To mark Nature Reviews Gastroenterology & Hepatology’s 20th anniversary, experts discussed the microbiome’s impact on biology, the field’s current strengths and limitations, and future research directions. They highlighted how the microbiome acts like an “essential organ,” influencing immunity, metabolism, and overall health. Early-life microbiome composition, especially from maternal transmission, has proven critical for shaping long-term health outcomes.
Strengths of microbiome research include advanced sequencing and data analysis, but limitations persist due to variability among individuals and reliance on association data rather than causation. Looking forward, the field aims to personalize treatment through microbiome-driven therapies, explore synthetic microbial communities, and integrate AI to enhance diagnostics and treatment strategies. These advances promise new, targeted approaches in healthcare by harnessing the microbiome’s unique role in human biology.