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

Prevoditelj: Marina Maras Recezent: Mislav Ante Omazić - EFZG

It's a pleasure to be here

Zadovoljstvo je biti danas ovdje

in Edinburgh, Scotland,

u Edinburghu, Škotskoj,

the birthplace of the needle and syringe.

mjestu gdje su nastale igla i šprica.

Less than a mile from here in this direction,

Manje od kilometra i pol u ovom smjeru

in 1853 a Scotsman

1853. godine jedan je Škot

filed his very first patent on the needle and syringe.

zatražio svoj prvi patent na iglu i špricu.

His name was Alexander Wood,

Njegovo ime je Alexander Wood,

and it was at the Royal College of Physicians.

i to se dogodilo na Kraljevskom koledžu liječnika.

This is the patent.

Ovo je patent.

What blows my mind when I look at it even today

Ono što me zapanjuje čak i danas kad ga pogledam

is that it looks almost identical

jest činjenica da izgleda skoro identično

to the needle in use today.

kao igla koju koristimo danas.

Yet, it's 160 years old.

A patent je star 160 godina.

So we turn to the field of vaccines.

Ali osvrnimo se malo na područje cjepiva.

Most vaccines are delivered with

Većina cjepiva se vrši ubodom

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

igle ili šprice, 160 godina starom tehnologijom.

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

Ali moramo joj odati veliko priznanje -- na mnogo razina,

vaccines are a successful technology.

cjepiva su vrlo uspješna tehnologija.

After clean water and sanitation,

Uz čistu vodu i sustav kanalizacije,

vaccines are the one technology that has increased

cjepiva su tehnologija koja je najviše pridonijela

our life span the most.

produžetku životnog vijeka ljudi.

That's a pretty hard act to beat.

Teško je to nadmašiti.

But just like any other technology,

Ali kao i svaka druga tehnologija

vaccines have their shortcomings,

cjepiva imaju svoje nedostatke,

and the needle and syringe

a igla i šprica

is a key part within that narrative --

su ključni dio ove priče --

this old technology.

ova zastarjela tehnologija.

So let's start with the obvious:

Pa počnimo s očitim:

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

mnogi ljudi ne vole igle i šprice.

I share that view.

I ja se u potpunosti slažem s tim stavom.

However, 20 percent of the population

Međutim 20 posto populacije

have a thing called needle phobia.

pati od nečega što se zove fobija od igala.

That's more than disliking the needle;

To je jače od osjećaja da ne volite igle;

that is actively avoiding being vaccinated

to znači da aktivno izbjegavate cijepljenje

because of needle phobia.

upravo zbog fobije od igala.

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

I to je problematično u smislu primjene cjepiva.

Now, related to this is another key issue,

Drugi ključan problem vezan uz ovo jesu

which is needlestick injuries.

ozljede prouzročene iglom.

And the WHO has figures

Statistika Svjetske zdrastvene organizacije

that suggest about 1.3 million deaths per year

ukazuje da negdje oko 1,3 milijuna ljudi umre godišnje

take place due to cross-contamination

zbog kontaminacije koja se dogodi

with needlestick injuries.

preko ozljeda prouzrokovanih iglom.

These are early deaths that take place.

Sve su ovo preuranjene smrti.

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

Ovo su dvije stvari za koje ste zasigurno čuli,

but there are two other shortcomings

ali postoje dva nedostatka

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

igle i šprice za koje možda niste čuli.

One is it could be holding back

Jedan od njih je taj što bi igla i šprica mogle usporiti razvoj

the next generation of vaccines

sljedeće generacije cjepiva

in terms of their immune responses.

po pitanju njihovog imunosnog odgovora.

And the second is that it could be responsible

A drugi nedostatak je taj što bi takva tehnologija mogla biti odgovorna

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

za problem hladnog lanca o kojem ću vam također govoriti.

I'm going to tell you about some work

Govorit ću vam o radu na kojem radim

that my team and I are doing in Australia

zajedno sa svojim timom u Australiji

at the University of Queensland

na Sveučilištu Queensland

on a technology designed to tackle those four problems.

i to na tehnologiji koja bi se upravo trebala baviti s ova četiri problema.

And that technology is called the Nanopatch.

I ta se tehnologija zove Nanoflaster.

Now, this is a specimen of the Nanopatch.

Ovo je primjerak Nanoflastera.

To the naked eye

Kada ga pogledamo golim okom,

it just looks like a square

izgleda nam poput kvadrata

smaller than a postage stamp,

manjeg od poštanske marke,

but under a microscope

ali ako ga pogledate ispod mikroskopa

what you see are thousands of tiny projections

vidjeti ćete tisuću sićušnih ispupčenja

that are invisible to the human eye.

koje su nevidljive ljudskom oku.

And there's about 4,000 projections

Oko 4.000 ispupčenja se nalazi

on this particular square compared to the needle.

na ovom kvadratu kad ga usporedimo s iglom.

And I've designed those projections

I dizajnirao sam ta ispupčenja

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

kako bi poslužili ključnoj svrsi, a to je da rade zajedno s imunosnim sustavom kože.

So that's a very important function

I to je vrlo važna funkcija

tied in with the Nanopatch.

povezana s Nanoflasterom.

Now we make the Nanopatch

Danas proizvodimo Nanoflaster

with a technique

tehnikom

called deep reactive ion etching.

koja se zove duboko reaktivno ionsko graviranje

And this particular technique is one that's been borrowed

I ta specifična tehnika je preuzeta

from the semiconductor industry,

iz područja industrije poluvodiča,

and therefore is low cost

i zbog toga je jeftina

and can be rolled out in large numbers.

te može imati široku primjenu.

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

Sad nanosimo sloj cjepiva u suhom stanju na ispupčenja Nanoflastera

and apply it to the skin.

i tada stavljamo Nanoflaster na kožu.

Now, the simplest form of application

Najednostavniji način primjene

is using our finger,

jest nanošenje prstima

but our finger has some limitations,

ali i naši prsti imaju ograničenja,

so we've devised an applicator.

pa smo osmislili aplikator.

And it's a very simple device --

I to je vrlo jednostavan mehanizam --

you could call it a sophisticated finger.

mogli bismo ga nazvati sofisticiranim prstom.

It's a spring-operated device.

To je mehanizam koji radi na principu opruge.

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

Što se događa kada nanesemo Nanoflaster na kožu --

(Click) --

(Klik) --

immediately a few things happen.

odmah se dogodi nekoliko stvari.

So firstly, the projections on the Nanopatch

Prvo, ispupčenja na Nanoflasteru

breach through the tough outer layer

probijaju čvrsti vanjski sloj kože

and the vaccine is very quickly released --

i cjepivo se brzo otpušta --

within less than a minute, in fact.

i sve to zapravo traje manje od jedne minute.

Then we can take the Nanopatch off

Tada možemo skinuti Nanoflaster

and discard it.

i baciti ga.

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

Ali sami aplikator možemo ponovno koristiti.

So that gives you an idea of the Nanopatch,

Ovo bi vam trebalo otprilike dati ideju o tome kako radi Nanoflaster,

and immediately you can see some key advantages.

i odmah možete uočiti neke ključne prednosti.

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

Rekli smo već kako smo iz primjene izbacili iglu --

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

ovdje se radi o ispupčenjima koje ne možete vidjeti --

and, of course, we get around

a tako, naravno, uspješno rješavamo

the needle phobia issue as well.

problem fobije od igle.

Now, if we take a step back and think about

Sad malo stanimo i promislimo

these other two really important advantages:

o druge dvije, vrlo važne, prednosti:

One is improved immune responses through delivery,

jedna je poboljšani imunosni odgovor zahvaljujući provedbi,

and the second is getting rid of the cold chain.

a druga je ta što se rješavamo hladnog lanca.

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

Počnimo s prvom prednošću, s idejom imunogenosti.

It takes a little while to get our heads around,

Trebat će vam malo vremena da shvatite ovaj pojam

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

ali pokušat ću pojednostavniti.

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

Vratit ću se korak unazad i objasniti vam

how vaccines work in a simple way.

na jednostavan način kako cjepiva funkcioniraju.

So vaccines work by introducing into our body

Dakle cjepiva funkcioniraju tako da u tijelo unosimo

a thing called an antigen

tvar koje se zove antigen

which is a safe form of a germ.

koja je zapravo sigurni oblik bakterije.

Now that safe germ, that antigen,

Tada ta sigurna bakterija, taj antigen

tricks our body into mounting an immune response,

na prevaru izaziva imunosnu reakciju našeg tijela

learning and remembering how to deal with intruders.

koji tako uči i pamti kako postupati s uljezima.

When the real intruder comes along

Kada pravi uljez dođe

the body quickly mounts an immune response

tijelo brzo stvori imunosnu reakciju

to deal with that vaccine

kako bi se suočilo s cjepivom

and neutralizes the infection.

i neutralizirao infekciju.

So it does that well.

I to radi dobro.

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

Danas se to radi iglom i špricom,

most vaccines are delivered that way --

većina cjepiva djeluje na taj način --

with this old technology and the needle.

koristeći ovu staru tehnologiju i iglu.

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

Ali moglo bi se argumentirano tvrditi da igla zapravo sputava našu imunosnu reakciju;

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

ona promašuje imunosno najučinkovitiji dio na našoj koži.

To describe this idea,

Kako bih vam predočio ovu ideju,

we need to take a journey through the skin,

moramo krenuti na putovanje kroz kožu,

starting with one of those projections

krenut ćemo od jednog ispupčenja

and applying the Nanopatch to the skin.

i nanošenja Nanoflastera na kožu.

And we see this kind of data.

I vidimo ovu vrstu podataka.

Now, this is real data --

Sada, ovo su stvarni podatci --

that thing that we can see there is one projection

ovo što možemo vidjeti tamo jest ispupčenje

from the Nanopatch that's been applied to the skin

s Nanoflastera koji je nanesen na kožu

and those colors are different layers.

a ove boje predstavljaju različite slojeve.

Now, to give you an idea of scale,

Kako bih vam dao nekakvu predodžbu o proporcijama,

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

kad bismo ovdje prikazali iglu, ona bi bila prevelika.

It would be 10 times bigger

Ona bi bila 10 puta veća

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

od veličine ovog ekrana, a također bi i prodirala 10 puta dublje.

It's off the grid entirely.

Usporedba nije čak ni moguća.

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

Možete odmah primijetiti da su ispupčenja u koži.

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

Ovaj crveni sloj je čvrsti vanjski sloj mrtve kože,

but the brown layer and the magenta layer

ali smeđi sloj i magenta sloj

are jammed full of immune cells.

su pretrpani imunosnim stanicama.

As one example, in the brown layer

Naprimjer, u smeđem sloju

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

se nalazi određena vrsta stanice koju nazivamo Langerhans stanica --

every square millimeter of our body

svaki četvorni milimetar našeg tijela

is jammed full of those Langerhans cells,

je pretrpan ovim Langerhans stanicama,

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

imunosnim stanica, a prikazane su i druge stanice

that we haven't stained in this image.

koje nismo zabilježili na ovoj slici.

But you can immediately see that the Nanopatch

Ali možete odmah vidjeti da Nanoflaster

achieves that penetration indeed.

uspijeva zaista prodrijeti.

We target thousands upon thousands of these particular cells

Mi ciljamo na tisuće i tisuće ovih stanica

just residing within a hair's width

koje se nalaze unutar površinskog sloja kože

of the surface of the skin.

tankog poput dlake.

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

Kao čovjek koji je smislio ovu napravu i dizajnirao je da čini sve ovo,

I found that exciting. But so what?

za mene je to uzbudljivo. Pa što?

So what if you've targeted cells?

Pa što ako smo naciljali stanice?

In the world of vaccines, what does that mean?

U svijetu cjepiva, što to zapravo znači?

The world of vaccines is getting better.

Svijet cjepiva postaje bolji.

It's getting more systematic.

Postaje sustavniji.

However, you still don't really know

Međutim, još uvijek ne možete zaista znati

if a vaccine is going to work

hoće li cjepivo raditi,

until you roll your sleeves up

sve dok ne zavrnete rukave,

and vaccinate and wait.

cijepite se i čekate.

It's a gambler's game even today.

To je kocka čak i danas.

So, we had to do that gamble.

Ali morali smo se kockati.

We obtained an influenza vaccine,

Uzeli smo cjepivo za gripu

we applied it to our Nanopatches

i nanijeli ga na naš Nanoflaster

and we applied the Nanopatches to the skin,

a Nanoflaster smo nanijeli na kožu

and we waited --

i onda smo čekali --

and this is in the live animal.

i sve smo to napravili na živoj životinji.

We waited a month,

Čekali smo mjesec dana

and this is what we found out.

i ovo smo otkrili.

This is a data slide showing the immune responses

Ovo je prikaz podataka koji pokazuju imunosnu reakciju

that we've generated with a Nanopatch

koju smo dobili Nanoflasterom

compared to the needle and syringe into muscle.

u usporedbi s onom koju smo dobili ubodom igle i šprice u mišić.

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

Na horizontalnoj osi je naznačena doza u nanogramima.

On the vertical axis we have the immune response generated,

Na vertikalnoj osi je prikazana dobivena imunosna reakcija,

and that dashed line indicates the protection threshold.

a isprekidana linija pokazuje prag zaštitnosti cjepiva.

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

Ako smo iznad tog praga, cjepivo se smatra zaštitnim;

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

a ako smo ispod te linije, onda nije.

So the red line is mostly below that curve

Crvena linija se većim dijelom nalazi ispod te krivulje

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

i zapravo samo je jedna točka dobivena metodom igle zaštitna

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

i to s visokom dozom od 6.000 nanograma,

But notice immediately the distinctly different curve

ali primjetit ćete odmah bitno drugačiju krivulju

that we achieve with the blue line.

koji smo postigli plavom linijom.

That's what's achieved with the Nanopatch;

To smo postigli Nanoflasterom;

the delivered dose of the Nanopatch is

korištena doza kod Nanoflastera je

a completely different immunogenicity curve.

prikazana posve drugačijom krivuljom imunogenosti.

That's a real fresh opportunity.

To je prava, sviježa prilika.

Suddenly we have a brand new lever

Odjednom imamo potpuno novu polugu

in the world of vaccines.

u svijetu cjepiva.

We can push it one way,

Možemo je gurnuti u tom smjeru

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

da uzmemo cjepivo koje je djelotvorno ali preskupo

and can get protection

i možemo dobiti zaštitu

with a hundredth of the dose compared to the needle.

uzimajući samo stoti dio doze koji bismo trebali uzeti kad bismo koristili iglu.

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

To bi moglo dovesti do toga da cjepivo koje košta 10$ padne na samo10 centi,

and that's particularly important within the developing world.

a to je pogotovo važno za zemlje u razvoju.

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

Ali postoji i druga strana svega ovoga --

you can take vaccines that currently don't work

možete uzeti cjepiva koja nisu djelotvorna

and get them over that line

i dovesti ih iznad te linije

and get them protective.

i učiniti ih zaštitnima.

And certainly in the world of vaccines

A naravno u svijetu cjepiva

that can be important.

ovo može biti vrlo važno.

Let's consider the big three:

Pogledajmo veliku trojku:

HIV, malaria, tuberculosis.

HIV, malariju i tuberkulozu.

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

Ove bolesti su odgovorne za otprilike 7 milijuna smrti godišnje,

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

i ne postoji primjerena metoda cijepljenja za bilo koju od njih.

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

Ovom novom polugom koju imamo zahvaljujući Nanoflasteru

we can help make that happen.

možemo potencijalno postići i to.

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

Možemo gurnuti tu polugu kako bismo pomogli potencijalnim cjepivima prijeći tu liniju.

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

Radili smo, naravno, u mom laboratoriju

with many other vaccines that have attained

s mnogo drugih cjepiva koja su postigla

similar responses and similar curves to this,

reakcije i krivulje slične ovoj koju

what we've achieved with influenza.

smo dobili koristeći cjepivo protiv gripe.

I'd like to now switch to talk about

Sada bih želio malo govoriti o

another key shortcoming of today's vaccines,

drugom ključnom nedostatku suvremenih cjepiva,

and that is the need to maintain the cold chain.

a to je potreba da se održava hladni lanac.

As the name suggests -- the cold chain --

Kao što i samo ime kaže -- hladni lanac --

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

to je zapravo potreba da se cjepivo od proizvodnje

all the way through to when the vaccine is applied,

pa sve do trenutka kad se primjenjuje,

to keep it refrigerated.

čuva zamrznuto.

Now, that presents some logistical challenges

i tu se javljaju neki logistički izazovi

but we have ways to do it.

ali imamo načine kako i to uspješno riješiti.

This is a slightly extreme case in point

Ovo je malo ekstremniji primjer

but it helps illustrate the logistical challenges,

ali može prikazati logističke izazove,

in particular in resource-poor settings,

posebno u okolini koja je siromašna resursima,

of what's required to get vaccines

što je sve potrebno kako bi se cjepiva

refrigerated and maintain the cold chain.

zamrznula i kako bi se održao hladni lanac.

If the vaccine is too warm the vaccine breaks down,

Cjepivo se kvari ako je izloženo previsokim temperaturama

but interestingly it can be too cold

ali zanimljivo je da cjepivo može biti izloženo i preniskim temperaturama

and the vaccine can break down as well.

i da se opet može pokvariti.

Now, the stakes are very high.

Sada, ulozi su vrlo visoki.

The WHO estimates that within Africa,

Svjetska zdravstvena organizacija procjenjuje da u Africi

up to half the vaccines used there

čak polovica cjepiva koja se tamo koristi

are considered to not be working properly

najvjerojatnije nije djelotvorna

because at some point the cold chain has fallen over.

jer se upravo u jednom trenutku prekinuo hladni lanac .

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

Tako da je to veliki problem a usko je povezan s korištenjem igle i šprice

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

zato što se tu radi o tekućem obliku cjepiva, a u tom slučaju cjepivo treba zamrzavati.

A key attribute of our Nanopatch

Ključna osobina našeg Nanoflastera

is that the vaccine is dry,

jest ta da se cjepivo nalazi u suhom stanju

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

a kad je suho, ne treba zamrzavanje.

Within my lab we've shown that we can keep

U laboratoriju smo pokazali da možemo

the vaccine stored at 23 degrees Celsius

skladištiti cjepivo na temperaturi od 23°C

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

i to u razdoblju dužem od godinu dana bez gubitka razine aktivnosti.

That's an important improvement.

To je vrlo važan napredak.

(Applause)

(Pljesak)

We're delighted about it as well.

I mi smo oduševljeni time.

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

A što je najbitnije u svemu ovome jest da smo zaista dokazali

the Nanopatch within the laboratory setting.

učinkovitost Nanoflastera u laboratorijskom okruženju.

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

I kao znanstvenik volim to i volim znanost.

However, as an engineer,

Međutim, kao inžinjer,

as a biomedical engineer

kao biomedicinski inžinjer

and also as a human being,

i kao ljudsko biće

I'm not going to be satisfied

neću biti zadovoljan

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

dok ne zakotrljamo ovaj projekt i ne izađemo iz laboratorija

and got it to people in large numbers

te učinimo ovo dostupno ljudima

and particularly the people that need it the most.

i to pogotovo ljudima kojima je to najpotrebnije.

So we've commenced this particular journey,

Tako da smo započeli ovo putovanje

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

a započeli smo ga na vrlo neobičan način.

We've started with Papua New Guinea.

Počeli smo u Papui Novoj Gvineji.

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

Papua Nova Gvineja je primjer zemlje u razvoju.

It's about the same size as France,

Otprilike je iste veličine kao i Francuska

but it suffers from many of the key barriers

ali tu smo naišli na mnoge ključne prepreke

existing within the world of today's vaccines.

koje postoje u svijetu suvremenih cjepiva.

There's the logistics:

Tu je logistika:

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

u ovoj zemlji postoji samo 800 hladnjaka u kojima se čuvaju cjepiva.

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

Mnogi su stari, poput onoga u Port Moresbyju, mnogi se kvare,

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

a mnogi nisu dostupni u Gorju gdje su prijeko potrebni.

That's a challenge.

To je izazov.

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

Ali također Papua Nova Gvineja ima najveću stopu pojave HPV-a,

human papillomavirus, the cervical cancer [risk factor].

humanog papilloma virusa, raka grlića maternice [činitelj rizika] u svijetu.

Yet, that vaccine is not available in large numbers

Ipak to cjepivo nije dostupno u velikim količinama

because it's too expensive.

jer je preskupo.

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

Iz ta dva razloga, te zahvaljujući karakterstikama Nanoflastera,

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

počeli smo se baviti ovim i raditi s Nanoflasterom

and taken it to Papua New Guinea

te smo ga odnijeli u Papuu Novu Gvineju

and we'll be following that up shortly.

a uskoro ćemo provesti i praćenje rezultata.

Now, doing this kind of work is not easy.

Nije lako obavljati ovu vrstu posla.

It's challenging,

Izazovno je,

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

ali nema toga na svijetu što bih radije radio.

And as we look ahead

I dok gledamo prema budućnosti,

I'd like to share with you a thought:

podijelio bih s vama ovu misao:

It's the thought of a future where

To je ideja o budućnosti u kojoj je

the 17 million deaths per year

17 milijuna smrtnih slučajeva

that we currently have due to infectious disease

koje godišnje imamo kao posljedicu zaraznih bolesti

is a historical footnote.

samo povijesna fusnota.

And it's a historical footnote that has been achieved

Povijesna fusnota koju smo uspjeli ostvariti

by improved, radically improved vaccines.

poboljšanim, radikalno poboljšanim cjepivima.

Now standing here today in front of you

I dok danas stojim pred vama

at the birthplace of the needle and syringe,

na mjestu gdje su nastale igla i šprica,

a device that's 160 years old,

izumi koji su 160 godina stari,

I'm presenting to you an alternative approach

predstavljam vam novi pristup

that could really help make that happen --

kojim bi se to moglo i ostvariti --

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

a to je upravo Nanoflaster, kojemu su glavne osobine to što smo se riješili igle i boli,

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

te mogućnost da se izbjegne potreba za hladnim lancem i da se poboljša imunogenost.

Thank you.

Hvala.

(Applause)

(Pljesak.)