It all of a sudden hits you, like theyre inside you right now. Todays scientists are blazing a trail to this very future. Youre actually more microbe than youre human. [julia] i want to know what breakthroughs are being made. Bioaugmenting our bodies will have a fundamental impact on modern day plagues. That will forge the future to for me, that was like, whoa. A disease free world. intrepid music computer beeping my name is julia ravey. I decided to become a neuroscientist because my nan and several great aunts developed alzheimers disease. This loss has made me determined to find a cure by any means. Im fascinated by recent research that links diseases of the brain to microbes in our bodies. And i think this is an avenue that is just coming into its own in terms of research. Microbes are tiny living things, smaller than the eye can see. Inside the body microbes like bacteria, parasites, and viruses can cause any number of infectious diseases. So what would happen if we just eradicated all of the bodys nasty microorganisms . What would the health of Society Look Like . To answer that i want to know how microorganisms cause disease in the first place. So ive come to australia to meet dr. Barry marshall. Barrys groundbreaking research turned the worlds understanding of stomach cancer on its head and won him the nobel prize in medicine. Barry is a complete science legend. Today barry is hunting a nasty microbe called helicobacter. This bacteria infects the guts of animals and makes them sick. There are about 30 different kinds of helicobacter. So one of the things im planning to do today is go around, get some animal scat. So most of its kangaroo. [julia] oh, im looking forward to seeing the whole process. Ive never seen a kangaroo, i dont think. Barry is trying to figure out where helicobacter came from by searching for it in a wide range of animals. You see those big grassy areas over there. Thats where the kangaroos might be hanging out. [julia] kangaroo [barry] so now youve seen one. [julia] seen one [barry] well, i think i can see one. [julia] oh yeah there, there, it looks like its good enough. [julia] by analyzing kangaroo feces, barry can get a snapshot of the microorganisms living inside these kangaroos guts. You get all different kinds of bacteria that well extract the dna and just put all the dna through the computer. [julia] it was the hunt for helicobacter that led barry and his colleague, robin warren, to overturn what they thought might be a myth, mainly the widely held belief in the medical community that stomach ulcers were caused by stress. I did have patients who had ulcers and it annoyed me that they seemed to be normal people, but when you couldnt find the cause of their ulcer, youd always, the medical books would blame it on stress. And id say, well these people just seemed to be normal. [julia] when they looked at patients stomach ulcers under the microscope, what they found was astonishing. [barry] these bacteria were unusual. Theyre curved bacteria. The infectious agent at work was helicobacter pylori. H. Pylori for short is a variation of helicobacter that infects humans. The presence of this microbe in the human stomach upended decades of medical understanding. All of the textbooks said that nothing can grow in our stomach, its a sterile environment for these types of bacteria, but your findings proved otherwise. So that became our research project, how could bacteria live in the stomach when theres so much acid . We knew these bacteria were really only human bacteria. So we had to find a Human Volunteer who could take the bacteria and maybe get an ulcer. [julia] he had to prove that these bacteria could infect a healthy stomach at all costs. So eventually i did a self experiment. We decided that i was gonna drink the bacteria, which i did. So we grew the bacteria up in meat broth, like beef soup, if you like, and i drank it down. And then i was having an endoscopy to see if they had colonized my stomach. And after 10 days, the bacteria were there, the infection was taking hold, and they were damaging the lining of the stomach. [julia] barry was probably the first person to be happy with this diagnosis. They didnt have any evidence until i did that self experiment. [julia] barrys experiment was a success, but how can h. Pylori thrive in the stomachs extreme conditions . We found out that helicobacter are unique. They make ammonia and they neutralize the hydrochloric acid so they can survive, nothg else can. [julia] once established in the stomach, these invasive bacteria lead to ulcers. And if allowed to fester, they can cause cancer. The question became, how could these killer microbes be stopped . I was excited abt the fa that potentially you could cure something if its caused by bacteria. [julia] it turned out that antibiotics can kill h. Pylori and cure the ulcers in a matter of weeks. Long before the discovery of microbes, scientists had no idea of the role microscopic germs played in human health, but in the 19th century, french scientist Louis Pasteur developed germ theory, which postulated that microorganisms cause infectious disease, and british surgeon Joseph Lister found a way to prevent germs from infecting his patients by using antiseptics to sterilize his Surgical Equipment and clean wounds. But the big breakthrough happened in 1928 when scottish physician Alexander Fleming accidentally discovered penicillin. Penicillin was an mediate cureall for scarlet fever, meningitis, and even pneumonia. This medication launched the modern era of antibiotics. I thought it was a great kindness to be able to tell people, no, its not stress, take some antibiotics and youll be cured. [julia] today ulcers are no longer a chnic illness for many, and in the u. S. , cases of stomach cancer have decreased almost every year. Like most people, i like to prove other people are wrong. I didnt realize it was going to take 23 years before people really believed it and accepted it. [julia] by eradicating the microbes that cause stomach ulcers and cancer, barrys research is forging a disease free future before infections even start. futuristic music [futuristic narrator] in the future, the exterior doors of most homes have microbial scanners that detect foreign agents. When people enter the home, the scanner sweeps the entire body for harmful microbes. If detected, a Home Health Robot immediately dispenses the apprriate medication. Most people no longer suffer from infectious disease, and doctors visits are mostly a thing of the past. [julia] a disease free future like this sounds very appealing. So what would happen if we just eradicated all microbes . To find out, i first want to know exactly what functions they serve. So ive come to amsterdam to speak with biologist and head of the micropia museum, jasper buikx. He has some sobering information about the microbes role in the human body. Theres about 10 times more microbes in and on your body than you have body cells. So youre actually more microbe than youre human. That is quite a scary thought. So im basically just a carrier for the microbes. Micropia developed a technology to help visualize this unseen universe. This is where you can visit your own microbes. This is you, youre being scanned and were gonna see who has the most microbes. So every dot that you see here is a microbe, a total of a hundred thousand billion of them. 99 of all those trillions of microbes live in your intestines. These are all digital dots, of course, but we also have them alive. The Staggering Number of microbes on display makes my skin crawl, but theres an odd sense of beauty to behold. When you see these under the microscope, moving, all of a sudden hits you like theyre inside you right now. That is crazy. The first person to accidentally see these tiny organisms was antony van leeuwenhoek in the 17th century. He was a draper. In order to test the quality of the cotton and of the threads, he decided to build his own magnifying lenses. And this is what he made. And he was able to reach a magnification of 250 times. [julia] by looking at everything, from water to the plaque on his teeth, he found the world teeming with all kinds of strange microscopic creatures. That made him the first scientist, so to speak, to discover the invisible world of microbes. [julia] but in fact, these creatures have been with us all along. Single cell bacteria evolved three and a half billion years ago. They are the oldest life forms on earth. On mars, these microbes exhaled oxygen, which eventually formed our monday atmosphere and created an ecosystem that changed t face of the entire planet. Scientists believe our oxygenated ecosystem led to the evolution of multicellular life forms at least 600 million years ago. And this in turn led to the evolution of even more complex creatures, including us humans. In this light, microbes are the most fundamental part of being human. They digest your foods. They produce all kinds of diffent vitans and hormones. So microbes are essential to our way of life. [julia] scientists call this vast collection of microbes living in us and on us the human microbiome. [jasper] in essence, you are a walking ecosystem. [jia] thats honestly mind owing. Each body is a unique walking ecosystem, but how exactly do these trillions of microbes contribute to a persons wellbeing . And how do we get our individual microbiome in the first place . To find out ive come to rutgers uversity to meet biologist dr. Maria gloria dominguezbello. Shes researching each persons dynamic relationship with their own individual microbiome. Microbes are a part of us. If we didnt have them, we wouldnt be healthy. We are now understanding that we didnt evolve ale. Every animal and plant on earth evolve with bactea in particular. [julia] like a coral reef or a rainforest, the microbiome is an ecosystem unto itself. When you have an ecosystem that is perturbed, the first question an ecologists asks is can you restore the ecosystem . [julia] glorias understanding of the microbiome started in of all places, the amazon jungle, where she saw firsthand how human microbial ecosystems can quickly change. Ive been working in the amazon for the last 30 years, since i was a student. Amerindians have been living there pretty isolated for the last 20,000 years, and i was very interested in understanding the microbiome of traditional peoples. [julia] through skin, mouth and fecal samples, she measured the impact that external environments in which people lived had on their internal ecosystems. Gloria found that those living in the amazonian jungle ha a signicantly hher diversy in the microbes as city dwellers living in instrializ countries. Buwhen an dividualrom the remote amazon moved to the city, they quickly lost their microbial diversity. This leads to a startling conclusion. So that work has shown us that urbanization depletes and destroys the diversity of the microbiome, and in the gut, diversity is good. We know that because diseases decrease diversity. And when you decrease diversity, you cause disease. There is a Strong Association between high diversity in the gut microbiome and health. [julia] knowing how vital microbiome diversity is in fighting disease, gloria is investigating how humans acquire microbes in the first place. [daycare worker] here we go, ah. And how do babies originally acquire their microbes . [gloria] inside the uterus, the baby is not being exposed to microbes, but once mom brks water, the baby comes in contact with the birth canal, which is loaded with massive amount of bacteria. [julia] it turns out the acquisition of microbes starts when a child is born. By the time the babys out, the babys heavily colonized. So its a microbial baptism. Then theres the skin to skin contact. Thats the secondary exposure. Then the mouth of the mother kissing. Its another exposure. The environment of that baby is heavily maternal and mom is the main source of bacter. That first set of bacteria starts the process of immune education. The immune system will recognize the good bacteria, dont attack. [julia] but modern medicine is chging the immunity education that comes from this microbial baptism. The rate of cesarean births is increasing. Since 1990, csections have more than tripled, going from around six percent to 21 percent of all births globally. baby cries csections successfully take the baby out, but without passing through the birth canal. This means that csection babies are born from a sterile uterus into the air of an operating room. [julia] and gloria has discovered that this may increase the risk of many diseases. Csection has been associated in humans with increased risk of the modern diseases. For example, an increased risk of asthma, type one diabetes, allergies, and obesity. Starting at birth, the first three years of life are critical in establishing a healthy diversity of microbes. I think its just fascinating that many new parents are probably quite unaware that the first few years of life are so important for e babys development of their microbiome. Not only that, glorias research is revealing that the overuse of antibiotics to eradicate harmful microbes early in life is leading to a bigger problem than we ever realized. We have impacted every step of delopment. The average baby receives 2. 7 doses of antibiotics in the first year of life. We have been so successful controlling infectious diseases. But what we didnt know was the Collateral Damage that was caused to our microbiome. We have increased the risk of our kids to live lives with chronic diseases. We evolved with this biology. We cannot ignore it, because if we do, we are screwing the health of our future generations. [julia] while helpful in many ways, the sterilization of modern day practices like csections and antibiotics could actually be harming on microbiomes, making us more susceptible to disease, but we cant just get rid of modern medicine altogether. Antibiotics and csections still save millions of lives. So whats the right apoach . Gloria has invited me to her home to meet her husband dr. Martin blaser. [martin] hey, how are you . Hi, im julia, lovely to meet you. Martin is a microbiologist who also researches the microbiome. When it comes to using antibiotics, bothloria and martin believe we need a better balance. By and large, we have overestimated the value of antibiotics. Were giving antibiotics like water. The big dogma is it might not help you, but it wont hurt. But what if it does hurt . Thes more and more evidence were losing microbial diversity, its just going down. [julia] martin and gloria wa to prevt the further loss of diversity in our microbiomes. Weve overdone it. Now we have to find a more moderate approach. And ultimately, if we find a more moderate approach, then maybe we can stop the decline in diversity, but how do we get it back . Thats gonna require restoration. [julia] one intriguing candidate for microbial restoration is the h. Pylori bacteria, the same one that Barry Marshall infected himself with. Most doctors in the world are trying to get rid of helicobacter on the idea that its a bad guy and is. But since then, weve been finding all kinds of good things that the bacteria does. It turns out that some microbes are Double Agents and can be both bad and good for the body. What are the good things you found out about h. Pylori . Well, we found that people who dont have helicobacter have more disease of their esophagus, and we also found that children who dont have helicobacter have more asthma, and thats really big, cause asthmas going up, helicobacter is going down. We think that theyre linked. [julia] though its been with humanity for millennia, today only five percent of children in the u. S. Have the h. Pylori bacteria. So if h. Pylori can cause stomach cancer, but eliminating it increases rates of asthma, what should we choose . It turns out we may not have to. I predict that well be giving helicobacter pylori back to children so that we can protect them against things like asthma. But we might wanna eradicate it when theyre 40 years old so that they wont get stomach cancer. We have to treat this bug differently in childhood and once you are an adult. [julia] this revelation shows how we can begin to get the balance right. By treating the microbiome differently at different stages in a persons life, gloria and martins dynamic approach is the key to eliminating modern diseases. [futuristic narrator] in the future, nearly every baby is born naturally at home. When cstions arneeded, babi are batd and incted with microbes taken from the mothers birth canal. From childhood, everyone receives personalized doses of healthy microbes as regularly as vaccines. Only prescribed in severe cases, the overuse of antiotics has plummeted. [julia] if the key to a disease free future lies in managing the balance of good and bad microbes, then what weve put into our bodies will have a huge impact on the microbiome. To better understand how the bodys microbes work as a whole, ive come to san diego to meet dr. Rob knight. Hes looking for ways to create a better balance in individual microbiomes by sequencing their dna. Based on numbers alone, this is a very daunting task. You have about 20,000 or so unique genes in your human genome, but you have millions of genes in your microbiome and all of those microbial genes, were just finding out about how they make us who we are. That is incredible that we call ourselves human, but maybe were not so human after all. Robs quest is an ambitious undertaking. Through the american gut project he cofounded, hes crowdsourcing and analyzing stool samples from across the planet. And because its an open source project, hell ultimately share the conclusions of this big data with everyone. For now by sequencing microbial dna from a wide array of pple, robs pioneering work is diving deeper into the human microbiome than ever before, especially in how our microbes respond to food. In tandem with this, robs team is also sequencing the dna of the microbes that colonize theoods we eat to analyze and compare its impact on microbes in the human body. So what diyou collect from the garden today . So we got another set of fruit and vegetable samples. So rosemary, tomato, eggplant we got today. Great. [julia] by understanding the microbial big picture, rohas discovered something surprising. One of the most fascinating and most unexpected things is the particular ways that diet impacts the microbiome. Categories that people tnk are gonna make a huge difference, like are you omnivore or you a vegan, are you on the paleo diet, that kind of thing, has almost no bearing on your microbiome results. This research is coradictinprevailing wisdom. It turns out what does affect the health of our gut microbiome is much more basic and even achievable for most of us. The things that do matter, turn out to behings like how many different species of plants you ate in the last couple of weeks. Things like do you eat a lot of salty snacks or sugary snacks . Wow that is really interesting work. Robs research is showing that eating at least 30 different types of plants per week leads to a more diverse