To detect diseases earlier, let's speak bacteria's secret language | Fatima AlZahra'a Alatraktchi

69,594 views

2019-04-19 ・ TED


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To detect diseases earlier, let's speak bacteria's secret language | Fatima AlZahra'a Alatraktchi

69,594 views ・ 2019-04-19

TED


Please double-click on the English subtitles below to play the video.

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Translator: Leslie Gauthier Reviewer: Camille Martínez
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You don't know them.
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You don't see them.
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But they're always around,
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whispering,
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making secret plans,
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building armies with millions of soldiers.
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And when they decide to attack,
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they all attack at the same time.
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I'm talking about bacteria.
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(Laughter)
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Who did you think I was talking about?
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Bacteria live in communities just like humans.
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They have families,
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they talk,
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and they plan their activities.
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And just like humans, they trick, deceive,
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and some might even cheat on each other.
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What if I tell you that we can listen to bacterial conversations
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and translate their confidential information into human language?
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And what if I tell you that translating bacterial conversations can save lives?
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I hold a PhD in nanophysics,
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and I've used nanotechnology to develop a real-time translation tool
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that can spy on bacterial communities
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and give us recordings of what bacteria are up to.
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Bacteria live everywhere.
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They're in the soil, on our furniture
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and inside our bodies.
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In fact, 90 percent of all the live cells in this theater are bacterial.
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Some bacteria are good for us;
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they help us digest food or produce antibiotics.
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And some bacteria are bad for us;
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they cause diseases and death.
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To coordinate all the functions bacteria have,
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they have to be able to organize,
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and they do that just like us humans --
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by communicating.
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But instead of using words,
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they use signaling molecules to communicate with each other.
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When bacteria are few,
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the signaling molecules just flow away,
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like the screams of a man alone in the desert.
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But when there are many bacteria, the signaling molecules accumulate,
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and the bacteria start sensing that they're not alone.
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They listen to each other.
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In this way, they keep track of how many they are
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and when they're many enough to initiate a new action.
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And when the signaling molecules have reached a certain threshold,
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all the bacteria sense at once that they need to act
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with the same action.
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So bacterial conversation consists of an initiative and a reaction,
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a production of a molecule and the response to it.
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In my research, I focused on spying on bacterial communities
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inside the human body.
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How does it work?
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We have a sample from a patient.
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It could be a blood or spit sample.
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We shoot electrons into the sample,
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the electrons will interact with any communication molecules present,
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and this interaction will give us information
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on the identity of the bacteria,
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the type of communication
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and how much the bacteria are talking.
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But what is it like when bacteria communicate?
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Before I developed the translation tool,
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my first assumption was that bacteria would have a primitive language,
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like infants that haven't developed words and sentences yet.
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When they laugh, they're happy; when they cry, they're sad.
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Simple as that.
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But bacteria turned out to be nowhere as primitive as I thought they would be.
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A molecule is not just a molecule.
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It can mean different things depending on the context,
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just like the crying of babies can mean different things:
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sometimes the baby is hungry,
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sometimes it's wet,
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sometimes it's hurt or afraid.
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Parents know how to decode those cries.
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And to be a real translation tool,
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it had to be able to decode the signaling molecules
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and translate them depending on the context.
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And who knows?
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Maybe Google Translate will adopt this soon.
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(Laughter)
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Let me give you an example.
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I've brought some bacterial data that can be a bit tricky to understand
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if you're not trained,
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but try to take a look.
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(Laughter)
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Here's a happy bacterial family that has infected a patient.
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Let's call them the Montague family.
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They share resources, they reproduce, and they grow.
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One day, they get a new neighbor,
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bacterial family Capulet.
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(Laughter)
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Everything is fine, as long as they're working together.
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But then something unplanned happens.
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Romeo from Montague has a relationship with Juliet from Capulet.
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(Laughter)
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And yes, they share genetic material.
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(Laughter)
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Now, this gene transfer can be dangerous to the Montagues
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that have the ambition to be the only family in the patient they have infected,
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and sharing genes contributes
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to the Capulets developing resistance to antibiotics.
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So the Montagues start talking internally to get rid of this other family
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by releasing this molecule.
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(Laughter)
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And with subtitles:
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[Let us coordinate an attack.]
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(Laughter)
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Let's coordinate an attack.
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And then everybody at once responds
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by releasing a poison that will kill the other family.
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[Eliminate!]
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(Laughter)
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The Capulets respond by calling for a counterattack.
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[Counterattack!]
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And they have a battle.
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This is a video of real bacteria dueling with swordlike organelles,
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where they try to kill each other
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by literally stabbing and rupturing each other.
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Whoever's family wins this battle becomes the dominant bacteria.
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So what I can do is to detect bacterial conversations
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that lead to different collective behaviors
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like the fight you just saw.
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And what I did was to spy on bacterial communities
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inside the human body
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in patients at a hospital.
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I followed 62 patients in an experiment,
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where I tested the patient samples for one particular infection,
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without knowing the results of the traditional diagnostic test.
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Now, in bacterial diagnostics,
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a sample is smeared out on a plate,
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and if the bacteria grow within five days,
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the patient is diagnosed as infected.
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When I finished the study and I compared the tool results
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to the traditional diagnostic test and the validation test,
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I was shocked.
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It was far more astonishing than I had ever anticipated.
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But before I tell you what the tool revealed,
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I would like to tell you about a specific patient I followed,
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a young girl.
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She had cystic fibrosis,
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a genetic disease that made her lungs susceptible to bacterial infections.
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This girl wasn't a part of the clinical trial.
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I followed her because I knew from her medical record
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that she had never had an infection before.
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Once a month, this girl went to the hospital
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to cough up a sputum sample that she spit in a cup.
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This sample was transferred for bacterial analysis
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at the central laboratory
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so the doctors could act quickly if they discovered an infection.
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And it allowed me to test my device on her samples as well.
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The first two months I measured on her samples, there was nothing.
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But the third month,
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I discovered some bacterial chatter in her sample.
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The bacteria were coordinating to damage her lung tissue.
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But the traditional diagnostics showed no bacteria at all.
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I measured again the next month,
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and I could see that the bacterial conversations became even more aggressive.
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Still, the traditional diagnostics showed nothing.
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My study ended, but a half a year later, I followed up on her status
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to see if the bacteria only I knew about had disappeared
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without medical intervention.
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They hadn't.
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But the girl was now diagnosed with a severe infection
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of deadly bacteria.
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It was the very same bacteria my tool discovered earlier.
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And despite aggressive antibiotic treatment,
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it was impossible to eradicate the infection.
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Doctors deemed that she would not survive her 20s.
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When I measured on this girl's samples,
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my tool was still in the initial stage.
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I didn't even know if my method worked at all,
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therefore I had an agreement with the doctors
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not to tell them what my tool revealed
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in order not to compromise their treatment.
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So when I saw these results that weren't even validated,
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I didn't dare to tell
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because treating a patient without an actual infection
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also has negative consequences for the patient.
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But now we know better,
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and there are many young boys and girls that still can be saved
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because, unfortunately, this scenario happens very often.
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Patients get infected,
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the bacteria somehow don't show on the traditional diagnostic test,
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and suddenly, the infection breaks out in the patient with severe symptoms.
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And at that point, it's already too late.
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The surprising result of the 62 patients I followed
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was that my device caught bacterial conversations
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in more than half of the patient samples
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that were diagnosed as negative by traditional methods.
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In other words, more than half of these patients went home thinking
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they were free from infection,
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although they actually carried dangerous bacteria.
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Inside these wrongly diagnosed patients,
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bacteria were coordinating a synchronized attack.
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They were whispering to each other.
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What I call "whispering bacteria"
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are bacteria that traditional methods cannot diagnose.
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So far, it's only the translation tool that can catch those whispers.
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I believe that the time frame in which bacteria are still whispering
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is a window of opportunity for targeted treatment.
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If the girl had been treated during this window of opportunity,
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it might have been possible to kill the bacteria
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in their initial stage,
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before the infection got out of hand.
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What I experienced with this young girl made me decide to do everything I can
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to push this technology into the hospital.
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Together with doctors,
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I'm already working on implementing this tool in clinics
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to diagnose early infections.
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Although it's still not known how doctors should treat patients
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during the whispering phase,
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this tool can help doctors keep a closer eye on patients in risk.
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It could help them confirm if a treatment had worked or not,
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and it could help answer simple questions:
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Is the patient infected?
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And what are the bacteria up to?
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Bacteria talk,
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they make secret plans,
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and they send confidential information to each other.
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But not only can we catch them whispering,
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we can all learn their secret language
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and become ourselves bacterial whisperers.
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And, as bacteria would say,
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"3-oxo-C12-aniline."
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(Laughter)
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(Applause)
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Thank you.
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