Alexander Khoruts is an associate professor at the University of Minnesota School of Medicine, and he is a graduate of the University of Minnesota. Some have titled his work, “Gut Reaction,” but it is much more complex than that, and most important his work has developed a procedure that is saving thousands of lives. Dr. Khoruts’s clinical interest is gastroenterology with a particular focus on immune disorders affecting gut function.

During the past decade there has been a revolution in medicine calling for a major revision of the germ theory of disease. Over the centuries, our society and its physicians, have learned to view microbes mostly as potential pathogens. Traditional clinical microbiologists have been able to isolate and grow many pathogens in the laboratory, and we learned how to kill them. Many infectious diseases have been largely defeated with this approach over the past century.

However, the pathogen-centric framework of thinking ignored the microbial communities that are an integral part of the human body. Indiscriminate use of antimicrobial drugs does have serious costs. First and foremost, this includes emergence of new superbugs resistant to most antibiotics, such as Clostridium difficile, vancomycin-resistant entertococci (VRE), carbapenem-resistant Enterobacteraceae (CRE, or “nightmare bacteria”), and many others. These formidable pathogens are normally prevented from causing disease by microbes indigenous within our bodies. This emerging new threat was recently identified by the white House as one of the most urgent problems of this time.

New approaches are needed to counteract this problem. Dr. Khoruts and his team have been the leaders in the country in developing the new field of “Microbiota Therapeutics.” they were the first group to demonstrate that it is possible to engraft entire microbial communities from healthy donors into recipient patients suffering from recurrent C. difficile infections. Because of this work, the procedure became known as “fecal microbiota transplants” or FMT. they then standardized the process, which has now been taken up throughout the country with thousands of patients receiving this life-saving treatment.

Dr. Khoruts believes this is only the beginning of a new chapter in medicine. There are many challenges ahead, including:

• Development of new microbiota therapeutics for other infectious disease problems.
• Development of a helpful regulatory framework.
• Applying microbiota therapeutics to the maladies that have become commonplace in the 21st century, including obesity, diabetes, autoimmunity, inflammatory bowel disease, atopic diseases, and even neurodevelopmental disorders such as autism.

—Donna Peterson, UMRA president-elect