Holy shit! Mental health and the gut (part 1 with Holobiome)

Business Trip by PsyMed Ventures, a podcast exploring the future of mental health & wellness

Welcome back to Business Trip by PsyMed Ventures, a podcast exploring the future of mental health & wellness! 🍄

One of our beliefs at PsyMed is that ancient or traditional wisdom can be reverse engineered to develop mental health treatments. To do so, we look for mechanistic explanations, and then try to decode, replicate, and improve the intervention using modern science

Psychedelics and meditation are a couple examples of areas we invested in based on this framework. We believe that the gut microbiota is another area for innovation in mental health.

The gut microbiome – bacteria, viruses, fungi living in our gut – play a big role in how we feel, act and experience the world. There are hundreds of studies that look at the relationship between the gut microbiota and mental health. This relationship is governed by the gut-brain axis, which is the two-way communication between the brain and the gut. 

There are many ancient diets tapping into the power of microbes. For example, Chinese medicine uses fermented foods to improve gut health and overall well-being. Ayurveda uses herbs and plants with antimicrobial properties.

The incidence of mental health disorders is on the rise as is the the dissatisfaction with existing treatments (i.e. SSRIs). This is why researchers are paying so much attention to the gut-brain axis and the potential for microbial interventions to treat neuropsychiatric conditions including depression, bipolar disorder, autism, addiction, Alzheimer's, and epilepsy.

Let's consider a mindblowing study from 2022: patients with depression orally ingested fecal matter (frozen poop) from healthy donors and their depressive symptoms improved. This radical approach is far from being entirely novel. In fourth-century China, feces were used for the treatment of a variety of conditions including diarrhea. The psychiatric possibilities aren’t limited to depression; a 2022 case study reports of successful fecal microbiota transplant (FMT) for patients with bipolar disorder. 

One more study to consider, this time with mice: transplanting microbiota from psychiatrically ill donors to healthy recipients resulted in transmitting depressive and anxiety-like symptoms and behaviors. It’s like catching a cold, but instead with depression or anxiety.

Today there are many companies harnessing the microbiome to treat diseases. Yet very few in mental health. It’s not surprising. There are unique challenges for psychiatric clinical (1) there aren’t objectively agreed upon biomarkers for mental health used as endpoints, (2) the placebo effect is really high. The placebo response is higher for conditions that are subjective, such as pain and depression, than for conditions that are objective, such as high blood pressure (3) recruiting and retaining patients is hard. Many people with mental illness are reluctant to participate in research.

I get why a startup might want to start somewhere else. But a few brave companies are tackling this issue and developing microbial therapeutics for mental health. We interviewed the founders of two early stage companies in the field: Holobiome and Bloom Science. 

This 2-part series also marks the start of Business Trip’s next chapter: covering the future of mental health and wellness. We believe microbial therapeutics will be one of many new paradigms in mental health, along with psychedelics, neurotech, and many others we’ll share over time.

Dr. Philip Strandwitz is the founder and CEO of Holobiome, a company that develops therapies for the human microbiome. Phil is an expert in the gut-brain-connection and ways to cultivate a healthy gut microbiome and one of Holobiome's lead programs is focused on depression.

In this episode we discuss:

• The gut microbiome's interactions with the brain and role in health

• Microbial therapeutics to treat epilepsy, pain, and mental illness

• Modulating the gut microbiome through food, prebiotics, probiotics, and fecal transplants

• How to build a viable business around the microbiome

Listen to the episode here, on Spotify, or on Apple Podcasts.

Once you've finished the episode, we'd love to hear your thoughts! Tweet us at @psymedventures to share your views.

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