Transcriber: Mohiedden Albendqji Reviewer: Denise RQ
TED talks are renowned
for their combination of style and substance.
I don't promise you anything about style,
but there is a substance I'd like to talk to you about.
It's something that, on one hand, we've known about forever,
and on the other hand, we basically know nothing about.
Before I introduce you to the substance,
I'd like to give you a couple of examples of its effects in health and so forth.
The first example I'd like to tell you about is a behavioral study in mice.
You might not have had the chance to notice it before,
but there're different types of mice, and mice with different attitudes.
So in this study, they used a mouse that was very extroverted
- so curious, risk-taking, sometimes aggressive -
and a mouse that was very introverted
- shy, timid, very hesitant to take risks.
In the study, when they gave the substance --
so we can call them extroverted or introverted mice,
or more simply, we can call them macho and wimp if you will.
(Laughter)
So when they gave the substance to the macho mice,
they could turn the mice more timid.
When they gave the substance to the timid mice,
they could turn them more macho.
Even more, when they took the substance
and gave it to the macho mouse that they had turned timid,
they could turn it back to macho, and vice versa;
the timid to macho and back to timid.
The other example I'll tell you about is very different.
It involves the pathogenic bacteria Clostridium difficile -
which I've worked on for a long time.
Over the last 10 years, in Quebec and across the world,
C. difficile has been a huge problem.
Tens and tens of thousands of people have been infected,
and thousands of people have died from the disease.
Even survivors of the infection,
25% of the time,
won't respond as hoped for to traditional antibiotic treatments;
and note the ones to have recurrent disease
so they'll suffer for years,
knowing that conventional medicine doesn't really offer
hope for them and a cure of the disease.
So these recurrent sufferers,
when given the substance,
the disease goes away.
In Quebec, Montreal, and across the world,
there's an astonishing 95% cure rate.
After years of suffering, the disease is gone.
I can tell you more stories about gum disease, asthma, bowel diseases,
but I'd like to introduce you to the substance.
It's quite well-known;
it's known by many names, most of them impolite.
So we'll just call it poop.
(Laughter)
And yes, in the studies,
when you take poop from timid mice and give it to macho mice,
you turn them more timid,
and vice versa, and so on and so on,
and when you give poop from healthy people
to people who are suffering from C. diff,
the disease goes away.
So let me explain a little bit more fully.
Our human bodies are homes
to trillions and trillions of microorganisms.
These are the bacteria, the fungi, the viruses, the amoeba.
They're on our skin, they're in our hair,
they're in our mouths, they're up our noses,
and by far most commonly, they're in our intestines.
They're interacting with each other and with ourselves in a myriad of ways.
We call it the microbiome.
"Micro-" for small, "-bio-" for living, "-ome" for collection.
So the microbiome is the collection of small living things,
just like the genome would be the collection of genes.
We can be a little more detailed.
The human microbiome would be the collection of small living things
living on us and in us.
Even more detailed, the intestinal microbiome would be
the collection of small living things in our intestines,
which leaves our body as poop.
The microbiome is vast;
compared to our human genome,
the microbiome contains about 100 more times the number of genes,
and in terms of comparing the number of cells,
our body carries 10 times more cells of microbial origin
than it does of human origin.
Each one of us in the room is probably carrying
about a kilogram's worth of microbiome.
So our microbiome weighs about a third times more than our brain,
and about six times more than our heart.
In some ways, it's staggering
to think that something so large and so intricate to us is so unstudied.
In some ways though, it's not quite a surprise;
these are microorganisms, they're small, you can't see them without a microscope,
and they tend to be living in all the cracks and crevices of our body.
They're also hard to grow.
In labs, we can only grow about 10% of the things.
If you can't grow it, it's really hard to study it.
On top of that, it's an interacting community;
so even if we could grow them and study them one by one,
it would still be hard to figure out
how they're interacting together with each other and then with us.
But hope is not lost
and in thinking about
how you study things you don't know anything about,
I go back to some of my previous history,
where 15 years ago, I was fortunate to work for the Human Genome Project.
The Human Genome Project was a massive undertaking,
dozens and dozens of labs, thousands of scientists across the world,
all working together to decipher and put together the human genome,
or about the 3 billion bases of DNA letters
that make up our genetic blue print of life.
At the time, we used fancy DNA sequencing machines,
which we considered to be very high-throughput.
In a single experiment,
we could reproduce about 60,000 letters of DNA.
60,000 letters of DNA is less than 1/100th of 1% of the genome,
and having to sequence the genome many, many times
to make sure we could reconstruct it correctly and accurately
meant that this was a huge project.
Fast forward to today,
we've been able to take advantage of some of magical properties of DNA.
First, DNA and its closely related molecule,
provide not just the genetic blueprint of the human genome,
but the genetic blueprint of every living organism.
You can think about it as letters in books.
I can take the letters, write the book that's called human;
the same letters that've been used
to write the book called elephant or tree, or bacteria, or whatever.
So on the one hand, if we have a technology that can sequence human DNA,
that same technology can sequence the DNA of any living organism.
The other magical property of DNA
is it's highly amenable to high-throughput automated processes.
So our DNA sequencing instruments today, compared to 15 years ago,
operate at a much more massive scale.
Today, in a single experiment,
we can produce 400 billion segments of DNA sequence
as opposed to the mere 60,000 a couple of years ago.
This massive increase in capacity allows us then
to start looking at more complex scenarios,
even more complex than the human genome.
Just as a quick aside,
this increase in productivity over the last 10 years
- to give you a sense of the scale -
if I could apply it to my work productivity,
I'd be able to accomplish my 40-hour work week
in a fraction of a second,
and in fact, my 50-week work year
I'd be able to then accomplish in less than two seconds.
So again, coming back to the DNA sequencing;
it gives us a new opportunity to go into complex environments like the microbiome
and start discerning what are all the genetic blueprints
of all the members present,
so that we can get an idea of what they are
and hopefully, what they're doing and how they're interacting.
My lab and several other labs across the world are embarked on this.
It's very early days,
but I think there're three key messages that are starting to come out.
I'd like to tell you about them.
The first message is
human health is intricately linked to microbiome health,
and the best indicator of health of your microbiome is diversity;
the more members, the more species present,
largely the better off you are.
The idea is very simple:
the more friends you have, the better equipped you are
to deal with the different kinds of problems that can arise.
The second lesson we're learning
is there're similarities and differences
between the microbiomes of different people.
This has profound consequences to health research.
Your microbiome depends on where you live, what you do, what you eat,
and it becomes attuned to you.
So we can think about the microbiome
as being something that can be modified, changed, and adapted.
When, for example, I look at your human genome,
you're pretty much stuck;
your genes are your genes, there's not much you can do about it,
and it's incredibly difficult
to think about the ways you would actually change your genes.
But the microbiome - which is interacting with our genome -
offers this promise that we have another in-road,
where we can change that and modify that for the better;
and then, even hopefully,
use the microbiome to compensate for deficiencies in the genome.
The third lesson we're learning is both humbling and exciting.
The humbling part is that in these studies
doesn't take too long before you realize
you're looking at evidence of organisms
that have just never been seen before in science.
There is so much that we don't know.
The flip side of that, the exciting part, is imagining the possibilities;
as we discover what these new organisms are doing
- new in the sense that we're just seeing them -
and seeing how we can harness their properties for improved health.
The microbiome is also our best demonstration yet
of a pretty significant change in society over the last decade or so
from the feeling that all germs are bad
to more and more of a feeling of many germs are good.
You already see this:
when you go into the grocery store and buy foods or food products,
You can buy things that are advertized as prebiotics,
where the idea is they have ingredients
that will stimulate the growth
of the beneficial organisms of your microbiome.
You can also buy items that are advertized as probiotics,
where the idea there is
that the organisms themselves are part of the ingredients,
and you're more directly replenishing your microbiome
with the beneficial organisms.
This is starting to percolate into health practice as well.
And, I think, in a very short time, certainly within your lifetime,
probably within the coming years,
you're going to see some changes
in the way health treatments are practiced.
You shouldn't be surprised to go into your doctor's office,
and your doctor, instead of prescribing a chemical medicine,
will more and more often start prescribing a biological medicine.
Even better than that;
your doctor, with the read-outs of your genome and of your microbiome,
might be prescribing biomedical treatments
even before you've got the disease,
or certainly before you're showing symptoms.
I think this combination
- the shift from reactive to proactive medicine -
combined with this arena where there're implications for so many diseases,
is going to be one of the triumphs of medicine over the coming decades.
I thank you very much for your attention.
(Applause)