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Column: Of Monarchs and Microbes – Prince George’s microbiome and the health of a nation

Of Monarchs and Microbes – Prince George’s microbiome and the health of a nation

In the final installment of ‘Just 10% Human,’ Daniel Sprockett looks at the microbiome of the Royal Baby. Guaranteed to be the only article you read about Prince George that considers the “vaginal microbiome” of the Duchess of Cambridge.

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I traveled to New Zealand with my wife last week, where she was giving a presentation on her work assessing health care systems in developing nations. The early morning meeting was interrupted for a very important announcement: Kate had given birth!

As an American living in the British Commonwealth, I recognize that I am probably more interested in the royals than the majority of my countrymen. Perhaps it is the strong influence of my English grandmother, or maybe it is that William and I are so close in age that I’ve always see a bit of myself in him. Whatever the reason, my ears always perk up when there is any exciting news of the royals. I have vivid memories of the night that Dianna died in Paris, and as embarrassing as this is to admit now, my wife and I definitely rose early to watch the Royal Wedding broadcasted live in the U.S. at 5:00AM.

So when I say that I was happy to hear that the future King of England had been born, it isn’t in snarky response to the never-ending news coverage of The Royal Nothing-In-Particular that preceded the birth.

I sincerely wish the House of Windsor well, and hope that young Prince George grows up happy and healthy. However, as a microbial ecologist interested in the human body, the word “healthy” has come to be defined very differently for me. My thoughts continually turned to one very underappreciated factor in every new baby’s life: their microbiome.

The human microbiome, or the entirety of the microorganisms that are associated with the body, has been a concern of royalty longer than microbiology itself has existed. In the 1530’s, King Francis I of France was suffering from a pernicious case of diarrhoea that no French physician could cure. In response, his great ally Suleiman the Magnificent, Sultan of the Ottoman Empire, sent his royal doctor to treat Francis I with probiotic yoghurt. Apparently cured of his ailments, Francis spread word of the benefits of eating fermented milk products, and in doing so helped introduce yoghurt across Europe.

In addition to easing stomach discomfort and related ailments, we know that the beneficial microbes living in your gut can have profound impacts on your health and development. The microbiome has far reaching affects on everything from autoimmune disorders like ulcerative colitis and psoriasis, obesity, and even how you respond to stress. While attempting to tease apart the mechanisms that underlie these conditions, scientists have begun tracking how the microbiome develops and changes over time. While human body is thought to be essentially sterile in utero, it first exposure to microbes happens during birth.  Proper colonisation by microbes may have an effect which species take up residence later in life, and which could in turn influence rates of diseases occurring later in life.

I’m sure Buckingham Palace would frown on a frank discussion of the Duchess of Cambridge’s vaginal microbiome, but it turns out to be quiet important to her baby’s health. The New York Post reports that the Prince George was born naturally, which is probably good thing for his microbiome. A recent study comparing mode of delivery found that babies born vaginally have a microbiome that mirrors their mothers vagina (dominated by species in the genera Lactobacillus, Prevotella, and Sneathia), but babies born via cesarean section have microbial profiles that a more similar their mother’s skin (dominated by species in the genera Staphylococcus, Corynebacterium, and Propionibacterium). We still aren’t entirely sure what, if any, impact these early baseline differences have on the child’s health later in life, but those types of studies are currently underway.

Whichever microbes colonise the baby first, they do an excellent job filling the available ecological niche. Newborns are coated in the same few bacterial species no matter where you sample on their bodies. Their microbiome is undifferentiated, as we say.  However, over time their microbiome slowly becomes more and more site specific, which suggests that their body is applying a selective pressure on the microbes living in different areas. Eventually, normally between the ages of two and three, the child’s microbiome begins to look as differentiated as an adult’s, showing huge differences in microbial biogeography all across their body. Two microbial community samples taken only a few centimeters apart can harbor microbial communities that are more different from each other then microbial communities living in a scorching desert and in the frozen tundra.

A healthy baby’s gut microbiome is also developing during this time, and researchers have begun characterizing these changes with laser precision. The movie below tracks the development of a baby’s gut microbiome over the first several years of their life.

What you see initially is a scattering of spheres on a 3D axis. Each sphere represents a microbial community sampled from one location on a healthy adult, with the color representing where that sample was taken from (brown – gut, blue – oral cavity, green – skin on the forearm, pink – vagina). The location of each sphere represents the overlap of bacterial species found in samples, so samples that are close together are more similar to on another, where distant spheres represent microbial communities that are very different from one another.

The first thing you’ll notice is that the colors generally appear to cluster together. This shows that, on average, the microbes living in your mouth are more similar to the microbes living in my mouth than they are to the microbes living in your gut, even though everything in your gut got there by first entering through your mouth! Collectively, the clusters of colored spheres can be thought of as representing the normal range of variation in the microbiome of given body site for healthy adults. But what is normal for children?

As the video progresses, you see that gut microbiome of a single child born via the birth canal (represented by the yellow sphere) begins by bounding around the graph. It begins by staying close to the pink vaginal cluster, and slowly moves more and more into the overlapping green skin cluster.  Remember, this is the baby’s gut microbiome, even though it doesn’t begin looking like a diverse adult gut until the baby reaches 27 months of age.

One factor that contributes to this change is the fact the microbes found in breast milk change over the course of lactation. Even more interesting is that breast milk itself is composed of hundreds of different sugars, some of which can’t even be digested by the baby. These sugars have instead evolved to nurture specific commensal bacterial (for example, certain species of Bifidobacteria) that contribute to the baby’s normal development. This is still a very active area of research, but it has become clear that mothers play a direct and extremely important role in shaping the microbial development of their babies.

The Duke and Duchess of Cambridge have also elected to spend the first weeks of Prince George’s life at the Middleton’s estate in the quaint village of Bucklebury, in West Berkshire, England. The Daily Mail reports:

…Kate, 31, would not employ a maternity nurse, instead living with her parents for at least the first six weeks – meaning the future king will start life in a commoners’ home rather than a palace.

I’m not sure if “a commoners’ home” is the most apt description of the £4.8million Georgian mansion in which they’ll be staying, but traditional knowledge suggests a bit of country air will be good for them.

Of course, it isn’t just tradition saying that time in the country is a good idea, but a fair amount of scientific data. We know that children raised in the rural environments have lower rates of allergies and autoimmune disorders like asthma and type 1 diabetes. In fact, this was one of the observations that lead to the hygiene hypothesis, or the idea that the reduction in microbial exposure due to modern day sanitation and antibiotic use has contributed to the rise in allergies and autoimmune disorders in developed nations. Its foundation lies on the assumption that our immune system evolved over a period when microbial bioburden was very high, and that this normal level of exposure gave our active immune systems something to fight.

I must point out, however, that it is quite unlikely that any royal children were included in these epidemiological studies. Rural life was simply a proxy for increased exposure to environmental microbes, and I doubt very much that the young Prince’s chores will include tending sheep or cleaning stables. Baby George in his country estate may be an outlier.

Either way, The Royal MicrobiomeTM could have an effect on the world that has thus far gone completely underappreciated. After all, King Henry the VIII remains famous (and infamous) in part due to his enormous girth, and we know that the gut microbiome plays an important role regulating weight and influencing obesity, through mechanisms that are completely independent of diet.

There is one way we could get a better look at this, and it wouldn’t cost much. A colleague of mine at the University of Technology Sydney recently suggested to that we could get the word out about the human microbiome if we could only convince ministers like Tony Abbott and Kevin Rudd to have themselves sampled by microbiologists (seriously…the headlines write themselves), but I’m going to take this idea one step further.

Kate. Wills. George. Heck, even Elizabeth! If you’re reading this, please have consider having your microbiome characterizedfor science?

 

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Daniel Sprockett is a researcher at the Case Western Reserve University School of Medicine in Cleveland, Ohio. He currently resides in Double Bay with his wife, Andrea, while she completes a Master’s of International Public Health at the University of Sydney. Dan will return to the United States in September, when he begins his PhD in Microbiology and Immunology at Stanford University.

@DanielSprockett
sprockettsdownunder.wordpress.com/

 

Read more Just 10% Human here.