The discovery of the scale of importance of the microbiome to humans as well as other species is an important trend in human health. While early formulations of the idea of the microbiome assumed it would be relevant to human digestion, we now know it impacts everything from the immune system to mental health, as well as moderating the effect of diet and medicines. Unlocking the power of this new jigsaw piece in human health is an exciting area of development globally, as of course, specifically within the UK. 

This review aims to contextualize the startups working on microbiome related products in the UK within the global market, and pull out themes of development that would be helpful to investors or individuals trying to understand the sector. 

Brief History of Microbiome Innovation

The idea of replacing ‘negative’ human gut bacteria with positive’ gut bacteria was first hypothesised in 1907 by a Russian Nobel Laureate, and the first probiotic product (Yakult) was introduced in 1935, but it wasn’t until the late 1980s that the term started to be used in a more mainstream way.

Roy Fuller redefined the term ‘probiotic’ in 1989 to its current definition which focuses on consuming dietary bacteria that leads to positive ‘host animal’ benefits, and products started to emerge with a new focus on the human gut. As early as 1987, Activia launched a probiotic product. These early products often introduced one or two strains of useful bacteria, hoping it would be generally healthy for the entire population. 

It wasn’t until the 2000s that mainstream products looked to provide relief towards specific ailments or conditions, for example, Align introducing a strain focussing on IBS relief in 2006. 

These early products therefore focussed on strains of probiotics that were helpful to entire populations or specific strains that might help a very general (umbrella diagnosis) terms like IBS. Research, however, has progressively shown how much more complex the microbiome is than first imagined. 

The idea that introducing generally ‘positive effect’ bacteria into the gut might be helpful seems intuitive, but a study in 2018 found that probiotics can actually delay the restoration of the gut microbiome in some individuals after treatment with antibiotics. Even more bizarre findings were even harder to understand – a study in 2016 found that heat-killed Lactobacillus plantarum L-137 (HK L-137) could enhance immune function, suggesting that dead bacteria also had an impact on the host’s health. Further evidence shows that the gut microbiome engages in ‘quorum sensing’, a process whereby bacterial populations communicate via the secretion and detection of specific metabolites, leading to different outcomes to host of the same bacteria to different human guts. 

Startups therefore have a difficult role to play in harnessing the powerful effects of the human microbiome to affect human health, as they are attempting to develop a product that will reliably have an effect on a very complex ecosystem.

The global microbiome startups have been categorized into 5 distinct categories of innovation. The companies within the UK are then analyzed in the section after. 

Categories of Microbiome Startups

1. The All Star Supplement: Companies focussing on creating an ‘ensemble’ supplement often containing a mixture of a large number of various strains of probiotics and prebiotic fibers. These products hope to be beneficial to the majority of humans. Notable startups in this category are Founder Fund-backed Seed or a company like Athletic Greens (who combine their product with standard multivitamins). 
2. The Personalised Approach: Companies focussing on conducting tests on an individual’s gut (and body more widely) in order to make personalized suggestions on pharmaceuticals, diet and supplements. Notable startups include Tim Spector affiliated Zoe or another well funded US-based startup called Viome.
3. The Superstar Strain: Companies focussing on productising a specific strain or small set of strains that are beneficial to clinical populations or small groups of people with similar traits. For example, Resbotic introduced a probiotic with strains specifically for those with difficulties breathing. 
4. The Healthy-Choice Food and Beverage: Companies in the food and beverage sector trying to include probiotic or prebiotics fibers into their drinks to create a ‘healthier’ offering than a traditional soda or snack. They are different to the ‘All Star’ supplements as they have more of a focus on taste as well as being much more expensive ‘per dose’ than a supplement would be. 
5. Non-Human Biomes: There are startups that don’t fit into the above pattern, which are directly about human health, but instead are focussing on the biomes of other species for a variety of reasons. These could be focussing on changing the biome of livestock or of within the soil in a farm. 

The All Star Supplement

There are many companies offering probiotic supplements which have scientific support as being healthy for the majority of humans. These companies can be difficult to dissociate from companies focussing exclusively on gut-health for clinical populations, as the generic reason for taking a probiotic for the non-clinical population is to aid gut health. As well as that, 43% of the UK population report issues in digestion, so offering probiotics for digestion is not totally dissimilar from a probiotic designed for ‘everyone’. 

This sector is already extremely well catered for – both with very well funded Direct to Consumer companies like Seed and Athletic Greens with massive marketing budgets (Athletic Greens reportedly spends over $2.2 million a month on podcast endorsements), but also with established UK brands offering products which feature in many pharmacies, health stores and grocery stores already. 

For example, Protexin Healthcare (1973) and Optibac (2004) both produce an ‘all Star’ probiotic offering which can be found in supermarkets under either the Bio-Kult brand for Protexin or the self-titled brand for Optibac. 

The only examples of startups in this space produce general probiotics are as a secondary product to their ‘hero product’. For example, Heights offer a product called ‘Biotic’, but merely from their nomenclature, their initial ‘Vital’ product seems more important in their line up.

Due to this competitiveness, this sector has less startup activity due to having established players both in the UK, and global companies producing offerings available online and in-store in the UK. The only examples of startups in the UK with new offerings are offering ‘add-on’ products to an existing consumer base. 

The Personalized Approach

Human microbiomes are extremely complicated, and supplements beneficial to one individual could be negative for another. Examining the specific biomes of a human, enables startups to attempt to create personalized diets for that individual. 

Tim Specter is a famous doctor and writer from the UK. He became prominent due to his work at the ‘Twin Studies’ lab, where they use genetically identical individuals to better understand environmental factors. This work led to the founding of a startup called Zoe (2018) which helps individuals track the effect of food on their body using both microbiome testing and blood sugar monitoring. Zoe has raised close to $100M in funding. Although technically not a London based company, describes itself as ‘London Born’ with UK co-founders and based on UK research. 

Tumchi (2019) is a much smaller company still in accelerator stage, which seems to be different from platforms like Zoe or Viome as it focuses on producing a fun and engaging experience while altering gut health – including gamification elements and including foods you self report to enjoy. 

Both the later stage Zoe and early stage Tumchi have heavy competition from other countries, including startups like Ombre (2016), and Viome (2016).  

While companies like Zoe use stool samples, a UK company called ‘BioMe’ is developing a ‘a pill-sized medical device for targeted and minimally invasive sampling of the human gut microbiome’, which aims to better understand the microbiome by taking samples within the human gut. If they can prove that this sampling outperforms traditional stool sampling at a reasonable cost, this will be an exciting improvement in the personalized sector. 

Within a pharmaceutical setting, BioCortex (2021) has trained an AI on its large microbiome database in order to predict whether a drug candidate will work (either in preclinical trials or in patients) or whether it can be tweaked for an individual. Alpha Biomics (2018) is developing microbiome-based predictive diagnostic and companion therapeutic, specifically focussing on IBD – using their inhouse tool to estimate the likelihood an individual responds to a specific treatment on the basis of a stool supplement. 

Gut health is the largest area of investment and interest in the larger biome sector, but humans have many closely related biomes that impact their health. Multiple companies are studying the vaginal biome in order to make recommendations to the individual. Juno Bio (2018) is a wellness company, collecting samples of vaginal biomes to build up their database to improve future recommendations, and making suggestions on the basis of those tests. They have raised $25M to date. ScreenMe (2019) is another vaginal microbiome company offering testing and consultation on the vaginal microbiome, specifically for improving fertility and preventing preventable diseases. They have competitors based in the US including Prende and Evvy.

Other companies are also testing the skin microbiome and making recommendations based on those tests. Sequential Skin (2018) offers at home microbiome tests on the basis of which they make comprehensive suggestions for improving and balancing the microbiome of the skin. Like gut health, there are a significant number of competitors from the US like Dr. Elsa Jungman (2018) but these competitors require physical samples to be shipped to the US, which makes the service prohibitively expensive for many people. 

There are currently no UK companies focussing on affecting mental health through the microbiome, but this is an area of active research with some startups (Vitract, for example) already attempting to offer personalized recommendations for supplements and diet to improve mental health. 

The Specific Strain

Companies focussing on unique strains are often targeted at a specific individual as an ‘intervention’ based therapy, meaning that individuals take it to address a certain issue. The promise of these types of products of startups is that you will gain relief or performance in a specific field with the help of certain probiotics. I will group these startups into the group of people these strains hope to address:

Inherited Microbiomes

Babies acquire their microbiome very quickly after leaving the womb, and the acquisition of this microbiome is extremely important. Rats who were kept in a sterile environment and therefore had no microbiome also failed to develop a normally functioning immune system, suggesting that the microbiome may be critical in developing the immune system. Babies born through C-Sections, also appear to have a different microbiome make up than those born vaginally. 

UK-based BoobyBiome develops probiotic supplements for babies that are born prematurely. The formula milk probiotic can act as a substitute for breast milk, allowing babies to consume important bacteria found in breast milk. Third party trackers indicate the company has raised at least £1.3M as a pre-seed investment and are currently pre product.

Established companies like Protexin Healthcare produce a range of probiotics that are currently available, but BoobyBiome’s new product will be based on a large sample of breast milk and will look to be a replacement for Breast Milk (as opposed to an oral supplement).

These UK companies will be competing with multiple new startups from other countries including Snapi Health and Begin Health offering similar or equivalent products.  

IBS / Digestion Issues

IBS was the first application for strain based treatments, as one theory of IBS is that it is caused by dysbiosis in the gut, which is supported by the fact that individuals with IBS are more likely to have SIBO than their ‘normal’ counterparts. SIBO is a condition where there is an overgrowth of bacteria in the gut, which causes bloating, discomfort and occasionally more systematic reactions. 

Symprove, founded in 2002, was born out of research on farms into the improvement of pig microbiomes. Their focus was on producing strains and delivery methods which successfully colonise the gut with ‘live’ bacteria. This was especially important in the 2000s as alternative methods for keeping bacteria stable were less refined, leading to supplements often needing to be refrigerated. In 2020, a Private Equity firm purchased the majority stake in Symprove. 

JUVIA (2016) is a prebiotic drink meant for those with IBS, which helps promote beneficial bacteria to thrive. Prebiotics are theorised to improve the gut through providing more food available to the bacteria seen as positive, increasing the number of strains and the amount of those strains.

Another company called Fermento Probiotics (2020), develops a line of probiotics for a number of different issues including a product (not yet released) specifically for gut health. This product combines 4 well researched strains with prebiotics. Their shop, however, is currently inactive and this company may no longer be trading. They have raised around £500k to date. 

Ferryx, founded in 2019, is a Bristol based biotech startup which released a product based on 10 years of development at the University of Bristol showing a specific probiotic bacteria named FX856 claiming to be able to calm an inflamed gut. Trustpilot reviews appear to be positive with a 4.2 rating. Ferryx has raised £300k which has been sufficient to launch their first product. 

Lungs

No UK companies are so far working on the lung microbiome specifically, but the area is under active research elsewhere. For example, Resbotic (2020) produces resB®, which is a probiotic supplement specifically for the lungs with a few strains which show a direct affect on the lungs.

Skin Issues

The skin is affected both by the gut probiotics indirectly through modulation of systemic inflammation and immune modulation, as well as the skin having its own microbiome. UK companies are addressing both. 

In the first example, VeMico (2018) is developing a class of gut supplements aimed at improving skin health by resolving gut inflammation and hormonal imbalances. 

Addressing the skin directly, Gallinée (2014) focussed on creating science-backed probiotic and prebiotic supplements for the skin. This company was recently acquired (2012) by a Japanese beauty brand called Shiseido. Sequential Skin (2018), covered more later, also has released a product called Biome Mask hoping to balance the skin microbiome.

Oral Issues

The oral microbiome has significant roles both in terms of mouth health (including with cavities and gum disease) and the health of the rest of the organism (including Arthritis and Alzheimer’s disease). By size and variety, it is second to only the gut in complexity. 

Similar to the gut, the oral microbiome can be affected by changing the ratio of various bacteria, which in turn mediate the relationship between cavities and diet. 

Lubiotics (2020), a company that was spun off from work at Imperial College London, was launched in 2020 offering a probiotic toothpaste. Gutology (2020), a platform that focuses mainly on gut health, also offers a probiotic toothpaste.

They compete with a variety of US-based companies offering competing probiotics products like Hyperbiotic (2016) as well as prebiotic only companies like Revitin (2005). Elsewhere, Zendium was launched in 1976 with about a close to 37% market share in Denmark. 

Other Issues

There are many different avenues for innovation in multiple biomes associated with human health. For example, Nella, a non UK based startup, isolated gut species from extremely athletic and fit people – and offers that as a supplement touted to increase energy and sleep performance. Genbioma developed a supplement specifically for prediabetic people hoping to help affect the glycemic regulation in those with prediabetes. 

With the scale of the effect of microbiomes on human health, there will continue to be startups appearing looking to innovate by introducing novel or isolated strains. 

The Healthy-Choice Food and Beverage

There are many different companies focussing on the microbiome through providing an alternative to traditional food and beverage choices. These are either (1) innately microbiome supporting (2) ‘added prebiotic’ food & drinks (3) ‘added probiotic’ food and drinks. 

Products like Kefir and Yogurt are naturally supporting the Gut. Milk Kefir producers Chuckling Goat (2014), water kefir producers Agua de Madre (2017) and Yogurt producers like Biomel owners Nutmeg and Hive (2015) include microbiome or probiotics.

Many other companies are now introducing prebiotics into the sodas, like Xoxo (2021), who recently raised a new round to accelerate their growth, and Dalston’s Soda (2012) a drinks startup which raised almost £500k crowdfunding, offering a prebiotic soda which has additional fiber and minerals, Rapscallion Soda (2016) also offers a range of bespoke soda, with added prebiotic fibre, Selfish (2021) contain Inulin as a prebiotic, and Happy Inside (2020) contains prebiotic fibres alongside Vitamin C.

More startups sell more specific products which have already made it onto the supermarket shelves. Moju (2014) is a juice and shots company which have also added prebiotic supplements to their line up. 

Other companies are approaching the gut from the angle of food. Bio & Me (2019) offer a line up of yogurts, granolas and mueslis to help introduce more positive bacteria to your gut and The Gut Stuff (2017) started as a source of information for all things gut health, but now offer a range of products to help support gut health. 

Non-Human Biomes

Microbiomes are useful for human health, but increasingly there have been innovations in finding alternative uses for them as the number of biomes are discovered. 

Some of those biomes are relevant to human health but not directly connected to the human body. For example, Luxembourg-based Probiotic Group has recently secured €2.5 million of fresh investment. The Biotech startup is developing probiotic care and cleaning products that clean effectively and sustainably, without using harsh chemicals. Biomes can also be used to help create food and pharmaceuticals more efficiently, like LyteGro (2015), which uses a banana extract to significantly increase the rate of reproduction of bacteria, which is useful for food production and in pharmaceutical use.

Away from humans, although close to their hearts, are the gut biomes of companion creatures like Dogs and Cats. Biome9, for example, decodes your dog’s gut health with an at home test and suggests improvement to their diet and Treat Therapeutics does the same with the additional benefit of producing probiotics that the test might suggest the dog takes. 

Within the agricultural industry, Bug Biome (2021) is using probiotics to change pest control by using microbes as a replacement for harsh chemicals and US-based Biome Makers offers tests and suggestions for examining and improving the bacterial populations in soil for farms, with their first product being WineSeq, a technology that enables the modeling of the microbiomes of vineyards. Concert Bio (2021) is also focussing on the microbiome of farming, focussing on the microbes in soilless environments. They produce testing and improvement software for agricultural soilless growers in Europe. 

Multiple companies are also working on reducing the need for antibiotics in animals as well as reducing the emissions caused through gastric emissions by changing the gut microbiome of farm animals. FOLIUM Science (2016), for example, produces a CRISPR-Cas based biotechnology that modulates the microbiomes by targeting individual bacterias within livestock to be removed avoiding the need to use general antibiotics. 

Conclusion

While the use of probiotics to improve human health has a history that spans over 100 years, the increase in innovation – both targeting the majority population, specific demographics or clinical populations – shows that probiotics are going to be a massive area of growth in the next decade. Hopefully, this growth will accompany improved outcomes for the general population as well as the clinical subpopulations.