Sarah Safranek

Knowledge Resources: Finding Answers to Primary Care Questions

9:00 a.m. Your clinic day starts with a teenage girl whose blood sugars are elevated and insulin requirements are increased. She reports that her weight is down. You probe and discover that she has been taking Ma-huang for weight control. You believe that the weight loss may not be worth the risk and recommend that she stop taking Ma-huang until a follow-up visit in two weeks. Before her next visit you will review the evidence on the safety of this herbal supplement for adolescent diabetics.

One Health Relationships Between Human, Animal, and Environmental Microbiomes: A Mini-Review

The One Health concept stresses the ecological relationships between human, animal, and environmental health. Much of the One Health literature to date has examined the transfer of pathogens from animals (e.g., emerging zoonoses) and the environment to humans. The recent rapid development of technology to perform high throughput DNA sequencing has expanded this view to include the study of entire microbial communities. Applying the One Health approach to the microbiome allows for consideration of both pathogenic and non-pathogenic microbial transfer between humans, animals, and the environment. We review recent research studies of such transmission, the molecular and statistical methods being used, and the implications of such microbiome relationships for human health. Our review identified evidence that the environmental microbiome as well as the microbiome of animals in close contact can affect both the human microbiome and human health outcomes. Such microbiome transfer can take place in the household as well as the workplace setting. Urbanization of built environments leads to changes in the environmental microbiome which could be a factor in human health. While affected by environmental exposures, the human microbiome also can modulate the response to environmental factors through effects on metabolic and immune function. Better understanding of these microbiome interactions between humans, animals, and the shared environment will require continued development of improved statistical and ecological modeling approaches. Such enhanced understanding could lead to innovative interventions to prevent and manage a variety of human health and disease states.