Jonathan Eisen: Meet your microbes

Translator: Morton Bast Reviewer: Thu-Huong Ha

翻译人员: Jia Zeng 校对人员: Yuguo Zhang

I'm going to start with a little story.

我来先讲一个小故事

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

我在附近的地区长大，我15岁时

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

在四个月里，我从一个自认为的体格强壮的年轻运动员

over four months, slowly wasting away until

逐渐消瘦

I was basically a famine victim

直到变成一个饥民

with an unquenchable thirst.

有着永不满足的饥渴感

I had basically digested away my body.

基本上我已经消化光了自己的身体

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

情况严重到，在我的一次背包旅途中

my first one ever actually, on Old Rag Mountain

实际上是我的第一次，在西弗吉尼亚的 Old Rag Mountain

in West Virginia, and was putting my face into puddles

我像狗一样

of water and drinking like a dog.

把脸埋在水坑里喝水

That night, I was taken into the emergency room

那天晚上，我被带到急救室

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

被诊断患有I型糖尿病导致的酮酸中毒

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

后来我康复了，感谢现代医学的奇迹

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

胰岛素和其它东西， 我的体重全恢复了，还有些增长

And something festered inside me after this happened.

这些事情发生后， 我心里开始有了些想法

What I thought about was, what caused the diabetes?

当时我想的是， 糖尿病是什么导致的?

You see, diabetes is an autoimmune disease

你们知道， 糖尿病是一种免疫疾病

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

你的身体攻击正常细胞，当时人们认为

that somehow maybe exposure to a pathogen

可能在一些情况下，人体接触到病原体

had triggered my immune system to fight the pathogen

免疫系统被激活，与病原体作斗争

and then kill the cells that make insulin.

结果杀死了制造胰岛素的细胞

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

对于这个解释，我思考了很长一段时间

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

这也是医学和大众主要关注的理论

the microbes that do bad things.

微生物是有害的

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

现在我需要我的助理帮忙

You may recognize her.

你们可能认得她

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

其实昨天，很抱歉，我没来听一些演讲

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

我去了一下国家科学院的大楼

and they sell toys, giant microbes.

楼里有人在卖玩具，巨型微生物

And here we go!

接好了!

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

如果你接住那一个，你就已经感染了食肉细菌

I gotta get back out my baseball ability here.

显然我的棒球技能已经不比当年了

(Laughter)

(笑声)

So, unfortunately or not surprisingly, most of the microbes

所以，不幸的是，也不让人惊奇的是

they sell at the National Academy building are pathogens.

他们在国家科学院大楼卖的微生物玩具是病原菌

Everybody focuses on the things that kill us,

大家都只关注致死的微生物

and that's what I was focusing on.

那也是我当时研究的重点

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

实际上我们正在被厚厚的一层微生物覆盖

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

而多数情况下, 这些微生物对我们是有益的

rather than killing us.

而不是有害致死的

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

而且我们认识到这一点，已经有一段时间了

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

人们用显微镜观察覆盖人体的微生物

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

我知道你没在听我讲话，但是……

(Laughter)

(笑声)

The microbes that cover us.

这些覆盖人体的微生物

And if you look at them in the microscope,

如果你用显微镜观察它们

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

你会发现在我们身上的微生物细胞

of microbes on us as we have human cells.

是人体细胞数量的10倍

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

我们身上微生物的质量比我们大脑的质量还重

We are literally a teeming ecosystem of microorganisms.

我们的身体实际上是一个丰富的微生物生态系统

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

不幸的是, 如果你想要研究微生物

just looking at them in a microscope is not sufficient.

仅仅用显微镜观察是不够的

And so we just heard about the DNA sequencing.

我们刚才听到了DNA测序

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

事实证明研究和理解微生物的最好方法之一

and to understand them is to look at their DNA.

是研究它们的DNA

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

这正是我20年来一直在做的事

using DNA sequencing, collecting samples from various places,

我通过DNA测序来分析从不同来源采来的样品

including the human body, reading the DNA sequence

其中包括人体样本，测出DNA序列

and then using that DNA sequencing to tell us about

然后从这些DNA序列中了解

the microbes that are in a particular place.

在特定位置的微生物

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

神奇的是，在使用这个技术时

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

比如说，研究人体系统

in a sea of microbes.

我们不只是被覆盖在数量众多的微生物中

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

我们身上的微生物种类也是成千上万的

We have millions of genes of microbes in our human

我们覆盖的微生物种群

microbiome covering us.

有数百类个基因

And so this microbial diversity differs between people,

而且每个人身上的微生物种群各不相同

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

在过去的10或15年里，人们一直在思考

maybe 15 years is, maybe these microbes,

也许这些微生物

this microbial cloud in and on us,

这些人体上覆盖的微生物云

and the variation between us, may be responsible

以及人和人之间的微生物差异

for some of the health and illness differences between us.

对人类的健康和疾病的个体差异有重要影响

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

这就回到了我之前和你们说过的糖尿病的故事

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

结果是人们现在认为

for type 1 diabetes is not fighting a pathogen,

一型糖尿病诱因之一并不是与病原体的战争

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

却是因为它其实在试着

that live in and on you.

与身体内外的微生物传达错误的信息

And somehow maybe the microbial community that's

然后这些在我身体内外的微生物群落不知怎么地消失了

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

这触发了某种免疫反应

of immune response and led to me killing the cells

让我的身体消灭了自身的

that make insulin in my body.

制造胰岛素的细胞

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

所以在接下来几分钟我想和你们分享的是

what people have learned using DNA sequencing techniques

人们通过DNA测序技术了解到哪些内容

in particular, to study the microbial cloud

尤其是对于身体内外的

that lives in and on us.

微生物云

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

我想和你们讲一个有关我个人研究课题的故事

My first personal experience with studying the microbes

我自己的第一次研究人体微生物的经历

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

实际上就来自

right around the corner from here at Georgetown.

我在街对角的乔治城大学做的一个演讲

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

我在那做了个演讲，而乔治城大学医学院的院长

the Dean of Georgetown Medical School was at the talk,

刚好是我的一个家族方面的朋友，去听了演讲

and came up to me afterwards saying, they were doing

会后他上来和我说，他们正在

a study of ileal transplants in people.

做人体回肠移植方面的研究

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

他们想要研究移植后的微生物分布情况

And so I started a collaboration with this person,

所以我开始和

Michael Zasloff and Thomas Fishbein, to look at the microbes

Michael Zasloff 和 Thomas Fishbein 合作

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

观察回肠移植后微生物繁殖情况

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

我可以和你们聊这项研究的所有细节

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

但是我想给你们讲这个故事的原因是

is something really striking that they did at the beginning

他们在这个课题开始阶段

of this project.

做了特别惊人的尝试

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

他们取得捐赠者的回肠，里边充满捐赠者身上的微生物

and they have a recipient who might have a problem

同时有受赠者，他们体内的微生物菌群可能出了些问题

with their microbial community, say Crohn's disease,

比如说，克罗恩病患者

and they sterilized the donor ileum.

然后他们消毒捐赠者的回肠

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

清除所有的微生物，然后移植到受赠者体内

They did this because this was common practice

他们这样做，因为这是医学上的通用做法

in medicine, even though it was obvious

即便它显然

that this was not a good idea.

不是一个好主意

And fortunately, in the course of this project,

幸好在这个研究过程中

the transplant surgeons and the other people

移植外科医生和其他成员决定

decided, forget common practice. We have to switch.

抛开通用做法，我们必须换个办法

So they actually switched to leaving some of the microbial

所以他们留下回肠中的部分微生物菌群

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

他们留下了捐赠者体内的微生物

and theoretically that might help the people who are

理论上说，这可能

receiving this ileal transplant.

对接受回肠移植的人有益

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

所以，大家，这就是我这些年来所做的研究

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

在过去几年中，通过DNA技术来观察人体内外的微生物研究

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

有了长足进展

There's something called the Human Microbiome Project

人类微生物菌落项目

that's going on in the United States,

正在美国展开

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

在欧洲, 有人类肠道宏基因组计划(MetaHIT)和很多其它研究

And when people have done a variety of studies,

当他们做了各种研究

they have learned things such as, when a baby is

他们发现了各种现象，比如一个婴儿

born, during vaginal delivery you get colonized by the

从产道出生时

microbes from your mother.

母体的微生物菌群会移植到婴儿上

There are risk factors associated with cesarean sections,

剖腹产有一些风险

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

其中有可能包括错误移植

when you carve a baby out of its mother

当婴儿经由剖腹被取出母体

rather than being delivered through the birth canal.

而非从产道生出时, 这有可能发生

And a variety of other studies have shown that the

许多不同研究显示

microbial community that lives in and on us

在我们身体和表面的微生物

helps in development of the immune system,

对免疫系统的发育有益

helps in fighting off pathogens, helps in our metabolism,

帮助击退病原体，促进新陈代谢

and determining our metabolic rate, probably

决定我们的代谢速度

determines our odor, and may even shape our behavior

可能决定我们的体味

in a variety of ways.

还可能在很多方面塑造我们的行为

And so, these studies have documented or suggested

因此这些研究证明或者推断了

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

这些微生物群落的各种重要功能

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

这些在我们体内和表面生活的非病原体，这层“云”的功能

And one area that I think is very interesting,

有个领域我觉得很有意思

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

就是既然刚才我们刚扔了一群菌到人群中

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

你们中间有许多人也许有这个心态, 我叫它“恐菌症”

So people are really into cleanliness, right?

人们真的很重视清洁, 是吗？

We have antibiotics in our kitchen counters,

我们的厨房桌台上有抗菌用品

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

人们时时刻刻都在洗身上的每个部分

we pump antibiotics into our food, into our communities,

抗生素大量地流入我们的食物和居住环境中

we take antibiotics excessively.

我们无节制地滥用抗生素

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

如果你生病了，杀死病原体是件好事

but we should understand that when we pump chemicals

但我们要知道，当我们把化工产品

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

和抗生素注入我们的生活中时，我们也在杀死

the cloud of microbes that live in and on us.

生活在我们体内和表面的微生物云

And excessive use of antibiotics, in particular in children,

研究发现，过度使用抗生素，尤其在儿童身上

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

和肥胖、自身免疫疾病

for obesity, for autoimmune diseases, for a variety

以及其它各种健康问题都有关

of problems that are probably due to disruption

因为抗生素破坏了

of the microbial community.

人体的微生物群落

So the microbial community can go wrong

所以微生物群落可能会出问题

whether we want it to or not,

不论我们喜不喜欢

or we can kill it with antibiotics,

或者我们可以用抗生素杀死这些微生物

but what can we do to restore it?

但是我们怎样才能重建这些群落?

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

我相信在座的许多人听说过益生菌群

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

人们可以尝试用益生菌来重建

the microbial community that is in and on you.

体内和体表的微生物群落

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

已经有一些使用益生菌的成功案例

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

在加州大学戴维斯分校有一项研究

probiotics to try and treat, prevent,

人们尝试用益生菌来治疗和预防

necrotizing enterocolitis in premature infants.

早产儿的坏死性小肠结肠炎

Premature infants have real problems with their microbial community.

早产儿身上有不少和微生物群落相关的问题

And it may be that probiotics can help prevent

也许益生菌可以帮助预防

the development of this horrible necrotizing enterocolitis

早产儿罹患

in these premature infants.

这种可怕的坏死性小肠结肠炎

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

但是益生菌是一个非常，非常简单的解决方法

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

许多你可以吃的药丸或酸奶

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

含有一或两种，还可能五种细菌

and the human community is thousands upon thousands of species.

而人体微生物群落包含数千个菌种

So what can we do to restore our microbial community

所以我们怎样才能重建我们的微生物群落

when we have thousands and thousands of species on us?

在我们身上有数千种微生物的情况下？

Well, one thing that animals seem to do is,

好吧，动物们所做的一件事是

they eat poo -- coprophagia.

它们吃类便——食粪症

And it turns out that many veterinarians,

实际上许多兽医

old school veterinarians in particular,

尤其是老派的兽医

have been doing something called "poo tea,"

一直在用一种叫“粪便茶”的东西

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

不是屁屁，而是粪便茶来治疗

ailments in horses and cows and things like that,

马和牛的腹绞痛和其它类似疾病

where you make tea from the poo from a healthy

就是用健康动物的粪便做成茶

individual animal and you feed it to a sick animal.

然后喂给生病的动物喝

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

但是，除非你有一头身上装了研究反刍消化装置的牛，肚子一侧开了个大洞

and you can put your hand into its rumen,

你可以把手伸进它的瘤胃

it's hard to imagine that the delivery of microbes

很难想象从嘴巴经过整个消化道上部

directly into the mouth and through the entire

传输微生物

top of the digestive tract is the best delivery system,

是最好的传输方式

so you may have heard in people they are now doing

所以你们可能听说过有人在做

fecal transplants, where rather than delivering

粪便移植，与其将少数益生菌种

a couple of probiotic microbes through the mouth,

从口腔传入体内

they are delivering a community of probiotics,

他们将一个益生菌群

a community of microbes from a healthy donor,

来自一个健康的捐赠者的整个微生物群落

through the other end.

从消化道的另一端送入体内

And this has turned out to be very effective in fighting

事实表明这种做法

certain intransigent infectious diseases

对于某些顽固的传染病很有疗效

like Clostridium difficile infections that can stay

比如可以在人体内存活多年的

with people for years and years and years.

艰难梭状芽孢杆菌感染

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

粪便移植

from a healthy donor has actually been shown to cure

从而实现健康捐赠者的粪便中微生物的移植

systemic C. dif infections in some people.

事实上已经有一些成功治愈系统性艰难梭状芽孢杆菌感染的案例

Now what these transplants, these fecal transplants, or

这些新的移植方法，这些粪便移植

the poo tea suggest to me, and many other people

或是粪便茶给我还有很多人以启示

have come up with this same idea, is that

我们有了共同的想法

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

就是这些在我们体内外的微生物群落，是一个器官

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

我们应该把它看成一个有功能的器官，看成人体的一部分

We should treat it carefully and with respect,

我们应该认真对待它，尊重它

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

我们不应该在不必要的情况下破坏它的平衡

or by antibiotics or excessive cleanliness,

比如采用剖腹产，使用抗生素

without some real good justification.

或过度清洁

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

因为用DNA测序技术，人们可以做详细的研究

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

就像比较100个克罗恩病患者

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

和100个没有克罗恩病的人

Or 100 people who took antibiotics when they were little,

或者比较100个在小时候服用过抗生素的人

and 100 people who did not take antibiotics.

和100个小时候没服用过抗生素的人

And we can now start to compare the community of microbes

我们现在可以开始比较他们的微生物群落

and their genes and see if there are differences.

和它们的基因来看是否存在差异

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

最终我们可能会弄明白，这些人群间的差异是否

just correlative differences, but causative.

不仅仅是相关的，还有因果关系

Studies in model systems like mouse and other animals

小鼠和其它动物实验模型系统

are also helping do this, but people are now using

也正帮助我们研究，但人们现在使用

these technologies because they've gotten very cheap,

DNA测序技术是因为成本已经很低

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

如果要研究不同人体内外的微生物的话

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

所以，总的来说，我想告诉你们的是

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

我并没有告诉你们我患糖尿病的故事

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

实际上我父亲是个医生

actually studied hormones. I told him many times

他研究内分泌激素。很多次我和他说

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

我又累，又渴，感觉不舒服

And he shrugged it off, I think he either thought

他耸耸肩，我想，他要么认为

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

我只是爱抱怨，要么

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

是一个医生认为“我家的小孩不会生病”的心态

We even went to the International Society of Endocrinology

我们甚至举家前往魁北克

meeting as family in Quebec.

参加国际内分泌学学会

And I was getting up every five minutes to pee,

我每五分钟就要起来尿尿

and drinking everybody's water at the table,

吃饭时要喝完每个人的水

and I think they all thought I was a druggie.

我想，他们可能都认为我嗑药了

(Laughter)

（笑声）

But the reason I'm telling you this is that

但我和你们说这个故事的原因是

the medical community, my father as an example,

在医学界，以我的父亲为例

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

有时候看不到眼前发生的事

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

这层微生物云，就在我们眼前

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

很多时候我们看不到它。它是隐形的

They're microbes. They're tiny.

它们是微生物，微小的生物。

But we can see them through their DNA,

但是我们可以通过它们的DNA看到它们

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

我们可以通过它们对人类的影响看到它们

And what we need now

我们现在需要做的是

is to start thinking about this microbial community in the context

开始思考在人类医学每个方面

of everything in human medicine.

微生物群落的作用

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

这并不意味着它会影响我们的每一部分

but it might.

但是有这个可能性

What we need is a full field guide to the microbes

我们需要一份人类体内和表面的微生物的实地指南

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

这样我们才能了解

what they're doing to our lives.

它们对我们生活的影响

We are them. They are us.

我们就是它们。它们就是我们

Thank you.

谢谢

(Applause)

（掌声）