or I mean originally there was one version or two versions. So basically we could, you know, we get this tool samples, we homogenize them obviously after analysis and so on, we kind of dilute them to be able to put them in a syringe and then we put them in the anus to. And then inject them into the colon. Right. So this is one. And the other one was during endoscopy we also inject them throughout there. The technology have been developed so far today that we can actually freeze and dry the stools to render them into a powder format and then we can put them in a capsule. So it's way more convenient than actually having to have a syringe or an injection or Endoscopy. So you can actually take those three or five pills a day containing. So you don't actually see that as a stool. It's brown pill that you can find like turmeric is brown. So yeah, imagine as turmeric or anything like that. So it's more like a brown pill that contains freeze and dried stools that you, you know, swallow. And that's basically it. So this is that. That's been said. Even today we still have the two varieties or the three. So we still have syringe injections, we still have now few companies developing these pills. And we do have endoscopy where you can actually give it, you know, through endoscopy to the colon, deliver it locally.

Amazing. And I'm imagining if people are interested in these particular therapeutics to speak to their medical professionals here. I'm based in Australia, so certainly wherever you are in the world, there's going to be different regulatory pathways. But majority of my audience tends to be in the US or Australia or Europe. I'm imagining these legislative frameworks are working closely in unison. Do speak to your medical practitioners, gastroenterologists, if you want to explore these treatment options. Now, Dr. Amy, I'm fascinated because you're one of these experts that are at the cutting edge. So we mentioned a few different pathways that the microbiome research is heading towards. Is there anything else that's exciting in terms of the advancements in microbiome research that's really piquing your interest right now?

Absolutely, I think so. There are, honestly, there are many, many things that excites me in the microbiome. Probably everything excites me in the microbiome, I would say, because everything is fairly new. So one of the things that they are developing in parallel today is having to develop these kind of therapeutics for variety of applications and diseases. And I'm extremely happy to see that today we're considering more and more women's health and infants health for the reasons we've mentioned earlier. I mean, women are the one conceiving and bringing happiness to this world and I think they definitely deserve more attention. And I really try to push this as much as I can. Even in my post LinkedIn, I try to post as much as possible when I find research relevant to that on women's health, because I think it was a little bit neglected. And, you know, when we speak about women's health and we try to see why investors will actually put money and companies and startups that do work on women's health, you'll be surprised to know that they just say that we don't have that much of return of investment, which is insane. I mean, it's not like everything is on return on investment. So today there are companies who have been financed in the microbiome space in women's health, or rather companies are working on fertility because there is a lot of money, obviously, so they will get their money back. But when we speak about bacterial vaginosis or candidasis or, you know, these recurrent infections that women have, and I got a lot of messages from women asking me what, what probiotic I should be taking or what treatment I should say. I said, I'm not a doctor, like a medical doctor, a scientist, rather. It's insane to see that we don't have that much of investment in it. So, thanks God we have some companies today stepping in and they managed to find money to kind of create products in that space. And I hope my message will reach any investors to put more money in women's health. Infant health is also another thing, because we know that the microbiome, or at least how it's shaped, is in the first five years, maximum of infancy, which will even shape how I do think today, or probably my immunity, how it reacts and so on. So it's very important that we seed the right microbiomes, not the right, but the, the correct one that enables us to stay healthy when we grow. So I think understanding how we should shape what we should be doing for infants, it's crucial. And I'm also happy to see more companies into that space. The other thing that I think, again is being taken from a wrong side, in my opinion, is microbiome testing. So we have a lot of, you know, companies actually selling gut microbiome testing or, you know, and name it, so many microbiome tests in the market, I think some of them are good, honestly, but not all of them, because there is also. So if you would like to test someone's microbiome, you have to be able to see what you can offer afterwards. Like, I've already, okay, I take your stool or take a swab from your skin to test your skin microbiome or your gut microbiome or whatever. What, what else? What, what can I do with those data afterwards? And I think it's more of a race against data than, than anything else. So I'm happy to see that now there are some, let's say, government initiatives, or at least from institutions that trying to use the microbiome testing to rather advance the microbiome research, not for commercial purposes. And that's a good thing because it enables us to again see beyond what we are already seeing here. And I think in my opinion, what will change the history of the microbiome in the coming years? In my opinion, it's not what the bacteria that are in there, but rather what products they're producing or what metabolites they're producing. And I think the first company who managed or the first person who manages to understand why the bacteria are where they are and why they're producing and more importantly what they're connecting to, like what human pathways they are illuminating or triggering. I think that would be a game changer because I think we do don't yet clearly understand why specific bacterium is there and why is there now. And that's the big question. Like I, you know, sometimes I even I can't sleep because I just why we didn't find that bacteria there and why is it now there? So, you know, that keeps me thinking a lot and I see a lot of companies, few actually trying to get it from what we call it the metabolomics. This is this the molecule that the bacteria produce. And that's the science of that. So yeah, I think that's excites me a lot and I hope to see more on that work then in the coming years.

Completely agree. I, I really think that the microbiota signatures are highly individualized, like a, almost like a, a fingerprint. But as you mentioned earlier, they're, they're consortias or, or a quorums of bacteria that are doing something beneficial in the body. And that's the, that's the, the where the research is exploring what are these metabolites producing? How do they react with the body, how do they react to disease pathologies? So I'm in complete agreement. I've had these same thoughts for years now. But I'm really excited to see where, where it's headed. And one particular area of research that's a little bit controversial and I'd love to hear your thoughts on that because there's really mixed opinions when it comes to it. But what's your thoughts on synthetic biology in the microbiome space?

Yeah, that's definitely an area of controversy. So let's clarify the controversy and what comes from. The controversy comes from the fact that if we take a microbe that is naturally existing and like nature created it that way, and we as humans go and do some genetic engineering, meaning that we can insert some genes that produces antibodies and deliver them to specific sites on the body like cancer, microenvironment and what. So we think that if we do that engineering, we will be introducing a gmo, like a genetically modified organism into the body and we might lose track or we might lose control to that microorganism and what it does. Right. So I think this is the fear for many people who probably don't really understand how genetic engineering works and how stable these genetic engineering actually. So I did my PhD. I've engineered microbes for literally 3 years during my whole PhD. Not engineering them for the sake of actually putting them in humans, but try and engineer them, because that's how we study microbes. So if you would like to study a microbe or a function of a microbe, let's say a microbe is, you know, degrading iron. Like you put a microbe with an iron, it degrades the iron. If you would like to understand how the microbe degrades the iron, you would try to identify the gene that codes the proteins for the degradation of iron. You remove those genes with genetic engineering, like you do a mutagenesis and see whether the microbe loses its ability to degrade iron or not. And that's what we call a genetic engineering. And you can do it in the other way. You put more genes into the microbe and see what it can do in the future. And I think the controversy today is basically, if we do engineer microbes and we release them in nature, we will be introducing something that it doesn't exist in nature and we might lose control of it. Yeah. But honestly, after learning, I have been doing engineering myself, and that's some of my background, if you do engineering and you do it in the right way, meaning that you insert something in the genome of a bacterium that is stable for generations, there is no way a bacterium can actually reverse engineer what you've done unless you give them the tool to do so. So, and that's something, sometimes we don't actually know whether the bacterium do have the tool or not. So this is why people are scared of it. They say, okay, yeah, you tell me. Unless you give them the tool to do so. But how do you know that the bacteria doesn't have that tool? Maybe it does have the tool, you just didn't discover it. And once the bacteria is in the right conditions, like the human body, okay, whatever, guys, I'm going to do whatever I want. So the bacterium starts reverse engineering what you've done and then start inserting genes in the DNA of human body. And what. So is it Impossible. The answer is no. Do we know how to stop it? The answer is no. However, genetic engineering today is possibly one of the most fascinating tools that have been invented in, I mean even received a Nobel Prize just last year, right? So this from Emmanuel Chapanti and Jennifer Doudna on the invention of the CRISPR Cas9, which is the human DNA scissors that we call them, which was also gotten from or invented from a bacterium in the first place. Let's say I'm not decided yet whether I am voting yes or no against it because I'm still waiting for. I think if we've managed to find the right tool to be able to turn the plugs off and on, on demand, I think there is probably the risk is mitigated. And this is what the law and the regulators are asking is can you give us how you mitigate the risks of this kind of genetic engineers? Like, meaning if how can you prevent the microbe from going rogue really and getting insane into the body? And can you control it on demand? Meaning you say, listen, I'm going to put the microbes in engineered because it's going to deliver potent antibodies for microenvironment in cancer that is extremely difficult to reach. We're going to target that. However, if we see there is any signs of the microbe going rogue, we can extinguish it immediately without any question and we can even put it into the right location. And so we call that contagement strategy. So we're not there yet and I'm not yet decided, to be honest, because I still need more data.

I mean, I'm in the same boat as you completely agree what you're saying. I think we just need a little bit more time to explore the space before we can make some sort of informed opinion on the matter.

We hope you enjoyed part one of our conversation with Dr. Amin Zorghani. If you found this podcast valuable, leave us a kind review and five stars on Apple Podcast, Spotify, YouTube or your favorite podcast podcasting app. If you want to connect with our host Cribban Govenda, please follow him on Instagram, Facebook and TikTokthealthgurus. Also check out our Gut Health Gurus Facebook group with 17,000 plus members ready to help you on your journey to amazing gut health. This episode is sponsored by Nourish Me Organics. Head to www.nourishmeorganics.com and use the code Happy Gut for 10% off. Make sure to check out their range of Gut Health supplements until next time.