How the gut microbes you're born with affect your lifelong health | Henna-Maria Uusitupa

Translator: Joseph Geni Reviewer: Joanna Pietrulewicz

翻译人员: Lipeng Chen 校对人员: Yolanda Zhang

Now, I know it might be easy to think

我知道很容易去这么想，

that microbes are bad,

微生物不好，

especially for infants,

尤其是对婴儿来说，

but research has in fact proven the opposite.

但是事实上， 研究证明了相反的结果。

And the truth might be a little bit more complex,

事实可能更加复杂一些，

but it's actually way more interesting.

但是也更加有趣。

It seems that we need microbes

看上去我们需要微生物

to be programmed for good health,

来为健康助力，

but not just any microbes,

但并不是任何微生物都可以，

we need the right combination.

我们需要正确的组合。

We succeed best with the little microbial bodies

在进化过程中，我们适应的

we have adapted to coexist with during evolution.

与之共存的微生物（组合）是最佳的。

And I guess it won't surprise you

我猜你们也不会惊讶于

to learn that we start acquiring that right combination right at birth.

我们从一出生之时 就开始获寻那种正确的组合。

Well, at least some of us do.

至少我们中的一些人是这样的。

Babies born by C-section and babies born vaginally

剖腹产出生的婴儿和 顺产出生的婴儿

aren't the same

在出生时

when it comes to microbial start to life,

拥有的微生物群是不一样的，

and after birth there are countless different early life events

出生后有数不清的 早期事件和环境因素

and circumstances

会进一步调整

that further modulate the way the gut microbiota is developing,

肠道菌群的发育，

such as the medications that might be prescribed for the infant or the mother,

像是开给婴儿或是母亲的药物，

number of pets and siblings in the family,

家庭中宠物和兄弟姐妹的数量，

as well as level of hygiene at home,

以及居家的卫生水平，

and, in this case, it's actually better

这种情况下，事实上

if it's not that perfectly clean all the time.

不总保持过分清洁反而是好事。

And also nutrition, both mothers and infants.

还有母亲和婴儿的营养状况。

All of these events and circumstances play a huge role

所有这些事件和环境 都在肠道菌群发育的过程中

in the gut microbial development

扮演着重要的角色，

and that has a huge impact on the lifelong health of that baby.

也对婴儿的长远健康 产生着巨大的影响。

And I'm not talking about small health implications here.

我讲的不是细微的健康影响。

I'm talking about the big stuff.

我讲的是很大的影响。

Microbes we acquire or do not acquire

我们获取或未获取的微生物

affect our likelihood of developing diseases like obesity, diabetes

影响着我们得像是肥胖症、糖尿病、

and even some cancers.

甚至是一些癌症的概率。

Since many of these early life events I just listed

因为许多我刚刚列出的早期事件

are such that we cannot affect them,

是我们无法掌控的，

they are inevitable,

因此这些事件不可避免，

for example C-sections have been invented to save lives,

比如为了拯救生命发明出的剖腹产，

and they do that daily,

每天都在发生，

and most medications are prescribed for a valid reason,

开大多数药物都有合理的理由，

especially for infants, and so on.

尤其对婴儿来说，等等。

That is why we have to learn

这就是为什么我们需要学习，

how to protect the health of these babies

在这些可能会扰乱 婴儿肠道菌群发育的

after the occurrence of such early life events

早期人生事件发生之后，

that might disrupt their gut microbiota development.

如何保护这些婴儿的健康。

I work as a researcher

我是一名研究人员，

and as a technical lead of an infant health platform,

同时还是一个 婴儿健康平台的技术带头人。

and the question I'm trying to find a solution to every day at work,

有一个我每天在工作中 试图解答的问题，

and the same question I'm aiming to answer in this talk,

同时也是我在这个演讲中 试图回答的问题，

is how can we make sure

那就是，从长远来看，

that all babies get the same shot at lifelong health,

无论这些婴儿以什么样的出生方式 或是在生命早期有什么样的经历，

no matter how they're born or what early life events they encounter.

我们如何确保他们 在健康方面处于同一起跑线。

Seems like a noble cause, right?

听上去是很崇高的事业，对吧？

Great.

很好。

那么让我们来一起分析一下。

So let's figure this out.

To begin, remember how I said that we need the right combination of microbes?

首先，还记得我说过 我们需要正确的微生物组合吗？

Well, to get that combination right,

要获得正确的组合，

we need to receive those microbes that inhabit our bodies

我们就需要以特定的顺序 来接收生活在

in a certain order.

我们体内的微生物。

You can think of it like a colonization march.

我们可以将其看成一种殖民活动。

The very early microbes that inhabit our bodies first

最早进入我们身体的微生物

change the environment in the infant's gut

改变了婴儿的肠道环境，

so that the next microbes are able to move in,

这样下一批微生物才能进来，

kind of like the first invaders

就有点像最早的殖民者

come in first and set up the infrastructure

第一个到来，并为后来的人

搭建起一定的基础设施。

for the other settlers to build upon.

Now, if babies are born via C-section,

如果婴儿是剖腹产出生的，

that early phase of colonization is greatly altered,

那么他们体内早期的“殖民”阶段 就会被大大的改写，

because instead of vaginal, fecal and skin bacteria of the mother,

因为母亲的阴道、粪便和 皮肤上的细菌三者中，

mainly only skin bacteria enter the infant gut.

只有皮肤上的细菌 才会进入婴儿的肠道。

And that sets that colonization march to a totally different tone,

这就给“殖民行军”设定了 完全不同的基调，

and simply because that's different to what we've adapted to during evolution,

仅仅是因为剖腹产和我们 通过进化所适应的方式（顺产）不同，

that might cause some health disadvantages for C-section-born babies later on.

这就可能会在将来为剖腹产 出生的婴儿带来一些健康劣势。

We can take weight development as an example here.

我们以体重的发展举例。

It has been already shown in several studies

数个研究已经显示

that gut microbiota composition

肠道菌群成分和体重

is associated to weight

以及患上像是糖尿病，

as well as the likelihood of developing diseases

还有心血管疾病的概率

like diabetes or cardiovascular diseases.

有着相关性。

But now there are some indications

然而现在有些证据表明，

that you could already at infancy

你已经可以在婴儿时期，

see from a fecal sample of a baby

从婴儿的粪便样本中看出，

some microbes missing from those individuals

将来会肥胖或超重的个体，

who will later on develop to be obese or overweight.

他们的肠道内缺少一些微生物。

It has also been shown that those same microbes

还有证据表明， 通过剖腹产出生的婴儿

might be missing from babies who are born by C-section

和在生命早期 接触大量抗生素的婴儿，

or who are predisposed to heavy loads of antibiotics in early life.

体内同样也缺少这些微生物。

And to kind of close this loop,

除此之外，

it has also been shown in some research

还有研究显示，

that babies born by C-section

通过剖腹产出生的婴儿

or are prescribed with many, many antibiotics early in life

或是在生命早期 摄入大量抗生素的婴儿

are more likely to be obese or overweight, even by 50 percent,

变得肥胖或超重的概率要高出 50%，

which is a lot.

这是个很大的数字。

Now, I know you might be thinking at this point

我知道你们可能现在在想，

that, oh no, I just had a C-section or I was born via C-section

哦不好，我刚刚接受了剖腹产， 或是我是剖腹产出生的，

or my child had the antibiotics.

或是我的孩子摄入了抗生素。

But I want you to not worry.

但是我希望你们不要担心。

If these microbes are missing

如果这些微生物因为某些原因

or are lost for any reason,

而缺失或是不见了，

they can be acquired later,

它们仍可以在将来被获取，

but the baby just needs a little help with that.

只是这时婴儿需要一些帮助。

One thing that has already for some time been known to help is breastfeeding.

一段时间以来已经为人所知的 一种方法就是母乳喂养。

Breast milk is kind of miraculous:

母乳真是神奇的东西：

in addition to containing nutrients for the baby,

除了帮婴儿维持营养供应，

it seems to contain food for the good microbes as well.

母乳还包含了给有益微生物的养分。

That's great for a breastfed baby,

这对母乳喂养的婴儿来说太好了，

but we all know that all babies are not breastfed.

但我们都知道不是所有的婴儿 都是母乳喂养的。

So what could we do to ensure that also those babies who are not breastfed

那么我们可以做些什么， 来确保没有母乳喂养的婴儿

could restore their microbiota development

在遭受到可能会导致

after encountering those disruptive early life events

肠道菌群发育紊乱的 干扰性生命早期事件之后，

that might disrupt their gut microbiota development?

仍可以恢复他们的菌群发育呢？

And now we get to the actual solution part of this talk.

现在我们到了这个演讲的 实际解决方案部分。

The research in this field has been taking giant steps lately.

最近，这个领域的研究 取得了巨大的进展。

First, it was understood that if there are some microbes missing,

首先，人们发现 如果有些微生物缺失了，

they can be ingested.

它们可以被摄入。

We call the good microbes, when they are ingested, probiotics,

我们称这些被摄入的 有益微生物为益生菌，

and probiotics have been tested

益生菌已经

in several clinical trials during the years,

在多年的临床试验中，

also in infants, with great effects,

包括婴儿身上，显示了不错的效果，

such as reducing their risk of eczema later in life.

比如降低将来患湿疹的风险。

Now, a second revolution was realized

当研究人员将目光转向母乳，

when the eyes of researchers were turned to breast milk.

第二项革命就发生了。

That was logical, as, like I mentioned,

这很符合逻辑，正如我提到的，

it was already known that breastfeeding is able to support the healthy development

母乳喂养对健康菌群 发展的支持作用

of gut microbiota.

已为人熟知。

There were these particles in breast milk

上世纪 30 年代，

人们就已经在母乳中发现了叫做

that were found already in the 1930s

called human milk oligosaccharides,

人乳寡糖（HMO）的颗粒，

but their function remained a mystery

但是在被发现的几十年后，

for decades and decades after their initial discovery.

它们的作用仍是一个谜。

They were really puzzling for researchers,

研究人员对此感到十分困惑，

as they are really abundant in human milk.

因为它们在母乳中含量丰富。

They are actually the third-largest group of solids,

人乳寡糖实际上是（母乳中） 第三大固态物质，

but they are not digestible by humans, not even infants.

但它们无法被人，甚至婴儿消化。

So why would mothers synthesize something to breast milk,

那么为什么母亲会消耗资源，

use their resources to put something there

在母乳中合成

that is not utilizable by the infant?

婴儿无法使用的东西？

Usually nature does not work that way.

通常情况下，大自然是不会这么做的。

Right?

是吧？

So it was quite a revelation when it was finally understood

所以在人们最终知晓 这些颗粒的作用之后

what's the role of these particles,

惊讶的发现，

and that it is to selectively feed the microbes that are best for infants,

人乳寡糖能够选择性的 培育对婴儿来说最好的微生物，

and that way to affect the infant health.

从而影响婴儿的健康。

There are over a hundred of different HMO structures,

HMO 有上百种不同的结构，

and nowadays we are able to synthesize some of them also in the lab,

现今，我们可以在实验室中 合成其中的一些，

and that enables us to package them up

这让我们可以将其

with probiotics for children and infants

和益生菌组合起来，

who are not able to receive them from breast milk

帮助那些在经历了 干扰性生命早期事件后，

to restore their microbiota

无法从母乳中获取益生菌

after encountering disruptive early life events.

来恢复肠道菌群的孩童和婴儿。

And that is the solution.

这就是解决方案。

As a researcher, I must say at this point

作为研究人员，我必须在此说明，

that research in this field is still ongoing

这个领域的研究仍在进展之中，

and a lot of work remains to be done.

许多的研究仍需要完成。

That's a favorite sentence of us scientists.

这是科学工作者最喜欢说的一句话。

But we are taking steps towards understanding better and better

但我们正采取措施， 一步步更好的理解

which are the key missing microbes in various situations

在不同情况下缺失的 关键微生物是什么，

and what HMOs we should package with which probiotics

什么样的 HMO 应该与 什么微生物组合起来

to help restore the microbiota of that particular baby in that particular case.

以恢复在特定病例下 特定婴儿的肠道菌群。

What I wish you to remember from this talk

我希望你们通过这个演讲记住的是，

is that, yes, vaginally born breastfed baby has the microbiota

顺产出生、母乳喂养的婴儿的确拥有

we have evolved to adapt to,

我们通过进化得以适应的菌群，

but in cases where that is not possible,

但如果无法实现顺产或母乳喂养，

there are means to reduce the negative health consequences.

仍有方法可以减少 对健康的负面影响。

Lastly, I wish you to imagine a world for a while,

最后，我希望你们花些时间 想象一下这样的世界，

a world where there would be such a health care system

这个世界中有这样的医疗保健体系，

that when you take your baby to a health care check,

当你带你的婴儿去体检时，

they would routinely monitor the gut microbiota development of that baby,

该系统会程序性的检查 婴儿的肠道菌群发展状况，

and if any disruptions would be noted,

如果有任何的紊乱被检测到了，

a tailor-made product to restore the microbiota

你就会得到用来恢复菌群的

would be prescribed.

个性化处方。

I mean, how wonderful would that be,

我的意思是，如果有了这样的 前瞻性医疗保健系统，

if the onset of any chronic diseases would be extremely rare

任何慢性疾病的发病率都显著减少，

because of this preemptive health care system?

那会多么美好啊！

Can you imagine such a world?

你们能想象这样的世界吗？

Do you believe that that kind of future would be possible?

你们相信这样的未来会实现吗？

I do.

我相信。

I believe in that future and I want to contribute

我相信这样的未来， 我也想为实现

in the unfolding of that future,

这样的未来出一份力——

a future in which each baby has an equal starting point for life

一个每个婴儿都有平等起点、

to be programmed for lifelong health.

能够规划终身健康的未来。

Thank you.

谢谢。

(Applause)

（掌声）