Jonathan Eisen: Meet your microbes

Translator: Morton Bast Reviewer: Thu-Huong Ha

Prevoditelj: SIBELA KESAC Recezent: Suzana Baric

I'm going to start with a little story.

Započet ću jednom pričicom.

So, I grew up in this neighborhood. When I was 15 years old,

Dakle, odrastao sam u jednom susjedstvu. Kada mi je bilo 15 godina,

I went from being what I think was a strapping young athlete,

kao jedan čvrsti, mladi sportaš

over four months, slowly wasting away until

počeo sam kopniti te sam kroz četiri mjeseca

I was basically a famine victim

praktički počeo umirati od gladi

with an unquenchable thirst.

i od neutažive žeđi.

I had basically digested away my body.

Zapravo sam probavljao vlastito tijelo.

And this all came to a head when I was on a backpacking trip,

Sve je kulminiralo na jednom planinarskom izletu,

my first one ever actually, on Old Rag Mountain

mom prvom ikada, na Old Rag Mountain u Zapadnoj Virginiji,

in West Virginia, and was putting my face into puddles

gdje sam gurao glavu u lokvice vode

of water and drinking like a dog.

i pio iz njih poput psa.

That night, I was taken into the emergency room

Te noći su me odvezli na hitnu pomoć

and diagnosed as a type 1 diabetic in full-blown ketoacidosis.

i dijagnosticirali mi dijabetes tipa 1 i uznapredovalu ketoacidozu.

And I recovered, thanks to the miracles of modern medicine,

Oporavio sam se, zahvaljujući čudima moderne medicine,

insulin and other things, and gained all my weight back and more.

inzulinu i drugim stvarima, te povratio svoju težinu i dobio još koju kilu više.

And something festered inside me after this happened.

I nešto se zagnojilo u meni nakon što se to dogodilo.

What I thought about was, what caused the diabetes?

Ono o čemu sam razmišljao bilo je, što je prouzrokovalo dijabetes?

You see, diabetes is an autoimmune disease

Vidite, dijabetes je autoimuna bolest,

where your body fights itself, and at the time people thought

tijelo napada samo sebe, a u to su vrijeme ljudi mislili

that somehow maybe exposure to a pathogen

da izlaganje patogenima nekako možda

had triggered my immune system to fight the pathogen

može potaknuti imunosni sustav da se bori protiv patogena

and then kill the cells that make insulin.

i tako uništi stanice koje proizvode inzulin.

And this is what I thought for a long period of time,

I sam sam dugo vremena isto mislio,

and that's in fact what medicine and people have focused on quite a bit,

i na to su se ljudi i medicina jako fokusirali,

the microbes that do bad things.

na mikrobe koji rade loše stvari.

And that's where I need my assistant here now.

U ovom trenutku potrebna mi je moja asistentica.

You may recognize her.

Možda ćete je prepoznati.

So, I went yesterday, I apologize, I skipped a few of the talks,

Dakle, otišao sam jučer, ispričavam se, ali preskočio sam par govora,

and I went over to the National Academy of Sciences building,

i posjetio zgradu Nacionalne akademije znanosti

and they sell toys, giant microbes.

gdje prodaju igračke, ogromne mikrobe.

And here we go!

I idemo!

So you have caught flesh-eating disease if you caught that one.

Pokupili ste bakteriju koja jede meso, ako ste uhvatili ovu igračku.

I gotta get back out my baseball ability here.

Moram se prisjetiti svojih bejzbolskih sposobnosti.

(Laughter)

(Smijeh)

So, unfortunately or not surprisingly, most of the microbes

Dakle, nažalost, iako ne iznenađuje, većina mikroba koje prodaju

they sell at the National Academy building are pathogens.

u Nacionalnoj akademiji znanosti su patogeni organizmi.

Everybody focuses on the things that kill us,

Svi se usredotočuju na stvari koje nas ubijaju,

and that's what I was focusing on.

i na to sam se fokusirao i ja.

And it turns out that we are covered in a cloud of microbes,

A ispada da smo mi prekriveni oblakom mikroba

and those microbes actually do us good much of the time,

i ti su mikrobi zapravo većinu vremena dobri za nas,

rather than killing us.

a ne smrtonosni.

And so, we've known about this for some period of time.

I tako, to nam je već neko vrijeme poznato.

People have used microscopes to look at the microbes that cover us,

Ljudi se koriste mikroskopima da bi promatrali mikrobe koji nas pokrivaju,

I know you're not paying attention to me, but ...

znam da ne obraćate pažnju na mene, ali...

(Laughter)

(Smijeh)

The microbes that cover us.

Promatrali su mikrobe koji nas prekrivaju.

And if you look at them in the microscope,

I ako ih promatrate kroz mikroskop,

you can see that we actually have 10 times as many cells

vidjeti ćete da mi zapravo imamo 10 puta više stanica

of microbes on us as we have human cells.

koje pripadaju mikrobima nego vlastitih.

There's more mass in the microbes than the mass of our brain.

Masa mikroba veća je od mase našeg mozga.

We are literally a teeming ecosystem of microorganisms.

Mi smo doslovno ekosistem prepun mikroorganizama.

And unfortunately, if you want to learn about the microorganisms,

Nažalost, ukoliko želite učiti o mikroorganizmima,

just looking at them in a microscope is not sufficient.

samo promatranje kroz mikroskop nije dovoljno.

And so we just heard about the DNA sequencing.

Upravo smo čuli o sekvenciranju DNK.

It turns out that one of the best ways to look at microbes

Ispada da je jedan od najboljih načina promatranja

and to understand them is to look at their DNA.

i razumijevanja mikroba promatranje njihove DNK.

And that's what I've been doing for 20 years,

I to je ono čime se ja bavim već 20 godina,

using DNA sequencing, collecting samples from various places,

koristim sekvenciranje DNK, skupljam uzorke s različitih mjesta,

including the human body, reading the DNA sequence

uključujući i ljudsko tijelo, čitam sekvence DNK

and then using that DNA sequencing to tell us about

i onda koristim te sekvence DNK da bismo doznali više

the microbes that are in a particular place.

o mikrobima koji se nalaze na određenom mjestu.

And what's amazing, when you use this technology,

Ono što je zadivljujuće jest da, kada koristite tu tehnologiju

for example, looking at humans, we're not just covered

kod, na primjer, promatranja ljudskog tijela, vidimo da nismo samo pokriveni

in a sea of microbes.

morem mikroba.

There are thousands upon thousands of different kinds of microbes on us.

Postoje na tisuće i tisuće različitih vrsta mikroba na nama.

We have millions of genes of microbes in our human

Imamo milijune gena mikroba u našem ljudskom

microbiome covering us.

mikrobiomu koji nas prekrivaju.

And so this microbial diversity differs between people,

Ta mikrobna raznolikost razlikuje se od čovjeka do čovjeka

and what people have been thinking about in the last 10,

i ono o čemu su ljudi razmišljali zadnjih 10,

maybe 15 years is, maybe these microbes,

možda 15 godina jest da su možda ti mikrobi,

this microbial cloud in and on us,

taj mikrobni oblak u i na nama,

and the variation between us, may be responsible

i razlike među nama, možda odgovorni

for some of the health and illness differences between us.

za razlike u našem zdravlju.

And that comes back to the diabetes story I was telling you.

I ponovo se vraćam na svoju priču o dijabetesu.

It turns out that people now think that one of the triggers

Sada se misli da jedan od okidača

for type 1 diabetes is not fighting a pathogen,

dijabetesa tipa 1 nije borba protiv patogena,

but is in fact trying to -- miscommunicating with the microbes

već je to u biti loša komunikacija s mikrobima

that live in and on you.

koji žive u i na vama.

And somehow maybe the microbial community that's

I nekako je možda ta moja zajednica mikroba

in and on me got off, and then this triggered some sort

nestala pa je to prouzročilo neki vrstu

of immune response and led to me killing the cells

imunosnog odgovora i dovelo do toga da sam ubijam stanice

that make insulin in my body.

koje u mom tijelu proizvode inzulin.

And so what I want to tell you about for a few minutes is,

Ono što vam želim reći u nekoliko minuta

what people have learned using DNA sequencing techniques

jest što su ljudi naučili koristeći tehnologiju sekvenciranja DNK

in particular, to study the microbial cloud

da bi proučavali oblak mikroba

that lives in and on us.

koji živi u i na nama.

And I want to tell you a story about a personal project.

I želim vam ispričati priču o osobnom projektu.

My first personal experience with studying the microbes

Moje prvo iskustvo proučavanja mikroba

on the human body actually came from a talk that I gave,

na ljudskom tijelu zapravo je proizašlo iz jednog mog predavanja,

right around the corner from here at Georgetown.

ovdje iza ugla, u Georgetownu.

I gave a talk, and a family friend who happened to be

Držao sam govor, a jedan obiteljski prijatelj,

the Dean of Georgetown Medical School was at the talk,

dekan Medicinskog fakulteta u Georgetownu, koji je slušao govor,

and came up to me afterwards saying, they were doing

prišao mi je nakon predavanja i rekao da rade studiju

a study of ileal transplants in people.

o transplataciji tankog crijeva kod ljudi.

And they wanted to look at the microbes after the transplants.

I željeli su promatrati mikrobe nakon transplatacije.

And so I started a collaboration with this person,

I tako smo započeli suradnju,

Michael Zasloff and Thomas Fishbein, to look at the microbes

Michael Zasloff, Thomas Fishbein i ja, promatrali smo mikrobe

that colonized these ilea after they were transplanted into a recipient.

koji su kolonizirali tanko crijevo nakon što je transplantirano u tijelo primatelja.

And I can tell you all the details about the microbial study

I mogu vam reći detalje naše mikrobne studije

that we did there, but the reason I want to tell you this story

koju smo napravili, ali razlog zbog kojeg vam ovo govorim

is something really striking that they did at the beginning

je nešto zaista izuzetno što su oni napravili na početku

of this project.

ovog projekta.

They take the donor ileum, which is filled with microbes from a donor

Uzeli bi tanko crijevo donora, koje je prepuno njegovih mikroba,

and they have a recipient who might have a problem

i jednog primatelja koji možda ima problem

with their microbial community, say Crohn's disease,

sa vlastitom mikrobnom zajednicom, npr. Crohnovu bolest,

and they sterilized the donor ileum.

i sterilizirali bi tanko crijevo donora.

Cleaned out all the microbes, and then put it in the recipient.

Očistili bi ga od mikroba i onda stavili u tijelo primatelja.

They did this because this was common practice

To je bila uobičajena praksa u medicini

in medicine, even though it was obvious

iako je bilo očito

that this was not a good idea.

da to nije bila baš dobra ideja.

And fortunately, in the course of this project,

Na svu sreću, tijekom tog projekta,

the transplant surgeons and the other people

kirurzi i ostalo osoblje odlučili su

decided, forget common practice. We have to switch.

da će zaboraviti uobičajenu praksu. Odlučili su se za promjenu.

So they actually switched to leaving some of the microbial

Odlučili su ostaviti neke zajednice mikroba u tankom crijevu.

community in the ileum. They leave the microbes with the donor,

Ostavljaju mikrobe na doniranom organu

and theoretically that might help the people who are

i u teoriji bi to moglo pomoći ljudima

receiving this ileal transplant.

koji primaju tanko crijevo.

And so, people -- this is a study that I did now.

I tako, ljudi -- ovo je studija koju sam znao.

In the last few years there's been a great expansion

U zadnjih nekoliko godina došlo je do velike ekspanzije

in using DNA technology to study the microbes in and on people.

u korištenju DNK tehnologije pri proučavanju mikroba u i na ljudima.

There's something called the Human Microbiome Project

Postoji nešto što se zove Projekt ljudskog mikrobioma,

that's going on in the United States,

koji se odvija u SAD-u,

and MetaHIT going on in Europe, and a lot of other projects.

MetaHIT u Europi i mnogi drugi projekti.

And when people have done a variety of studies,

I kada su ljudi napravili mnoge studije,

they have learned things such as, when a baby is

naučili su stvari poput, npr., kada se rodi dijete

born, during vaginal delivery you get colonized by the

tijekom normalnog vaginalnog porođaja koloniziraju ga

microbes from your mother.

mikrobi njegove majke.

There are risk factors associated with cesarean sections,

Postoje faktori rizika povezani sa carskim rezom.

some of those risk factors may be due to mis-colonization

neki od kojih mogu biti povezani s činjenicom da

when you carve a baby out of its mother

kada izvadite dijete iz majčine utrobe, dolazi do kolonizacije krivim mikrobima,

rather than being delivered through the birth canal.

za razliku od normalnog poroda kroz rodnicu.

And a variety of other studies have shown that the

Mnoge su studije pokazale da

microbial community that lives in and on us

mikrobna zajednica koja živi u i na nama

helps in development of the immune system,

pomaže razvoju imunosnog sustava,

helps in fighting off pathogens, helps in our metabolism,

pomaže nam u borbi protiv patogena, pomaže našem metabolizmu

and determining our metabolic rate, probably

i određuju naš metabolizam, vjerojatno

determines our odor, and may even shape our behavior

određuje naš miris, a možda oblikuje i naše ponašanje

in a variety of ways.

na više različitih načina.

And so, these studies have documented or suggested

I tako su te studije zabilježile

out of a variety of important functions for the microbial community,

mnoge važne funkcije koje ima mikrobna zajednica,

this cloud, the non-pathogens that live in and on us.

taj oblak ne-patogena koji žive u i na nama.

And one area that I think is very interesting,

Jedno područje koje smatram jako zanimljivim,

which many of you may have now that we've thrown

a mnogi od vas ga imaju sada kada smo bacili

microbes into the crowd, is something that I would call "germophobia."

mikrobe među vas, a to je "strah od klica".

So people are really into cleanliness, right?

Ljudi su opsjednuti čistoćom, zar ne?

We have antibiotics in our kitchen counters,

Držimo antibiotike u kuhinjskim ormarićima,

people are washing every part of them all of the time,

stalno peremo svaki dio svog tijela,

we pump antibiotics into our food, into our communities,

dodajemo antibiotike u našu hranu, u naše zajednice,

we take antibiotics excessively.

pretjerujemo s uzimanjem antibiotika.

And killing pathogens is a good thing if you're sick,

Ubijanje patogena je dobra stvar ako ste bolesni,

but we should understand that when we pump chemicals

no trebali bismo znati da kada svoj svijet punimo kemikalijama

and antibiotics into our world, that we're also killing

i antibioticima, tada također ubijamo

the cloud of microbes that live in and on us.

i oblak mikroba koji živi u i na nama.

And excessive use of antibiotics, in particular in children,

Pretjerana uporaba antibiotika, posebno u djece,

has been shown to be associated with, again, risk factors

dokazano povećava rizik

for obesity, for autoimmune diseases, for a variety

za pretilost, autoimune bolesti, i pojavu čitavog niza problema

of problems that are probably due to disruption

koji se javljaju najvjerojatnije zbog poremećaja

of the microbial community.

u mikrobnoj zajednici.

So the microbial community can go wrong

Dakle, mikrobna ravnoteža se može poremetiti,

whether we want it to or not,

željeli mi to ili ne,

or we can kill it with antibiotics,

ili je mi možemo ubiti antibioticima,

but what can we do to restore it?

ali kako je možemo obnoviti?

I'm sure many people here have heard about probiotics.

Siguran sam da je mnogo ljudi čulo za probiotike.

Probiotics are one thing that you can try and do to restore

Probiotici su jedan način kojim možetepokušati obnoviti

the microbial community that is in and on you.

zajednicu mikroba u i na vama.

And they definitely have been shown to be effective in some cases.

I definitivno su se pokazali učinkovitima u nekim slučajevima.

There's a project going on at UC Davis where people are using

Na Kalifornijskom sveučilištu Davis u tijeku je projekt u kojem ljudi

probiotics to try and treat, prevent,

uzimaju probiotike kako bi pokušali tretirati i spriječiti

necrotizing enterocolitis in premature infants.

nekrotični enterokolitis u nedonoščadi.

Premature infants have real problems with their microbial community.

Nedonoščad ima ozbiljan problem sa svojom mikrobnom zajednicom.

And it may be that probiotics can help prevent

I možda probiotici mogu pomoći u sprječavanju

the development of this horrible necrotizing enterocolitis

razvoja ovog užasnog oboljenja

in these premature infants.

kod prijevremeno rođene djece

But probiotics are sort of a very, very simple solution.

No, probiotici su zapravo jako, jako jednostavno rješenje.

Most of the pills that you can take or the yogurts that you can eat

Većina tableta ili jogurta koje možete popiti

have one or two species in them, maybe five species in them,

sadrži jednu ili dvije vrste bakterija u sebi, možda pet,

and the human community is thousands upon thousands of species.

a ljudska zajednica se sastoji od tisuća i tisuća različitih vrsta.

So what can we do to restore our microbial community

Što, dakle, možemo napraviti da bismo obnovili mikrobnu zajednicu

when we have thousands and thousands of species on us?

kada na nama imamo na tisuće i tisuće vrsta?

Well, one thing that animals seem to do is,

Pa, jedna od stvari koju, čini se, rade životinje jest to

they eat poo -- coprophagia.

da jedu izmet -- koprofagija.

And it turns out that many veterinarians,

I ispada da mnogi veterinari,

old school veterinarians in particular,

posebno oni "stare škole",

have been doing something called "poo tea,"

pripremaju nešto što se zove "čaj od kakice",

not booty, but poo tea, to treat colic and other

čaj, koji koriste za liječenje kolika i drugih bolesti

ailments in horses and cows and things like that,

konja, krava i slično.

where you make tea from the poo from a healthy

Čaj napravite od kakice zdrave životinje

individual animal and you feed it to a sick animal.

i onda ga date bolesnoj životinji.

Although, unless you have a fistulated cow with a big hole in its side,

Iako, osim ako imate kravu sa velikom fistulom na boku

and you can put your hand into its rumen,

pa možete staviti ruku u njen burag,

it's hard to imagine that the delivery of microbes

teško je zamisliti da je dostava mikroba

directly into the mouth and through the entire

direktno u usta i kroz cijeli

top of the digestive tract is the best delivery system,

gornji probavni sustav najbolji način dostavljanja,

so you may have heard in people they are now doing

tako da ste možda čuli da ljudi sada rade

fecal transplants, where rather than delivering

fekalne transplantacije, u kojima, umjesto da se

a couple of probiotic microbes through the mouth,

nekoliko probitičkih mikroba unosi oralno,

they are delivering a community of probiotics,

zajednica probiotika, zajednica mikroba

a community of microbes from a healthy donor,

dostavlja se od zdravog donora

through the other end.

kroz drugi kraj.

And this has turned out to be very effective in fighting

I ispostavilo se da je to jako učinkovito u borbi protiv

certain intransigent infectious diseases

nekih upornih infektivnih bolesti

like Clostridium difficile infections that can stay

kao, npr., infekcije bakterijom Clostridium difficile koje ljudi imaju

with people for years and years and years.

godinama i godinama.

Transplants of the feces, of the microbes from the feces,

Transplantacija izmeta, odnosno mikroba iz izmeta,

from a healthy donor has actually been shown to cure

iz zdravog donora dokazano liječi

systemic C. dif infections in some people.

sistemske Clostridium difficile infekcije u nekih ljudi.

Now what these transplants, these fecal transplants, or

Ono što meni te transplantacije, transplantacije izmeta

the poo tea suggest to me, and many other people

ili čaj od kakice govore, a i mnogi drugi ljudi su došli

have come up with this same idea, is that

do iste ideje, jest to

the microbial community in and on us, it's an organ.

da je ta mikrobna zajednica u i na nama, zapravo je jedan organ.

We should view it as a functioning organ, part of ourselves.

Trebali bismo na nju gledati kao na funkcionalni organ, dio nas samih.

We should treat it carefully and with respect,

Trebali bismo se prema njemu odnositi pažljivo i s poštovanjem,

and we do not want to mess with it, say by C-sections

i ne igrati se njime, na primjer, sa carskim rezovima

or by antibiotics or excessive cleanliness,

ili antibioticima ili pretjeranom čistoćom,

without some real good justification.

bez nekakvog posebnog opravdanja.

And what the DNA sequencing technologies are allowing people to do now

Ono što nam tehnologija skvenciranja DNK danas omogućava

is do detailed studies of, say, 100 patients who have Crohn's disease

jest da napravimo detaljnu studiju na, recimo, 100 pacijenata sa Crohnovom bolesti

and 100 people who don't have Crohn's disease.

i na 100 ljudi koji nemaju Crohnovu bolest.

Or 100 people who took antibiotics when they were little,

Ili 100 ljudi koji su uzimali antibiotike kada su bili mali,

and 100 people who did not take antibiotics.

i 100 ljudi koji ih nisu uzimali.

And we can now start to compare the community of microbes

I sada možemo početi uspoređivati zajednicu mikroba

and their genes and see if there are differences.

i njihove gene i vidjeti postoje li razlike.

And eventually we may be able to understand if they're not

I jednom ćemo možda razumijeti jesu li te razlike

just correlative differences, but causative.

samo korelativne ili su i uzročne.

Studies in model systems like mouse and other animals

Studije na miševima i drugim životinjama

are also helping do this, but people are now using

nam također u tome pomažu, ali ljudi sada koriste

these technologies because they've gotten very cheap,

te tehnologije zato što su postale veoma jeftine,

to study the microbes in and on a variety of people.

da bi proučavali mikrobe u i na različitim ljudima.

So, in wrapping up, what I want to tell you about is,

Dakle, da zaključim, nisam vam još ispričao jedan

I didn't tell you a part of the story of coming down with diabetes.

dio priče o tome kako sam obolio od dijabetesa.

It turns out that my father was an M.D.,

Moj otac je bio doktor medicine,

actually studied hormones. I told him many times

zapravo je proučavao hormone. Mnogo bih mu puta rekao

that I was tired, thirsty, not feeling very good.

kako sam umoran, žedan, da se ne osjećam dobro.

And he shrugged it off, I think he either thought

No, samo bi slegnuo ramenima, mislim da je mislio

I was just complaining a lot, or it was the typical

da se previše žalim, ili je to bio tipičan stav doktora medicine:

M.D. "nothing can be wrong with my children."

"S mojom je djecom sve u redu."

We even went to the International Society of Endocrinology

Čak smo svi zajedno, kao obitelj, otišli na susret

meeting as family in Quebec.

Međunarodnog endokrilnološkog društva u Quebecu.

And I was getting up every five minutes to pee,

Ja bih se ustajao svakih pet minuta da bih piškio,

and drinking everybody's water at the table,

i popio svu vodu sa stola,

and I think they all thought I was a druggie.

a oni su mislili da se drogiram.

(Laughter)

(Smijeh)

But the reason I'm telling you this is that

Razlog zbog kojeg vam ovo pričam jest taj

the medical community, my father as an example,

da medicinska zajednica, uzmite mog oca za primjer,

sometimes doesn't see what's right in front of their eyes.

nekad ne vidi ono što joj je ispred nosa.

The microbial cloud, it is right in front of us.

Mikrobni oblak je ravno ispred nas.

We can't see it most of the time. It's invisible.

Većinu vremena ga ne možemo vidjeti. Nevidljiv je.

They're microbes. They're tiny.

To su mikrobi. Sitni su.

But we can see them through their DNA,

Ali, možemo ih vidjeti kroz njihovu DNK,

we can see them through the effects that they have on people.

kroz utjecaj koji imaju na ljude.

And what we need now

I trebali bismo početi

is to start thinking about this microbial community in the context

razmišljati o toj mikrobnoj zajednici u kontekstu

of everything in human medicine.

svega u ljudskoj medicini.

It doesn't mean that it affects every part of us,

To ne znači da utječe na svaki dio nas,

but it might.

ali bi moglo.

What we need is a full field guide to the microbes

I treba nam cijeli vodič kroz mikrobe

that live in and on people, so that we can understand

koji žive u i na ljudima, tako da bismo razumjeli

what they're doing to our lives.

njihovu ulogu u našim životima.

We are them. They are us.

Mi smo oni. Oni su mi.

Thank you.

Hvala vam.

(Applause)

(Pljesak)