Siddharthan Chandran: Can the damaged brain repair itself?

Prevoditelj: Senzos Osijek Recezent: Ivan Stamenković

I'm very pleased to be here today

Jako mi je drago što mogu danas ovdje

to talk to you all about how we might repair

razgovarati s vama o tome kako bi mogli popraviti

the damaged brain,

moždana oštećenja,

and I'm particularly excited by this field,

a posebice sam uzbuđen zbog ovoga,

because as a neurologist myself,

zato što sam neurolog,

I believe that this offers one of the great ways

i vjerujem da ovo nudi jedan od izvrsnih načina

that we might be able to offer hope

kojima bismo mogli pobuditi nadu

for patients who today live with devastating

pacijentima koji danas žive s razarajućim

and yet untreatable diseases of the brain.

i još neizlječivim bolestima mozga.

So here's the problem.

Ovdje leži problem.

You can see here the picture of somebody's brain

Možete vidjeti sliku mozga osobe

with Alzheimer's disease

s Alzheimerovom bolešću

next to a healthy brain,

i zdravi mozak,

and what's obvious is, in the Alzheimer's brain,

a očito je da se kod mozga osobe s Alzheimerom,

ringed red, there's obvious damage -- atrophy, scarring.

što je zaokruženo crveno, vidi jasno oštećenje – atrofija, ožiljci.

And I could show you equivalent pictures

Mogao bih vam pokazati jednake slike

from other disease: multiple sclerosis,

kod drugih stanja: multiple skleroze,

motor neuron disease, Parkinson's disease,

bolesti motoneurona, Parkinsonove

even Huntington's disease,

ili Huntingtonove bolesti,

and they would all tell a similar story.

i sve bi izgledale slično.

And collectively these brain disorders represent

Zajedno ovi poremećaji mozga predstavljaju

one of the major public health threats of our time.

jednu od glavnih javnozdravstvenih problema našeg doba.

And the numbers here are really rather staggering.

Dobiveni brojevi su prilično zapanjujući.

At any one time, there are 35 million people today

U svakom trenutku postoji 35 milijuna ljudi

living with one of these brain diseases,

koji žive s jednim od ovih moždanih poremećaja,

and the annual cost globally

a godišnji trošak u globalu

is 700 billion dollars.

iznosi 700 milijardi dolara.

I mean, just think about that.

Samo razmislite o tome.

That's greater than one percent

To je više od jedan posto

of the global GDP.

globalnog BDP-a.

And it gets worse,

Postaje još i gore,

because all these numbers are rising

zato što ovi brojevi rastu

because these are by and large

jer je riječ o bolestima naveliko

age-related diseases, and we're living longer.

povezanim s godinama, a mi živimo sve duže.

So the question we really need to ask ourselves is,

Pitanje koje moramo postaviti sami sebi je,

why, given the devastating impact of these diseases

zašto, unatoč poražavajućem utjecaju ovih bolesti

to the individual,

na pojedinca,

never mind the scale of the societal problem,

izuzev veličine društevnih problema,

why are there no effective treatments?

zašto ne postoje učinkoviti tretmani?

Now in order to consider this,

Kako bi ovo razmotrili,

I first need to give you a crash course

prvo vam moram dati brzi tečaj

in how the brain works.

o tome kako mozak funkcionira.

So in other words, I need to tell you

Drugim riječima, ispričat ću vam

everything I learned at medical school.

sve što sam naučio na medicinskom fakultetu.

(Laughter)

(Smijeh)

But believe me, this isn't going to take very long.

Vjerujte mi, neće trajati predugo.

Okay? (Laughter)

U redu? (Smijeh)

So the brain is terribly simple:

Mozak je jako jednostavan:

it's made up of four cells,

sastoji se od četiri vrste stanica,

and two of them are shown here.

a dvije su prikazane ovdje.

There's the nerve cell,

Vidite živčanu stanicu,

and then there's the myelinating cell,

i mijelinizacijsku stanicu

or the insulating cell.

ili izolacijsku stanicu.

It's called oligodendrocyte.

Ona se zove oligodendrocit.

And when these four cells work together

Kada ove četiri stanice rade zajedno

in health and harmony,

u zdravlju i skladu,

they create an extraordinary symphony of electrical activity,

one stvaraju iznimnu simfoniju električne aktivnosti,

and it is this electrical activity

a upravo je ta električna aktivnost

that underpins our ability to think, to emote,

osnova naše sposobnosti razmišljanja, emotivnosti,

to remember, to learn, move, feel and so on.

sjećanja, učenja, kretanja, osjećanja i drugog.

But equally, each of these individual four cells

Jednako tako, svaka od ove četiri stanice

alone or together, can go rogue or die,

pojedinačno ili zajedno, može odumrijeti

and when that happens, you get damage.

a kada se to dogodi nastaje oštećenje.

You get damaged wiring.

Nastaje oštećenje veza.

You get disrupted connections.

Dobijete narušene veze.

And that's evident here with the slower conduction.

A to je vidljivo kao sporija provodljivost veza.

But ultimately, this damage will manifest

U konačnici, to oštećenje se očituje

as disease, clearly.

kao bolest.

And if the starting dying nerve cell

Ako je živčana stanica koja umire

is a motor nerve, for example,

na primjer, motoneuron,

you'll get motor neuron disease.

nastat će bolest motoneurona.

So I'd like to give you a real-life illustration

Voli bih vam dati primjer iz stvarnog života

of what happens with motor neuron disease.

o onome što se događa kod bolesti motoneurona.

So this is a patient of mine called John.

Ovo je moj pacijent koji se zove John.

John I saw just last week in the clinic.

Posjetio sam Johna prošli tjedan u bolnici.

And I've asked John to tell us something about what were his problems

Zamolio sam ga da nam kaže nešto o svojim problemima koji

that led to the initial diagnosis

su doveli do početne dijagnoze

of motor neuron disease.

bolesti motoneurona.

John: I was diagnosed in October in 2011,

John: Dijagnosticiran sam u studenome 2011,

and the main problem was a breathing problem,

a glavni problem bio je s disanjem,

difficulty breathing.

otežano disanje.

Siddharthan Chandran: I don't know if you caught all of that, but what John was telling us

Siddharthan Chandran: Nisam siguran jeste razumijeli, ali što je John rekao

was that difficulty with breathing

bilo je da su poteškoće s disanjem

led eventually to the diagnosis

dovele s vremenom do dijagnoze

of motor neuron disease.

bolesti motoneurona.

So John's now 18 months further down in that journey,

Prošlo je 18 mjeseci od Johnove dijagnoze

and I've now asked him to tell us something about

pa sam ga upitao da nam kaže nešto o

his current predicament.

trenutnoj situaciji.

John: What I've got now is the breathing's gotten worse.

John: Ono što je sada novo je da se disanje pogoršalo.

I've got weakness in my hands, my arms and my legs.

Osjećam slabost u rukama i nogama.

So basically I'm in a wheelchair most of the time.

Većinu vremena provodim u kolicima.

SC: John's just told us he's in a wheelchair

SC: John nam je rekao da je u kolicima

most of the time.

većinu vremena.

So what these two clips show

Ono što pokazuju ova dva isječka

is not just the devastating consequence of the disease,

nisu samo razarajuće posljedice ove bolesti.

but they also tell us something about

već nam govore nešto i o

the shocking pace of the disease,

šokantnoj dinamici ove bolesti,

because in just 18 months,

jer je u samo 18 mjeseci

a fit adult man has been rendered

sposobnu odraslu osobu učinila

wheelchair- and respirator-dependent.

ovisnom o kolicima i respiratoru.

And let's face it, John could be anybody's father,

Budimo realni, John bi mogao biti nečiji otac,

brother or friend.

brat ili prijatelj.

So that's what happens when the motor nerve dies.

To se događa kada odumru motoneuroni.

But what happens when that myelin cell dies?

Ali što se događa kada propadnu mijelinske stanice?

You get multiple sclerosis.

Dobijete multiplu sklerozu.

So the scan on your left

Slika s lijeve strane

is an illustration of the brain,

je ilustracija mozga,

and it's a map of the connections of the brain,

to je mapa moždanih veza,

and superimposed upon which

koja je prekrivena

are areas of damage.

područjima oštećenja.

We call them lesions of demyelination.

Nazivamo ih demijeliniziacijskim lezijama.

But they're damage, and they're white.

To su oštećenja i bijela su.

So I know what you're thinking here.

Znam o čemu sad razmišljate.

You're thinking, "My God, this bloke came up

Mislite: „Moj Bože, ovaj je došao ovdje

and said he's going to talk about hope,

i rekao da će pričati o nadi,

and all he's done is give a really rather bleak

a sve što je ispričao je prilično mračna

and depressing tale."

i depresivna priča.“

I've told you these diseases are terrible.

Rekao sam vam da su ove bolesti užasne.

They're devastating, numbers are rising,

Razarajuće su, brojevi rastu,

the costs are ridiculous, and worst of all,

cijene su apsurdne, a najgore od svega

we have no treatment. Where's the hope?

ne postoji liječenje. Pa gdje je nada?

Well, you know what? I think there is hope.

Znate što? Mislim da postoji nada.

And there's hope in this next section,

I postoji u sljedećem odsječku

of this brain section of somebody else with M.S.,

ove moždane sekcije osobe s multiplom sklerozom,

because what it illustrates

a ono što prikazuje

is, amazingly, the brain can repair itself.

je nevjerojatno, mozak se može popraviti sam.

It just doesn't do it well enough.

Ali ne čini to dovoljno dobro.

And so again, there are two things I want to show you.

I ponovno, postoje dvije stvari koje vam želim pokazati.

First of all is the damage of this patient with M.S.

Prva je oštećenje pacijenta s M.S.

And again, it's another one of these white masses.

To je još jedna od ovih bijelih masa.

But crucially, the area that's ringed red

Ali najbitnije je da crveno zaokruženo područje

highlights an area that is pale blue.

ističe područje koje je svjetloplavo.

But that area that is pale blue was once white.

Ovo svjetloplavo područje bilo je bijelo.

So it was damaged. It's now repaired.

Bilo je oštećeno. A sada je popravljeno.

Just to be clear: It's not because of doctors.

Da pojasnim: To nije zbog liječnika.

It's in spite of doctors, not because of doctors.

Već unatoč liječnicima, a ne zbog njih.

This is spontaneous repair.

Ovo je spontani popravak.

It's amazing and it's occurred

To je nevjerojatno i dogodilo se

because there are stem cells in the brain, even,

jer postoje matične stanice u mozgu

which can enable new myelin, new insulation,

koje stvaraju novi mijelin, novu izolaciju

to be laid down over the damaged nerves.

koja će biti postavljena oko oštećenih živaca.

And this observation is important for two reasons.

Ovo opažanje važno je iz dva razloga.

The first is it challenges one of the orthodoxies

Prvi razlog je da osporava jednu od dogmi

that we learnt at medical school,

koje smo naučili na medicini,

or at least I did, admittedly last century,

ili barem ja jesam, priznajem prošlog stoljeća,

which is that the brain doesn't repair itself,

a to je da se mozak ne može popraviti sam,

unlike, say, the bone or the liver.

kao, primjerice, kost ili jetra.

But actually it does, but it just doesn't do it well enough.

Zapravo može, ali ne radi to dovoljno dobro.

And the second thing it does,

Druga stvar koju čini

and it gives us a very clear direction of travel for new therapies --

a daje nam vrlo jasan smjer traganja za novim terapijama --

I mean, you don't need to be a rocket scientist

ne morate biti posebno inteligentni

to know what to do here.

da znate što učiniti.

You simply need to find ways of promoting

Potrebno je samo pronaći i način za promicanjem

the endogenous, spontaneous repair that occurs anyway.

endogenih, spontanih popravaka koji se sami događaju.

So the question is, why, if we've known that

Pitanje je, zašto, ako smo to znali

for some time, as we have,

neko vrijeme, a jesmo,

why do we not have those treatments?

zašto ne postoji takvo liječenje?

And that in part reflects the complexity

A to dijelom odražava složenost

of drug development.

razvoja lijekova.

Now, drug development you might think of

Razvoj lijekova možete zamisliti

as a rather expensive but risky bet,

kao prilično skupu i rizičnu okladu,

and the odds of this bet are roughly this:

a izgledi za ovu okladu su otprilike ovi:

they're 10,000 to one against,

oni su 10,000 naprema 1,

because you need to screen about 10,000 compounds

zato što je potrebno ispitati oko 10,000 spojeva

to find that one potential winner.

kako bi se pronašao potencijalni pobjednik.

And then you need to spend 15 years

A zatim je potrebno potrošiti 15 godina

and spend over a billion dollars,

i oko milijardu dolara,

and even then, you may not have a winner.

a ni onda, možda nećete imati pobjednika.

So the question for us is,

Pitanje za nas je,

can you change the rules of the game

možemo li promijeniti pravila igre

and can you shorten the odds?

i poboljšati izglede?

And in order to do that, you have to think,

Kako bismo to učinili, treba razmisliti,

where is the bottleneck in this drug discovery?

gdje je napredak u otkrivanju ovog lijeka?

And one of the bottlenecks is early in drug discovery.

Jedan od napredaka nastao je rano u otkrivanju lijeka.

All that screening occurs in animal models.

Sav taj odabir odnosi se na životinjske modele.

But we know that the proper study of mankind is man,

A znamo da je pogodno istraživati čovječanstvo na čovjeku,

to borrow from Alexander Pope.

da citiram Alexandera Popea.

So the question is, can we study these diseases

Pitanje je, možemo li proučavati ove bolesti

using human material?

koristeći ljudski materijal?

And of course, absolutely we can.

Naravno da možemo.

We can use stem cells,

Možemo koristiti matične stanice,

and specifically we can use human stem cells.

posebice možemo koristiti humane matične stanice.

And human stem cells are these extraordinary

A humane matične stanice su iznimne

but simple cells that can do two things:

ali jednostavne stanice koje mogu dvije stvari:

they can self-renew or make more of themselves,

imaju sposobnost samoobnove i umnažanja,

but they can also become specialized

ali i mogu se sepecijalizirati u

to make bone, liver or, crucially, nerve cells,

koštane, jetrene ili još bitnije živčane stanice,

maybe even the motor nerve cell

možda čak i motoneurone

or the myelin cell.

ili mijelinske stanice.

And the challenge has long been,

A izazov je dugo bio:

can we harness the power,

možemo li iskoristiti moć,

the undoubted power of these stem cells

neosporivu moć ovih matičnih stanica

in order to realize their promise

s ciljem da ih iskoristimo

for regenerative neurology?

za regenerativnu neurolgiju?

And I think we can now, and the reason we can

Ja mislim da možemo, a razlog da možemo

is because there have been several major discoveries

je zato što postoji nekoliko velikih otkrića

in the last 10, 20 years.

u proteklih 10, 20 godina.

One of them was here in Edinburgh,

Jedno od njih bilo je ovdje u Edinburghu,

and it must be the only celebrity sheep, Dolly.

a to je jedina slavna ovca, Dolly.

So Dolly was made in Edinburgh,

Dolly je napravljena u Edinburghu,

and Dolly was an example

i Dolly je bila primjer

of the first cloning of a mammal

prvog sisavca koji je kloniran

from an adult cell.

iz zrelih stanica.

But I think the even more significant breakthrough

Ali mislim da je mnogo značajnije otkriće

for the purposes of our discussion today

za potrebne naše današnje rasprave

was made in 2006 by a Japanese scientist

napravio 2006. japanski znanstvanik

called Yamanaka.

koji se zvao Yamanaka.

And what Yamaka did,

Ono što je Yamanaka učinio,

in a fantastic form of scientific cookery,

u vidu izvrsnog znanstvenog kulinarstva,

was he showed that four ingredients,

pokazao je da četiri sastojka,

just four ingredients,

samo četiri sastojka,

could effectively convert any cell, adult cell,

mogu učinkovito pretvoriti bilo koju stanicu, odraslu stanicu,

into a master stem cell.

u glavnu matičnu stanicu.

And the significance of this is difficult to exaggerate,

A važnost ovoga teško je preuveličati,

because what it means that from anybody in this room,

zato što to znači da od bilo koga u ovoj prostoriji,

but particularly patients,

a osobito bolesnika,

you could now generate

sada možete stvoriti

a bespoke, personalized tissue repair kit.

po mjeri, osoban set za popravak tkiva.

Take a skin cell, make it a master pluripotent cell,

Uzmete stanicu kože, učinite ju pluripotentnom stanicom,

so you could then make those cells

kako bi mogle napraviti one stanice

that are relevant to their disease,

koje su bitne za neku bolest,

both to study but potentially to treat.

za proučavanje, ali i potencijalno liječenje.

Now, the idea of that at medical school --

Ta ideja na medicinskom fakultetu --

this is a recurring theme, isn't it, me and medical school? —

ova se tema ponavlja, zar ne, medicinski fakultet i ja? —

would have been ridiculous,

bila bi smiješna,

but it's an absolute reality today.

ali je danas stvarnost.

And I see this as the cornerstone

Gledam na ovo kao temelj

of regeneration, repair and hope.

za regeneraciju, popravak i nadu.

And whilst we're on the theme of hope,

I kad smo već na temi nade

for those of you who might have failed at school,

za vas koji možda niste imali uspjeha u školi,

there's hope for you as well,

postoji nada i za vas,

because this is the school report of John Gerdon.

zato što je ovo školsko izvješće Johna Gerdona.

["I believe he has ideas about becoming a scientist; on his present showing this is quite ridiculous."]

[„Mislim da ima želju postati znanstvenik; kako se dosad pokazao to je poprilično smiješno.“]

So they didn't think much of him then.

Nisu tada imali visoko mišljenje o njemu.

But what you may not know is that he got the Nobel Prize for medicine

Ali ono što možda ne znate je da je dobio Nobelovu nagradu za medicinu

just three months ago.

prije tri mjeseca.

So to return to the original problem,

Da se vratim prvotnom problemu,

what is the opportunity of these stem cells,

koja je mogućnost da ove matične stanice,

or this disruptive technology,

ili ova disruptivna tehnika,

for repairing the damaged brain,

poprave oštećeni mozak,

which we call regenerative neurology?

a zovemu ju regenerativna neurologija?

I think there are two ways you can think about this:

Mislim da postoje dva načina razmišljanja o ovome:

as a fantastic 21st-century drug discovery tool,

kao fanatastičan ljekoviti izum 21. stoljeća

and/or as a form of therapy.

I/ili kao oblik terapije.

So I want to tell you a little bit about both of those

Želim vam reći nešto o oba

in the next few moments.

u sljedećim trenucima.

Drug discovery in a dish is how people often

Ljudi često pričaju o ovome kao

talk about this.

lijek otkriven u posudici.

It's very simple: You take a patient with a disease,

Vrlo je jednostavno: Uzmete pacijenta sa bolešću,

let's say motor neuron disease,

primjerice motoneurona,

you take a skin sample,

uzmete uzorak kože,

you do the pluripotent reprogramming,

napravite pluripotentno reprogramiranje,

as I've already told you,

kao što sam prije rekao,

and you generate live motor nerve cells.

i uzgajate živu motornu živčanu stanicu.

That's straightforward, because that's what

To je pojednostavljeno, zato što je to ono

pluripotent cells can do.

što pluripotentne stanice mogu.

But crucially, you can then compare their behavior

Bitno je da možete usporediti njihovo ponašanje

to their equivalent but healthy counterparts,

s njima jednakim, ali zdravim parom,

ideally from an unaffected relative.

idealno, od zdravog rođaka.

That way, you're matching for genetic variation.

Na taj način, odgovarajuće su za genetske varijacije.

And that's exactly what we did here.

A to je upravo ono što smo učinili ovdje.

This was a collaboration with colleagues:

Ovo je bilo u suradnji s kolegama:

in London, Chris Shaw; in the U.S., Steve Finkbeiner and Tom Maniatis.

iz Londona, Chris Shaw, iz SAD-a, Steve Finkerbeiner i Tom Maniatis.

And what you're looking at, and this is amazing,

Ono što gledate vrlo je nevjerojatno,

these are living, growing, motor nerve cells

to su živi, rastući, motoneuroni

from a patient with motor neuron disease.

od pacijetna s bolesti motoneurona.

It happens to be an inherited form.

U ovom slučaju naslijeđeni oblik.

I mean, just imagine that.

Samo zamislite ovo.

This would have been unimaginable 10 years ago.

To je bilo nezamislivo prije 10 godina.

So apart from seeing them grow and put out processes,

Osim što ih vidimo kako rastu i rade različite procese

we can also engineer them so that they fluoresce,

možemo ih učiniti flourescentnima

but crucially, we can then track their individual health

a što je bitno, tada možemo pratiti zdravlje svake posebno

and compare the diseased motor nerve cells

te usporediti boelsne motoneurone

to the healthy ones.

sa zdravima.

And when you do all that and put it together,

A kada to učinite i stavite ih zajedno,

you realize that the diseased ones,

uočavamo da one bolesne,

which is represented in the red line,

koje su predstavljene crvenom linijom,

are two and a half times more likely to die

imaju dva i pol puta veću vjerojatnost da umru

than the healthy counterpart.

od zdravog para.

And the crucial point about this is that you then have

Bitna stvar u ovome je da onda imate

a fantastic assay to discover drugs,

odličan testa za otkrivanje lijekova,

because what would you ask of the drugs,

zato što ono što bi tražili od lijeka,

and you could do this through a high-throughput

a to možete učinit pomoću visoko-protočni

automated screening system,

automatizirani probirni sustav,

you'd ask the drugs, give me one thing:

zatražili biste od lijeka jednu stvar:

find me a drug that will bring the red line

pronađi mi lijek koji će crvenu liniju dovesti

closer to the blue line,

bliže plavoj liniji

because that drug will be a high-value candidate

zato što će taj lijek tada biti kandidat visoke vrijednosti

that you could probably take direct to human trial

koji bi vjerojatno mogli odnijeti na ljudsko ispitivanje

and almost bypass that bottleneck

i gotovo zaobići to usko grlo

that I've told you about in drug discovery

o kojem sam vam pričao kod otkrivanja lijekova

with the animal models,

na životinjskim modelima,

if that makes sense. It's fantastic.

ako to ima smisla. To je odlično.

But I want to come back

Ali želio bih se vratiti

to how you might use stem cells directly

na to kako bi mogli koristiti matične stanice izravno

to repair damage.

za popravak oštećenja.

And again there are two ways to think about this,

Opet postoje dva načina razmišljanja o ovome,

and they're not mutually exclusive.

i međusobno se ne isključuju.

The first, and I think in the long run

Prvi, a mislim i na duge staze

the one that will give us the biggest dividend,

onaj koji će nam dati najveće dividende,

but it's not thought of that way just yet,

ali se o njemu još ne razmišlja na taj način,

is to think about those stem cells that are already

je da razmislimo o matičnim stanicama koje su već

in your brain, and I've told you that.

u našem mozgu, a to sam vam rekao.

All of us have stem cells in the brain,

Svi imamo matične stanice u mozgu,

even the diseased brain,

čak i u bolesnom mozgu,

and surely the smart way forward

a sigurno pametan put za napredak

is to find ways that you can promote and activate

je pronaći načine kako potaknuti i aktivirati

those stem cells in your brain already

te matične stanicu koje su već u mozgu

to react and respond appropriately to damage

da na odgovarajući reagiraju i odgovore na štetu

to repair it.

i poprave ju.

That will be the future.

To je budućnost.

There will be drugs that will do that.

Postojat će lijekovi koji će to moći učiniti.

But the other way is to effectively parachute in cells,

Drugi način je da se učinkovito uzmu stanice,

transplant them in,

transplantiraju

to replace dying or lost cells, even in the brain.

da zamjene umiruće ili izgubljene stanice, čak i u mozgu,

And I want to tell you now an experiment,

Želim vam reći za eksperiment,

it's a clinical trial that we did,

kliničko ispitivanje koji smo napravili

which recently completed,

koje je nedavno dovršeno,

which is with colleagues in UCL,

sa kolegama s UCL-a,

David Miller in particular.

posebice Davidom Millerom.

So this study was very simple.

Ispitivanje je bilo vrlo jednostavno.

We took patients with multiple sclerosis

Izabrali smo pacijente s multiplom sklerozom

and asked a simple question:

i pitali jednostavno pitanje:

Would stem cells from the bone marrow

Bi li matične stanice iz koštane srži

be protective of their nerves?

štitile svoje živce?

So what we did was we took this bone marrow,

Ono što smo napravili je da smo uzeli koštanu srž,

grew up the stem cells in the lab,

uzgojili matičnu stanicu u laboratoriju,

and then injected them back into the vein.

a zatim je ubrizgali natrag u venu.

I'm making this sound really simple.

Čini vam ovo vrlo jednostavnim.

It took five years off a lot of people, okay?

Oduzelo je pet godina mnogim ljudima, u redu?

And it put gray hair on me

A mene je posijedilo

and caused all kinds of issues.

i uzrokovalo razne probleme.

But conceptually, it's essentially simple.

No konceptualno je vrlo jednostavno.

So we've given them into the vein, right?

Ubacili smo ih natrag u venu, zar ne?

So in order to measure whether this was successful or not,

Kako bi izmjerili je li ovo bilo uspješno ili ne,

we measured the optic nerve

uzeli smo vidni živac

as our outcome measure.

kao ishod mjerenja.

And that's a good thing to measure in M.S.,

A to je dobra stvar za mjeriti u M.S.

because patients with M.S. sadly suffer

jer bolesnici s M.S. nažalost pate

with problems with vision --

od problema s vidom --

loss of vision, unclear vision.

gubitak vida, nejasan vid.

And so we measured the size of the optic nerve

Mjerili smo veličinu vidni živca

using the scans with David Miller

s Davidom Millerom koristeći skenere

three times -- 12 months, six months,

tri puta -- 12 mjeseci, šest mjeseci

and before the infusion --

i prije infuzije --

and you can see the gently declining red line.

i možete vidjeti lagano padanje crvene linije.

And that's telling you that the optic nerve is shrinking,

A to vam govori da se vidni živac smanjuje,

which makes sense, because their nerves are dying.

što ima smisla, jer odumiru njegovi neuroni.

We then gave the stem cell infusion

zatim smo dali infuziju matičnih stanica

and repeated the measurement twice --

i ponovili mjerenje dva puta --

three months and six months --

tri mjeseca i šest mjeseci --

and to our surprise, almost,

i na naše iznenađenje,

the line's gone up.

linija je porasla.

That suggests that the intervention

To upućuje da je intervencija

has been protective.

bila preventivna.

I don't think myself that what's happened

Ne mislim da je ono što se dogodilo

is that those stem cells have made new myelin

da su matične stanice napravile novi mijelin

or new nerves.

ili nove neurone.

What I think they've done is they've promoted

Ono što ja mislim je da su potaknule

the endogenous stem cells, or precursor cells,

endogene matične stanice ili prekursorske stanice,

to do their job, wake up, lay down new myelin.

na posao, probudile ih da stvaraju novi mijelin.

So this is a proof of concept.

Ovo je dokaz ideje.

I'm very excited about that.

Jako sam uzbuđen zbog toga.

So I just want to end with the theme I began on,

Želim završiti s temom s kojom sam započeo,

which was regeneration and hope.

a to je regeneracija i nada.

So here I've asked John

Upitao sam Johna

what his hopes are for the future.

koja su njegova nadanja za budućnost.

John: I would hope that

John: Nadam se da će

sometime in the future

jednom u budućnosti

through the research that you people are doing,

kroz istraživanja koja vi ljudi radite,

we can come up with a cure

proizvesti lijek

so that people like me can lead a normal life.

kako bi ljudi kao ja mogli voditi normalan život.

SC: I mean, that speaks volumes.

To dovoljno govori.

But I'd like to close by first of all thanking John --

Želio bih završiti prije svega zahvalivši Johnu --

thanking John for allowing me to share

zahvalan sam što je dopustio da podijelim

his insights and these clips with you all.

njegov uvid i ove isječke s vama svima.

But I'd also like to add to John and to others

Htio bih dodati za Johna i ostale

that my own view is, I'm hopeful for the future.

da sam osobno pun nade za budućnost.

I do believe that the disruptive technologies

Vjerujem da će disruptivne tehnologije

like stem cells that I've tried to explain to you

kao matične stanice koje sam pokušao objasniti

do offer very real hope.

pružaju stvarnu nadu.

And I do think that the day that we might be able

Mislim da će dan kada ćemo biti u mogućnosti

to repair the damaged brain

popravljati moždana oštećenja

is sooner than we think.

doći ranije nego što mislimo.

Thank you.

Hvala.

(Applause)

(Pljesak)