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

Translator: Joseph Geni Reviewer: Joanna Pietrulewicz

譯者: Helen Chang 審譯者: Bruce Sung

Now, I know it might be easy to think

我知道或許很容易視微生物為有害，

that microbes are bad,

especially for infants,

尤其是對嬰兒有害，

but research has in fact proven the opposite.

但研究證明事實恰恰相反。

And the truth might be a little bit more complex,

事實可能更複雜、更有趣。

but it's actually way more interesting.

It seems that we need microbes

我們似乎需要微生物 讓我們的健康狀態良好，

to be programmed for good health,

but not just any microbes,

不是任何微生物都行，

we need the right combination.

而是需要有適切的微生物組合。

We succeed best with the little microbial bodies

若與我們共同進化的微生物在一起

we have adapted to coexist with during evolution.

就最成功了。

And I guess it won't surprise you

得知我們一出生就具有 適切的微生物組合

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

應該不會令你驚訝。

Well, at least some of us do.

至少我們當中有些人不會驚訝。

Babies born by C-section and babies born vaginally

剖腹產和自然產的嬰兒

aren't the same

出生時擁有的微生物並不相同，

when it comes to microbial start to life,

and after birth there are countless different early life events

出生後還有無數不同的 早期生命事件和環境

and circumstances

會進一步調節腸道菌群的發育方式，

that further modulate the way the gut microbiota is developing,

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

例如為嬰兒或母親開的藥物，

number of pets and siblings in the family,

家庭裡寵物和兄弟姐妹的數目，

as well as level of hygiene at home,

以及家裡衛生水平；

and, in this case, it's actually better

以衛生水平而言，

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

如果家裡不是一直都 一塵不染實際上會更好。

And also nutrition, both mothers and infants.

還有母親和嬰兒的營養。

All of these events and circumstances play a huge role

所有這些事件和環境

在腸道微生物的發展中起巨大作用，

in the gut microbial development

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

並對嬰兒的終生健康 產生了巨大影響。

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

我可不是談論對健康的小影響，

I'm talking about the big stuff.

而是大影響。

Microbes we acquire or do not acquire

我們獲得或未得的微生物

affect our likelihood of developing diseases like obesity, diabetes

會影響我們患上肥胖、糖尿病

甚至某些癌症等疾病的可能性。

and even some cancers.

Since many of these early life events I just listed

由於我們無法掌握

許多我剛列出的此類早期生命事件，

are such that we cannot affect them,

they are inevitable,

不可避免，

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

例如，為挽救生命而發明了剖腹產，

and they do that daily,

剖腹產的確天天挽救性命；

and most medications are prescribed for a valid reason,

還有特別是對嬰兒

基於正當理由而開的大多數藥物等。

especially for infants, and so on.

That is why we have to learn

這就是為什麼我們必須知道

how to protect the health of these babies

在發生此類生命早期事件後

after the occurrence of such early life events

如何保護這些嬰兒的健康，

that might disrupt their gut microbiota development.

因為這些事件可能會破壞 嬰兒腸道菌群的發育。

I work as a researcher

我是嬰兒保健平台的 研究人員和技術負責人，

and as a technical lead of an infant health platform,

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

每天工作找尋解決問題的方案，

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

本次演講中我要回答的問題相同，

is how can we make sure

是我們如何確保所有的嬰兒 此生都能獲得等值的生命，

that all babies get the same shot at lifelong health,

無論其出生方式為何 或遇到哪些早期生命事件。

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

Seems like a noble cause, right?

這似乎是個崇高的使命，對不對？

Great.

好，讓我們弄清楚吧。

So let's figure this out.

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

首先，記得我曾說過 我們需要適當的微生物組合嗎？

Well, to get that combination right,

為要使組合適當，

we need to receive those microbes that inhabit our bodies

我們需要依一定的次序 接收那些住在我們體內的微生物。

in a certain order.

You can think of it like a colonization march.

可以將其視為進行殖民。

The very early microbes that inhabit our bodies first

最早到達我們體內的微生物

change the environment in the infant's gut

會先改變嬰兒腸道中的環境，

so that the next microbes are able to move in,

以便下一個微生物能夠進入，

kind of like the first invaders

就像第一個入侵者

come in first and set up the infrastructure

為後來的其他定居者打基礎一樣。

for the other settlers to build upon.

Now, if babies are born via C-section,

如果嬰兒通過剖腹產出生，

that early phase of colonization is greatly altered,

那麼他早期的定殖階段就大大變了，

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

因為不是自然產，母親的 產道、糞便和皮膚細菌

mainly only skin bacteria enter the infant gut.

只剩皮膚細菌進入嬰兒的腸道了。

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

這就使定殖行軍 進入了完全不同的基調，

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

僅因這與我們在進化過程中 所適應的情況不同，

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

就可能以後對剖腹產的嬰兒 造成一些不利於健康的影響。

We can take weight development as an example here.

這裡我們以體重為例。

It has been already shown in several studies

已經有些研究表明

that gut microbiota composition

腸道菌群的組成與體重，

is associated to weight

as well as the likelihood of developing diseases

以及患上糖尿病或心血管疾病等 疾病的可能性有關。

like diabetes or cardiovascular diseases.

But now there are some indications

但現在已有跡象顯示，

that you could already at infancy

成長後肥胖或超重的人，

see from a fecal sample of a baby

在嬰兒期就已經能從 嬰兒的糞便樣本中

some microbes missing from those individuals

who will later on develop to be obese or overweight.

看到缺失一些微生物。

It has also been shown that those same microbes

研究還表明

剖腹產或在生命早期 接受大量抗生素的嬰兒

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

可能會缺少相同的微生物。

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

And to kind of close this loop,

為了獲得結果，

it has also been shown in some research

一些研究還表明，

that babies born by C-section

剖腹產

or are prescribed with many, many antibiotics early in life

或生命早期接受大量 抗生素處方的許多嬰兒

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

更可能肥胖或超重，

甚至超重 50％，非常的多。

which is a lot.

Now, I know you might be thinking at this point

此刻你可能會想，哦，糟糕，

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

我剛做剖腹產，

或者我是通過剖腹產出生的，

or my child had the antibiotics.

或者我的孩子接受了抗生素治療。

But I want you to not worry.

但我希望你不要擔心。

If these microbes are missing

由於任何原因失去這些微生物，

or are lost for any reason,

they can be acquired later,

還可以在以後獲得它們，

but the baby just needs a little help with that.

對此嬰兒只需要一點幫助。

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

一段時間以來，眾所周知的 一件事就是母乳餵養。

Breast milk is kind of miraculous:

母乳是個奇蹟：

in addition to containing nutrients for the baby,

除了為嬰兒提供營養外，

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

母乳也包含有益微生物的食物。

That's great for a breastfed baby,

這對母乳餵養的嬰兒來說很棒，

but we all know that all babies are not breastfed.

但人人皆知

並非所有的嬰兒都以母乳餵養。

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

那麼，我們如何確保 那些沒有母乳餵養的嬰兒

could restore their microbiota development

在生命早期遇到

after encountering those disruptive early life events

可能破壞腸道菌群發育的 破壞性事件後，

that might disrupt their gut microbiota development?

也能恢復其菌群發育呢？

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

現在我們進入本演講 實際解決方案的部分。

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

最近該領域的研究已邁出巨步。

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

首先，據了解，

如果缺少某些微生物，

they can be ingested.

可以將其攝入。

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

我們稱被攝入的好菌為益生菌。

and probiotics have been tested

多年來，這些益生菌

in several clinical trials during the years,

已在數項臨床試驗中被測試過，

also in infants, with great effects,

在嬰兒中也有很好的效果，

such as reducing their risk of eczema later in life.

例如降低了以後患濕疹的風險。

Now, a second revolution was realized

當研究人員將目光轉向母乳時， 第二次革命就實現了。

when the eyes of researchers were turned to breast milk.

That was logical, as, like I mentioned,

正如我所提到的那樣合乎邏輯，

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

因為眾所周知

餵母乳能支持腸道菌群的健康發展。

of gut microbiota.

There were these particles in breast milk

早在 1930 年代就已發現 母乳中的這些顆粒，

that were found already in the 1930s

called human milk oligosaccharides,

稱之為人乳寡糖，

but their function remained a mystery

但在其最初發現後數十年之久， 其功能仍是一個謎。

for decades and decades after their initial discovery.

They were really puzzling for researchers,

它們真讓研究人員感到困惑，

as they are really abundant in human milk.

因為它們在母乳裡的量非常豐富。

They are actually the third-largest group of solids,

它們實際上是第三大類的固體，

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

但不被人類甚至嬰兒消化。

So why would mothers synthesize something to breast milk,

那麼，為什麼母親會耗費資源

use their resources to put something there

在母乳中合成一些 嬰兒無法利用的東西呢？

that is not utilizable by the infant?

Usually nature does not work that way.

通常那不是大自然的運作方式。

Right?

對吧？

So it was quite a revelation when it was finally understood

因此，當最終了解這些顆粒的作用

what's the role of these particles,

是為選擇性地餵給 最適合嬰兒的微生物

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

和影響嬰兒健康的方式時，

and that way to affect the infant health.

這真是一個大啟示。

There are over a hundred of different HMO structures,

目前有超過一百種 不同的人乳寡糖結構，

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

其中一些可在實驗室中被合成，

and that enables us to package them up

使我們能夠將其與 益生菌包裝在一起，

with probiotics for children and infants

供給無法自母乳吸收的 兒童和嬰兒使用，

who are not able to receive them from breast milk

讓他們在生命早期 遇到破壞性的事件後

to restore their microbiota

after encountering disruptive early life events.

能夠恢復微生物群。

And that is the solution.

這就是解決方案。

As a researcher, I must say at this point

作為研究者，我現在必須說，

that research in this field is still ongoing

這領域的研究仍在進行，

and a lot of work remains to be done.

還有許多工作要做。

That's a favorite sentence of us scientists.

這是我們科學家最喜歡的一句話。

But we are taking steps towards understanding better and better

但是我們正採取措施

以更了解各種情況下 哪些是缺少的關鍵微生物，

which are the key missing microbes in various situations

and what HMOs we should package with which probiotics

和該與哪些益生菌 包裝哪些人乳寡糖，

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

提供特定的微生物 幫助特定情況下的嬰兒恢復。

What I wish you to remember from this talk

我希望你從這次談話中記住的是

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

自然產、母乳餵養的嬰兒

已具有我們已經適應的微生物群落，

we have evolved to adapt to,

but in cases where that is not possible,

但在不可能自然生產 或餵養母乳的情況下，

there are means to reduce the negative health consequences.

仍有辦法減少對健康的負面影響。

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

最後，我希望您能想像一個世界，

a world where there would be such a health care system

在這個世界上有這樣一個 醫療保健系統，

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

在為嬰兒健康檢查時

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

會例行監視嬰兒的腸道菌群發育，

and if any disruptions would be noted,

如果如果發現任何破壞，

a tailor-made product to restore the microbiota

將為他開立客製的產品 以恢復其微生物群。

would be prescribed.

I mean, how wonderful would that be,

如果用這種先發制人的衛生保健系統

if the onset of any chronic diseases would be extremely rare

致使以後鮮少發生慢性疾病，

because of this preemptive health care system?

那將是多麼美妙？

Can you imagine such a world?

能想像這樣的世界嗎？

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

相信能有這樣的未來嗎？

I do.

我相信。

I believe in that future and I want to contribute

我相信那個未來，

也希望貢獻於發展這個未來——

in the unfolding of that future,

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

每個嬰兒都有平等起點的未來，

to be programmed for lifelong health.

能夠訂製終身的健康。

Thank you.

謝謝。

(Applause)

（掌聲）