How nanoparticles could change the way we treat cancer | Joy Wolfram

Translator: Candela Lafuente Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

It was a Sunday afternoon back in April of this year.

Unha tarde de domingo, en abril deste ano,

My phone was ringing,

o meu teléfono púxose a soar.

I picked it up.

Collino.

The voice said, "It's Rebecca.

A voz dixo: "Son Rebecca.

I'm just calling to invite you

Só chamaba para convidarte

to my funeral."

ao meu funeral."

I said, "Rebecca, what are you talking about?"

Eu contesteille: "Rebecca, de que falas?"

She said, "Joy, as my friend, you have to let me go.

"Joy, es a miña amiga, tesme que deixar partir.

It's my time."

Chegou a miña hora."

The next day, she was dead.

Morreu ao día seguinte.

Rebecca was 31 years old when she died.

Rebeca tiña 31 anos cando morreu.

She had an eight-year struggle with breast cancer.

Estivera loitando durante oito anos contra un cancro de mama.

It came back three times.

Tivo tres recaídas.

I failed her.

E eu falleille.

The scientific community failed her.

A comunidade científica falloulle

And the medical community failed her.

e a comunidade médica tamén.

And she's not the only one.

Pero non é a única.

Every five seconds,

Cada cinco segundos,

someone dies of cancer.

morre alguén de cancro.

Today, we medical researchers are committed

A día de hoxe, nós, investigadores médicos, comprometémonos

to having Rebecca and people like her

a que Rebecca, e xente coma ela,

be one of the last patients that we fail.

sexan os derradeiros pacientes aos que lles fallamos.

The US government alone has spent over 100 billion on cancer research

Dende os anos 70, só o goberno dos EE. UU. leva gastado máis de 100 mil millóns

since the 1970s,

na investigación do cancro

with limited progress in regards to patient survival,

con progresos limitados en relación á supervivencia dos doentes,

especially for certain types of very aggressive cancers.

especialmente en certos tipos de cancro moi agresivos.

So we need a change because, clearly,

É por iso que precisamos un cambio,

what we've been doing so far has not been working.

pois, claramente, o que levamos feito ata agora non funcionou.

And what we do in medicine is to send out firefighters,

En medicina, o que facemos é enviar os bombeiros,

because cancer is like a big fire.

porque o cancro é coma un grande incendio.

And these firefighters are the cancer drugs.

Estes bombeiros son os medicamentos contra o cancro.

But we're sending them out without a fire truck --

Pero estámolos enviando sen o seu camión,

so without transportation, without ladders

é dicir, sen transporte, sen escaleiras

and without emergency equipment.

e sen equipo de emerxencia.

And over 99 percent of these firefighters never make it to the fire.

Máis do 99% destes bombeiros nunca chegan ao incendio.

Over 99 percent of cancer drugs never make it to the tumor

Máis do 99% destes fármacos nunca chegan ao tumor

because they lack transportation and tools

porque carecen do transporte e das ferramentas

to take them to the location they're aiming for.

que os levarían ao lugar a onde deben dirixirse.

Turns out, it really is all about location, location, location.

Parece ser entón, que todo ten que ver coa localización.

(Laughter)

(Risas)

So we need a fire truck to get to the right location.

Así que precisamos un camión de bombeiros para que cheguen ao lugar correcto.

And I'm here to tell you that nanoparticles are the fire trucks.

E estou aquí para dicirvos que as nanopartículas son ese camión.

We can load cancer drugs inside nanoparticles,

Podemos introducir os medicamentos contra o cancro dentro de nanopartículas

and nanoparticles can function as the carrier

que funcionan como portadoras

and necessary equipment

do equipo necesario

to bring the cancer drugs to the heart of the tumor.

para levar os fármacos cara ao centro do tumor.

So what are nanoparticles,

Pero, que son as nanopartículas

and what does it really mean to be nano-sized?

e que hai que entender por nanométrico?

Well, there are many different types of nanoparticles

Hai moitos tipos diferentes de nanopartículas

made out of various materials,

feitas de diversos materiais,

such as metal-based nanoparticles

como as de metal

or fat-based nanoparticles.

ou as de graxa.

But to really illustrate what it means to be nano-sized,

Pero para mostrar o que realmente é o tamaño nano,

I took one of my hair strands

collín un cabelo

and placed it under the microscope.

e púxeno no microscopio.

Now, I have very thin hair,

Eu son de pelo fino,

so my hair is approximately 40,000 nanometers in diameter.

xa que ten 40 000 nanómetros de diámetro, aproximadamente.

So this means, if we take 400 of our nanoparticles

Isto significa que se collemos 400 nanopartículas

and we stack them on top of each other,

e as empillamos unhas sobre outras,

we get the thickness of a single hair strand.

obtemos o grosor dun único pelo.

I lead a nanoparticle laboratory to fight cancer and other diseases

Dirixo un laboratorio de nanopartículas

dedicado a combater o cancro e outras enfermidades

at Mayo Clinic here in Jacksonville.

na Clínica Mayo, aquí en Jacksonville.

And at Mayo Clinic,

Na clínica temos as ferramentas para cambiar a vida dos nosos pacientes,

we really have the tools to make a difference for patients,

thanks to the generous donations and grants to fund our research.

grazas ás xenerosas doazóns e subvencións

que financian as nosas investigacións.

And so, how do these nanoparticles manage to transport cancer drugs

Pero, como logran estas nanopartículas transportar os medicamentos

to the tumor?

ao tumor?

Well, they have an extensive toolbox.

Pois ben, teñen unha gran caixa de ferramentas.

Cancer drugs without nanoparticles are quickly washed out of the body

Os fármacos contra o cancro sen nanopartículas

elimínanse moi rápido do corpo a través dos riles

through the kidneys

because they're so small.

porque son moi pequenos.

So it's like water going through a sieve.

É como a auga atravesando un filtro.

And so they don't really have time to reach the tumor.

O que fai que non teñan tempo para chegar ao tumor.

Here we see an illustration of this.

Velaquí unha ilustración disto.

We have the firefighters, the cancer drugs.

Temos os bombeiros, os medicamentos.

They're circulating in the blood,

Circulan polo sangue,

but they're quickly washed out of the body

pero son rapidamente eliminados do corpo

and they don't really end up inside the tumor.

e non chegan ao interior do tumor.

But if we put these cancer drugs inside nanoparticles,

Pero se poñemos estes fármacos dentro de nanopartículas,

they will not get washed out by the body

non serán eliminados do corpo

because the nanoparticles are too big.

porque as nanopartículas son moi grandes.

And they will continue to circulate in the blood,

Continuarán circulando no sangue

giving them more time to find the tumor.

e terán máis tempo para atopar o tumor.

And here we see the cancer drug, the firefighters,

Aquí vemos os medicamentos, é dicir, os bombeiros,

inside the fire truck, the nanoparticles.

dentro do seu camión, as nanopartículas.

They're circulating in the blood,

Circulan no sangue,

they don't get washed out

non son eliminados

and they actually end up reaching the tumor.

e acaban chegando ao tumor.

And so what other tools do nanoparticles have?

Que outras ferramentas teñen as nanopartículas?

Well, they can protect cancer drugs from getting destroyed inside the body.

Pois poden protexer os fármacos para que o corpo non os destrúa.

There are certain very important but sensitive drugs

Hai certos medicamentos, moi importantes pero sensibles,

that are easily degraded by enzymes in the blood.

que son facilmente degradados polos encimas do sangue.

So unless they have this nanoparticle protection,

Xa que logo, a menos que teñan a protección das nanopartículas,

they will not be able to function.

non poderán actuar.

Another nanoparticle tool are these surface extensions

Outra ferramenta das nanopartículas son as súas extensións,

that are like tiny hands with fingers that grab on to the tumor

especies de mans diminutas con dedos que se aferran ao tumor

and fit exactly onto it,

e fíxanse firmemente,

so that when the nanoparticles are circulating,

así que, cando as nanopartículas circulan

they can attach onto the cancer cells,

pódense adherir ás células cancerosas,

buying the cancer drugs more time to do their job.

dándolles máis tempo aos medicamentos para realizar o seu traballo.

And these are just some of the many tools that nanoparticles can have.

Estas son algunhas das moitas ferramentas das nanopartículas.

And today,

E hoxe en día,

we have more than 10 clinically approved nanoparticles for cancer

temos máis de 10 nanopartículas aprobadas clinicamente para o cancro

that are given to patients all over the world.

que se subministran a pacientes en todo o mundo.

Yet, we have patients, like Rebecca, who die.

Aínda así, temos doentes, como Rebecca, que morren.

So what are the major challenges and limitations

Entón, cales son os principais desafíos e limitacións

with currently approved nanoparticles?

das nanopartículas actualmente aprobadas?

Well, a major challenge is the liver,

Un dos principais retos é o fígado,

because the liver is the body's filtration system,

porque é o sistema de filtración do corpo

and the liver recognizes and destroys foreign objects,

que recoñece e destrúe os axentes estraños

such as viruses, bacteria and also nanoparticles.

coma os virus, as bacterias e as nanopartículas.

And the immune cells in the liver eat the nanoparticles,

As células inmunitarias do fígado "comen" as nanopartículas,

preventing them from reaching the tumor.

evitando que cheguen ao tumor.

And here we see an illustration where the kidney is no longer a problem,

Velaquí unha ilustración na que os riles xa non son un problema,

but these fire trucks, the nanoparticles,

pero os camións de bombeiros, as nanopartículas,

get stuck in the liver

quedan atrapadas no fígado

and, actually, less of them end up reaching the tumor.

e, por iso, poucas chegan ao tumor.

So a future strategy to improve nanoparticles

Unha estratexia futura para mellorar as nanopartículas

is to temporarily disarm the immune cells in the liver.

é desarmar, temporalmente, as células inmunitarias do fígado.

So how do we disarm these cells?

E como o facemos?

Well, we looked at drugs that were already clinically approved

Investigamos os medicamentos

xa aprobados clinicamente para outras indicacións

for other indications

to see if any of them could stop the immune cells

para ver se algún podería evitar que as células inmunitarias

from eating the nanoparticles.

"comeran" as nanopartículas.

And unexpectedly, in one of our preclinical studies,

E inesperadamente, nun dos nosos ensaios preclínicos,

we found that a 70-year-old malaria drug

atopamos que un fármaco para a malaria, que existe dende hai 70 anos,

was able to stop the immune cells from internalizing the nanoparticles

era quen de impedir que as células inmunitarias

so that they could escape the liver

para que puidesen escapar do fígado

and continue their journey to their goal, the tumor.

e continuar a súa viaxe cara ao seu obxectivo, o tumor.

And here we see the illustration of blocking the liver.

Aquí vemos a ilustración de como bloquean o fígado.

The nanoparticles don't go there,

As nanopartículas non entran

and they instead end up in the tumor.

e acaban chegando ao tumor.

So, sometimes, unexpected connections are made in science

Ás veces, na ciencia, aparecen conexións inesperadas

that lead to new solutions.

que conducen a solucións novas.

Another strategy for preventing nanoparticles

Outra estratexia para evitar que as nanopartículas

from getting stuck in the liver

queden atrapadas no fígado

is to use the body's own nanoparticles.

é usar as propias nanopartículas do corpo.

Yes -- surprise, surprise.

Si... sorpresa, sorpresa!

You, and you and you, and all of us have a lot of nanoparticles

Ti, e ti, e ti, e todos nós temos un montón de nanopartículas

circulating in our bodies.

que circulan polo noso corpo.

And because they're part of our bodies,

E como son parte del,

the liver is less likely to label them as foreign.

é menos probable que o fígado as recoñeza como algo estraño.

And these biological nanoparticles can be found in the saliva,

Estas nanopartículas biolóxicas pódense atopar na saliva,

in the blood, in the urine, in pancreatic juice.

no sangue, na urina, no zume pancreático.

And we can collect them from the body

Podémolas recoller do corpo

and use them as fire trucks for cancer drugs.

e utilizalas como camións de bombeiros para os fármacos.

And in this case,

Neste caso,

the immune cells in the liver are less likely to eat

é menos probable que as células do fígado

the biological nanoparticles.

"coman" as nanopartículas biolóxicas.

So we're using a Trojan-horse-based concept

Estariamos utilizando o concepto do cabalo de Troia

to fool the liver.

para enganar o fígado.

And here we see the biological nanoparticles

Aquí vemos as nanopartículas biolóxicas

circulating in the blood.

circulando no sangue.

They don't get recognized by the liver,

O fígado non as recoñece,

and they end up in the tumor.

e conseguen chegar ao tumor.

And in the future,

Nun futuro,

we want to exploit nature's own nanoparticles

queremos aproveitar as propias nanopartículas da natureza

for cancer drug delivery,

para administrar os medicamentos contra o cancro,

to reduce side effects and save lives

para reducir os efectos secundarios e salvar vidas

by preventing the cancer drugs from being in the wrong location.

evitando que os fármacos cheguen ao lugar equivocado.

However, a major problem has been:

Non obstante, apareceu outro problema:

How do we isolate these biological nanoparticles in large quantities

como illamos en grandes cantidades estas nanopartículas biolóxicas

without damaging them?

sen danalas?

My lab has developed an efficient method for doing this.

O meu laboratorio desenvolveu un método eficiente.

We can process large quantities of liquids from the body

Podemos procesar grandes cantidades de líquidos corporais

to produce a highly concentrated, high-quality formulation

para producir unha fórmula altamente concentrada e de calidade

of biological nanoparticles.

de nanopartículas biolóxicas.

And these nanoparticles are not yet in clinical use,

Estas nanopartículas non se usan aínda clinicamente,

because it takes an average of 12 years

porque se precisa unha media de 12 anos

to get something from the lab

para que o que facemos no laboratorio

to your medicine cabinet.

chegue ás mans dos particulares.

And this is the type of challenge that requires teamwork

Este é o tipo de problema que require traballo en equipo

from scientists and physicians,

de científicos e médicos,

who dedicate their lives to this battle.

que dedican a súa vida a esta batalla.

And we keep going, thanks to inspiration from patients.

E continuamos grazas á inspiración que nos dan os doentes.

And I believe that if we keep working on these nanomedicines,

E penso que, se seguimos traballando nestes nanofármacos,

we will be able to reduce harm to healthy organs,

poderemos reducir o dano aos órganos sans,

improve quality of life

mellorar a calidade de vida

and save future patients.

e salvar a futuros pacientes.

I like to imagine

Gústame imaxinar

that if these treatments had been available for Rebecca,

que se Rebecca puidera acceder a estes tratamentos,

that call from her

aquela chamada súa

could have been an invitation

podería ser unha invitación

not to her funeral,

non para o seu funeral,

but her wedding.

senón para a súa voda.

Thank you.

Grazas.

(Applause)

(Aplausos)