Trusting gut bacteria: MRM Health develops microbiome treatments for IBD and more

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Hands forming a heart over the gut

In the last decade, there has been a growing interest in the potential of microbiome-based therapeutics: using gut bacteria as a medication to battle a wide array of diseases. Ghent-based start-up MRM Health is an important innovator in this growing field, building on the expertise of sister company ProDigest and of prominent partners such as VIB and DuPont Nutrition Biosciences. In the coming months, MRM Health is starting clinical trials for a drug candidate for ulcerative colitis, a type of inflammatory bowel disease (IBD).

This article was authored by Andy Furniere.

The story of MRM Health started about fifteen years ago, when CEO Sam Possemiers was still a PhD Student at Ghent University. Together with his professor Willy Verstraete and other co-workers, he helped develop the Simulator of the Human Intestinal Microbial Ecosystem (SHIME®). A unique lab model of the human and animal gastrointestinal tract, SHIME® enables a detailed examination of digestion processes under realistic conditions.

“We realized this technology was not only useful for academic research, but also for different business sectors,” says Possemiers. “In 2008, we therefore established the UGent spin-off ProDigest: a contract research organization carrying out research for the food and pharmaceutical industries.”

Since then, SHIME® has been used to simulate the metabolism and biodistribution of various pharmaceuticals in development, as well as elucidate the interaction of the intestinal microbiome with pharmaceuticals, food ingredients, animal feed and health products. After starting up in the Ghent University basement facilities, the company moved to the Tech Lane Ghent Science Park.

Support from major partners and investors

“After some time, we wanted to go beyond testing the medicine made by others and develop our own microbiome-based therapeutics,” says Possemiers. The new company, MRM Health, was born.

“We wanted to go beyond testing the medicine made by others and develop our own microbiome-based therapeutics.” – Sam Possemiers, MRM Health

To achieve their ambitions, Possemiers’ team reached out to experienced partners such as VIB. This provided access to complementary assets, such as the extensive microbiome and bioinformatics capabilities of the lab of Prof. Jeroen Raes (VIB – KU Leuven) and the multidisciplinary knowhow in arthritis and inflammatory diseases of Prof. Dirk Elewaut and his team (VIB – UGent).

Read this article for an interview with Prof. Jeroen Raes

The young company also joined forces with an important industrial player: DuPont Nutrition & Biosciences. DuPont’s knowledge and experience in the use of bacterial strains is highly relevant for MRM Health; the companies have teamed up on the development of new therapeutic products in the field of metabolic diseases.

Both DuPont and VIB also contributed to MRM Health’s first investment round, which enabled them to launch with an initial capital of €14 million in February 2020. Other important investors were investor Ackermans & van Haaren, the OMX Europe Venture Fund and venture capital fund Qbic II.

Tackling disease using bacterial consortia

Thanks to all this expertise and financial support, MRM Health was able to set up an innovative development process which overcame several critical bottlenecks that often hamper microbiome-based product development.

“To tackle complex chronic diseases, we believe more than one type of bacteria is required. Instead of producing each of those bacteria separately, we develop consortia.” – Sam Possemiers, MRM Health

“With our highly advanced bioinformatics tools, we first analyze which bacteria are needed to treat a certain condition,” explains Possemiers. “One of our truly pioneering solutions is our optimization and manufacturing technology of groups of bacteria to produce the therapeutics. To tackle complex chronic diseases, we believe more than one type of bacteria is required. Instead of producing each of those bacteria separately, we develop consortia of five to ten bacteria, which are then manufactured in a single step. This strongly facilitates the overall manufacturing process and makes it significantly more cost-effective. The optimization technology makes the consortia more robust and active, which should render the drug more effective.”

To make the products, the researchers first isolate bacteria out of stool samples of healthy persons. They cultivate them through a fermentation process, freeze-dry them and then turn them into a powder that is put in capsules. Those capsules can be swallowed, after which they break open in the colon and release the bacteria. Then, the bacteria get to work treating specific health problems.

Treating the root cause, not just symptoms

“We are currently working on five therapeutic programs,” declares Possemiers. “Our most advanced program is a drug candidate consisting of a consortium of six strains of bacteria, currently named MH002, for ulcerative colitis.”

Ulcerative colitis is one of two types of inflammatory bowel disease (IBD), the other being Crohn’s disease. “In the future, we will also examine the candidate’s potential for Crohn’s disease and specific niche disease applications, but for now we’re focusing on a first clinical trial on 45 patients with ulcerative colitis. The trial will take place in the second half of this year in three countries: Belgium, Czech Republic and Poland.” If all goes to plan, the medication could be on the market in three to five years.

“In the future, microbiome-based solutions could help in the fight against numerous common conditions such as cancers, diabetes, obesity and depression.” – Sam Possemiers, MRM Health

MRM Health is also working hard to find medical solutions for other diseases, including spondyloarthritis (an umbrella term for different types of inflammatory diseases affecting the spine and joints), Parkinson’s disease and two metabolic diseases. “There are currently no treatments that can truly cure these conditions; they only reduce the symptoms, often with considerable side effects. Our microbiome-based therapeutics should be able to get to the core of the health problems without causing further damage.”

The advantages of microbiome-based therapeutics

How would these groups of bacteria manage all that? “One crucial aspect is that they can deal with different mechanisms in the body at the same time, while traditional drugs often only have one specific target. The bacteria are, for example, also able to repair and normalize the functioning of key body processes such as the immune system, while classic medicines often shut these processes down to battle inflammation. As the immune system also has an important role to protect the body from infections and cancer, our solution reduces the chance of side effects. That risk is further lowered because the bacteria stay in the gut and don’t affect other parts of the body. What’s more: these bacteria originally come from healthy people, so it’s expected that they are intrinsically safe.”

Read this article to learn about another Belgian microbiome start-up: S-Biomedic

Apart from medicine, MRM Health is also developing two kinds of probiotics: preventive treatments to keep people healthy. “These will be part of the next generation of probiotics, not using lactic acid bacteria but real gut bacteria. Their potential should be considerably larger than that of the probiotics that we know today, like those in yogurts.”

High confidence in the future of microbiome medicines

While much progress has been made in the domain of microbiome-based therapeutics, there still is no such medication on the market today. Possemiers responds:  “True, but this is not just a hype: there has already been about $4 billion invested in this field. I think a first drug will soon be available, probably medication against Clostridium difficile [a bacterium causing diarrhea and inflammation of the colon]. The current boom will then only gain strength, as more mainstream pharmaceutical companies become convinced as well. In the future, microbiome-based solutions could help in the fight against numerous common conditions such as cancers, diabetes, obesity and depression.”

In the meantime, MRM Health is demonstrating its confidence in the future by preparing a second investment round.