Jonathan Eisen: Meet your microbes

Translator: Morton Bast Reviewer: Thu-Huong Ha

Prevodilac: Tereza Ivanovic Lektor: Ivana Korom

I'm going to start with a little story.

Počeću jednom kratkom pričom.

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

Odrastao sam u susedstvu. Kada sam imao 15 godina,

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

smatrao sam za sebe da sam robustan, mlad atletski građen tip

over four months, slowly wasting away until

ali tokom četiri meseca polako sam slabio

I was basically a famine victim

i skoro da sam postao žrtva gladi

with an unquenchable thirst.

sa osećajem neutoljive žeđi.

I had basically digested away my body.

Skoro sam "svario" svoje telo.

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

Svega ovoga sam postao svestan kada sam otišao na "bekpek" putovanje,

my first one ever actually, on Old Rag Mountain

u stvari, na moje prvo takvo putovanje, na Old Rag planinu

in West Virginia, and was putting my face into puddles

u Zapadnoj Virdžiniji i kada sam uranjao lice u barice

of water and drinking like a dog.

vode i pio kao pas.

That night, I was taken into the emergency room

Te noći su me odveli u Hitnu pomoć

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

i dijagnostikovali su mi dijabetes tip 1 sa potpunom ketoacidozom.

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

I oporavio sam se, zahvaljujući čudima savremene medicine,

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

insulinu i drugim stvarima i povratio sam svu svoju težinu, čak i više od toga.

And something festered inside me after this happened.

Posle ovoga nešto se skupljalo u meni.

What I thought about was, what caused the diabetes?

Razmišljao sam o tome šta je bio uzrok dijabetesu.

You see, diabetes is an autoimmune disease

Znate, dijabetes je autoimuno oboljenje

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

gde se organizam bori sa sobom i jedno vreme su ljudi mislili

that somehow maybe exposure to a pathogen

da je nekako možda izloženost patogenu

had triggered my immune system to fight the pathogen

aktivirao moj imuni sistem da se bori sa patogenom,

and then kill the cells that make insulin.

a zatim da uništi ćelije koje proizvode insulin.

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

I ja sam dugo tako mislio,

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

i to je, u stvari, ono na šta se medicina i ljudi prilično fokusiraju,

the microbes that do bad things.

a to je da mikrobi čine loše stvari.

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

I sada mi treba moj pomoćnik.

You may recognize her.

Možda je prepoznajete.

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

Juče sam išao, izvinite, preskočio sam nekoliko govora,

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

i išao sam do Nacionalne akademije nauka

and they sell toys, giant microbes.

gde su prodavali igračke, ogromne mikrobe.

And here we go!

Evo, idemo!

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

Ako ste uhvatili neku, dobićete bolest koja jede meso.

I gotta get back out my baseball ability here.

Moram da povratim svoju veštinu za bejzbol.

(Laughter)

(Smeh)

So, unfortunately or not surprisingly, most of the microbes

Pa, na žalost, ali nije iznenađujuće, većina mikroba

they sell at the National Academy building are pathogens.

koje prodaju u Nacionalnoj akademiji su patogeni.

Everybody focuses on the things that kill us,

Svi se fokusiraju na stvari koje nas uništavaju

and that's what I was focusing on.

pa sam tako i ja.

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

Ispostavlja se da smo prekriveni oblakom mikroba

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

i oni nam uglavnom čine dobro,

rather than killing us.

više nego što nas uništavaju.

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

I tako, ovo nam je poznato već izvesno vreme.

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

Ljudi koriste mikroskope da pogledaju mikrobe kojima smo prekriveni,

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

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

(Laughter)

(Smeh)

The microbes that cover us.

Ti mikrobi koji nas pokrivaju.

And if you look at them in the microscope,

I ako ih pogledate u mikroskopu

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

možete videti da, u stvari, imamo 10 puta više ćelija

of microbes on us as we have human cells.

mikroba nego što imamo ljudskih ćelija.

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

Masa mikroba je veća od mase našeg mozga.

We are literally a teeming ecosystem of microorganisms.

Mi smo bukvalno ekosistem koji vrvi od mikroorganizama.

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

I nažalost, ako želite da saznate nešto o mikroorganizmima,

just looking at them in a microscope is not sufficient.

nije dovoljno da ih samo gledate na mikroskopu.

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

Ispostavlja se da je najbolji način da posmatramo mikrobe

and to understand them is to look at their DNA.

i da ih razumemo, taj da pratimo njihov DNK.

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

To upravo i radim već 20 godina,

using DNA sequencing, collecting samples from various places,

koristim sekvenciranje DNK, sakupljam primerke sa raznih mesta,

including the human body, reading the DNA sequence

uključujući i ljudsko telo, zatim čitam DNK nizove

and then using that DNA sequencing to tell us about

i koristim to da saznam o

the microbes that are in a particular place.

mikrobima koji su na određenom mestu.

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

I ono što je neverovatno kad koristite ovu tehnologiju

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

na primer, posmatrajući ljude, nije da smo samo prekriveni

in a sea of microbes.

morem mikroba.

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

Ima na hiljade i hiljade različitih vrsta mikroba na nama.

We have millions of genes of microbes in our human

Milioni gena mikroba nas pokrivaju

microbiome covering us.

u našem ljudskom mikrobiomu.

And so this microbial diversity differs between people,

Tako, diverzitet mikroba se razlikuje od čoveka do čoveka

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

i ono o čemu ljudi razmišljaju u zadnjih 10 godina,

maybe 15 years is, maybe these microbes,

možda i 15, da su ovi mikrobi,

this microbial cloud in and on us,

ovaj oblak od mikroba oko nas

and the variation between us, may be responsible

i varijacije među nama, možda odgovorne

for some of the health and illness differences between us.

za razlike u zdravlju i u bolestima kod ljudi.

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

Evo vraćam se na priču koju sam vam pričao o dijabetesu.

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

Ispada da ljudi sada misle da jedan od okidača

for type 1 diabetes is not fighting a pathogen,

za dijabetes tipa 1 nije borba sa patogenom,

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

nego, u stvari, pokušaj pogrešne komunikacije sa mikrobima

that live in and on you.

koji žive u nama i na nama.

And somehow maybe the microbial community that's

I možda je nekako ta zajednica mikroba

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

nestala sa mene i to je pokrenulo neku vrstu

of immune response and led to me killing the cells

odgovora imunosistema što je dovelo do uništavanja ćelija

that make insulin in my body.

koje proizvode insulin u mom telu.

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

Ono o čemu želim da vam pričam nekoliko minuta je,

what people have learned using DNA sequencing techniques

šta su ljudi saznali, posebno koristeći tehniku sekvenciranja DNK

in particular, to study the microbial cloud

za proučavanje oblaka mikroba

that lives in and on us.

koji žive u nama i na nama.

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

Želim da vam ispričam priču o jednom ličnom projektu.

My first personal experience with studying the microbes

Moje prvo lično iskustvo u vezi sa proučavanjem mikroba

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

na ljudskom telu potiče, u stvari, iz jednog govora koji sam održao

right around the corner from here at Georgetown.

ovde, blizu, u Džordžtaunu.

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

Ja sam govorio i jedan porodični prijatelj, koji je slučajno bio

the Dean of Georgetown Medical School was at the talk,

dekan Medicinske škole u Džordžtaunu, je bio tamo

and came up to me afterwards saying, they were doing

i posle je došao do mene da mi kaže da rade

a study of ileal transplants in people.

studiju o transplantaciji ileuma kod ljudi.

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

I hteli su da vide mikrobe posle transplantacije.

And so I started a collaboration with this person,

Tako sam počeo saradnju sa ovim osobama,

Michael Zasloff and Thomas Fishbein, to look at the microbes

sa Majklom Zaslofim i Tomasom Fišbajnom, da proučimo mikrobe

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

koji su zaposeli ileum posle transplantacije na primaoca.

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

Mogu da vam pričam o svim detaljima ove mikrobijalne studije

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

koju smo radili, ali razlog zbog čega želim da vam ispričam ovu priču

is something really striking that they did at the beginning

je nešto zaista upečatljivo što su činili na početku

of this project.

ovog projekta.

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

Uzeli su ileum pun mikroba od davaoca

and they have a recipient who might have a problem

i imali su primaoca koji bi mogao imati problem

with their microbial community, say Crohn's disease,

sa njihovom mikrobijalnom zajednicom, recimo sa Kronovom bolešću

and they sterilized the donor ileum.

i zato su sterilisali ileum davaoca.

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

Očistili su sve mikrobe i presadili ileum u primaoca.

They did this because this was common practice

Učinili su ovo jer je to bila uobičajna praksa

in medicine, even though it was obvious

u medicini, iako je bilo očigledno

that this was not a good idea.

da to nije dobra ideja.

And fortunately, in the course of this project,

I srećom, tokom ovog projekta,

the transplant surgeons and the other people

hirurzi koji su vršili presađivanje, a i drugi ljudi,

decided, forget common practice. We have to switch.

odlučili su da zaborave na uobičajenu praksu. Morali su da promene nešto.

So they actually switched to leaving some of the microbial

U stvari, ostavili su malo mikrobijalne

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

zajednice na ileumu. Ostavili su mikrobe davaoca,

and theoretically that might help the people who are

i teoretski, ovo je moglo da pomogne onima

receiving this ileal transplant.

koji primaju ovaj transplantat ileuma.

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

I tako, ljudi - ovo je studija koju sam zaista radio.

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

U poslednjih nekoliko godina postoji velika ekspanzija

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

upotrebe DNK tehnologije za proučavanje mikroba u ljudima.

There's something called the Human Microbiome Project

Postoji nešto što se zove Projekat ljudskog mikrobioma

that's going on in the United States,

koji se sprovodi u SAD

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

i projekat MetaHIT u Evropi i mnogo drugih projekata.

And when people have done a variety of studies,

I kada se uradi mnoštvo studija,

they have learned things such as, when a baby is

ljudi su shvatili, na primer, kada se beba rodi,

born, during vaginal delivery you get colonized by the

tokom vaginalnog porođaja, kolonije

microbes from your mother.

mikroba se prenose sa majke na dete.

There are risk factors associated with cesarean sections,

Postoje faktori rizika kod carskog reza,

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

neki od tih faktora rizika mogu nastati zbog odsustva prenošenja kolonija

when you carve a baby out of its mother

kada se beba vadi iz majke,

rather than being delivered through the birth canal.

a ne rađa se preko porođajnog kanala.

And a variety of other studies have shown that the

Mnoštvo drugih studija je pokazalo da

microbial community that lives in and on us

mikrobijalne zajednice sa kojima živimo

helps in development of the immune system,

pomažu u razvoju imunosistema,

helps in fighting off pathogens, helps in our metabolism,

pomažu da se izborimo sa patogenima, pomažu u metabolizmu

and determining our metabolic rate, probably

i određuju vreme razmene materije, verovatno

determines our odor, and may even shape our behavior

određuju naš miris, možda čak i oblikuju naše ponašanje

in a variety of ways.

na razne načine.

And so, these studies have documented or suggested

Dakle, ove studije su dokumentovale ili nagovestile

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

raznovrsne, važne uloge mikrobijalnih zajednica,

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

ovog oblaka, ne-patogena, sa kojima živimo.

And one area that I think is very interesting,

I mislim da je jedno područje veoma zanimljivo,

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

možda vam je i poznato, sad kad smo izbacili

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

mikrobe u masu, a ja volim da ga zovem "klicofobijom"

So people are really into cleanliness, right?

Ljudi su zaista za čistoću, zar ne?

We have antibiotics in our kitchen counters,

Imamo antibiotike na radnim površinama u kuhinji,

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

ljudi stalno peru svaki deo svog tela,

we pump antibiotics into our food, into our communities,

ubacujemo antibiotike u hranu, u naše zajednice,

we take antibiotics excessively.

prekomerno uzimamo antibiotike.

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

Dobro je uništavati patogene kad ste bolesni,

but we should understand that when we pump chemicals

ali bi trebalo da shvatimo da, kada unosimo hemikalije

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

i antibiotike u naš svet, takođe uništavamo

the cloud of microbes that live in and on us.

oblak mikroba sa kojima živimo.

And excessive use of antibiotics, in particular in children,

Prekomerna upotreba antibiotika, naročito kod dece,

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

može biti faktor rizika

for obesity, for autoimmune diseases, for a variety

za gojaznost, za autoimune bolesti, za različite

of problems that are probably due to disruption

probleme prouzrokovane razbijanjem

of the microbial community.

mikrobijalne zajednice.

So the microbial community can go wrong

Može doći do devijacije mikrobijalne zajednice

whether we want it to or not,

hteli to ili ne

or we can kill it with antibiotics,

ili ih možemo uništiti antibioticima,

but what can we do to restore it?

ali šta možemo učiniti da ih vratimo?

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

Siguran sam da su mnogi čuli za probiotike.

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

Možete pokušati da vratite

the microbial community that is in and on you.

mikrobijalne zajednice uz pomoć probiotika.

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

U nekim slučajevima su se definitivno pokazali efikasnim.

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

Na Dejvis Univerzitetu u Koloradu u toku je projekat gde ljudi koriste

probiotics to try and treat, prevent,

probiotike za lečenje, prevenciju

necrotizing enterocolitis in premature infants.

nekrotičnog enterokolitisa kod prevremeno rođene dece.

Premature infants have real problems with their microbial community.

Prevremeno rođena deca zaista imaju problem sa mikrobijalnom zajednicom.

And it may be that probiotics can help prevent

Moguće je da probiotik pomaže u prevenciji

the development of this horrible necrotizing enterocolitis

razvoja ovog užasnog nekrotičnog enterokolitisa

in these premature infants.

kod prevremeno rođenih.

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

Ali probiotici su samo mali deo rešenja.

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

Većina tableta koje uzimate ili jogurt koji pijete

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

sadrži samo jednu ili dve vrste probiotika ili možda pet,

and the human community is thousands upon thousands of species.

a u čoveku postoje na hiljade vrsta.

So what can we do to restore our microbial community

Stoga, šta možemo učiniti da vratimo mikrobijalnu zajednicu

when we have thousands and thousands of species on us?

kad ih imamo na hiljade vrsta?

Well, one thing that animals seem to do is,

Pa, izgleda da životinje

they eat poo -- coprophagia.

jedu kaku -- koprofagija.

And it turns out that many veterinarians,

Izgleda da mnogi veterinari,

old school veterinarians in particular,

naročito iskusni,

have been doing something called "poo tea,"

prave nešto što bi nazvali "čaj od izmeta",

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

da bi lečlii bol u stomaku

ailments in horses and cows and things like that,

i druge bolesti kod konja i krava i slično,

where you make tea from the poo from a healthy

gde se pravi čaj od izmeta zdrave

individual animal and you feed it to a sick animal.

životinje i time se hrani bolesna životinja.

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

Mada, kada je kod krave burag otvoren

and you can put your hand into its rumen,

i možete da stavite ruku unutra

it's hard to imagine that the delivery of microbes

teško je zamisliti da "isporuka" mikroba

directly into the mouth and through the entire

direktno u usta i kroz ceo

top of the digestive tract is the best delivery system,

gornji deo sistema za varenje najbolji način za ubacivanje mikroba,

so you may have heard in people they are now doing

pa ste možda čuli da se kod ljudi sada radi

fecal transplants, where rather than delivering

transplantacija fecesa, što je bolje nego ubacivanje

a couple of probiotic microbes through the mouth,

par probiotskih mikroba preko usta.

they are delivering a community of probiotics,

Sada se ubacuju zajednice probiotika,

a community of microbes from a healthy donor,

zajednice mikroba uzetih od zdravog davaoca,

through the other end.

ali s drugog kraja.

And this has turned out to be very effective in fighting

Ispostavilo se da je ovaj način veoma efikasan u borbi protiv

certain intransigent infectious diseases

određenih upornih zaraznih bolesti,

like Clostridium difficile infections that can stay

kao što je infekcija gram pozitivnim bakterijama Clostridium difficele

with people for years and years and years.

koja može trajati godinama.

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

Transplantacija fecesa, mikroba iz fecesa,

from a healthy donor has actually been shown to cure

od zdravog davaoca, pokazala se kao lek

systemic C. dif infections in some people.

za infekciju ljudi zaraženih Clostridium diff. bakterijom.

Now what these transplants, these fecal transplants, or

Ove fekalne transplantacije

the poo tea suggest to me, and many other people

ili čaj od izmeta, pokazalo se, a i mnogi

have come up with this same idea, is that

misle slično,

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

da je mikrobijalna zajednica - jedan organ.

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

Trebalo bi da ga smatramo funkcionalnim organom, delom nas samih.

We should treat it carefully and with respect,

Trebalo bi da ga lečimo pažljivo i sa poštovanjem,

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

ne bi trebalo da se zafrkavamo s tim, recimo carskim rezom

or by antibiotics or excessive cleanliness,

antibioticma, preteranom čistoćom,

without some real good justification.

bez nekog zaista dobrog opravdanja.

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

Tehnologija sekvenciranja DNK sada omogućava ljudima

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

da detaljno prouče, recimo, 100 pacijenata sa Kronovom bolešću

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

i 100 ljudi bez te 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 nisu uzimali antibiotike.

And we can now start to compare the community of microbes

I sada možemo početi upoređivanje zajednice mikroba

and their genes and see if there are differences.

i njihovih gena, da vidimo ima li razlike.

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

I na kraju moći ćemo da shvatimo

just correlative differences, but causative.

da razlike nisu samo korelativne već i uzročne.

Studies in model systems like mouse and other animals

Proučavanje miša ili nekih drugih životinja

are also helping do this, but people are now using

takođe pomaže, ali ljudi sad koriste

these technologies because they've gotten very cheap,

ove tehnologije jer je proučavanje mikroba na mnoštvu ljudi

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

postalo veoma jeftino.

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

Pa, da zaokružim, ono o čemu hoću da vam pričam,

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

a nisam još ispričao, je deo priče o tome kako sam dobio dijabetes.

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

Moj otac je bio doktor medicine

actually studied hormones. I told him many times

u stvari, proučavao je hormone. Mnogo puta sam mu rekao

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

da sam umoran, žedan, da se ne osećam baš dobro.

And he shrugged it off, I think he either thought

Samo je slegao ramenima misleći

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

da se previše žalim ili je to bilo ono tipično

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

doktorsko: "Mojoj deci ništa ne fali".

We even went to the International Society of Endocrinology

Išli smo porodično na susret

meeting as family in Quebec.

Međunarodnog udruženja endokrinologa u Kvebek.

And I was getting up every five minutes to pee,

Svakih pet minuta sam ustajao da piškim

and drinking everybody's water at the table,

i svu vodu sa stola sam popio

and I think they all thought I was a druggie.

i mislim da su me smatrali za narkosa.

(Laughter)

(Smeh)

But the reason I'm telling you this is that

Ovo vam govorim jer medicinari,

the medical community, my father as an example,

kao moj otac na primer,

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

ponekad ne vide šta imaju ispred sebe.

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

Mikrobijalni oblak je upravo ispred nas.

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

Uglavnom ga ne vidimo. Nevidljiv je.

They're microbes. They're tiny.

Mikrobi su majušni.

But we can see them through their DNA,

Ali ih vidimo kroz DNK

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

i kroz uticaj koji imaju na ljude.

And what we need now

Sada nam je potrebno

is to start thinking about this microbial community in the context

da počnemo razmišljati o mikrobijalnoj zajednici u kontekstu

of everything in human medicine.

celokupne medicine.

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

Ne znači da utiče na sve u nama,

but it might.

ali mogao bi.

What we need is a full field guide to the microbes

Treba nam sveobuhvatan vodič za mikrobe

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

sa kojima živimo, da bismo razumeli

what they're doing to our lives.

kako utiču na naš život.

We are them. They are us.

Mi smo oni. Oni su mi.

Thank you.

Hvala.

(Applause)

(Aplauz)