The Future of Early Cancer Detection? | Jorge Soto | TED Talks

Prevoditelj: Senzos Osijek Recezent: Ivan Stamenković

Almost a year ago,

Prije skoro godinu dana,

my aunt started suffering back pains.

moju tetu su počeli mučiti bolovi u leđima.

She went to see the doctor

Otišla je kod doktora

and they told her it was a normal injury

i rekao joj je da je to normalna ozljeda

for someone who had been playing tennis

za nekoga tko igra tenis

for almost 30 years.

skoro pa 30 godina.

They recommended that she do some therapy,

Preporučili su joj određene terapije,

but after a while she wasn't feeling better,

ali i dalje se nije osjećala bolje,

so the doctors decided to do further tests.

pa je doktor odlučio napraviti daljnja testiranja.

They did an x-ray

Napravili su rendgen

and discovered an injury in her lungs,

i otkrili ozljedu u njenim plućima,

and at the time they thought that the injury

i tada su mislili da je ozljeda

was a strain in the muscles and tendons

bila zbog napora mišića i tetiva

between her ribs,

između rebara,

but after a few weeks of treatment,

ali nakon nekoliko tjedana liječenja,

again her health wasn't getting any better.

njeno zdravlja nije postajalo bolje.

So finally, they decided to do a biopsy,

Na kraju su se odlučili napraviti biopsiju

and two weeks later,

i dva tjedna kasnije,

the results of the biopsy came back.

došao je razultat biopsije.

It was stage 3 lung cancer.

Imala je karcinom pluća trećeg stadija.

Her lifestyle was almost free of risk.

Njen životni stil je skoro bio bez rizika.

She never smoked a cigarette,

Nikada nije popušila cigaretu,

she never drank alcohol,

nikada nije pila alkohol,

and she had been playing sports

i bavila se sportom

for almost half her life.

skoro cijeli njen život.

Perhaps, that is why it took them almost six months

Možda je zbog toga trebalo skoro šest mjeseci

to get her properly diagnosed.

da se postavi točna dijagnoza.

My story might be, unfortunately,

Moja priča je možda, nažalost,

familiar to most of you.

poznata većini vas.

One out of three people sitting in this audience

Jednoj od tri osobe koje sjede u publici

will be diagnosed with some type of cancer,

će biti dijagnosticira neka vrsta raka,

and one out of four

a jedna od četiri

will die because of it.

će umrijeti od toga.

Not only did that cancer diagnosis

Ne samo da je dijagnoza tog karcinoma

change the life of our family,

promijenila život naše obitelji,

but that process of going

već taj proces odlaska

back and forth with new tests,

na nove testove,

different doctors describing symptoms,

različiti doktori koji opisuju simptome,

discarding diseases over and over,

odbacuju druge bolesti opet nanovo,

was stressful and frustrating,

bilo je stresno i frustrirajuće,

especially for my aunt.

pogotovo za moju tetu.

And that is the way cancer diagnosis has been done

I to je način na koji se rak dijagnosticirao

since the beginning of history.

od početka povijesti.

We have 21st-century medical treatments and drugs

Imamo medicinske tretmane i lijekove 21-og stoljeća

to treat cancer,

za liječenje raka,

but we still have 20th-century procedures

ali i dalje imamo procedure i načine 20-og stoljeća

and processes for diagnosis, if any.

dijagnosticiranja 20-og stoljeća, ako i to.

Today, most of us have to wait for symptoms

Danas, većina nas mora čekati pojavu simptoma

to indicate that something is wrong.

koji pokazuju da nešto nije u redu.

Today, the majority of people still don't have access

Danas, većina ljudi i dalje nema pristup

to early cancer detection methods,

metodama ranog otkrivanja karcinoma

even though we know

iako znamo

that catching cancer early

da je rano hvatanje karcinoma

is basically the closest thing we have

zapravo najbliže što imamo

to a silver bullet cure against it.

sigurnom i brzom izliječenju.

We know that we can change this in our lifetime,

Znamo da to možemo promijeniti u našem životnom vijeku,

and that is why my team and I

i zato smo moj tim i ja

have decided to begin this journey,

odlučili započeti ovo putovanje,

this journey to try to make cancer detection

putovanje ka pokušaju da se detektiranje karcinoma

at the early stages

u ranim stadijima,

and monitoring the appropriate response at the molecular level

i nadgledanje prikladnih odgovora na molekularnoj razini,

easier, cheaper, smarter

učini lakšim, jeftinijim, pametnijim

and more accessible than ever before.

i pristupačnijim no ikad prije.

The context, of course,

U biti,

is that we're living at a time

mi živimo u vremenu

where technology is disrupting our present

kada tehnologija mijenja sadašnjost

at exponential rates,

eksponencijalnom brzinom,

and the biological realm is no exception.

a biološka sfera nije isključena iz toga.

It is said today that biotech is advancing

Biotehnologija se razvija

at least six times faster than the growth rate

bar šest puta brže no razvitak

of the processing power of computers.

snage kompjuterskog procesiranja.

But progress in biotech

Ali napredak u biotehnologiji

is not only being accelerated,

nije samo ubrzan,

it is also being democratized.

već je i demokratiziran.

Just as personal computers or the Internet

Isto kako osobna računala ili internet

or smartphones leveled the playing field

ili pametni telefoni izjednačavaju mogućnosti

for entrepreneurship, politics or education,

za poduzetništvo, politiku ili edukaciju,

recent advances have leveled it up for biotech progress as well,

nedavni napredci su izjednačili i za biotehnološki progres također,

and that is allowing

i to dozvoljava

multidisciplinary teams like ours

multidisciplinarnim timovima poput našeg

to try to tackle and look at these problems

da se uhvate u koštac s ovim problemima

with new approaches.

s novim pristupima.

We are a team of scientists and technologists

Mi smo tim znanstvenika i tehničara

from Chile, Panama,

iz Čilea, Paname,

Mexico, Israel and Greece,

Meksika, Izraela i Grčke,

and based on recent scientific discoveries,

i bazirano na nedavnim znanstvenim otkrićima,

we believe that we have found

vjerujemo da smo pronašli

a reliable and accurate way

pouzdan i točan način

of detecting several types of cancer

detektiranja nekoliko tipova karcinoma

at the very early stages through a blood sample.

u vrlo ranom stadiju preko uzorka krvi.

We do it by detecting a set of very small molecules

Radimo to detektirajući skup vrlo malih molekula

that circulate freely in our blood

koje slobodno cirkuliraju u našoj krvi,

called microRNAs.

imena microRNA.

To explain what microRNAs are

Kako bi objasnio što su microRNA

and their important role in cancer,

i njihovu važnu ulogu u raku,

I need to start with proteins,

moram početi od proteina,

because when cancer is present in our body,

jer kada je rak prisutan u našem tijelu,

protein modification is observed

primijeti se modifikacija proteina

in all cancerous cells.

u svim kancerogenim stanicama.

As you might know,

Možda već i znate,

proteins are large biological molecules

proteini su velike biološke molekule

that perform different functions within our body,

koje obavljaju različite funkcije u našem tijelu,

like catalyzing metabolic reactions

poput ubrzanja metaboličkih reakcija

or responding to stimuli

ili odgovora na stimulus

or replicating DNA,

ili repliciranja DNA,

but before a protein is expressed or produced,

ali prije no što je protein izražen ili produciran,

relevant parts of its genetic code

određeni dijelovi genetskog koda

present in the DNA

koji se nalazi u DNA

are copied into the messenger RNA,

se kopiraju na glasničku RNA

so this messenger RNA

i ta glasnička RNA

has instructions on how to build a specific protein,

ima upute kako izgraditi određeni protein,

and potentially it can build hundreds of proteins,

i potencijalno može izgraditi stotine proteina,

but the one that tells them when to build them

ali ono što im govori kada ih izgraditi

and how many to build

i koliko ih izgraditi

are microRNAs.

su microRNA.

So microRNAs are small molecules

MicroRNA su male molekule

that regulate gene expression.

loje reguliraju ekspresiju gena.

Unlike DNA, which is mainly fixed,

Nasuprot DNA, koja je nepromjenjiva,

microRNAs can vary depending on internal

microRNA se mijenjaju ovisno o unutarnjim

and environmental conditions at any given time,

i okolišnim uvjetima u određenom vremenu,

telling us which genes are actively expressed at that particular moment.

i govore nam koji geni se trebaju aktivno eksprimirati u određenom vremenu.

And that is what makes microRNAs

I to je ono što microRNA čini

such a promising biomarker for cancer,

obećavajućim biomarkerom za karcinom,

because as you know,

jer kao što znate,

cancer is a disease of altered gene expression.

karcinom je bolest promijenjene ekspresije gena.

It is the uncontrolled regulation of genes.

To je nekontrolirana regulacija gena.

Another important thing to consider

Bitno je i to da

is that no two cancers are the same,

ne postoje dva ista karcinoma,

but at the microRNA level, there are patterns.

ali na razini microRNA, postoje sličnosti.

Several scientific studies have shown

Nekoliko znanstvenih istraživanja su pokazala

that abnormal microRNA expression levels

da razina abnormalne ekspresije microRNA

varies and creates a unique, specific pattern

varira i stvara jedinstveni određeni uzorak

for each type of cancer,

za svaku vrstu karcinoma,

even at the early stages,

čak i u ranim stadijima,

reflecting the progression of the disease,

odgovarajući razvoju bolesti,

and whether it's responding to medication

i bilo da reagira na lijekove

or in remission,

ili je u remisiji,

making microRNAs a perfect,

microRNA je savršen,

highly sensitive biomarker.

visoko osjetljiv biomarker.

However, the problem with microRNAs

Naime, problem s microRNA

is that we cannot use existing DNA-based technology

je taj da ne možemo koristiti postojeću tehnologiju baziranu na DNA

to detect them in a reliable way,

kako bismo ih pouzdano detektirali,

because they are very short sequences of nucleotides,

jer oni su vrlo kratki dijelovi nukleotida,

much smaller than DNA.

mnogo manji od DNA.

And also, all microRNAs are very similar to each other,

I također, sve microRNA su veoma slične jedna drugoj,

with just tiny differences.

s vrlo malim razlikama.

So imagine trying to differentiate two molecules,

Zamislite pokušaj razlikovanja dvije molekule,

extremely similar, extremely small.

vrlo slične, vrlo male.

We believe that we have found a way to do so,

Vjerujemo da smo pronašli način za to,

and this is the first time that we've shown it in public.

i ovo je prvi put da ovo pokazujemo u javnosti.

Let me do a demonstration.

Dozvolite da vam demonstriram.

Imagine that next time you go to your doctor

Zamislite da sljedeći put kada idete kod doktora

and do your next standard blood test,

i napravite normalno testiranje krvi,

a lab technician extracts a total RNA,

laboratorijski tehničar ekstrahira RNA,

which is quite simple today,

što je vrlo jednostavno danas,

and puts it in a standard 96-well plate like this one.

i stavi ju u standardne jažice poput ovih.

Each well of these plates

Svaka od ovih jažica

has specific biochemistry that we assign,

ima određenu biokemiju koju dodijelimo,

that is looking for a specific microRNA,

koja traži specifičnu microRNA,

acting like a trap that closes

i djeluje poput zamke koja se zatvara

only when the microRNA is present in the sample,

jedino kada je microRNA prisutna u uzorku,

and when it does, it will shine with green color.

a kada se zatvori, svijetli zelenom bojom,

To run the reaction,

Da bi pokrenuli reakciju,

you put the plate inside a device like this one,

stavite jažice u uređaj poput ovoga,

and then you can put your smartphone on top of it.

a zatim možete staviti svoj pametni telefon na njega.

If we can have a camera here

Možemo li usmjeriti kameru ovdje

so you can see my screen.

da možete vidjeti moj zaslon.

A smartphone is a connected computer

Smartphone je povezano računalo,

and it's also a camera,

a također je i kamera,

good enough for our purpose.

dovoljno dobra za ovu svrhu.

The smartphone is taking pictures,

Pametni telefon fotografira,

and when the reaction is over,

i kada reakcija završi,

it will send the pictures

poslat će fotografije

to our online database for processing

u našu online bazu podataka na obradu

and interpretation.

i interpretaciju.

This entire process lasts around 60 minutes,

Cijeli proces traje oko 60 minuta,

but when the process is over,

ali kada proces završi,

wells that shine are matched with the specific microRNAs

jažice koje sjaje su pozitivne na određenu microRNA

and analyzed in terms of how much and how fast

i analiziraju se ovisno o tome koliko puno i brzo

they shine.

sjaje.

And then, when this entire process is over,

I onda, kada je proces gotov,

this is what happens.

dogodi se ovo.

This chart is showing the specific microRNAs

Ovaj graf prikazuje određene microRNA

present in this sample

prisutne u uzorku

and how they reacted over time.

i kako su reagirali tijekom vremena.

Then, if we take this specific pattern of microRNA

Onda, ako uzmemo ove specifične obrasce microRNA

of this person's samples

uzorka ove osobe

and compare it with existing scientific documentation

i usporedimo ih s postojećom znanstvenom dokumentacijom

that correlates microRNA patterns

koja povezuje uzorke microRNA

with a specific presence of a disease,

s određenom bolesti,

this is how pancreatic cancer looks like.

ovako izgleda karcinom gušterače.

This inside is a real sample

Unutra je pravi uzorak

where we just detected pancreatic cancer.

gdje smo upravo detektirali karcinom gušterače.

(Applause)

(Pljesak)

Another important aspect of this approach

Također bitno kod ovog pristupa

is the gathering and mining of data in the cloud,

je prikupljanje i obrada podataka u oblaku,

so we can get results in real time

tako da dobijemo rezultate u stvarnom vremenu

and analyze them with our contextual information.

i analiziramo ih sa kontekstualnim informacijama.

If we want to better understand

Ako želimo bolje razumjeti

and decode diseases like cancer,

i odgonetnuti bolesti poput karcinoma,

we need to stop treating them

moramo ih prestati tretirati

as acute, isolated episodes,

kao akutne, izolirane epizode

and consider and measure everything

i uzeti u obzir i mjeriti sve

that affects our health on a permanent basis.

što kroz dulji period utječe na naše zdravlje.

This entire platform is a working prototype.

Cijela platforma je prototip u izradi.

It uses state-of-the-art molecular biology,

Koristi najnovije spoznaje molekularne biologije,

a low-cost, 3D-printed device,

jeftini, 3D printani uređaj,

and data science

i znanost o podatcima

to try to tackle one of humanity's toughest challenges.

kako bi se uhvatilo u koštac s najvećim izazovom čovječanstva.

Since we believe early cancer detection

Vjerujemo da bi rano otkrivanje raka

should really be democratized,

trebalo biti demokratizirano,

this entire solution costs at least 50 times less

sve ovo košta bar 50 puta manje

than current available methods,

no trenutno dostupne metode

and we know that the community can help us

i znamo da nam društvo može pomoći

accelerate this even more,

još više to ubrzati,

so we're making the design of the device

pa ćemo učiniti dizajn uređaja

open-source.

javno dostupnim.

(Applause)

(Pljesak)

Let me say very clearly

Želim vrlo jasno reći

that we are at the very early stages,

da smo mi u ranim stadijima,

but so far, we have been able

ali zasad smo

to successfully identify the microRNA pattern

uspješno identificirali microRNA uzorke

of pancreatic cancer, lung cancer,

za karcinom gušterače, pluća

breast cancer and hepatic cancer.

dojki i jetre.

And currently, we're doing a clinical trial

I trenutno, provodimo kliničko istraživanje

in collaboration with the German Cancer Research Center

u suradnji s NJemačkim centrom za istraživanje raka

with 200 women for breast cancer.

s dvjesto žena o karcinomu dojke.

(Applause)

(Pljesak)

This is the single non-invasive,

Ovo je jedini neinvazivni,

accurate and affordable test

točan i povoljan test

that has the potential to dramatically change

koji ima potencijal dramatično promijeniti

how cancer procedures and diagnostics

procedure i dijagnostike raka

have been done.

rađene dosad.

Since we're looking for the microRNA patterns

Zbog toga što tražimo uzorke microRNA

in your blood at any given time,

u vašoj krvi u određenom vremenu,

you don't need to know which cancer you're looking for.

ne morate znati koji rak tražite.

You don't need to have any symptoms.

Ne morate imati ikakvih simptoma.

You only need one milliliter of blood

Samo vam je potreban mililitar krvi

and a relatively simple array of tools.

i relativno jednostavan set alata.

Today, cancer detection happens mainly

Danas, detekcija raka se odvija uglavnom

when symptoms appear.

kada se pojave simptomi.

That is, at stage 3 or 4,

To jest, kod 3. ili 4. stadija

and I believe that is too late.

i vjerujem da je to prekasno.

It is too expensive for our families.

Preskupo je za naše obitelji.

It is too expensive for humanity.

Preskupo je za čovječanstvo.

We cannot lose the war against cancer.

Ne možemo izgubiti rat protiv raka.

It not only costs us billions of dollars,

Ne košta nas samo milijarde dolara

but it also costs us the people we love.

već nas košta i ljudi koje volimo.

Today, my aunt, she's fighting bravely

Danas, moja teta, bori se hrabro

and going through this process with a very positive attitude.

i prolazi kroz sve to s vrlo pozitivnim stavom.

However, I want fights like this

No ipak, želim da ovakve borbe

to become very rare.

postanu rijetkost.

I want to see the day

Želim vidjeti dan

when cancer is treated easily

kada se rak tretira lako

because it can be routinely diagnosed

jer je to rutinska dijagnostika

at the very early stages,

u vrlo ranim stadijima,

and I'm certain

i siguran sam

that in the very near future,

da u vrlo bliskoj budućnosti,

because of this

zbog ovog

and other breakthroughs that we are seeing

i drugih otkrića koje vidimo

every day in the life sciences,

svaki dan u životnoj znanosti,

the way we see cancer

način na koji vidimo karcinome

will radically change.

će se drastično promjeniti.

It will give us the chance of detecting it early,

Dat će nam šansu ranog detektiranja,

understanding it better,

boljeg razumijevanja

and finding a cure.

i pronalaska lijeka.

Thank you very much.

Hvala vam puno.

(Applause)

(Pljesak)