The oral microbiome during kidney transplantation

Humans interact with diverse communities of microbes living throughout the body. These microbiomes are involved in close feedbacks with their host, amounting to a complex set of symbiotic relationships. These relationships are mediated by the immune system, which is both educated by and controls aspects of microbiome development and maintenance. These relationships become apparent when this homeostatic system is perturbed. Organ transplantation represents a major perturbation, both through the process itself and the immunosuppressive medication that it requires. This project will address microbiome changes associated with kidney transplantation, the 'gold standard' treatment for kidney failure.

A key human microbiome is in the mouth, where a range of microbes, both bacterial and eukaryotic, interact with their host's immune system across the oral barrier. This system is relatively unexplored, despite the existence of complex communities and mixed biofilms that are responsive to host changes. Under some circumstances, that response results in disease. For instance, oral thrush and ulcers are fairly common after transplantation and immunosuppression. However, understanding the responses and feedbacks between host and microbiome more generally has the potential to give insights into wider issues of human health and disease. That is what this project aims to achieve.

This project will consider oral microbiome samples from patients both before and after transplant, including transplant from living donors, where the donor microbiome may in some cases also be available. It will address how the co-occurrence networks of microbes in the oral microbiome respond to the perturbation of transplantation, using and developing quantitative analyses and models. It will also consider aspects of immune system response, thereby looking at relationships going both ways across the oral barrier.

This is an interdisciplinary project, with a supervisory team with broad expertise stretching from transplantation to microbiome analysis and beyond. The successful candidate will have a strong interest in understanding the interaction between microbes and host. They will have the opportunity to take forward that understanding using cutting edge approaches, while training in a unique inter-disciplinary environment.