The brain is not sterile.

Open your mind to a new and exciting view of human brain evolution and our symbiotic relationship with microbes in this 4 week research-based educational course led by Dr Marco Ruggiero.

Like the rest of our body, the brain is home to bacteria, viruses and fungus, such as yeast and larger parasites such as amoebas. This changes the clinical landscape of many conditions, including autism, neurodegenerative disease such as Alzheimer's and Parkinson's and chronic inflammatory response syndromes (CIRS). It also forces us to consider the 'mind', 'self', and 'agency' blurring the lines between science and philosophy.

Join Dr Ruggiero as he unravels the latest research in these remits, elucidating our relationship with microbes in the brain, and the aetiology and pathogenesis of these increasingly common conditions, opening the way for novel treatments.

Course Details:






Book Your Place

4 weeks beginning Wednesday 7th February 2018

Watch live at 16:00-18:00, or watch the recorded classes at a time that suits you. These will be yours to keep.


8 hours (pending BANT, NNA, NTOI)


Course Introduction | Dr Marco Ruggiero

The brain microbiome is the array of microbes that live in symbiosis with our neurons and glial cells. This is a completely novel concept that had never been described until my publication in 2016 (Clin Endosc. 2016 Nov;49(6):579. Epub 2016 Nov 11) and has been dubbed “the fourth brain”. 

The idea for such a fourth brain derives from a paper that was published a few years ago by Canadian researchers who were looking for microbes in the brains of HIV/AIDS patients (PLoS One. 2013;8(1):e54673). I guess that it was a surprise for them to find out that: 

“ an organ widely assumed to be free of infectious agents in the absence of a specific disease process, autopsied and surgically-derived human brain specimens showed a restricted, but distinct bacterial population in the present studies, which was composed of bacterial classes chiefly recognized in the physical environment, i.e., soil and water.”

In other words, in the brain of healthy people there are the same microbes that are found in the environment and, consequently, in the gut. It is interesting to notice that, according to the Authors, the microbes travel to the brain carried by cells of the immune system, including macrophages. In fact, they write

“The brain is constantly surveyed by trafficking leukocytes (activated lymphocytes and macrophages), which provide a Trojan horse mechanism for microbial entry into the nervous system across the blood brain barrier.”

And, quite, obviously, the presence of the microbes in the brain, has an enormous influence on the functioning of the neurons and the glial cells up to the point that the Authors are compelled to write, in a rather poetic fashion “Since bacteria express multiple molecules … their capacity for influencing brain function is immense”, being “immense” an absolute superlative. 

In 2013, however, the existence of another immunological pathway leading to an even closer interconnection between the brain and the immune system, and hence the microbes that are carried by immune cells, was unknown, and only in 2015 it became evident that the brain has a classical lymphatic system like any other organ. Thus, as we describe in our paper in Frontiers in Neuroscience (Front Neurosci. 2015 Dec 22;9:485), there is an even stricter relationship between the function of the immune system and the function of the brain - the cells of our immune system carry microbes to and from the brain, travelling through these newly discovered lymphatic vessels, by-passing the blood-brain-barrier. 

The identification of the fourth brain bears unimaginable consequences: we have to consider the microbes as cells of the central nervous system with a dignity equal to that of neurons and glial cells, but with two important differences. First of all, they are non-human and the information in their DNA is microbial and not human; this means that they are looking after their interest that may or may not be coincident with the human interest. Second, they change continuously as we interact with the environment and, most important, with food, quite at variance with neurons and glial cells.

Dr Marco Ruggiero, MD, PhD

About Dr Marco Ruggiero, MD, PhD

Dr Ruggiero graduated from the School of Medicine at the University of Firenze in 1980. He has a PhD in Molecular Biology and returned to the University of Firenze as Professor of Molecular Biology until his retirement in 2014.

Dr Ruggiero's main research interests are in the fields of oncology, neurosciences and immunotherapy. Two recent peer-reviewed papers - co-authored by Dr. J. J. Bradstreet - describe the neurological alterations in the brain of autistic children and elucidate the aetiology and pathogenesis of autism opening the way for specific treatments.

The observations by Ruggiero, Pacini and Bradstreet open new ways to the diagnosis and treatment of neurological diseases such as Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, Amyotrophic Lateral Sclerosis and brain ageing.

Dr Marco Ruggiero

In 2017, together with Dr. Dietrich Klinghardt, he developed a revolutionary procedure denominated the "Ruggiero-Klinghardt Protocol" (RK Protocol) that represents a paradigm change with profound implications for diagnosis and treatment of chronic conditions ranging from silent infections to neurodegenerative diseases, autism and cancer. The RK Protocol represents a quantum leap in medical diagnostics and therapeutics.

Class 1 | 07.02.18 | 16:00-18:00

An Introduction To The Brain Microbiome & Evolutionary Implications

Learning Objectives:

To understand the role of the brain microbiome in brain and mind function and how it contributed to the evolution of the human brain.

To learn about the role of the brain microbiome in the evolution of human speech.

Class 2 | 14.02.18 | 16:00-18:00

The Brain Microbiome & Autism 

Learning Objectives:

To understand the role of the brain microbiome as it relates to autism spectrum disorders.

To learn about the role of the brain lymphatic system in the pathogenesis of autism spectrum disorders and in the imbalance of the brain microbiome.

To learn about diagnostic and therapeutic approaches aimed at restoring the alterations of the brain microbiome that are associated with autism spectrum disorders.

Class 3 | 21.02.18 | 16:00-18:00

The Brain Microbiome & CIRS 

Learning Objectives:

To understand the role of inflammation in altering the brain microbiome.

To understand the role of microglial cells in the immunology of the brain and how they relate to the brain microbiome.

Class 4 | 28.02.18 | 16:00-18:00

The Brain Microbiome, Neurodegeneration & The Ageing Brain

Learning Objectives:

To understand the role of the brain microbiome in neurodegenerative diseases, as well as in the normal ageing of the brain. 

To learn about diagnostic and therapeutic approaches aimed at restoring the alterations of the brain microbiome that are associated with neurodegenerative diseases and normal ageing of the brain.