Excess fermentation and lactic acidosis as detrimental functions of the gut microbes in treatment-naive TB patientsOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
Researchers examined the metabolic capacity and taxonomic makeup of the gut microbiome in 23 treatment-naive tuberculosis patients compared with 48 healthy donors. Prior TB microbiome studies had looked at taxonomy but not metabolic function.
How was it studied?
The team used deep sequencing of fecal samples to reconstruct strain and species-level community composition alongside metabolic pathway content.
What did they find?
TB patients showed depletion of commensal Bacteroidetes and expansion of Actinobacteria, Firmicutes, and Proteobacteria, including Streptococcaceae, Erysipelotrichaceae, Lachnospiraceae, and Enterobacteriaceae. These disease-associated pathobionts made up about a quarter of the total gut microbiota, and the community shifted toward glycolysis and excess fermentation producing acetate and lactate, consistent with higher gut glucose availability driving acidosis and endotoxemia.
Why it matters
Lactic acidosis suppresses normal gut flora, interferes with macrophage function, and has been linked to TB mortality. The authors propose gut acidosis as a novel host-directed treatment target to complement standard TB therapy, pending confirmation.