Mark Kendall: Demo: A needle-free vaccine patch that's safer and way cheaper

Translator: Òscar Aznar Alemany Reviewer: Nuria Estrada

It's a pleasure to be here

És un plaer ser aquí

in Edinburgh, Scotland,

a Edimburg, Escòcia,

the birthplace of the needle and syringe.

el lloc de naixement de l'agulla i la xeringa.

Less than a mile from here in this direction,

A menys d'1,6 km d'aquí en aquesta direcció,

in 1853 a Scotsman

el 1853 un escocès

filed his very first patent on the needle and syringe.

va sol·licitar la seva primera patent de l'agulla i la xeringa.

His name was Alexander Wood,

Es deia Alexander Wood,

and it was at the Royal College of Physicians.

i va ser al Col·legi Reial de Metges.

This is the patent.

Aquesta és la patent.

What blows my mind when I look at it even today

El que em sorprèn quan ho miro, fins i tot avui,

is that it looks almost identical

és que és quasi idèntica

to the needle in use today.

a l'agulla d'avui en dia.

Yet, it's 160 years old.

Tot i que té 160 anys.

So we turn to the field of vaccines.

Tornem al camp de les vacunes.

Most vaccines are delivered with

La majoria de vacunes se subministren

the needle and syringe, this 160-year-old technology.

amb l'agulla i la xeringa, una tecnologia que té 160 anys.

And credit where it's due -- on many levels,

I s'ha de reconèixer, en molts aspectes,

vaccines are a successful technology.

que les vacunes són una tecnologia d'èxit.

After clean water and sanitation,

Després de l'aigua potable i la higiene,

vaccines are the one technology that has increased

les vacunes són la tecnologia que més ha incrementat

our life span the most.

la nostra esperança de vida.

That's a pretty hard act to beat.

Això és prou difícil de superar.

But just like any other technology,

Però, com qualsevol altra tecnologia,

vaccines have their shortcomings,

les vacunes tenen els seus inconvenients,

and the needle and syringe

i l'agulla i la xeringa

is a key part within that narrative --

són un punt clau en aquesta narrativa,

this old technology.

en aquesta antiga tecnologia.

So let's start with the obvious:

Comencem amb l'obvi:

Many of us don't like the needle and syringe.

A molts no ens agrada l'agulla i la xeringa.

I share that view.

Comparteixo aquesta opinió.

However, 20 percent of the population

No obstant, el 20% de la població

have a thing called needle phobia.

té fòbia a les agulles.

That's more than disliking the needle;

Va més enllà que no t'agradi l'agulla,

that is actively avoiding being vaccinated

és evitar activament ser vacunat

because of needle phobia.

per aquesta fòbia a les agulles.

And that's problematic in terms of the rollout of vaccines.

Això és problemàtic per a l'ús de les vacunes.

Now, related to this is another key issue,

Hi ha una altra qüestió clau,

which is needlestick injuries.

que són les ferides de la punxada.

And the WHO has figures

Segons l'OMS,

that suggest about 1.3 million deaths per year

uns 1,3 milions de morts a l'any

take place due to cross-contamination

són per contaminació creuada

with needlestick injuries.

en la punxada.

These are early deaths that take place.

Aquestes són morts prematures.

Now, these are two things that you probably may have heard of,

Potser ja coneixíeu aquestes dues coses,

but there are two other shortcomings

però hi ha uns altres dos inconvenients

of the needle and syringe you may not have heard about.

de l'agulla i la xeringa que potser desconeixeu.

One is it could be holding back

Un és que podria estar endarrerint

the next generation of vaccines

la pròxima generació de vacunes

in terms of their immune responses.

en quant a resposta immunitària.

And the second is that it could be responsible

El segon és que podria ser responsable

for the problem of the cold chain that I'll tell you about as well.

del problema de la cadena de fred, de la que us parlaré també.

I'm going to tell you about some work

Us parlaré una mica del treball

that my team and I are doing in Australia

que el meu equip i jo estem fent a Austràlia

at the University of Queensland

a la Universitat de Queensland

on a technology designed to tackle those four problems.

en una tecnologia dissenyada per abordar aquests quatre problemes.

And that technology is called the Nanopatch.

I aquesta tecnologia és el Nanopegat.

Now, this is a specimen of the Nanopatch.

Això és una mostra del Nanopegat.

To the naked eye

A primera vista

it just looks like a square

simplement sembla un quadrat

smaller than a postage stamp,

més petit que un segell,

but under a microscope

però sota un microscopi

what you see are thousands of tiny projections

es veuen milers de petites projeccions

that are invisible to the human eye.

invisibles a l'ull humà.

And there's about 4,000 projections

I hi ha unes 4.000 projeccions

on this particular square compared to the needle.

en aquest quadrat comparat amb l'agulla.

And I've designed those projections

I les he dissenyades

to serve a key role, which is to work with the skin's immune system.

per al paper clau de treballar amb el sistema immunitari de la pell.

So that's a very important function

Per tant, és una funció molt important

tied in with the Nanopatch.

del Nanopegat.

Now we make the Nanopatch

Fabriquem el Nanopegat

with a technique

amb una tècnica anomenada

called deep reactive ion etching.

gravat profund amb ions reactius.

And this particular technique is one that's been borrowed

Hem pres aquesta tècnica

from the semiconductor industry,

de la indústria dels semiconductors

and therefore is low cost

i per tant és de baix cost

and can be rolled out in large numbers.

i permet una elevada producció.

Now we dry-coat vaccines to the projections of the Nanopatch

Recobrim de vacuna les projeccionsdel Nanopegat

and apply it to the skin.

i l'apliquem a la pell.

Now, the simplest form of application

La manera més senzilla d'aplicar-lo

is using our finger,

és utilitzar el dit,

but our finger has some limitations,

però el dit té algunes limitacions

so we've devised an applicator.

i hem dissenyat un aplicador.

And it's a very simple device --

És un dispositiu molt simple;

you could call it a sophisticated finger.

li podríem dir dit sofisticat.

It's a spring-operated device.

És un dispositiu operat per un motlle.

What we do is when we apply the Nanopatch to the skin as so --

Quan apliquem el Nanopegat a la pell així,

(Click) --

(clic)

immediately a few things happen.

immediatament passen algunes coses.

So firstly, the projections on the Nanopatch

Primer, les projeccions del nanopegat

breach through the tough outer layer

travessen la capa exterior

and the vaccine is very quickly released --

i la vacuna s'allibera molt ràpidament,

within less than a minute, in fact.

en menys d'un minut, de fet.

Then we can take the Nanopatch off

Llavors podem treure el Nanopegat

and discard it.

i desfer-nos-en.

And indeed we can make a reuse of the applicator itself.

I, en efecte, podem reutilitzar l'aplicador.

So that gives you an idea of the Nanopatch,

Això us dóna una idea del Nanopegat

and immediately you can see some key advantages.

i de cop hi podeu veure alguns avantatges.

We've talked about it being needle-free --

Hem dit que no utilitza agulles

these are projections that you can't even see --

—té projeccions que ni es poden veure—

and, of course, we get around

i, és clar, evitem també

the needle phobia issue as well.

el tema de la fòbia a les agulles.

Now, if we take a step back and think about

Tornem endarrere i pensem

these other two really important advantages:

en els dos avantatges realment importants:

One is improved immune responses through delivery,

Un, la resposta immunitària millorada en el subministrament,

and the second is getting rid of the cold chain.

i, el segon, desfer-nos de la cadena de fred.

So let's start with the first one, this immunogenicity idea.

Comencem per la primera, la idea d'immunogenicitat.

It takes a little while to get our heads around,

Costa una mica d'entendre,

but I'll try to explain it in simple terms.

però intentaré explicar-ho amb paraules simples,

So I'll take a step back and explain to you

Retrocediré una mica i us explicaré

how vaccines work in a simple way.

com funcionen les vacunes d'una manera senzilla.

So vaccines work by introducing into our body

Les vacunes funcionen introduint al cos

a thing called an antigen

una cosa anomenada antigen

which is a safe form of a germ.

que és una forma segura d'un germen.

Now that safe germ, that antigen,

Aquest germen segur, aquest antigen,

tricks our body into mounting an immune response,

enganya al cos perquè generi una resposta immunitària,

learning and remembering how to deal with intruders.

per tal que aprengui i recordi com tractar els intrusos.

When the real intruder comes along

Quan l'intrús real arriba,

the body quickly mounts an immune response

el cos crea una resposta immune ràpida

to deal with that vaccine

d'acord amb la vacuna

and neutralizes the infection.

i neutralitza la infecció.

So it does that well.

Per tant, funciona.

Now, the way it's done today with the needle and syringe,

Avui en dia s'utilitzen les xeringues

most vaccines are delivered that way --

per administrar la majoria de vacunes,

with this old technology and the needle.

aquesta antiga tecnologia de l'agulla.

But it could be argued that the needle is holding back our immune responses;

Però l'agulla podria dificultar la resposta immunitària;

it's missing our immune sweet spot in the skin.

no aprofita el punt òptim de la immunitat que és a la pell.

To describe this idea,

Per descriure aquesta idea,

we need to take a journey through the skin,

hem de fer un viatge a través de la pell,

starting with one of those projections

començant amb una de les projeccions

and applying the Nanopatch to the skin.

i aplicant el Nanopegat a la pell.

And we see this kind of data.

I això és el que veiem.

Now, this is real data --

És realment així;

that thing that we can see there is one projection

això és una de les projeccions

from the Nanopatch that's been applied to the skin

del Nanopegat aplicat a la pell

and those colors are different layers.

i els colors són capes diferents.

Now, to give you an idea of scale,

Per donar-vos una idea de l'escala,

if the needle was shown here, it would be too big.

si l'agulla es veges aquí, seria massa gran.

It would be 10 times bigger

Seria 10 vegades més gran

than the size of that screen, going 10 times deeper as well.

que la pantalla i estaria 10 vegades més profunda.

It's off the grid entirely.

Desproporcionat.

You can see immediately that we have those projections in the skin.

Com veieu, tenim les projeccions dins de la pell,

That red layer is a tough outer layer of dead skin,

La part vermella és una capa exterior de pell morta,

but the brown layer and the magenta layer

però la capa marró i la capa lila

are jammed full of immune cells.

estan pleníssimes de cèl·lules immunitàries.

As one example, in the brown layer

Per exemple, en la capa marró

there's a certain type of cell called a Langerhans cell --

hi ha un tipus de cèl·lula anomenada cèl·lula de Langerhans.

every square millimeter of our body

Cada mil·límetre quadrat del nostre cos

is jammed full of those Langerhans cells,

està ple d'aquestes cèl·lules,

those immune cells, and there's others shown as well

aquestes cèl·lules immunitàries, i n'hi ha d'altres

that we haven't stained in this image.

que no hem representat.

But you can immediately see that the Nanopatch

Però és obvi que el Nanopegat

achieves that penetration indeed.

aconsegueix penetrar-hi.

We target thousands upon thousands of these particular cells

Arribem a milers i milers d'aquestes cèl·lules

just residing within a hair's width

que estan a l'amplada d'un cabell

of the surface of the skin.

per sota de la superfície de la pell.

Now, as the guy that's invented this thing and designed it to do that,

Jo, que ho he inventat i ho he dissenyat,

I found that exciting. But so what?

ho trobo excitant. Però... i què?

So what if you've targeted cells?

I què si arribes a les cèl·lules?

In the world of vaccines, what does that mean?

En el món de les vacunes, què significa?

The world of vaccines is getting better.

El món de les vacunes està millorant.

It's getting more systematic.

Està esdevenint més sistemàtic.

However, you still don't really know

No obstant, encara no saps realment

if a vaccine is going to work

si una vacuna funcionarà

until you roll your sleeves up

fins que no t'arromangues

and vaccinate and wait.

et vacunes i esperes.

It's a gambler's game even today.

És un joc d'atzar fins i tot avui en dia.

So, we had to do that gamble.

I hi vam haver de jugar.

We obtained an influenza vaccine,

Vam obtenir una vacuna de la grip,

we applied it to our Nanopatches

la vam aplicar als Nanopegats

and we applied the Nanopatches to the skin,

i els vam aplicar la pell,

and we waited --

i vam esperar;

and this is in the live animal.

amb un animal viu.

We waited a month,

Vam esperar un mes

and this is what we found out.

i vam descobrir això.

This is a data slide showing the immune responses

Aquí es mostra la resposta immunitària

that we've generated with a Nanopatch

que hem generat amb el Nanopegat

compared to the needle and syringe into muscle.

comparada a la de la xeringa en múscul.

So on the horizontal axis we have the dose shown in nanograms.

En l'eix horitzontal tenim la dosi en nanograms,

On the vertical axis we have the immune response generated,

en l'eix vertical tenim la resposta generada,

and that dashed line indicates the protection threshold.

i la línia discontínua indica el llindar de protecció.

If we're above that line it's considered protective;

Per sobre del llindar hi ha protecció,

if we're below that line it's not.

per sota no n'hi ha.

So the red line is mostly below that curve

Quasi tota la línia vermella va per sota

and indeed there's only one point that is achieved with the needle that's protective,

i, certament, només a un nivell de la xeringa és protector,

and that's with a high dose of 6,000 nanograms.

que és amb una dosi alta de 6.000 nanograms.

But notice immediately the distinctly different curve

Però mireu la corba clarament diferent

that we achieve with the blue line.

que tenim en la línia blava.

That's what's achieved with the Nanopatch;

Això és el que aconseguim amb el Nanopegat.

the delivered dose of the Nanopatch is

La dosi subministrada pel Nanopegat

a completely different immunogenicity curve.

ens dóna una corba d'immunitat completament diferent.

That's a real fresh opportunity.

És una gran oportunitat.

Suddenly we have a brand new lever

De sobte tenim una nova palanca

in the world of vaccines.

en el món de les vacunes.

We can push it one way,

La podem accionar d'un costat,

where we can take a vaccine that works but is too expensive

on hi ha una vacuna que funciona, però que és molt cara,

and can get protection

i passar a una protecció

with a hundredth of the dose compared to the needle.

amb una centèsima de la dosi de l'agulla.

That can take a vaccine that's suddenly 10 dollars down to 10 cents,

Podem reduir el cost d'una vacuna de 10 € a 10 cèntims,

and that's particularly important within the developing world.

i això és molt important en països en desenvolupament.

But there's another angle to this as well --

Però hi ha un altre punt positiu;

you can take vaccines that currently don't work

pots agafar vacunes que actualment no funcionen,

and get them over that line

passar-les a sobre de la línia

and get them protective.

i fer-les eficaces.

And certainly in the world of vaccines

Evidentment, en el món de les vacunes

that can be important.

això pot ser important.

Let's consider the big three:

Fixem-nos en tres de grans:

HIV, malaria, tuberculosis.

el VIH, la malària i la tuberculosi.

They're responsible for about 7 million deaths per year,

Causen uns 7 milions de morts a l'any

and there is no adequate vaccination method for any of those.

i no hi ha vacuna eficaç per a cap d'elles.

So potentially, with this new lever that we have with the Nanopatch,

Potencialment, amb aquesta palanca nova del Nanopegat

we can help make that happen.

podem fer-ho possible.

We can push that lever to help get those candidate vaccines over the line.

Podem ajudar les vacunes candidates a estar sobre la línia.

Now, of course, we've worked within my lab

Evidentment, al laboratori hem treballat

with many other vaccines that have attained

amb moltes altres vacunes que han aconseguit

similar responses and similar curves to this,

respostes i corbes similars a aquesta

what we've achieved with influenza.

del Nanopegat de la grip.

I'd like to now switch to talk about

M'agradaria parlar sobre

another key shortcoming of today's vaccines,

un altre inconvenient de les vacunes d'avui en dia,

and that is the need to maintain the cold chain.

que és la necessitat de conservar la cadena de fred.

As the name suggests -- the cold chain --

Com el nom suggereix, la cadena de fred,

it's the requirements of keeping a vaccine right from production

és la necessitat que una vacuna, des que es produeix

all the way through to when the vaccine is applied,

fins que s'aplica,

to keep it refrigerated.

ha d'estar refrigerada.

Now, that presents some logistical challenges

Això presenta alguns reptes logístics

but we have ways to do it.

però podem fer-ho.

This is a slightly extreme case in point

Aquest és un cas una mica extrem

but it helps illustrate the logistical challenges,

però ajuda a il·lustrar els reptes logístics

in particular in resource-poor settings,

—en particular en llocs amb pocs recursos—

of what's required to get vaccines

del que cal per tenir les vacunes

refrigerated and maintain the cold chain.

refrigerades i mantenir la cadena de fred.

If the vaccine is too warm the vaccine breaks down,

Si la vacuna s'escalfa massa, es fa malbé,

but interestingly it can be too cold

però, curiosament, si està massa freda

and the vaccine can break down as well.

també pot fer-se malbé.

Now, the stakes are very high.

Ens hi juguem molt.

The WHO estimates that within Africa,

L'OMS estima que a l'Àfrica

up to half the vaccines used there

fins al 50 % de les vacunes

are considered to not be working properly

no funcionen correctament

because at some point the cold chain has fallen over.

perquè en algun punt la cadena de fred s'ha trencat.

So it's a big problem, and it's tied in with the needle and syringe

És un gran problema lligat a la xeringa

because it's a liquid form vaccine, and when it's liquid it needs the refrigeration.

perquè la vacuna és líquida i el líquid necessita refrigeració.

A key attribute of our Nanopatch

Un atribut clau del Nanopegat

is that the vaccine is dry,

és que la vacuna és seca,

and when it's dry it doesn't need refrigeration.

i quan és seca no necessita refrigeració.

Within my lab we've shown that we can keep

Al laboratori hem demostrat que podem

the vaccine stored at 23 degrees Celsius

emmagatzemar la vacuna a 23 ºC

for more than a year without any loss in activity at all.

durant més d'un any sense cap pèrdua d'activitat.

That's an important improvement.

Això és una millora important.

(Applause)

(Aplaudiment)

We're delighted about it as well.

Nosaltres també n'estem encantats.

And the thing about it is that we have well and truly proven

El cas és que hem posat a prova

the Nanopatch within the laboratory setting.

el Nanopegat dins del laboratori.

And as a scientist, I love that and I love science.

I com a científic, m'encanta i m'encanta la ciència.

However, as an engineer,

Tot i que, com a enginyer,

as a biomedical engineer

com a enginyer biomèdic

and also as a human being,

i també com a ésser humà,

I'm not going to be satisfied

no estaré satisfet

until we've rolled this thing out, taken it out of the lab

fins que no el posem en circulació fora del laboratori

and got it to people in large numbers

i el fem accessible en grans quantitats,

and particularly the people that need it the most.

especialment a qui més ho necessita.

So we've commenced this particular journey,

Així que hem començat aquest viatge particular

and we've commenced this journey in an unusual way.

i l'hem començat d'una manera poc habitual.

We've started with Papua New Guinea.

Hem començat amb Papua Nova Guinea.

Now, Papua New Guinea is an example of a developing world country.

Papua Nova Guinea és un exemple de país en desenvolupament.

It's about the same size as France,

Té la mida aproximada de França,

but it suffers from many of the key barriers

però pateix moltes de les barreres bàsiques

existing within the world of today's vaccines.

del món de les vacunes d'avui.

There's the logistics:

Hi ha la logística.

Within this country there are only 800 refrigerators to keep vaccines chilled.

En tot el país hi ha només 800 neveres per guardar-hi les vacunes.

Many of them are old, like this one in Port Moresby, many of them are breaking down

Moltes són velles, com aquesta, moltes s'estan espatllant

and many are not in the Highlands where they are required.

i moltes no són al lloc on es necessiten.

That's a challenge.

Això és un repte.

But also, Papua New Guinea has the world's highest incidence of HPV,

Però també, Papua Nova Guinea té la major incidència del món de VPH,

human papillomavirus, the cervical cancer [risk factor].

el virus del papil·loma humà, el factor de risc del càncer cervical.

Yet, that vaccine is not available in large numbers

La vacuna no està disponible en grans quantitats

because it's too expensive.

perquè és massa cara.

So for those two reasons, with the attributes of the Nanopatch,

Per aquests dos factors i tenint el Nanopegat

we've got into the field and worked with the Nanopatch,

ens hi hem desplaçat per treballar-hi

and taken it to Papua New Guinea

i l'hem portat a Papua Nova Guinea

and we'll be following that up shortly.

i hi seguirem treballant un temps.

Now, doing this kind of work is not easy.

Aquesta no és una feina fàcil.

It's challenging,

És un repte,

but there's nothing else in the world I'd rather be doing.

però no hi ha res al món que preferiria fer.

And as we look ahead

I, mirant endavant,

I'd like to share with you a thought:

m'agradaria compartir una fantasia.

It's the thought of a future where

La imatge d'un futur

the 17 million deaths per year

en què els 17 milions de morts a l'any

that we currently have due to infectious disease

que ara tenim a causa de malalties infeccioses

is a historical footnote.

fos un apunt històric.

And it's a historical footnote that has been achieved

I que fos un apunt històric aconseguit

by improved, radically improved vaccines.

gràcies a vacunes millorades radicalment.

Now standing here today in front of you

Avui, dempeus aquí davant vostre

at the birthplace of the needle and syringe,

al lloc de naixement de l'agulla i la xeringa,

a device that's 160 years old,

un dispositiu de fa 160 anys,

I'm presenting to you an alternative approach

us presento una alternativa

that could really help make that happen --

que ho podria fer possible:

and it's the Nanopatch with its attributes of being needle-free, pain-free,

el Nanopegat amb els seus atributs, sense agulla, sense dolor,

the ability for removing the cold chain and improving the immunogenicity.

sense cadena de fred i capaç de millorar la immunogenicitat.

Thank you.

Gràcies.

(Applause)

(Aplaudiments)