Sean Spencer

Sean Spencer, MD

Instructor

Gastroenterology

map
Stanford Digestive Health Clinic
420 Broadway St, Pavilion D 2nd Fl
Redwood City, CA 94063
Fax: (650) 498-6323

Locations

Stanford Digestive Health Clinic
Stanford Digestive Health Clinic

420 Broadway St, Pavilion D 2nd Fl

Redwood City, CA 94063

Maps, Directions & Parking

Phone : (650) 736-6555

Fax : (650) 498-6323

Work and Education

Professional Education

Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, 05/15/2015

Residency

Massachusetts General Hospital Internal Medicine Residency, Boston, MA, 06/30/2017

Fellowship

Stanford University Division of Gastroenterology and Hepatology, Palo Alto, CA, 06/30/2020

Stanford University Division of Gastroenterology and Hepatology, Palo Alto, CA, 06/30/2021

Board Certifications

Gastroenterology, American Board of Gastroenterology, 2022

Internal Medicine, American Board of Internal Medicine, 2018

Languages

English

Publications

Metagenomic immunoglobulin sequencing reveals IgA coating of microbial strains in the healthy human gut. Nature microbiology Olm, M. R., Spencer, S. P., Takeuchi, T., Silva, E. L., Sonnenburg, J. L. 2025

Abstract

IgA, the primary human antibody secreted from the gut mucosa, shapes the intestinal microbiota. Methodological limitations have hindered defining which microbial strains are targeted by IgA and the implications of binding. Here we develop a technique, metagenomic immunoglobulin sequencing (MIg-seq), that provides strain-level resolution of microbes coated by IgA and use it to determine IgA coating levels for 3,520 gut microbiome strains in healthy human faeces. We find that both health and disease-associated bacteria are targeted by IgA. Microbial genes are highly predictive of IgA binding levels; in particular, mucus degradation genes are correlated with high binding, and replication rates are significantly reduced for microbes bound by IgA. We demonstrate that IgA binding is more correlated with host immune status than traditional relative abundance measures of microbial community composition. This study introduces a powerful technique for assessing strain-level IgA binding in human stool, paving the way for deeper understanding of IgA-based host-microbe interactions.

View details for DOI 10.1038/s41564-024-01887-4

View details for PubMedID 39747692

View details for PubMedCentralID 6753154

Intestinal Methanogen Overgrowth (IMO) Is Associated with Delayed Small Bowel and Colonic Transit Time (TT) on the Wireless Motility Capsule (WMC). Digestive diseases and sciences Talamantes, S., Steiner, F., Spencer, S., Neshatian, L., Sonu, I. 2024

Abstract

Methanogens are associated with gut dysmotility in animal models but have not been robustly studied in humans. The WMC assesses regional transit time (TT) and pH in the GI tract.To study the segmental TT and pH among patients with SIBO or IMO utilizing WMC.We conducted a retrospective study of 207 patients who underwent a glucose or lactulose breath test (BT) and WMC from 2010 to 2022. Diagnosis of SIBO and IMO were based on the 2017 North American consensus criteria. TT and pH were extracted from WMC recordings. We tested for differences in means of continuous variables and frequencies of categorical variables using two-sample t tests, Wilcoxon Rank Sum test, Chi-square, and Fisher exact tests. We used R version 3.3.1 (2016-06-21) for all statistical analyses.A total of 196 patients met criteria, mean age 47.4 years and 155 (79.1%) females. Of the 86 (43.9%) patients with a positive BT, 42 (58.3%) had IMO only (meeting only CH4 criteria) and 30 (34.9%) met both H2 and CH4 criteria. Colonic TT was longer in patients with a positive BT compared to negative patients (40 h:29 min vs 28 h:51 min, p = 0.028). Small bowel TT and colonic TT were longer in patients with IMO compared to negative patients (SBTT: 5 h:15 min vs 4 h:32 min, p = 0.021; CTT: 44 h:23 min vs 28 h:51 min, p = 0.030). There were no significant differences in segmental pH compared to negative patients.To our knowledge, this is the largest study of patients who have undergone both BT and WMC. A positive BT was associated with delayed CTT, while having IMO only was associated with both delayed CTT and SBTT, but neither with pH. Future investigation is needed to elucidate whether changes in intestinal microbiota affect gut transit.

View details for DOI 10.1007/s10620-024-08563-x

View details for PubMedID 39068378

View details for PubMedCentralID 2890937

Improved mouse models of the small intestine microbiota using region-specific sampling from humans. bioRxiv : the preprint server for biology Culver, R. N., Spencer, S. P., Violette, A., Lemus Silva, E. G., Takeuchi, T., Nafarzadegan, C., Higginbottom, S. K., Shalon, D., Sonnenburg, J., Huang, K. C. 2024

Abstract

Our understanding of region-specific microbial function within the gut is limited due to reliance on stool. Using a recently developed capsule device, we exploit regional sampling from the human intestines to develop models for interrogating small intestine (SI) microbiota composition and function. In vitro culturing of human intestinal contents produced stable, representative communities that robustly colonize the SI of germ-free mice. During mouse colonization, the combination of SI and stool microbes altered gut microbiota composition, functional capacity, and response to diet, resulting in increased diversity and reproducibility of SI colonization relative to stool microbes alone. Using a diverse strain library representative of the human SI microbiota, we constructed defined communities with taxa that largely exhibited the expected regional preferences. Response to a fiber-deficient diet was region-specific and reflected strain-specific fiber-processing and host mucus-degrading capabilities, suggesting that dietary fiber is critical for maintaining SI microbiota homeostasis. These tools should advance mechanistic modeling of the human SI microbiota and its role in disease and dietary responses.

View details for DOI 10.1101/2024.04.24.590999

View details for PubMedID 38712253

Resisting weight gain with prebiotic fibre. Nature metabolism Carter, M. M., Spencer, S. P. 2024

View details for DOI 10.1038/s42255-024-00998-w

View details for PubMedID 38409603

CH4, H2S, and H2O: How Do They Relate to Microbiome-Driven IBS Pathogenesis? Digestive diseases and sciences Spencer, S. 2023

View details for DOI 10.1007/s10620-023-08198-4

View details for PubMedID 38060166

Metagenomic Immunoglobulin Sequencing (MIG-Seq) Exposes Patterns of IgA Antibody Binding in the Healthy Human Gut Microbiome. bioRxiv : the preprint server for biology Olm, M. R., Spencer, S. P., Silva, E. L., Sonnenburg, J. L. 2023

Abstract

IgA, the most highly produced human antibody, is continually secreted into the gut to shape the intestinal microbiota. Methodological limitations have critically hindered defining which microbial strains are targeted by IgA and why. Here, we develop a new technique, Metagenomic Immunoglobulin Sequencing (MIG-Seq), and use it to determine IgA coating levels for thousands of gut microbiome strains in healthy humans. We find that microbes associated with both health and disease have higher levels of coating, and that microbial genes are highly predictive of IgA binding levels, with mucus degradation genes especially correlated with high binding. We find a significant reduction in replication rates among microbes bound by IgA, and demonstrate that IgA binding is more correlated with host immune status than traditional microbial abundance measures. This study introduces a powerful technique for assessing strain-level IgA binding in human stool, paving the way for deeper understanding of IgA-based host microbe interactions.

View details for DOI 10.1101/2023.11.21.568153

View details for PubMedID 38045399

Cromolyn Reduces Symptoms in Patients With Irritable Bowel Syndrome, Functional Dyspepsia, or Gastroparesis Karhu, E., Linda Anh Nguyen, Sonu, I., Neshatian, L., Gottfried-Blackmore, A., Fernandez-Becker, N., Spencer, S. LIPPINCOTT WILLIAMS & WILKINS. 2023: S492

Ultra-deep sequencing of Hadza hunter-gatherers recovers vanishing gut microbes. Cell Carter, M. M., Olm, M. R., Merrill, B. D., Dahan, D., Tripathi, S., Spencer, S. P., Yu, F. B., Jain, S., Neff, N., Jha, A. R., Sonnenburg, E. D., Sonnenburg, J. L. 2023

Abstract

The gut microbiome modulates immune and metabolic health. Human microbiome data are biased toward industrialized populations, limiting our understanding of non-industrialized microbiomes. Here, we performed ultra-deep metagenomic sequencing on 351 fecal samples from the Hadza hunter-gatherers of Tanzania and comparative populations in Nepal and California. We recovered 91,662 genomes of bacteria, archaea, bacteriophages, and eukaryotes, 44% of which are absent from existing unified datasets. We identified 124 gut-resident species vanishing in industrialized populations and highlighted distinct aspects of the Hadza gut microbiome related to in situ replication rates, signatures of selection, and strain sharing. Industrialized gut microbes were found to be enriched in genes associated with oxidative stress, possibly a result of microbiome adaptation to inflammatory processes. This unparalleled view of the Hadza gut microbiome provides a valuable resource, expands our understanding of microbes capable of colonizing the human gut, and clarifies the extensive perturbation induced by the industrialized lifestyle.

View details for DOI 10.1016/j.cell.2023.05.046

View details for PubMedID 37348505

Profiling the human intestinal environment under physiological conditions. Nature Shalon, D., Culver, R. N., Grembi, J. A., Folz, J., Treit, P. V., Shi, H., Rosenberger, F. A., Dethlefsen, L., Meng, X., Yaffe, E., Aranda-Diaz, A., Geyer, P. E., Mueller-Reif, J. B., Spencer, S., Patterson, A. D., Triadafilopoulos, G., Holmes, S. P., Mann, M., Fiehn, O., Relman, D. A., Huang, K. C. 2023

Abstract

The spatiotemporal structure of the human microbiome1,2, proteome3 and metabolome4,5 reflects and determines regional intestinal physiology and may have implications for disease6. Yet, little is known about the distribution of microorganisms, their environment and their biochemical activity in the gut because of reliance on stool samples and limited access to only some regions of the gut using endoscopy in fasting or sedated individuals7. To address these deficiencies, we developed an ingestible device that collects samples from multiple regions of the human intestinal tract during normal digestion. Collection of 240 intestinal samples from 15 healthy individuals using the device and subsequent multi-omics analyses identified significant differences between bacteria, phages, host proteins and metabolites in the intestines versus stool. Certain microbial taxa were differentially enriched and prophage induction was more prevalent in the intestines than in stool. The host proteome and bile acid profiles varied along the intestines and were highly distinct from those of stool. Correlations between gradients in bile acid concentrations and microbial abundance predicted species that altered the bile acid pool through deconjugation. Furthermore, microbially conjugated bile acid concentrations exhibited amino acid-dependent trends that were not apparent in stool. Overall, non-invasive, longitudinal profiling of microorganisms, proteins and bile acids along the intestinal tract under physiological conditions can help elucidate the roles of the gut microbiome and metabolome in human physiology and disease.

View details for DOI 10.1038/s41586-023-05989-7

View details for PubMedID 37165188

Ultra-deep Sequencing of Hadza Hunter-Gatherers Recovers Vanishing Gut Microbes. bioRxiv : the preprint server for biology Merrill, B. D., Carter, M. M., Olm, M. R., Dahan, D., Tripathi, S., Spencer, S. P., Yu, B., Jain, S., Neff, N., Jha, A. R., Sonnenburg, E. D., Sonnenburg, J. L. 2022

Abstract

The gut microbiome is a key modulator of immune and metabolic health. Human microbiome data is biased towards industrialized populations, providing limited understanding of the distinct and diverse non-industrialized microbiomes. Here, we performed ultra-deep metagenomic sequencing and strain cultivation on 351 fecal samples from the Hadza, hunter-gatherers in Tanzania, and comparative populations in Nepal and California. We recover 94,971 total genomes of bacteria, archaea, bacteriophages, and eukaryotes, 43% of which are absent from existing unified datasets. Analysis of in situ growth rates, genetic pN/pS signatures, high-resolution strain tracking, and 124 gut-resident species vanishing in industrialized populations reveals differentiating dynamics of the Hadza gut microbiome. Industrialized gut microbes are enriched in genes associated with oxidative stress, possibly a result of microbiome adaptation to inflammatory processes. This unparalleled view of the Hadza gut microbiome provides a valuable resource that expands our understanding of microbes capable of colonizing the human gut and clarifies the extensive perturbation brought on by the industrialized lifestyle.

View details for DOI 10.1101/2022.03.30.486478

View details for PubMedID 36238714