Meet your microbes
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0:01 - 0:02I'm going to start with a little story.
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0:02 - 0:05So, I grew up in this neighborhood. When I was 15 years old,
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0:05 - 0:10I went from being what I think was a strapping young athlete,
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0:10 - 0:14over four months, slowly wasting away until
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0:14 - 0:16I was basically a famine victim
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0:16 - 0:18with an unquenchable thirst.
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0:18 - 0:21I had basically digested away my body.
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0:21 - 0:26And this all came to a head when I was on a backpacking trip,
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0:26 - 0:28my first one ever actually, on Old Rag Mountain
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0:28 - 0:32in West Virginia, and was putting my face into puddles
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0:32 - 0:34of water and drinking like a dog.
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0:34 - 0:38That night, I was taken into the emergency room
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0:38 - 0:42and diagnosed as a type 1 diabetic in full-blown ketoacidosis.
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0:42 - 0:48And I recovered, thanks to the miracles of modern medicine,
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0:48 - 0:54insulin and other things, and gained all my weight back and more.
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0:54 - 0:59And something festered inside me after this happened.
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0:59 - 1:03What I thought about was, what caused the diabetes?
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1:03 - 1:04You see, diabetes is an autoimmune disease
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1:04 - 1:08where your body fights itself, and at the time people thought
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1:08 - 1:11that somehow maybe exposure to a pathogen
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1:11 - 1:15had triggered my immune system to fight the pathogen
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1:15 - 1:17and then kill the cells that make insulin.
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1:17 - 1:20And this is what I thought for a long period of time,
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1:20 - 1:24and that's in fact what medicine and people have focused on quite a bit,
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1:24 - 1:27the microbes that do bad things.
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1:27 - 1:30And that's where I need my assistant here now.
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1:30 - 1:32You may recognize her.
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1:32 - 1:38So, I went yesterday, I apologize, I skipped a few of the talks,
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1:38 - 1:40and I went over to the National Academy of Sciences building,
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1:40 - 1:46and they sell toys, giant microbes.
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1:46 - 1:49And here we go!
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1:49 - 1:54So you have caught flesh-eating disease if you caught that one.
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1:54 - 1:58I gotta get back out my baseball ability here.
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1:58 - 2:02(Laughter)
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2:02 - 2:08So, unfortunately or not surprisingly, most of the microbes
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2:08 - 2:12they sell at the National Academy building are pathogens.
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2:12 - 2:15Everybody focuses on the things that kill us,
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2:15 - 2:16and that's what I was focusing on.
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2:16 - 2:21And it turns out that we are covered in a cloud of microbes,
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2:21 - 2:25and those microbes actually do us good much of the time,
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2:25 - 2:26rather than killing us.
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2:26 - 2:30And so, we've known about this for some period of time.
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2:30 - 2:33People have used microscopes to look at the microbes that cover us,
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2:33 - 2:35I know you're not paying attention to me, but ...
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2:35 - 2:37(Laughter)
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2:37 - 2:39The microbes that cover us.
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2:39 - 2:42And if you look at them in the microscope,
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2:42 - 2:46you can see that we actually have 10 times as many cells
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2:46 - 2:49of microbes on us as we have human cells.
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2:49 - 2:54There's more mass in the microbes than the mass of our brain.
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2:54 - 2:58We are literally a teeming ecosystem of microorganisms.
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2:58 - 3:03And unfortunately, if you want to learn about the microorganisms,
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3:03 - 3:05just looking at them in a microscope is not sufficient.
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3:05 - 3:08And so we just heard about the DNA sequencing.
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3:08 - 3:10It turns out that one of the best ways to look at microbes
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3:10 - 3:13and to understand them is to look at their DNA.
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3:13 - 3:15And that's what I've been doing for 20 years,
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3:15 - 3:19using DNA sequencing, collecting samples from various places,
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3:19 - 3:22including the human body, reading the DNA sequence
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3:22 - 3:24and then using that DNA sequencing to tell us about
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3:24 - 3:26the microbes that are in a particular place.
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3:26 - 3:29And what's amazing, when you use this technology,
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3:29 - 3:32for example, looking at humans, we're not just covered
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3:32 - 3:33in a sea of microbes.
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3:33 - 3:39There are thousands upon thousands of different kinds of microbes on us.
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3:39 - 3:44We have millions of genes of microbes in our human
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3:44 - 3:46microbiome covering us.
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3:46 - 3:49And so this microbial diversity differs between people,
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3:49 - 3:52and what people have been thinking about in the last 10,
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3:52 - 3:55maybe 15 years is, maybe these microbes,
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3:55 - 3:57this microbial cloud in and on us,
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3:57 - 4:01and the variation between us, may be responsible
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4:01 - 4:05for some of the health and illness differences between us.
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4:05 - 4:08And that comes back to the diabetes story I was telling you.
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4:08 - 4:11It turns out that people now think that one of the triggers
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4:11 - 4:14for type 1 diabetes is not fighting a pathogen,
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4:14 - 4:18but is in fact trying to -- miscommunicating with the microbes
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4:18 - 4:20that live in and on you.
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4:20 - 4:22And somehow maybe the microbial community that's
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4:22 - 4:26in and on me got off, and then this triggered some sort
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4:26 - 4:29of immune response and led to me killing the cells
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4:29 - 4:31that make insulin in my body.
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4:31 - 4:34And so what I want to tell you about for a few minutes is,
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4:34 - 4:38what people have learned using DNA sequencing techniques
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4:38 - 4:41in particular, to study the microbial cloud
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4:41 - 4:43that lives in and on us.
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4:43 - 4:45And I want to tell you a story about a personal project.
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4:45 - 4:48My first personal experience with studying the microbes
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4:48 - 4:52on the human body actually came from a talk that I gave,
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4:52 - 4:54right around the corner from here at Georgetown.
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4:54 - 4:57I gave a talk, and a family friend who happened to be
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4:57 - 5:00the Dean of Georgetown Medical School was at the talk,
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5:00 - 5:02and came up to me afterwards saying, they were doing
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5:02 - 5:06a study of ileal transplants in people.
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5:06 - 5:10And they wanted to look at the microbes after the transplants.
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5:10 - 5:13And so I started a collaboration with this person,
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5:13 - 5:16Michael Zasloff and Thomas Fishbein, to look at the microbes
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5:16 - 5:20that colonized these ilea after they were transplanted into a recipient.
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5:20 - 5:24And I can tell you all the details about the microbial study
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5:24 - 5:26that we did there, but the reason I want to tell you this story
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5:26 - 5:29is something really striking that they did at the beginning
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5:29 - 5:30of this project.
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5:30 - 5:34They take the donor ileum, which is filled with microbes from a donor
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5:34 - 5:37and they have a recipient who might have a problem
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5:37 - 5:39with their microbial community, say Crohn's disease,
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5:39 - 5:43and they sterilized the donor ileum.
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5:43 - 5:47Cleaned out all the microbes, and then put it in the recipient.
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5:47 - 5:50They did this because this was common practice
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5:50 - 5:53in medicine, even though it was obvious
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5:53 - 5:55that this was not a good idea.
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5:55 - 5:58And fortunately, in the course of this project,
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5:58 - 6:01the transplant surgeons and the other people
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6:01 - 6:05decided, forget common practice. We have to switch.
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6:05 - 6:09So they actually switched to leaving some of the microbial
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6:09 - 6:13community in the ileum. They leave the microbes with the donor,
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6:13 - 6:17and theoretically that might help the people who are
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6:17 - 6:19receiving this ileal transplant.
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6:19 - 6:22And so, people -- this is a study that I did now.
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6:22 - 6:24In the last few years there's been a great expansion
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6:24 - 6:29in using DNA technology to study the microbes in and on people.
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6:29 - 6:30There's something called the Human Microbiome Project
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6:30 - 6:32that's going on in the United States,
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6:32 - 6:35and MetaHIT going on in Europe, and a lot of other projects.
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6:35 - 6:38And when people have done a variety of studies,
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6:38 - 6:42they have learned things such as, when a baby is
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6:42 - 6:45born, during vaginal delivery you get colonized by the
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6:45 - 6:46microbes from your mother.
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6:46 - 6:49There are risk factors associated with cesarean sections,
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6:49 - 6:53some of those risk factors may be due to mis-colonization
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6:53 - 6:55when you carve a baby out of its mother
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6:55 - 6:58rather than being delivered through the birth canal.
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6:58 - 7:02And a variety of other studies have shown that the
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7:02 - 7:03microbial community that lives in and on us
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7:03 - 7:06helps in development of the immune system,
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7:06 - 7:11helps in fighting off pathogens, helps in our metabolism,
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7:11 - 7:14and determining our metabolic rate, probably
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7:14 - 7:17determines our odor, and may even shape our behavior
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7:17 - 7:19in a variety of ways.
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7:19 - 7:22And so, these studies have documented or suggested
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7:22 - 7:26out of a variety of important functions for the microbial community,
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7:26 - 7:31this cloud, the non-pathogens that live in and on us.
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7:31 - 7:34And one area that I think is very interesting,
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7:34 - 7:37which many of you may have now that we've thrown
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7:37 - 7:41microbes into the crowd, is something that I would call "germophobia."
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7:41 - 7:44So people are really into cleanliness, right?
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7:44 - 7:46We have antibiotics in our kitchen counters,
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7:46 - 7:49people are washing every part of them all of the time,
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7:49 - 7:54we pump antibiotics into our food, into our communities,
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7:54 - 7:56we take antibiotics excessively.
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7:56 - 8:00And killing pathogens is a good thing if you're sick,
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8:00 - 8:03but we should understand that when we pump chemicals
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8:03 - 8:06and antibiotics into our world, that we're also killing
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8:06 - 8:09the cloud of microbes that live in and on us.
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8:09 - 8:12And excessive use of antibiotics, in particular in children,
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8:12 - 8:15has been shown to be associated with, again, risk factors
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8:15 - 8:19for obesity, for autoimmune diseases, for a variety
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8:19 - 8:21of problems that are probably due to disruption
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8:21 - 8:24of the microbial community.
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8:24 - 8:28So the microbial community can go wrong
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8:28 - 8:29whether we want it to or not,
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8:29 - 8:31or we can kill it with antibiotics,
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8:31 - 8:34but what can we do to restore it?
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8:34 - 8:37I'm sure many people here have heard about probiotics.
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8:37 - 8:40Probiotics are one thing that you can try and do to restore
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8:40 - 8:42the microbial community that is in and on you.
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8:42 - 8:46And they definitely have been shown to be effective in some cases.
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8:46 - 8:49There's a project going on at UC Davis where people are using
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8:49 - 8:52probiotics to try and treat, prevent,
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8:52 - 8:54necrotizing enterocolitis in premature infants.
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8:54 - 8:57Premature infants have real problems with their microbial community.
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8:57 - 9:00And it may be that probiotics can help prevent
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9:00 - 9:03the development of this horrible necrotizing enterocolitis
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9:03 - 9:05in these premature infants.
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9:05 - 9:09But probiotics are sort of a very, very simple solution.
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9:09 - 9:12Most of the pills that you can take or the yogurts that you can eat
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9:12 - 9:17have one or two species in them, maybe five species in them,
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9:17 - 9:21and the human community is thousands upon thousands of species.
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9:21 - 9:25So what can we do to restore our microbial community
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9:25 - 9:28when we have thousands and thousands of species on us?
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9:28 - 9:30Well, one thing that animals seem to do is,
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9:30 - 9:34they eat poo -- coprophagia.
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9:34 - 9:39And it turns out that many veterinarians,
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9:39 - 9:41old school veterinarians in particular,
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9:41 - 9:44have been doing something called "poo tea,"
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9:44 - 9:50not booty, but poo tea, to treat colic and other
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9:50 - 9:53ailments in horses and cows and things like that,
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9:53 - 9:57where you make tea from the poo from a healthy
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9:57 - 10:00individual animal and you feed it to a sick animal.
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10:00 - 10:05Although, unless you have a fistulated cow with a big hole in its side,
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10:05 - 10:07and you can put your hand into its rumen,
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10:07 - 10:11it's hard to imagine that the delivery of microbes
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10:11 - 10:14directly into the mouth and through the entire
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10:14 - 10:17top of the digestive tract is the best delivery system,
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10:17 - 10:21so you may have heard in people they are now doing
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10:21 - 10:26fecal transplants, where rather than delivering
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10:26 - 10:28a couple of probiotic microbes through the mouth,
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10:28 - 10:32they are delivering a community of probiotics,
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10:32 - 10:34a community of microbes from a healthy donor,
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10:34 - 10:37through the other end.
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10:37 - 10:40And this has turned out to be very effective in fighting
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10:40 - 10:42certain intransigent infectious diseases
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10:42 - 10:46like Clostridium difficile infections that can stay
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10:46 - 10:48with people for years and years and years.
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10:48 - 10:53Transplants of the feces, of the microbes from the feces,
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10:53 - 10:56from a healthy donor has actually been shown to cure
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10:56 - 10:59systemic C. dif infections in some people.
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10:59 - 11:05Now what these transplants, these fecal transplants, or
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11:05 - 11:09the poo tea suggest to me, and many other people
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11:09 - 11:11have come up with this same idea, is that
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11:11 - 11:15the microbial community in and on us, it's an organ.
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11:15 - 11:20We should view it as a functioning organ, part of ourselves.
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11:20 - 11:24We should treat it carefully and with respect,
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11:24 - 11:28and we do not want to mess with it, say by C-sections
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11:28 - 11:33or by antibiotics or excessive cleanliness,
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11:33 - 11:36without some real good justification.
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11:36 - 11:39And what the DNA sequencing technologies are allowing people to do now
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11:39 - 11:46is do detailed studies of, say, 100 patients who have Crohn's disease
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11:46 - 11:49and 100 people who don't have Crohn's disease.
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11:49 - 11:53Or 100 people who took antibiotics when they were little,
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11:53 - 11:55and 100 people who did not take antibiotics.
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11:55 - 11:59And we can now start to compare the community of microbes
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11:59 - 12:03and their genes and see if there are differences.
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12:03 - 12:06And eventually we may be able to understand if they're not
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12:06 - 12:09just correlative differences, but causative.
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12:09 - 12:12Studies in model systems like mouse and other animals
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12:12 - 12:15are also helping do this, but people are now using
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12:15 - 12:18these technologies because they've gotten very cheap,
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12:18 - 12:22to study the microbes in and on a variety of people.
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12:22 - 12:26So, in wrapping up, what I want to tell you about is,
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12:26 - 12:29I didn't tell you a part of the story of coming down with diabetes.
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12:29 - 12:32It turns out that my father was an M.D.,
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12:32 - 12:37actually studied hormones. I told him many times
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12:37 - 12:41that I was tired, thirsty, not feeling very good.
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12:41 - 12:44And he shrugged it off, I think he either thought
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12:44 - 12:47I was just complaining a lot, or it was the typical
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12:47 - 12:50M.D. "nothing can be wrong with my children."
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12:50 - 12:53We even went to the International Society of Endocrinology
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12:53 - 12:55meeting as family in Quebec.
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12:55 - 13:01And I was getting up every five minutes to pee,
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13:01 - 13:03and drinking everybody's water at the table,
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13:03 - 13:06and I think they all thought I was a druggie.
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13:06 - 13:08(Laughter)
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13:08 - 13:10But the reason I'm telling you this is that
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13:10 - 13:13the medical community, my father as an example,
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13:13 - 13:17sometimes doesn't see what's right in front of their eyes.
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13:17 - 13:21The microbial cloud, it is right in front of us.
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13:21 - 13:23We can't see it most of the time. It's invisible.
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13:23 - 13:25They're microbes. They're tiny.
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13:25 - 13:28But we can see them through their DNA,
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13:28 - 13:31we can see them through the effects that they have on people.
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13:31 - 13:33And what we need now
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13:33 - 13:36is to start thinking about this microbial community in the context
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13:36 - 13:39of everything in human medicine.
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13:39 - 13:42It doesn't mean that it affects every part of us,
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13:42 - 13:43but it might.
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13:43 - 13:47What we need is a full field guide to the microbes
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13:47 - 13:51that live in and on people, so that we can understand
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13:51 - 13:54what they're doing to our lives.
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13:54 - 13:57We are them. They are us.
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13:57 - 13:58Thank you.
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13:58 - 14:00(Applause)
- Title:
- Meet your microbes
- Speaker:
- Jonathan Eisen
- Description:
-
Our bodies are covered in a sea of microbes -- both the pathogens that make us sick and the "good" microbes, about which we know less, that might be keeping us healthy. At TEDMED, microbiologist Jonathan Eisen shares what we know, including some surprising ways to put those good microbes to work.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 14:23
Thu-Huong Ha edited English subtitles for Meet your microbes | ||
Thu-Huong Ha approved English subtitles for Meet your microbes | ||
Thu-Huong Ha accepted English subtitles for Meet your microbes | ||
Thu-Huong Ha edited English subtitles for Meet your microbes | ||
Morton Bast added a translation |