We've talked about ABC as

an epidemic facing the world.

What about diseases that more
specifically affect hygots?
Things like colon cancer
are kinds of disease, for example.
How do our microbes play into those?
The, the answer is microbial disbiers,
which links microbial
diversity to disease.
As we discussed earlier most
of the microbes that are in,
most of the microbes in your gut
are there to, are there to do good.
They're, they're, they're either
beneficial or at least harmless.
And this makes sense in a way
because they outnumber us so
vastly, that if they were out to
get us we'd really be in trouble.
So these beneficial microbes maintain
a balance in healthy people,
a stable state known as Homeostasis.
Now when you get sick or when you have
a chronic disease the composition of
the microbial community in your
guts may change and you may have
more harmful microbes, in other words the
pathogens, than you do beneficial ones.
So this phenomenon where the gap
microbial community is out of
balance is know as dysbiosis.
That is, the balance has shifted
the stable state of health of
dysbiosis is no longer
maintained in the gut.
This is associated with responses from
the immune system, such as inflammation.
Subacute gastro intestinal illnesses, for
example E coli infection, Cholarea and
Clostridium difficile infection.
And cause such dramatic changes that gut
microbial communities, look more like
communities normally found in some totally
different part of the body like, for
example, the skin, rather than looking
like the normal community in the gut.
Dysbiosis has been observed in people with
more chronic diseases like inflammatory,
inflammatory bowel disease,
Crohn's disease, and colorectal cancer.
Another thing that happens when you
get a disease is the diversity in
the gut microbial communities
often tends to decrease.
Healthy people usually have many more
different types of microbes in their
guts than those with chronic diseases and
so this is an answer to that question,
why should you care about

the diversity in your gut.

Does it really matter?
How can I count how many kinds
of microbes are in there?
Or or
is it pretty much relevant to your life.
So let's take a look at
a few specific examples.
The first case study we'll look at is IBD,
or inflammatory bowel disease.
Inflammatory bowel disease is disease, or
really a suite of or
really a suite of diseases.
And, and
which parts of the small intestine, or
parts of the colon,
are chronically inflamed.
The two most common types of inflammatory
bowel disease are Chron's Disease and
Ulcerative Colitis.
The gut microbes in people
with Chron's disease and
Ulcerative Colitis are different from
each other, and also different from
the communities of people who do not
have inflammatory bowel disease at all.
In other words, my curvial Dysbiosis has
been demonstrated in people with IBD.
Specifically, healthy individuals tend to
have a higher diversity of microbes in
general, and especially more and
relative to other kinds of microbes
inside the protiobacteria.
Furthermore, the microbes
associated with Crohn's disease and
ulcerative colitis have been shown to
carry out different functions from
those that are found in healthy people.
Functions have more relation
to infection than to disease.
In the specific case of
children with Crohn's disease,
we've also seen what antibiotic use
leads to more extreme dysbosis.
Even in early stages of the disease.
The second test study we'll talk about,
is colon cancer.
There is increasing evidence that many
cancers are linked by curbulations.
And in the case of colon cancer,
one particular microbe,
has been found to be associated with
tumors in several different studies
conducted independently by different
labs in different parts of the world.
Fusobacterium nucleatum is an anaerobe,
so in other words it typically thrives in
environments with little to no oxygen and
and
they're found in the gut tissue of healthy

people, but usually in very small amounts.

Interesting the other places
we see it frequently are in
the mouth of healthy people where it's a
normal constituent of the oral microbiota.
And then we see it in
animals that are carnivores.
So for example your dog typically has
a lot of fusobacterium nucleatum.
Certainly much more than you do.
Now in people with colon cancer, there's
much more fusobacterium nucleatum than
we see, than we see in the healthy colon.
And in particular the species
is is concentrated in tumors.
So in other words, it seems to home in
on the tumor, on the tumor environment.
And studies are in progress at
the moment to figure out whether this is
a cause or an effect.
In other words,
fuso nucleatum just like to go to
the tumors once they're already starting.
But once they actually go to
particular sides of the gut and
then cause those tumors to occur.
Interestingly, a organism is capable
of inducing information and inducing
the growth of cancerous lesions by
interacting with human cells in the colon.
More recently, er, other bacteria
have been implicated as partners in
crime with [INAUDIBLE] and
colon rectal cancer and
some of these other players include
leptotrichia and campylobacter species.
So in general it seems there's
a signature of anaerobic bacteria er,
in general that are associated
with tumors in the colon.
So in summary, out gut microbes maintain
the delicate balance which keeps our
gut healthy and
our immune system in check.
The less balance is tipped away
from beneficial bacteria it can
lead to diseases of the gut
including IBD and colon cancer.
In the future we hope to be able to
manipulate gut microbes to prevent,
treat and even reverse these diseases.
In the next lecture, Jessica will
tell us about recent advances in
manipulating the gut microbiome
using fecal transplants.
These fecal transplants have
been wildly successful for
curing people with infections
of Clostridium difficile.
Which kills 14,000 people a year

in the United States alone.

But first, let's hear from Dr.
Martin Blaser.
Marty was until recently the Chief
of Medicine at Y, at NYU.
Although he's just recently stepped
down from that position to focus on
the really exciting research
that's going on in his lab.
He's a member of the Institute of Medicine
of the National Academy of Sciences.
And among other things, such as his
groundbreaking back to Pylori and
his association with ulcers with cancer,
and
the tracking of human migrations in
different populations he's been doing some
really groundbreaking work on the effects
of the, the overuse of antibiotics.
He's also the author of the book Missing
Microbes, which describes exactly how bad
it is that we may be that we may be
losing all those microbial communities.
Through the overuse of of antibiotics and
other lifestyle choices that we're making
and you'll definitely want to take care of
that first,
which we'll too on the Coursera site.