Prevention is better than cure: Prof. Eugene B. CHANG reexamines “health” through the lens of microbiome ecology

On 30 March 2026, Prof. Eugene B. CHANG, Martin Boyer Distinguished Professor at the University of Chicago (UChicago), delivered a PAIR Distinguished Lecture, titled “Microbiome Medicine: Understanding Health and Disease through the Lens of Ecological and Evolutionary Principles” at the PolyU campus. The seminar drew nearly 100 researchers, clinicians and students joining onsite, and over 15,400 online viewers across various social media platforms to learn about the burgeoning field of the “gut microbial organ”.

At the seminar, Prof. Chang introduced the concept of “proactive health”, echoing Benjamin Franklin’s famous adage: “An ounce of prevention is worth a pound of cure”. He affirmed that the future of medicine lies in the shift from “reactive treatments” to “preventive healthcare”, and that maintaining the ecological balance of the human microbiome is the key to achieving this transformation.

Prof. Chang described the gut microbiome as a vital organ that provides essential functions―uniquely “acquired” after birth and “modifiable” throughout life. He explained that when this ecosystem experiences perturbations or “dysbiosis”, it can trigger a vast array of disorders, including inflammatory bowel disease, metabolic syndromes, and even neurodevelopmental disorders like Autism Spectrum Disorder (ASD). He emphasised that to truly restore health, clinicians must adopt an ecological perspective and focus on “ecological succession”, the process by which microbial communities grow, evolve and stabilise over time.

Another key highlight of the presentation was Prof. Chang’s discussion of the “seed and soil” principle. He explained that for microbiome-based interventions to be effective, both the “seed” (the microbial strain) and the “soil” (the host’s gut environment) must be taken into account. He noted that many current probiotics fail to engraft because the supplemented microbes lack evolutionary compatibility with the host. To solve this, he presented cutting-edge research on using mass spectrometry for functional profiling and demonstrated how Large Science Models and AI technologies help identify infants at risk of ASD, allowing for early intervention before symptoms emerge.

In his concluding remarks, Prof. Chang reaffirmed his strong belief in the value of prevention, highlighting that “microbiome medicine” should evolve into a medical specialty dedicated to maintaining long-term health rather than just treating disease. He underscored the need for precision tools, such as biomarkers and AI-driven predictive platforms, to identify and correct microbial imbalances at an early stage. By understanding the ecological and evolutionary principles governing the gut, he affirmed that medicine could advance toward more effective, evidence-based preventive strategies to support lifelong health.

The seminar concluded with a lively Q&A session moderated by Prof. CHIOU Jiachi, Amber, Associate Head of the Department of Food Science and Nutrition and Associate Director of RiFood. The discussion explored how microbiome medicine is fundamentally reshaping the landscape of both traditional and preventive healthcare. Key topics included the effectiveness of gut microbiome interventions in combating antibiotic resistance and enhancing immunity in immunosuppressed patients, as well as the specific applications of this research in treating Parkinson’s disease. Furthermore, Prof. Chang shared his views on precision diagnostics for the gut-brain axis, specifically whether clinical decision-making should prioritise static microbial signatures, or dynamic response phenotypes following dietary or antibiotic perturbations.

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