The idea that our microbiome plays an important role to our proper functioning as organisms has been around for several decades now, but we don’t really understand all underlying mechanisms of this relationship in its entirety. But that’s going to change soon as we start to leverage the powerful computational capabilities of artificial intelligence to help us explore this relatively untapped space. Guru Banavar finds himself at the forefront of these developments that would soon define the future of our microbiome. In this conversation with Doctor Awesome, talks about his work on host/microbe molecular data analysis and the interesting applications he is working on at Viome Inc. They talk about the link between oral health, gut health, and systemic health, the regulating role of microbiota in the whole picture, and how these insights can help us manage one of the biggest problems in the 21st century – chronic disease. Tune in and learn how are little friends in and on our bodies might play and even bigger role in our future as a species than they already do now.
—
Watch the episode here
Listen to the podcast here
The Future Of Our Microbiome – A Conversation With Guru Banavar
In this episode, we’re going to be talking in the present, but talking about the future with an interesting person, Guru Banavar, who’s a leader in both artificial intelligence and the intersection between biology and how those two intermingle. He’s a Chief Technical Officer at Viome. I’m excited to have him. Guru, thanks for coming. Thanks for joining us. Please tell us a little bit about yourself and what you’re doing at Viome.
Thank you so much. It’s great to be here, Doctor Awesome, which is a lovely name. I am like you said, the Chief Technology Officer at Viome, one of the founding members of Viome. In Viome, we believe basically that to solve one of the most complex problems in the 21st century, which is chronic disease, every other person you know has some kind of chronic disease. To solve that, you need to get to the bottom of the biology of human beings. The biology of human beings includes not only the human molecular processes that go on in your body but also the microbial processes that go on in your body. Every human is a walking ecosystem, as you know. There’s a lot of microbes. In fact, for every human gene you have in your body, you have more than 100 microbial genes in your body.
Understanding the interplay between your human genes and your microbial genes, and the microbial genes being super influenced and controlled by the environment and the lifestyle that you practice every single day. Understanding that biology, and then using that biology to get to the bottom of chronic diseases, everything like you mentioned oral microbiome earlier. There is the oral microbiome, there’s a gut microbiome, there’s a skin microbiome, there’s microbiomes all over your body.
Understanding the whole system, we think of it as a systems biology type of approach. The way to understand it, we think, is to convert as much of that as possible into data. From the molecules to the bits and bytes. Once you convert that into bits and bytes, you possibly cannot understand that with the human brain because the amount of data is so much, and the complexity of all the interactions is so much. You have to bring in the most advanced AI techniques to understand that data.
That’s where this connection between biology and AI happens. My job is to look at the massive amounts of data that we generate from the molecular biology of humans and figure out what are the underlying molecular processes for many of the chronic diseases. Here, when we say chronic disease, we are not talking about 1 thing or 2 things. We are talking about systemic chronic diseases, the metabolic diseases. There are immune diseases, there are cardiovascular, neurological, there are oral diseases. All of these things are interrelated.
When we look at large amounts of data, we look at what kinds of clinical implications there are, lifestyle implications there are, and we give a number of our customers. We have more than 600,000 customers around the world from 100 countries right now. We give customers insights into what’s going on in their biology based on this AI analysis of the molecular data. Based on that, we also give them recommendations and we say, “These are the kinds of lifestyle changes that may make a difference for you versus you versus you.” It’s very precise and personal for each individual that we talk to.
AI is in the middle of all of this. We do all kinds of different machine learning on the molecular data. We use all kinds of different AI algorithms to bring that insight to the widest possible audience. I have to say, from a technologist’s perspective, this is a very exciting agenda. Also, from a humanity perspective, this is what I think we need to do to take, I would call it medicine, general lifestyle medicine, so to speak, to the next level, because that’s the only way that we can address chronic disease, which I believe is one of the biggest problems in the 21st century. The same as climate change and space exploration, all of those things. Chronic disease is one of those super important problems for humanity. That’s what I spend all my time thinking about.
Insights Into Personal Health
I think that that’s interesting because I would argue that we have a lot of information about individual subsections of biology. I know a lot about a particular bacteria, but there are so many bacteria in our body and how they interact with each other. We’re still on the baby steps in regards to how we’re putting it all together. What are some insights that you’ve found from some of this stuff? If I were to sign up as a customer, what would be some insights that you would tell me? We’re both of South Asian background. I know that particular metabolic diseases are very common in our background. What would be some insights that maybe I would get if I were to sign up for volume?
There’s a lot of insights you get, but let me start with some of the basic ones and then we can work down depending on what you’re interested in. First of all, there is the notion of gut health. Gut health has been interpreted in many ways. Gut health is connected to everything starting from metabolic disease and cardiovascular disease, you and I, as you said, or from a similar geographical background. It turns out that the geographical background has a certain amount of commonality, but our lifestyle backgrounds probably have a much bigger influence on our everyday biological processes.
Let me give you a few examples. When you think about inflammation in the gut. That’s a very big component of gut health. These inflammatory processes are going on in your gut. Comes usually from a lot of microbial triggers. We think about bacteria, but it’s not just bacteria. There’s bacteria, there’s fungi, there’s archaea, there’s viruses, there’s all kind of different microbes in your gut. They all have a lot of their genes, but they’re expressing very different types of genes or transcripts like in RNA molecules based on what you eat. Everything you eat is first consumed by your microbiome.
Based on whether you eat too much protein whether you eat too much sugar, or whether you eat too much complex carbohydrates like fibers and stuff like that. There is a difference in how the microbes consume the food that you consume and then produce both inflammatory and anti-inflammatory molecules. For example, many bacteria have a molecule called lipopolysaccharide or LPS, which is a very well-known inflammatory molecule. If there’s a lot of LPS that is produced, then your gut can get inflamed. When you are inflamed, there are a lot of bad things that are going on. There’s all of the immune system, cytokines, stuff like that, passing around. There’s a lot of blood flowing. There’s a lot of repair happening. There’s a lot of immune system activation that’s happening.
At the same time, there are certain microbes, and I’ll call them microbes rather than bacteria because I’m including bacteria, viruses, fungi, etc. All of the microbes in your gut can produce anti-inflammatory molecules. The most common anti-inflammatory molecules that people may have heard of are short-chain fatty acids, like butyrate, propionate, and so on. There’s this war going on between the inflammation and the anti-inflammatory molecules in your gut.
What if I told you that on balance, this is the amount of inflammatory activity going on in your gut, and this is the amount of anti-inflammatory activity that’s going on in your gut. These two things are interacting with each other. Overall, your gut health seems to be okay because the anti-inflammatory molecules are fighting off the inflammatory processes well enough to be able to not get you into crazy diseases like inflammatory bowel disease.
On the other hand, I might tell you that the inflammatory processes are winning out on the anti-inflammatory stuff. Unless you change something, you will not be able to balance out the inflammatory and anti-inflammatory fight water that’s going on in your gut. That is all encapsulated in this idea of gut health. We not only tell you about your gut health, we do it on a scale of 0 to 100. We can say the higher the better. If your score is like 70, you’re in good shape compared to the general population. If your score is in the 20s or 30s, you’re not in very good shape.
I could tell you where your inflammatory processes are on that scale. When I say gut health, you can say, “If my score is in the 20s, maybe I should take my food habits a little more seriously, and maybe I should change my food habits to be more anti-inflammatory friendly, so that I can bring my gut health score up into a good zone.” We then give you some recommendations. We say, “You may want to have these food items that have more complex carbohydrates specific to the kinds of bacteria that we see are microbes in your gut that can help your anti-inflammatory process.”
We give you recommendations and say, “You can have these.” If you want, we can even send you precisely formulated supplements to your home so you can supplement your food. I’m not saying that you will replace your food with supplements, but you can have only so many complex carbohydrates. If you want to add more or if you want to change some metabolites like butyrate, we can send you those after looking at your gut activities, and then you can decide whether or not you want to do that.
All of that information is encapsulated in this one idea called gut health. We not only do gut health, we do oral health. We have a separate score called oral health. There, you have a background in oral health, so I can tell you about the inflammatory processes that are going on in your mouth. The gum inflammation, what exactly is happening in your mouth? Is it breaking down the gum-teeth barriers and causing caries or periodontitis or maybe even some premalignancies? Whatever is happening in your mouth, I can see all of that activity in your mouth, put it all together in another score called oral health, and tell you where your oral health is.
By the way, if you’re interested, if you’re a geek like me, you can say, “It’s not enough for me to know just how my oral health is doing. I want to see what exactly are the processes.” We break it down and we say, “If your oral health is bad, is it your gum health that is bad? Is it your tooth health that is bad? Is it your breath that is bad? Are the volatile sulfur compounds too much? There’s a lot of hydrogen sulfide being produced? Is there a lot of acidity in your mouth? Is there a variety of different, all the way to cancer processes? We look at all the cancer processes like genotoxic and fungal activity. We break down all of those things and we give you information about everything that’s going on in your mouth.
We do that for all the major parts of your body, your oral health, your gut health, your inflammatory health or immune health, your heart and cardiovascular health, your kidney health. We have a few of these scores that we tell you about. Based on that, you can decide what else you want to do. You can go do some more research on your own, you can change your lifestyle, you can talk to your doctor, you can do a variety of things based on that information.
Microbiome And Gut Health
Are you setting in saliva samples? What are the nuts and bolts of this whole process?
If you are interested in Viome, you can go to our website and we have several different kits. There’s one kit called the Full Body Intelligence, which is our flagship product. The Full Body Intelligence, when you purchase it, arrives in your home in one box, but it has three samples in it. There is a saliva sample, there is a very simple finger prick blood sample, and there’s a stool sample. The stool sample gives us information about your gut health. The saliva sample gives us information about your oral health. The blood sample gives us information about your overall system.
Think of it as if you look at the elementary canal starting from the mouth to the other end, so the top of the tube, the bottom of the tube, and around the tube. The whole system is what we get through the three samples, and then we put all of that data together into all of these scores that I was talking about. Those scores then drive all the recommendations. There’s a ton of science behind this that we keep publishing about. Every time we have enough insights from these molecular processes, from these three samples, especially in the large populations that we deal with. We put together a scientific publication and published it in one of the usual journals that the science community looks at.
If somebody’s interested in looking at those journals and the scientific publications, you’re welcome to go do that. We also do randomized clinical trials and figure out what are the differences between people who follow these recommendations versus people who don’t follow the recommendations. We’ve shown some good results about how it changes your overall molecular health, so to speak.
What were the results specifically from the randomized clinical trial because I know that that’s the gold standard for evaluating the ineffectiveness of treatment? What did you guys find in that?
The latest one that we’ve done is a metabolic health randomized clinical trial. To break it down a little bit for the audience here. We have 2 arms and there’s 1 arm that’s receiving placebos. We give them these inert supplement pills. There’s this water in them. There’s another arm that gets the precise molecular data-based recommendations and converts them into these micronutrients and macronutrients that we think are appropriate for that particular individual.
Those are the two arms of the study. We randomized all the people who we recruited into the study into one of those two arms. What we found, and this study is still not fully completed, but we did an interim analysis. In the interim analysis, we see that the endpoints that we looked at, in this case, the endpoints were diabetes endpoints, like HBA1C, and other markers around like insulin resistance and so on. We are also looking at several other markers as secondary endpoints, including some clinically validated questionnaires.
All of those are going in the right direction. There’s a statistically significant difference, even in the interim analysis between the intervention arm and the placebo control arm. Already we’ve seen that and we want to finish that in the next few months and we’ll publish the result. We are starting to put together the results already based on the interim analysis. That is our latest study. We’ve also done several retrospective observational analyses on very large populations. The reason it’s a very large population is because we have 600,000 or so customers around the world.
We can retrospectively look at all the people who had disease X, whatever the disease is, versus people who did not have disease X because we get that information from that population and we can see retrospectively, we can do the analysis and say what were the differences between people who followed our recommendations from people who did not. We’ve published a few studies. One of the papers that we submitted, which we published recently is in the American Journal of Lifestyle Medicine. You’ll see there that this is a retrospective study. That one was a single-arm study, so that was a preliminary result. The new RCT that I mentioned is still not out there, but it’ll be out there shortly.
In the previous paper, we were looking at IBS endpoints, which is if I have irritable bowel syndrome measured through a clinically validated questionnaire called the IBS Symptom Severity Score, which tells you what level of IBS symptoms you have on a scale of 0 to 500. That was one, and then we did a depression analysis on a PHQ-9 scale over a period of, I think it was around nine months or so of intervention. We then did anxiety scores and so on.
That paper is published in the American Journal of Lifestyle Medicine. You can see that. Again the markers, the endpoints that we were looking at were better in the intervention arm or in the arm that had taken these precision supplements that I’m talking about versus the arm that did not take the precision supplements. We’ve done the retrospective, we’ve done now the prospective, which will be published shortly, and we’ve done many other studies, which I write a research blog by the way. I welcome your readers to look at the blog that we write, where we put out these kinds of results as we find them in our population. We try to make it accessible to the broad population and say what are the real takeaways from each one of this analysis. There are a number of these kinds of results out there right now.
Microbiome And Oral Health
I agree that there’s a lot of promise from all the things that you’re talking about, but from your personal experience, have you tried it? Have you done it yourself? What were some insights that you got and how do you feel in your personal experience?
Each person’s experience changes. In my case, I did have a major problem with my oral health. The reason I ended up in that problem space is because I skipped going to the dentist during COVID for almost two years. I was too worried about going to the dentist and getting COVID. I avoided COVID for the first two years. I was maybe being too careful, but at the end of the COVID season, I realized that my oral health was terrible. The biggest problem I had was that my oral health had gone in the direction of periodontitis.
That is very common within our demographic. For whatever reason, we’re more predisposed to it. Something that I would advise all South Asians is to go see your dentist regularly because it can happen like that.
It did in my case. I was shocked to see how bad it was. That was about a year ago, or maybe a little more than a year. About 18 months ago, I realized that I had terrible oral health after the whole COVID episode happened. Of course, I was already focused on my gut health. I knew what was going on and all that stuff, but oral health, I neglected it. I started addressing it with some of the recommendations that we provide to our customers in Viome. We have these lozenges. Now, we have a toothpaste also that we are personalizing with, with a whole bunch of different ingredients that come from all of the known current science.
Is this like beneficial bacteria or what is it that you’re putting into these products?
Probiotics and postbiotics. We’re taking a base and we are adding probiotics and postbiotics into the toothpaste. We are doing the same thing with lozenges that you can pop in your mouth. This is a new product, and we’ve been experimenting with it and building it over the last year. I get, of course, early access to all of these things. I have to tell you, I feel so much better now. The last time I went to the dentist, which was about a month ago, I saw that there was a major improvement in my oral health. I don’t know whether it’ll happen that way or not, but I’m hoping that I can take the periodontitis backward. To reverse it and get my gums back to where they were, my teeth back to where they were, and so forth.
That’s my current story about how this can make a difference. If you go to our website and look at the stories of all our customers who have had gut issues. Many of them have these abdominal pain type issues and people have skin issues and so forth. A lot of them talk about the issues that were resolved, but of course, there are studies as well. There’s all of the above that’s happening right now.
I think that it’s not only your company. From a broader perspective, this inward journey that we’re going on as a species, people are getting these full body scans. A lot more interest in lifestyle medicine is cropping up you have people like Peter Atia and all these people who are publishing and promoting it. I think that the technology is still catching up with all the interest in my opinion. I think that we have a lot of sensor technology, but as you said, there are not enough people to process all the data that we already have. Science, especially academic science is so particularly focused on individual things, and it’s tough to see the whole picture and to evaluate all of the things interacting with each other.
I’m hopefully optimistic about all the different technological breakthroughs that are going to happen because of the advanced computational power of AI. Specifically, the oral microbiome, which is my wheelhouse. There’s so much interest in that. Here in Cambridge, Massachusetts, 70 different companies are focusing on the oral microbiome, and they want to do it as almost like an advanced sensor type of situation. Whereas instead of doing blood tests, we spit into a cup and then they give us a breakdown of our health. Do you think that that’s realistic based on what you’ve seen? You’re kind of in the thick of it. Do you think that that’s a realistic endpoint for us?
I think so, yes. Let me tell you about the NIH proposal that we just submitted with the foresight people in Boston since you mentioned those guys and multiple other centers around the country. What we are looking at now is a way to start with one of the most deadly diseases that happen in your mouth, which is oral cancer or throat cancer. It turns out that it’s increasing in the last few years, unfortunately. It’s increasing because of all of the lifestyle things that people have. HPV infections increasing. Vaping has been increasing even among young people. There’s been a lot more bad outcomes from all of these lifestyle practices.
In order to solve one of the most complex problems in the 21st century, which is chronic disease, we really need to get to the bottom of the biology of human beings.
It’s still super deadly, but people don’t realize that it has a 50% mortality rate. That hasn’t changed for decades.
The primary driver of the 50% mortality is because it’s caught at a late stage. You don’t see that at the early stages and do something about it. It can develop over a decade or more right after all of these things. The whole name of the game is early detection and don’t depend on somebody looking at it through the human eyes and figuring out that something is turning malignant or something like that. Try to catch it at the molecular level as early as possible, and then figure out how to change habits or do whatever medical interventions you can do, whether it’s nipping off something early or anything that yet we can do.
When it comes to oral cancer, the name of the game is early detection.
Going back to our NIH proposal, we have already developed in Viome a first-generation oral and throat cancer test. It’s a laboratory-developed test that’s available right now through dentists. What we are now doing is, we got an FDA breakthrough designation for that test, the oral and throat cancer test. It’s based on saliva, it’s based on the microbiome of your mouth, and the interaction with the host gene expression. Again, gene expression is what we do. We don’t do DNA in Viome, we do RNA. The reason why we think RNA is important is because you are the same person. In the beginning, you may be healthy. Later, you may be sick. Your DNA did not change, your RNA changed. We want to track RNA, not your DNA because your DNA doesn’t give us a lot of information about what’s changing in your body.
Anyway, so based on that, we developed that first-generation oral throat cancer test. After getting the FDA breakthrough designation for that test, we are doing a pivotal study, which is a phase three type of study clinical trial. We now have created a little consortium of many researchers, including all of the institutes I mentioned earlier and we are going to create what I think should be the standard of care for oral and throat cancer. I think every dentist, every hygienist, and every oral health professional should be using this like they use a blood test for a cardiovascular exam.
You walk into a dentist’s office, you should be getting your saliva tested, and it’s now being shown. We have multiple papers on this. The latest paper we wrote was in the Journal of Oral Oncology where we showed what our FDA breakthrough designation results were, what the biomarkers were, the microbiome-based biomarkers, and the host markers, and what the clinical outcomes were that we submitted to the FDA.
That’s the extreme part of what can happen if you don’t take care of your oral health. Work backward from there. Even before the malignancy happens, there are a lot of different kinds of premalignancies that are becoming more prevalent. For example, these white patches in your mouth, the leukoplakia, and the dysplasias, that’s now hit 2.6%, almost close to 3% of the population have these issues in their mouth.
I see them all the time.
You see them all the time, I’m sure you do.
They come to me to get a biopsy. I’m the surgeon who cuts it out. I feel like the morbidity associated with that procedure is unnecessary. It would be great to have some sort of test that I could do so that I didn’t have to filet open somebody’s tongue to figure out if this is cancerous or not. One day, I had this guy come in on his tongue and the tongue is a huge muscle, so you cut into it and he’s going to be sore for days. You can’t take a day off from using your tongue. You still got to talk, you still got to eat, and still got to do all these things that are necessary for the activities of daily life. If I could test that through saliva, that would be huge.
That’s one of the reasons why I was so interested in speaking with you because oral cancer is a real problem. It is getting worse. I don’t think it’s talked about enough, but I think more importantly is that I don’t think we’ve tapped into the potential of the oral. Systemically, we can talk about the focused stuff in the mouth, but systemically, I don’t think that we’ve made enough connections between how healthy our mouth is and how healthy the rest of our body is.
I’m so glad you brought that up because I was working backward from the cancer to the pre-cancer to the inflammatory diseases like periodontitis and caries. You then start looking at the connection between oral health and systemic health. We submitted a paper, which is available right now on bio archive where we show the eight most important molecular pathways in your mouth, eight of them.
Also, the connections between those eight pathways and systemic health to cardiovascular health and neurological health. We have a lot of research and I’m going to start writing more blogs on this topic about each of these connections between oral health and other systemic health aspects and I would love to work with you on this. Get your feedback on it at least and see if this corresponds to what you’re seeing in your practice.
Our science is showing that the oral inflammatory pathway is connected to not only the usual oral health issues like periodontitis and all of that, but type two diabetes and non-alcoholic fatty liver disease. There’s a connection between your oral inflammation and your metabolic health. I’m not quoting somebody else here. I’m telling you this is primary data from our molecular analysis.
Do you think it’s a correlation, not causation though? I don’t think that there’s been a smoking gun yet for some of these systemic health. I think that there is. That’s coming from somebody who’s a believer like you are. I think that there is some core connection and we haven’t defined it yet. We haven’t proven it yet.
At this point, the causation is not yet established. Let me be super clear about it, but I think we have a shot at it with the data we have at Viome. We are heading in that direction. Currently, we are only seeing that there’s a correlation happening. If you look at the underlying molecular processes, let me give you an example of what I mean. If you say that, porphyromonas gingivalis, which everybody thinks of as a bad micro bacteria in your mouth. It turns out by the way that 80% of the people have porphyromonas gingivalis or p-gingivalis in their mouth in America. That’s true in our population as well. 78% plus.
Now, it turns out that only about 15% of them are expressing the virulent toxins that are associated with all of these diseases we think about. The gingipain gene, which is part of the p-gingivalis genome, is only expressed by about 15%, not 80% of the people. We track that because, for a meta-transcriptomic technology, we can see what are the genes that are being expressed. We see how many people have gingipain expressed, and then we can go to the next step and say, “How many of those people have leaky gum?”
There’s bleeding happening. There’s translocation of the gingipain from your oral cavity into your bloodstream, and the bloodstream then takes your gingipain molecules. These are transcripts that can turn into proteins that can cause havoc in your cardiovascular system or your metabolic system. You can then track that and see, “Is that now being expressed in the blood? Is that connected to metabolic issues, whether it’s insulin resistance or it is some fat storage that’s happening that causes non-alcoholic fatty liver disease. That whole path of causality could be analyzed using our data.
For the first time I believe when you start looking at the expression of the genes and you’re looking at both the oral and the blood molecules, you can trace what is going on in the connection. I’ve already seen the connection between the oral and the gut microbiome, but one of the next steps we want to do is to the oral and the blood transcriptome and see what the connections are. I believe we are getting there, and I think in the next couple of years, we have a good shot at it because you need a large enough data set to be able to establish its causality, but I think we’ll get there. We have the resolution of the data and we have the scale of the data to be able to do this now.
Oral Health And Gut Health Connection
Can you tell me a little bit more about the connection between the oil and the gut microbiome that you’ve identified? Here’s the thing that I see as a big clinical question that I have. I would argue that the biggest problem from an oral health perspective is edentulism and partial edentulism. You lose the ability to chew with the back of your teeth, and then now you start self-selecting for softer foods. You start chewing like a rabbit. You’re not experiencing life the way that you did when you were younger and that’s common. After the age of 40, the average American has lost about 7 teeth. There’s about 20% of people who are over 65 that are have no teeth whatsoever, no real teeth to chew with.
Either they’re in dentures or they might have like a handful of teeth that are in the front that aren’t functional. Those people come to me and they say, “I want to have my smile back. I had a big surgery and I restored that. I’m telling you, Guru, their life changes. They become healthier. They become different people from start to finish. I see it not only with the older people but the younger people that I take care of, that people who have significant overbites or underbites, they look like this and they can’t chew either. I do this big surgery and I give them the ability to chew again, the ability to function correctly again, and their life changes too.
I’ve always credited it as a psychological thing. They look different and they feel different. Now they’re making different lifestyle decision choices. I’ve done it on people who don’t have that same social burden. I had this one 91-year-old woman that’s losing all of her teeth and she’s like, “I have to lose all my teeth, but I want to eat saltwater taffy.” I was like, “You’re not going to be able to do that in dentures, so this is what I can provide for you.” I gave that to her and she became healthier afterwards.
I don’t know why it’s happening, but I feel like I don’t have access to the same kind of resources that you do. Tell me a little bit more about that connection between the oral and gut connection, because maybe there’s something there. It’s something that’s been a burning question in the back of my head that I see regularly. When people start declining from an oral health perspective, they see somebody like me. I see them before and after this transformation, and I’m telling you, there’s something there. I haven’t been able to ask the right questions to get some lead on why it’s happening.
Imran, I believe that we are at the beginning of this era of understanding that connection. I can’t tell you that we have all the answers yet, but I think we can now ask the right questions. I can tell you some examples of the questions that we are beginning to ask because these are the hypotheses based on which we are designing the scientific experiments. We will keep publishing this as we find more information.
We don’t have all the answers yet. But I we are now able to ask the right questions.
Here are a few examples. What is the connection between the oral microbiome and the gut microbiome? It’s one of the fundamental questions. I’ll give you an example of something that’s been thrown around in the oral health industry and also in the gut health industry but the connection between the two has never been established. Fusobacterium nucleatum is like a famous bug. You know that there’s a lot of Fuso in your mouth. Everybody has a lot of it. When you look at the gut, you see a little bit of it. Is there a connection between the fuso in the mouth and the gut? People have associated in the mouth, people have associated Fusobacterium nucleatum with inflammation, periodontitis, and all kinds of premalignancies. In the gut, it turns out fuso is responsible, apparently, there’s a hypothesis going on for colon polyps to colorectal cancer.
People have found Fusobacterium nucleatum in the tumor tissue of colorectal cancer. The question is, is there a movement of Fusobacterium nucleatum from the mouth to the gut? That’s a question to ask and see what kinds of lifestyles and acidity in your gastric system might cause this. One of the experiments we did was we looked at people who were taking antacids right in their mouth and people who were not and asked the question, “What is the connection between the amount of Fusobacterium nucleatum in their mouth and their gut in both cases?” Turns out that for people who are taking antacids, the amount of fusobacterium is higher in the gut than for people who are not. The acid is kind of killing what’s coming from the mouth.
A typical person swallows something like 10 or 15 liters of saliva per day. There are a lot of things going on in your mouth that end up going into your gut through the whole gastric system. If your gastric system is acid, it’s killing off things that are going in. If it’s not, then it lets it through and there are gut health issues that can show up. I’m just giving you one particular example of what might be happening here, but there are a lot of such things that we are beginning to see in the connection between the oral and the gut microbiome.
I want to start writing about these and showing the data for it and so on. It’s a long conversation and there’s probably a lot more science here that we can talk about and stuff like that. It’s the beginning of an era where we have the data to be able to first ask the right questions and then hopefully find the data-driven answers for this rather than somebody giving an opinion about it or whatever. That’s where we are.
The idea of going from a hypothesis to actual causality is very difficult in academic medicine. I understand the limitations of the resources that we have currently in 2024. It’s something that we have to be realistic about. I understand that, but it’s interesting to talk to because even that idea of the oral-to-gut connection is not something that I pondered until you said it. That’s interesting. One of the things that I do want to talk to you more about, and we can talk more offline and in the future, is how to expedite those hypotheses into maybe even a research project or something like that.
That’s definitely what I’m interested in. If you were to do a clinical study and recruit people in these arms, you would do this intervention to improve their chewing teeth on one side. Certain people have not yet done that intervention and see what the differences are or the before-after kind of a thing. If you want to do a single-arm study, we could do a before-after intervention that we do. Super interested in doing those kinds of things.
We should talk more offline about this, but super interesting. What I’m amazed by is that your background is in computer science and you have so much knowledge about all these intricate systems. I’m impressed with how much you’ve been able to even teach me about this.
I’ve picked up all of the science in the last years since we started Viome. My background is in computer science and AI about a decade ago, I started looking at computational biology and how you apply AI in the world of biology. To me, biology is an information science. It is a biological science, but it’s reached a level of complexity where it’s become an information science. You have to be able to apply the advanced algorithms to biology to be able to truly understand it.
That was a simple thing for me. I said, “What is the best way to do it?” Let’s jump head first and go into the depths of it. It’s amazing. I love the science and technology part of it and its application, but now I’m seeing all the clinical implications and how we can take this to patients and doctors and everything. I said I’m going to dedicate the rest of my life to this pursuit.
That’s awesome, Guru. I wish you all the best. Computation in general is like this commodity now that’s going to explode in all the different fields because of the advent of artificial intelligence. I appreciate people like you who are doing it to stuff that I feel is a very niche topic, but so important. What I do on a daily basis I don’t think has the same kind of mass appeal as the cosmetic applications of medicine or the longevity of medicine. If longevity is such a hot topic right now. I do think that it’s important that we look inward and focus on some of these more underrepresented areas of science.
I want to say that this is not a niche topic anymore. The reason it’s not a niche topic is because chronic disease is affecting more than 50%, 70% of the population of the planet. Everybody on this planet unless you’re living in one of those corner case blue zones and stuff like that where your life is so good that you don’t face chronic disease. If you’re living in the industrialized world, which is 80, 90% of the population of the world, you are going to suffer chronic disease at some point in your life. To address chronic disease, you have to do what we are trying to do. To me, this is one of the biggest topics that all of humanity should care about. That’s why I think we got into it.
When I went to medical school, dental school, and residency and all of these different things that I had to do, it was still in the sick care era of medicine. I still feel like the idea of preventative healthcare, lifestyle medicine, and chronic conditions being treated before they become chronic, I still think of that as relatively novel, even though I do feel like what you’re saying it’s accurate. It’s in the general public’s consciousness now. My wife has talked to me more about this stuff than anybody else.
The point is I’m happy to hear people like you that are doing this cutting-edge work. Like everybody who comes onto the show, I always ask three general questions to fire other young scientists and other people who are interested in this field of futurism and advancing technology. Specifically for me, I feel like the driver for a lot of what I do is the motivation of science fiction and having this utopian idea of what we can achieve. As you can see from my background, I love science. I can’t wait until we’re able to live more productive lives through technology. What about yourself? What motivates you? For me, it’s science fiction, but for you, it might be something different. What motivates you in your off hours to do what you’re doing?
I also spend a lot of time with science fiction and think about the future and so forth and the life that our kids and our grandkids are likely to face even later in this century. Being in the world of AI, we are evolving as a species to the point where we are going to create a new subspecies or species of Homo sapiens, which will be in some sense more integrated with silicon. We are carbon-based life forms and maybe some silicon-based technologies will somehow be part of our lives. Right now my glasses, my ring, and my phone these things are part of my life every day. It has the same impact on my life that pretty much any of my senses do. I think a lot about how we are going to create a new type of species that is going to be a lot more capable in many ways of solving kinds of problems that will make us understand the universe better. That’s how I think about the world and AI is critical for that.
We are going to create a new type of species that is going to be a lot more capable in solving our problems and understanding the universe better. AI is critical for that.
I look forward to the day where we are optimized. Every component of our life is optimized for the being the best that we can be. Similar to Star Trek. We’re in a post-scarcity society. Everybody’s healthy, it’s geared towards being the best version of ourselves. That’s something that AI is going to help with.
If I may add one more point, people are getting to live longer and I want to make sure that we all live very healthy, high quality of life until the last day of our lives. That drives me a lot. For myself, for our generation, for the next generations, and so on, that’s where we are headed. I think about it drives my work.
Second question specifically in regards to the convergence of AI and computational biology, where do you see this in ten years? Do you think that this is going to become commonplace? Do you think this is going to become much more significant in our lives? What do you feel the future is going to look like in ten years for this particular area of science?
My hope to be honest with you is that our current healthcare system, which is so massive and so broken, is somehow disrupted through this entire new world of AI, computational biology, and so forth. Where the way I think about it is that every individual has a ton of information about themselves. The way I think about it is that every individual should have a digital twin who is able to answer questions about every process that’s going on in the body and using that they’re able to take care of their health much better than what we do now, which is to run to a doctor who has five minutes to talk to you about a few things and try to decide about and so on. That system with all of the middlemen with all of the different entities in our healthcare system with insurance and lab managers, the pharmaceutical benefit managers.
All of these people are there for process purposes. They’re not adding a lot of value. I wish and I hope that in the next ten years, we can disrupt that industry and bring healthcare directly to the individual where people can do it at home, have full knowledge of themselves, and take care of it by changing their lifestyle, changing their practice of everyday habits and stop waiting until the big acute events happen. Like a cardiovascular failure or some acute diabetes. Let’s not get to that point. Let’s figure it out a lot sooner and make it stop or go backward. That’s what I hope will happen in the next ten years.
That would be great. The focus has been so much on treating some of these end-stage complications of chronic issues of lifestyle issues. I look forward to the day when the end-stage product is less and we’re living healthier lifestyles. That’s what I’m looking forward to. Last question. The computational biology and artificial intelligence component is something that you’ve contributed to that you’re doing a lot of interesting things in. Outside of that, what excites you about futurist technologies? What excites you about things that you read in the paper that are science-related, that are apart from your field of interest?
For me, I like robots. That’s something that I can’t wait until I have a butler robot that’s able to wash my dishes and do my laundry for me. I’m always keeping up with like what Tesla’s doing with their humanoid robot and stuff like that. It’s independent of my field. It doesn’t have anything to do with it, but it certainly is something that I’m excited about. What about you, Guru? What’s something aside from your field that you’re excited about?
I love flying. I feel at home when I’m flying in the air and I follow everything that’s going on in space technologies and look forward to the day when we can get to Mars, for example. Your background looks like we could be on any planet. I don’t know which planet but the water tells me that it’s not Mars something else. Maybe some remote con to our planet but it’s got two moons, so it’s different. It’s some other planet. I don’t know if I’ll ever get a chance to do space declaration myself, but if I ever do in my lifetime, I would probably take it. My kids will probably have a chance to do something in their lifetimes if they want to do it. I love that. It goes back to Star Trek and everything else that we grew up with, but it’s becoming real.
I agree. It’s such a unifying vision. Everybody’s excited about it. We’re going to be going up back to the moon. Potentially this year, 2024 with the new NASA missions. I think that’s going to be an awesome time for humanity. That’s an exciting piece of science that all of us are excited about. Honestly, thank you so much. It was interesting talking with you and I’d love to talk with you more.
For all of the audience who are interested in everything that Guru is doing, we’re going to be having all of his information on our website and all of our social media, as always, as all of our guests come on. We want to promote the interesting things that they’re doing and help build the future. For all the audience who tuned in regularly, thank you so much for supporting us. Please like and subscribe as always. As always, I will see you in the future. Thanks, everybody. Have a great day.
Thank you.
Important Link
About Guru Banavar
Guru is driven to develop and apply deep science and technology innovations to solve the big challenges of humanity, especially in health and education. He has founded many successful initiatives, and is known for his work on Host/Microbe Molecular Data Analysis, IBM Watson AI Systems, Smarter Cities, Services Innovation, Mobile Computing, and Distributed Systems. He has a PhD in Computer Science and an MBA (accelerated).
Guru is the founding CTO of Viome Inc, where he leads AI and discovery. Viome offers deep insights into health and disease using host and microbiome gene expression, and provides precision food & supplements to deter chronic diseases. Guru’s focus is on analyzing large host-microbiome gene expression datasets (from blood, stool, saliva, & other samples), and discovering biomarkers and identifying therapeutic targets from clinical research studies targeting metabolic, gastrointestinal, autoimmune, and neurological disorders, as well as cancer. He led the development of a first-of-a-kind saliva-based early detection system for oral and throat cancers using host/microbiome gene expression, which won FDA’s designation as a breakthrough device, and is now available as a product.
Earlier, Guru was a global VP & Chief Science Officer at IBM and a member of IBM CEO’s top executive team. Throughout his IBM career, he developed and commercialized a range of advanced technology solutions in multiple industries, and helped build multiple successful businesses. As the founding VP of the Watson AI Research team, he led a team of hundreds and collaborated with leading universities (MIT, RPI, UIUC, UCSD, etc) to create AI systems that exceed human abilities but also augment human expertise in every domain, from healthcare & education to finance & law.
Guru is a recognized leader who delivered the 2017 Turing Lecture, and has spoken on prestigious stages including the Nobel Prize (twice), the Aspen Ideas Festival, the Milken Conference, and President Obama’s Frontiers Conference. Recent talks include the National Academies of Science, Precision Medicine World Conference, and Exponential Medicine. His awards include a Leadership in Technology Management Award and a National Innovation Award from the President of India. He has served on NY Governor’s commission for state resiliency, and was an elected member of the IBM Academy of Technology. He has published extensively and holds more than 35 US patents. His work has been featured in major international media including the New York Times, the Economist, the Wall Street Journal, BBC, and NPR.
0 Comments