Alan Russell: The potential of regenerative medicine

Prevoditelj: Ante Benić Recezent: Mislav Ante Omazić - EFZG

I'm going to talk to you today about

Danas ću vam govoriti o nečemu

hopefully converting fear into hope.

što će, nadamo se, pretvoriti naše strahove u nadu.

When we go to the physician today --

Danas, kada idemo kod liječnika,

when we go to the doctor's office and we walk in,

i kada uđemo u ordinaciju,

there are words that we just don't want to hear.

postoje neke riječi koje jednostavno ne želimo čuti.

There are words that we're truly afraid of.

To su riječi kojih se zaista bojimo.

Diabetes, cancer, Parkinson's, Alzheimer's,

Dijabetis, rak, Parkinsonova, Alzheimerova,

heart failure, lung failure --

srčani problemi, plućni problemi.

things that we know are debilitating diseases,

To su stvari za koje znamo da su opasne,

for which there's relatively little that can be done.

i kod kojih možemo učiniti relativno malo.

And what I want to lay out for you today is

Ono što vam želim danas pokazati

a different way of thinking about how to treat debilitating disease,

je drugačiji način u tretiranju teških, iscrpljujućih bolesti

why it's important,

te zašto je on važan.

why without it perhaps our health care system will melt down

Zašto će se bez njega naš sustav možda, urušiti,

if you think it already hasn't,

ako mislite da se već nije.

and where we are clinically today, and where we might go tomorrow,

Što možemo danas liječiti, gdje ćemo biti sutra

and what some of the hurdles are.

i koje su neke prepreke.

And we're going to do all of that in 18 minutes, I promise.

I napravit ćemo sve to u 18 minuta, obećajem.

I want to start with this slide,

Želio bih početi s ovom slikom,

because this slide sort of tells the story the way Science Magazine thinks of it.

jer ova slika na neki način pokazuje što Science Magazin misli o ovome.

This was an issue from 2002

Ovo je broj iz 2002.

that they published with a lot of different articles on the bionic human.

koji su izdali s mnogo članaka o bioničkom čovjeku.

It was basically a regenerative medicine issue.

U osnovi, to je bio broj o regenerativnoj medicini.

Regenerative medicine is an extraordinarily simple concept

Regenerativna medicina je izvanredno jednostavna metoda

that everybody can understand.

koju svatko može razumjeti.

It's simply accelerating the pace at which the body heals itself

Radi se jednostavno o ubrzavanju brzine kojom se tijelo samo liječi

to a clinically relevant timescale.

na razinu koja nam je relevantna za postupak liječenja.

So we know how to do this in many of the ways that are up there.

Znamo kako raditi ovo na mnoge načine koji su prikazani ovdje.

We know that if we have a damaged hip, you can put an artificial hip in.

Znamo da ako imamo bolesni kuk, kako ga možemo zamijeniti umjetnim.

And this is the idea that Science Magazine used on their front cover.

To je ideja koju je Science Magazin koristio na njihovoj naslovnici.

This is the complete antithesis of regenerative medicine.

To je potpuna suprotnost regenerativnoj medicini.

This is not regenerative medicine.

To nije regenerativna medicina.

Regenerative medicine is what Business Week put up

Regenerativna medicina je ovo što je Business Week stavio na naslovnicu

when they did a story about regenerative medicine not too long ago.

kada su, ne tako davno, radili priču o regenerativnoj medicini.

The idea is that instead of figuring out how to ameliorate symptoms

Radi se o tome da, umjesto da smišljamo kako popraviti simptome

with devices and drugs and the like --

uređajima, lijekovima i takvim stvarima --

and I'll come back to that theme a few times --

vratit ću se na ovo nekoliko puta --

instead of doing that, we will regenerate lost function of the body

umjesto da činimo to, regenerirat ćemo izgubljene funkcije tijela

by regenerating the function of organs and damaged tissue.

regenerirajući funkcije organa i oštećenog tkiva.

So that at the end of the treatment,

Na taj način da ste na kraju tretmana

you are the same as you were at the beginning of the treatment.

jednaki kao na početku tretmana.

Very few good ideas -- if you agree that this is a good idea --

Jako malo dobrih ideja -- ako se složite kako je ovo dobra ideja --

very few good ideas are truly novel.

jako malo dobrih ideja su stvarno nove.

And this is just the same.

Tako je i s ovom.

If you look back in history,

Ako pogledamo u prošlost,

Charles Lindbergh, who was better known for flying airplanes,

Charles Lindbergh -- poznatiji po letenju avionima --

was actually one of the first people

je ustvari jedan od prvih ljudi koji je,

along with Alexis Carrel, one of the Nobel Laureates from Rockefeller,

zajedno s Alexis Carrel, jednim od Nobelovaca iz Rockefellera,

to begin to think about, could you culture organs?

počeo razmišljati o mogućnosti uzgoja organa.

And they published this book in 1937,

Tako su 1937. izdali svoju knjigu

where they actually began to think about,

u kojoj su ustvari počeli razmišljati

what could you do in bio-reactors to grow whole organs?

što se može napraviti u bio-reaktorima kako bi se uzgojili čitavi organi?

We've come a long way since then.

Od tada smo prošli dugačak put.

I'm going to share with you some of the exciting work that's going on.

Podijelit ću s vama dio uzbudljivog rada koji je u tijeku.

But before doing that, what I'd like to do

Ali prije nego što to učinim, volio bih učiniti jednu stvar,

is share my depression about the health care system

a to je podijeliti svoje nezadovoljstvo u vezi zdravstvenog sustava

and the need for this with you.

i njegovu potrebu sa svima vama.

Many of the talks yesterday talked about

Jučer smo čuli mnoge govore o

improving the quality of life, and reducing poverty,

poboljšanju kvalitete života i smanjivanju siromaštva.

and essentially increasing life expectancy all around the globe.

U stvari o produženju očekivane životne dobi diljem svijeta.

One of the challenges is that the richer we are, the longer we live.

Jedan od izazova je -- što smo bogatiji to dulje živimo.

And the longer we live, the more expensive it is

I što dulje živimo, skuplje je

to take care of our diseases as we get older.

brinuti se o našim zdravstvenim problemima kako starimo.

This is simply the wealth of a country

U stvari, radi se o bogatstvu države

versus the percent of population over the age of 65.

protiv postotka populacije starije od 65 godina.

And you can basically see that the richer a country is,

Tako možete vidjeti kako što je zemlja bogatija

the older the people are within it.

njezino stanovništvo je starije.

Why is this important?

Zašto je to važno?

And why is this a particularly dramatic challenge right now?

I zašto je to posebno dramatičan izazov upravo sada?

If the average age of your population is 30,

Ako je prosječna dob vašeg stanovništva 30 godina

then the average kind of disease that you have to treat

tada su prosječne bolesti koje trebate liječiti

is maybe a broken ankle every now and again,

možda svako toliko slomljeni gležanj,

maybe a little bit of asthma.

možda malo astme.

If the average age in your country is 45 to 55,

Ako je prosječna dob u vašoj zemlji između 45 i 55 godina,

now the average person is looking at diabetes,

tada se prosječna osoba suočava s dijabetesom,

early-onset diabetes, heart failure, coronary artery disease --

ranim dijabetesom, problemima sa srcem, krvožilnim bolestima.

things that are inherently more difficult to treat,

Stvarima koje je sve teže,

and much more expensive to treat.

a ujedno i mnogo skuplje liječiti.

Just have a look at the demographics in the U.S. here.

Pogledajte samo stanovništvo SAD na ovom prikazu.

This is from "The Untied States of America."

Ovo je iz Sjedinjenih Američkih Država.

In 1930, there were 41 workers per retiree.

1930. odnos je bio 41 radnik po umirovljeniku.

41 people who were basically outside of being really sick,

Znači, 41 osoba koje su u osnovi bile više manje zdrave,

paying for the one retiree who was experiencing debilitating disease.

plaćaju za tog jednog umirovljenika koji ima ozbiljnu bolest.

In 2010, two workers per retiree in the U.S.

2010. u SAD-u taj je odnos 2 radnika po umirovljeniku.

And this is matched in every industrialized, wealthy country in the world.

Isti trend vidimo u svim bogatim, industrijaliziranim zemljama na svijetu.

How can you actually afford to treat patients

Kako uopće možemo priuštiti tretman pacijentima

when the reality of getting old looks like this?

kada u stvarnosti starenje izgleda ovako?

This is age versus cost of health care.

Ovdje vidimo odnos godina i zdravstvenih troškova.

And you can see that right around age 45, 40 to 45,

Možete vidjeti kako negdje oko 45. godine, 40. do 45.

there's a sudden spike in the cost of health care.

događa nagli porast troškova.

It's actually quite interesting. If you do the right studies,

Zapravo je to prilično zanimljivo -- ako ispravno vodite istraživanje,

you can look at how much you as an individual spend on your own health care,

možete vidjeti koliko vi kao individualac trošite na zdravstvenu njegu

plotted over your lifetime.

u odnosu na vašu dob.

And about seven years before you're about to die, there's a spike.

Otprilike sedam godina prije nego umrete pojavi se vrhunac troškova.

And you can actually --

Zapravo možete --

(Laughter)

(Smijeh)

-- we won't get into that.

-- nećemo ulaziti u to.

(Laughter)

(Smijeh)

There are very few things, very few things that you can really do

Postoji jako malo stvari, zbilja malo stvari koje možete učiniti

that will change the way that you can treat these kinds of diseases

koje će promijeniti način tretiranja ovakvih bolesti

and experience what I would call healthy aging.

i pružiti vam ono što bih nazvao zdravom starošću.

I'd suggest there are four things,

Ja bih preporučio četiri stvari.

and none of these things include an insurance system or a legal system.

I nijedna od njih ne uključuje osiguranje ili zakone.

All those things do is change who pays.

Te stvari samo mijenjaju onoga tko plaća.

They don't actually change what the actual cost of the treatment is.

U stvari, one ne mijenjaju stvarnu cijenu liječenja.

One thing you can do is not treat. You can ration health care.

Jedna stvar koju možete je ne liječiti. Možemo racionalizirati zdravstvenu skrb.

We won't talk about that anymore. It's too depressing.

Nećemo više govoriti o tome. Previše je deprimirajuće.

You can prevent.

Možete preventirati bolesti.

Obviously a lot of monies should be put into prevention.

Očito je kako bi puno novca trebalo biti uloženo u prevenciju.

But perhaps most interesting, to me anyway, and most important,

Ali možda najzanimljivija, barem meni osobno, i najvažnija

is the idea of diagnosing a disease much earlier on in the progression,

je ideja dijagnosticiranja bolesti puno ranije u razvoju

and then treating the disease to cure the disease

i na taj način liječili bi bolest

instead of treating a symptom.

umjesto da liječimo simptome.

Think of it in terms of diabetes, for instance.

Uzmimo, na primjer, dijabetes.

Today, with diabetes, what do we do?

Što danas činimo s dijabetesom?

We diagnose the disease eventually, once it becomes symptomatic,

Dijagnosticiramo bolest uglavnom tek kada se pojave simptomi

and then we treat the symptom for 10, 20, 30, 40 years.

i onda liječimo simptome 10, 20, 30, 40 godina.

And we do OK. Insulin's a pretty good therapy.

I to nam ide sasvim dobro. Inzulin je prilično dobra terapija.

But eventually it stops working,

Ali prije ili kasnije on prestaje djelovati

and diabetes leads to a predictable onset of debilitating disease.

i dijabetes tada vodi do pojave težih, opasnijih bolesti.

Why couldn't we just inject the pancreas with something

Zašto ne možemo samo ubrizgati nešto u gušteraču

to regenerate the pancreas early on in the disease,

tako da se ona regenerira u ranom stadiju bolesti,

perhaps even before it was symptomatic?

možda čak i prije pojave samih simptoma?

And it might be a little bit expensive at the time that we did it,

Možda bi to i bilo skupo u tom trenutku,

but if it worked, we would truly be able to do something different.

ali ako bi to djelovalo, zaista bi bili u mogućnosti napraviti razliku.

This video, I think, gets across the concept that I'm talking about quite dramatically.

Mislim kako ovaj video prilično dramatično pokazuje koncept o kojem govorim.

This is a newt re-growing its limb.

Ovo je daždevnjak koji regenerira svoj ud.

If a newt can do this kind of thing, why can't we?

Ako daždevnjak može činiti nešto takvo, zašto ne možemo i mi?

I'll actually show you some more important features

Ubrzo ću vam pokazati neke važnije stvari

about limb regeneration in a moment.

u vezi regeneracije djelova tijela.

But what we're talking about in regenerative medicine

Ali ono o čemu govorimo u regenerativnoj medicini je

is doing this in every organ system of the body,

kako se ovo događa u svakom organskom sustavu u tijelu,

for tissues and for organs themselves.

na razini samih tkiva i organa.

So today's reality is that if we get sick,

Današnja stvarnost je da ako se razbolimo

the message is we will treat your symptoms,

kažu vam kako će liječiti vaše simptome,

and you need to adjust to a new way of life.

te da se trebate prilagoditi na novi način života.

I would pose to you that tomorrow --

Rekao bih kako ćemo sutra --

and when tomorrow is we could debate,

a možemo raspravljati kada će to sutra biti,

but it's within the foreseeable future --

ali to je u doglednoj budućnosti --

we will talk about regenerative rehabilitation.

govoriti o regenerativnoj rehabilitaciji.

There's a limb prosthetic up here,

Ovdje vidite protezu za nogu,

similar actually one on the soldier

sličnu onima koje nose vojnici

that's come back from Iraq.

koji su se vratili iz Iraka...

There are 370 soldiers that have come back from Iraq that have lost limbs.

370 vojnika se vratilo iz Iraka s amputacijom.

Imagine if instead of facing that, they could actually

Zamislite da umjesto toga, oni mogu

face the regeneration of that limb.

regenerirati taj ud.

It's a wild concept.

To je luda ideja.

I'll show you where we are at the moment in working towards that concept.

Pokazati ću vam gdje smo danas došli u radu prema toj ideji.

But it's applicable, again, to every organ system.

Ali to je primjenjivo na sve organe.

How can we do that?

Kako to možemo ostvariti?

The way to do that is to develop a conversation with the body.

Način da to učinimo je razviti vrstu komunikacije s tijelom.

We need to learn to speak the body's language.

Trebamo naučiti govoriti govor tijela.

And to switch on processes that we knew how to do when we were a fetus.

I uključiti procese koje smo mogli raditi kada smo bili fetus.

A mammalian fetus, if it loses a limb during the first trimester of pregnancy,

Ako fetus sisavca izgubi ud tijekom prvog tromjesečja trudnoće

will re-grow that limb.

on će mu ponovo izrasti.

So our DNA has the capacity to do these kinds of wound-healing mechanisms.

Znači naša DNA ima mogućnost ovakvih metoda izlječenja.

It's a natural process,

To je prirodan proces,

but it is lost as we age.

ali se gubi kako starimo.

In a child, before the age of about six months,

Ako dijete, u dobi oko šest mjeseci,

if they lose their fingertip in an accident,

izgubi vrh prsta u nesreći,

they'll re-grow their fingertip.

on će im ponovo izrasti.

By the time they're five, they won't be able to do that anymore.

Do dobi od pet godina, oni to više neće moći.

So to engage in that conversation with the body,

Znači, kako bi mogli komunicirati s tijelom,

we need to speak the body's language.

moramo govoriti govor tijela.

And there are certain tools in our toolbox that allow us to do this today.

A alati kojima danas raspolažemo omogućavaju nam to.

I'm going to give you an example of three of these tools

Pokazati ću vam primjer tri takva alata

through which to converse with the body.

pomoću kojih razgovaramo s tijelom.

The first is cellular therapies.

Prvi je stanična terapija.

Clearly, we heal ourselves in a natural process,

Očito, liječimo se u prirodnom procesu,

using cells to do most of the work.

koristeći stanice da obave najveći dio posla.

Therefore, if we can find the right cells

Ako možemo naći prave stanice

and implant them in the body, they may do the healing.

i usaditi ih u tijelo, one nas možda mogu liječiti.

Secondly, we can use materials.

Drugi način su materijali.

We heard yesterday about the importance of new materials.

Jučer smo čuli o važnosti novih materijala.

If we can invent materials, design materials,

Ako možemo izmisliti, kreirati ili

or extract materials from a natural environment,

izvući materijale iz njihovog prirodnog okruženja,

then we might be able to have those materials induce the body to heal itself.

onda bi možda mogli inducirati liječenje pomoću tih materijala.

And finally, we may be able to use smart devices

Konačno, mogli bi koristiti pametne uređaje

that will offload the work of the body and allow it to heal.

koji će preuzeti rad tijela i omogućiti mu da se izliječi.

I'm going to show you an example of each of these,

Pokazati ću vam primjer za svaku od tih metoda,

and I'm going to start with materials.

a početi ću s materijalima.

Steve Badylak -- who's at the University of Pittsburgh --

Steve Badylak -- sa sveučilišta u Pittsburgu --

about a decade ago had a remarkable idea.

je prije otprilike deset godina imao nevjerovatnu ideju.

And that idea was that the small intestine of a pig,

Ideja je bila da tanko crijevo svinje,

if you threw away all the cells,

ako odbacite sve stanice,

and if you did that in a way that allowed it to remain biologically active,

i ako to napravite tako da ono ostane biološki aktivno,

may contain all of the necessary factors and signals

može sadržavati sve potrebne faktore i signale

that would signal the body to heal itself.

koji signaliziraju tijelu da se samoliječi.

And he asked a very important question.

On je postavio važno pitanje.

He asked the question,

Pitao se je,

if I take that material, which is a natural material

ako uzmem taj materijal, koji je prirodan,

that usually induces healing in the small intestine,

i koji obično potiče oporavak u tankom crijevu,

and I place it somewhere else on a person's body,

i stavim ga negdje drugdje u tijelu,

would it give a tissue-specific response,

hoće li ono reagirati s tim specifičnim tkivom,

or would it make small intestine if I tried to make a new ear?

ili će mi napraviti tanko crijevo umjesto uha?

I wouldn't be telling you this story if it weren't compelling.

Ne bih vam govorio ovu priču da nije zanimljiva.

The picture I'm about to show you

Slika koju ću vam pokazati --

is a compelling picture.

(Smijeh)

(Laughter)

-- je "zanimljiva" slika.

However, for those of you that are even the slightest bit squeamish --

Ipak, za sve one među vama koji su barem malo gadljivi --

even though you may not like to admit it in front of your friends --

čak i ako to ne želite priznati pred vašim prijateljima --

the lights are down. This is a good time to look at your feet,

svjetla su ugašena. Ovo bi bio dobar trenutak da spustite pogled na vaše noge,

check your Blackberry, do anything other than look at the screen.

provjerite svoj Blackberry, učinite bilo što osim gledanja u ekran.

(Laughter)

(Smijeh)

What I'm about to show you is a diabetic ulcer.

Ono što ću vam pokazati je dijabetsko stopalo.

And although -- it's good to laugh before we look at this.

I -- iako se je dobro smijati prije nego to vidimo.

This is the reality of diabetes.

Ovo je stvarnost dijabetesa.

I think a lot of times we hear about diabetics, diabetic ulcers,

Mislim kako puno puta kada čujemo o dijabetesu i dijabetskom stopalu

we just don't connect the ulcer with the eventual treatment,

jednostavno ne povezujemo to sa konačnim tretmanom,

which is amputation, if you can't heal it.

a to je amputacija, ako ne uspije izliječenje.

So I'm going to put the slide up now. It won't be up for long.

Sada ću pokazati fotografiju. Neće biti na ekranu dugo.

This is a diabetic ulcer. It's tragic.

Ovo je dijabetsko stopalo. To je tragično.

The treatment for this is amputation.

Tretman za ovo je amputacija.

This is an older lady. She has cancer of the liver as well as diabetes,

Ovo je starija gospođa. Uz dijabetes ima i rak jetre

and has decided to die with what' s left of her body intact.

i odlučila je umrijeti s očuvanim tijelom.

And this lady decided, after a year of attempted treatment of that ulcer,

Ta je gospođa, nakon godine pokušaja liječenja stopala, odlučila

that she would try this new therapy that Steve invented.

probati jednu tu novu terapiju koju je Steve izmislio.

That's what the wound looked like 11 weeks later.

Ovako je rana izgledala nakon 11 tjedana.

That material contained only natural signals.

Taj je materijal sadržavao samo prirodne signale.

And that material induced the body to switch back on a healing response

I taj je materijal potaknuo tijelo da uključi svoje mehanizme izliječenja

that it didn't have before.

koji su bili isključeni.

There's going to be a couple more distressing slides for those of you --

Biti će još uznemirujućih slika, za one među vama --

I'll let you know when you can look again.

reći ću vam kada možete gledati.

This is a horse. The horse is not in pain.

Ovo je konj. Njega ne boli.

If the horse was in pain, I wouldn't show you this slide.

Da ga u boli, ne bih vam pokazivao ovu sliku.

The horse just has another nostril that's developed

Konju se razvila još jedna nosnica

because of a riding accident.

zbog nezgode na jahanju.

Just a few weeks after treatment --

Nakon samo nekoliko tjedana liječenja --

in this case, taking that material, turning it into a gel,

u ovom slučaju, uzimanje materijala, pretvaranja u gel,

and packing that area, and then repeating the treatment a few times --

ispunjavanja tog područja i ponavljanja tretmana nekoliko puta --

and the horse heals up.

konj se odlično oporavio.

And if you took an ultrasound of that area, it would look great.

I da ste napravili ultrazvuk tog područja izgleda¸lo bi odlično.

Here's a dolphin where the fin's been re-attached.

Ovo je dupin kojemu je peraja ponovo učvršćena.

There are now 400,000 patients around the world

Danas imamo oko 400,000 pacijenata diljem svijeta

who have used that material to heal their wounds.

koji koriste taj materijal za liječenje svojih ozljeda.

Could you regenerate a limb?

Je li moguće regenerirati ud?

DARPA just gave Steve 15 million dollars to lead an eight-institution project

DARPA (vojna agencija za razvoj novih tehnologija) upravo je dala Steveu 15 milijuna

to begin the process of asking that question.

dolara i vodstvo nad osam institucija da počne istraživati to područje.

And I'll show you the 15 million dollar picture.

Pokazati ću vam sliku od 15 milijuna dolara.

This is a 78 year-old man who's lost the end of his fingertip.

Ovo je muškarac od 78 godina koji je izgubio vrh jagodice prsta.

Remember that I mentioned before the children who lose their fingertips.

Sjaćate se što sam vam prije rekao o djeci kojima se to dogodi.

After treatment that's what it looks like.

Ovo je taj prst nakon tretmana.

This is happening today.

Ovo se događa danas.

This is clinically relevant today.

Ovo je danas medicinski važno.

There are materials that do this. Here are the heart patches.

Postoje materijali koji mogu ovo. Postoje zakrpe.

But could you go a little further?

Ali, možemo li ići još malo dalje?

Could you, say, instead of using material,

Možemo li, recimo, umjesto korištenja materijala,

can I take some cells along with the material,

mogu li uzeti neke stanice s materijalom,

and remove a damaged piece of tissue,

ukloniti oštećeno tkivo

put a bio-degradable material on there?

i staviti taj biorazgradivi materijal na to mjesto?

You can see here a little bit of heart muscle beating in a dish.

Ovdje možete vidjeti mali dio srca kako lupa u posudi.

This was done by Teruo Okano at Tokyo Women's Hospital.

Ovo je napravio Teruo Okano iz Ženske bolnice u Tokiju.

He can actually grow beating tissue in a dish.

On može uzgojiti živo, kucajuće tkivo u posudi.

He chills the dish, it changes its properties

Na kraju ohladi posudu, ona promijeni svojstva

and he peels it right out of the dish.

i stanice se ogule sa posude.

It's the coolest stuff.

To je fantastična stvar.

Now I'm going to show you cell-based regeneration.

Sada bih vam pokazao regeneraciju baziranu na stanicama.

And what I'm going to show you here

Ono što ću vam pokazati

is stem cells being removed from the hip of a patient.

su matične stanice koje se izvuku iz kuka pacijenta.

Again, if you're squeamish, you don't want to watch.

Još jednom, ako ste gadljivi, ne želite ovo gledati.

But this one's kind of cool.

Ali ovo je na neki način fora.

So this is a bypass operation, just like what Al Gore had,

Znači, ovo je postavljenje premosnice, kao što je Al Gore imao,

with a difference.

ali s razlikom.

In this case, at the end of the bypass operation,

U ovom slučaju, na kraju operacije prijemosnice

you're going to see the stem cells from the patient

vidjeti ćete matične stanice pacijenta,

that were removed at the beginning of the procedure

koje su bile izvučene na početku,

being injected directly into the heart of the patient.

i ubrizgane direktno u srce pacijenta.

And I'm standing up here because at one point

A ja stojim ovdje gore jer ću vam u jednom trenutku

I'm going to show you just how early this technology is.

pokazati koliko je nova ova tehnologija.

Here go the stem cells, right into the beating heart of the patient.

Evo matičnih stanica, direktno u pulsirajuće srce pacijenta.

And if you look really carefully,

I ako pogledate zbilja pažljivo,

it's going to be right around this point

negdje oko ovog područja

you'll actually see a back-flush.

primjetit ćete vraćanje.

You see the cells coming back out.

Vidite kako se stanice vraćaju van.

We need all sorts of new technology, new devices,

Trebamo mnogo novih tehnologija i novih uređaja

to get the cells to the right place at the right time.

kako bi doveli stanice na pravo mjesto u pravo vrijeme.

Just a little bit of data, a tiny bit of data.

Imamo malo podataka, tako malo podataka.

This was a randomized trial.

Ovo je bio pokus.

At this time this was an N of 20. Now there's an N of about 100.

U to vrijeme ovo je bio 20. pacijent. Danas ih je oko 100.

Basically, if you take an extremely sick patient

Ukratko, ako uzmete jako bolesnog čovjeka

and you give them a bypass, they get a little bit better.

i ugradite im premosnicu bude im malo bolje.

If you give them stem cells as well as their bypass,

Ako im uz premosnicu date i matične stanice,

for these particular patients, they became asymptomatic.

ovi pacijenti, oni izgube simptome.

These are now two years out.

To postoji već dvije godine.

The coolest thing would be is if you could diagnose the disease early,

Najbolja stvar bi bila mogućnost rane dijagnoze

and prevent the onset of the disease to a bad state.

i prevencije prelaska bolesti u lošu fazu.

This is the same procedure, but now done minimally invasively,

Ovo je ista stvar, samo minimalno invazivno,

with only three holes in the body where they're taking the heart

sa samo tri otvora u tijelu kroz koje se dođe do srca

and simply injecting stem cells through a laparoscopic procedure.

i jednostavno, laparoskopijom ubrizga matične stanice.

There go the cells.

Evo vidimo stanice.

We don't have time to go into all of those details,

Nemamo vremena za ići u ovo detaljno,

but basically, that works too.

ali, u osnovi, i to funkcionira.

You can take patients who are less sick,

Možete uzeti pacijente koji imaju blaže simptome

and bring them back to an almost asymptomatic state

i vratiti ih nazad do stanja u kojem gotovo i nemaju simptome,

through that kind of therapy.

kroz ovakvu terapiju.

Here's another example of stem-cell therapy that isn't quite clinical yet,

Evo još jednog primjera terapije matičnim stanicama; još nije u kliničkoj fazi,

but I think very soon will be.

ali mislim kako će ubrzo biti.

This is the work of Kacey Marra from Pittsburgh,

Ovo je djelo Kacey Marre iz Pittsburga,

along with a number of colleagues around the world.

uz kolege širom svijeta.

They've decided that liposuction fluid,

Oni su shvatili kako liposukcijska tekućina,

which -- in the United States, we have a lot of liposuction fluid.

koje -- u SAD-u, imamo mnogo liposukcijske tekućine.

(Laughter)

(Smijeh)

It's a great source of stem cells.

To je sjajan izvor matičnih stanica.

Stem cells are packed in that liposuction fluid.

Matične stanice se nalaze u liposukcijskoj tekućini.

So you could go in, you could get your tummy-tuck.

Tako da možete ići zategnuti trbuh.

Out comes the liposuction fluid,

Izvuku vam liposukcijsku tekućinu,

and in this case, the stem cells are isolated and turned into neurons.

i u ovom slučaju, matične stanice su izolirane i pretvorene u neurone.

All done in the lab.

Sve to u laboratoriju.

And I think fairly soon, you will see patients being treated

I mislim kako ćemo prilično brzo vidjeti pacijente tretirane

with their own fat-derived, or adipose-derived, stem cells.

vlastitim matičnim stanicama iz masnog tkiva.

I talked before about the use of devices

Spomenuo sam korištenje uređaja

to dramatically change the way we treat disease.

da dramatično promijenimo način na koji liječimo bolesti.

Here's just one example before I close up.

Ovdje je jedan primjer, prije nego završim.

This is equally tragic.

Ovo je jednako tragično.

We have a very abiding and heartbreaking partnership

Imamo trajno i veoma emotivno partnerstvo

with our colleagues at the Institute for Surgical Research in the US Army,

s našim kolegama u Institutu za kirurška istraživanja (IKI) pri Američkoj vojsci,

who have to treat the now 11,000 kids that have come back from Iraq.

koji moraju tretirati 11,000 djece koja su se vratila iz Iraka.

Many of those patients are very severely burned.

Mnogi od njih imaju strašne opekline.

And if there's anything that's been learned about burn,

I ako smo išta naučili o opeklinama,

it's that we don't know how to treat it.

to je da ih ne znamo liječiti.

Everything that is done to treat burn --

Sve što se radi u tretiranju opeklina --

basically we do a sodding approach.

u osnovi radimo po principu presađivanja.

We make something over here,

Napravimo nešto ondje,

and then we transplant it onto the site of the wound,

i to onda transplantiramo na mjesto opekline,

and we try and get the two to take.

i onda pokušavamo da se ta dva dijela prihvate.

In this case here, a new, wearable bio-reactor has been designed --

Za ovo je razvijen novi, nosivi bio-reaktor --

it should be tested clinically later this year at ISR --

trebao bi biti klinički testiran kasnije ove godine u IKI --

by Joerg Gerlach in Pittsburgh.

koji je djelo Joerga Gerlacha iz Pittsburga.

And that bio-reactor will lay down in the wound bed.

Taj bio-reaktor će biti postavljen na samu ozljedu.

The gun that you see there sprays cells.

Ovim pištoljem će se raspršivati stanice.

That's going to spray cells over that area.

Stanice će biti raspršene po tom cijelom području.

The reactor will serve to fertilize the environment,

Reaktor će služiti kao hranjiva podloga u tom području,

deliver other things as well at the same time,

radeći mnoge stvari u isto vrijeme,

and therefore we will seed that lawn,

i na taj način ćemo uzgajati kožu na samoj opeklini,

as opposed to try the sodding approach.

umjesto da koristimo presađivanje.

It's a completely different way of doing it.

To je potpuno drugačiji način.

So my 18 minutes is up.

Mojih 18 minuta je pri kraju.

So let me finish up with some good news,

Dopustite mi da završim dobrim vijestima,

and maybe a little bit of bad news.

i s možda malo loših.

The good news is that this is happening today.

Dobra vijest je kako se sve ovo događa danas.

It's very powerful work.

To je jako moćan i važan rad.

Clearly the images kind of get that across.

Slike su to zaista pokazale.

It's incredibly difficult because it's highly inter-disciplinary.

Zbog multidisciplinarnog pristupa to je nevjerovatno težak posao.

Almost every field of science engineering and clinical practice

Gotovo sva područja znanstvenog inžinjerstva i kliničkih pokusa

is involved in trying to get this to happen.

su uključena u pokušaju ostvarivanja ovoga.

A number of governments, and a number of regions,

Nekoliko vlada, i nekoliko regija,

have recognized that this is a new way to treat disease.

je prepoznalo ovaj novi način liječenja.

The Japanese government were perhaps the first,

Japanska vlada je vjerovatno bila prva

when they decided to invest first 3 billion,

kada su odlučili investirati prve tri milijarde,

later another 2 billion in this field.

a onda i još dvije milijarde u ovo područje.

It's no coincidence.

To nije slučajnost.

Japan is the oldest country on earth in terms of its average age.

Japan je najstarija zemlja na svijetu po prosječnoj dobi stanovništva.

They need this to work or their health system dies.

Oni trebaju ovo ili će se njihov zdravstveni sustav srušiti.

So they're putting a lot of strategic investment focused in this area.

Tako imaju mnogo strateških investicija u ovom polju.

The European Union, same thing.

Ista stvar je u Europskoj uniji.

China, the same thing.

Kina, također.

China just launched a national tissue-engineering center.

Kinezi su upravo otvorili nacionalni center za inžinjering tkiva.

The first year budget was 250 million US dollars.

Budžet za prvu godinu je bio 250 milijuna američkih dolara.

In the United States we've had a somewhat different approach.

U SAD-u smo imali ponešto drugačiji pristup. Mi --

(Laughter)

(Smijeh)

Oh, for Al Gore to come and be in the real world as president.

-- eh, da Al Gore dođe i stvarno bude predsjednik.

We've had a different approach.

Mi smo imali drugačiji pristup.

And the approach has basically been to just sort of fund things as they come along.

A taj pristup je u osnovi, financiranje stvari kako koja dođe.

But there's been no strategic investment

Ali nemamo strateških investicija

to bring all of the necessary things to bear and focus them in a careful way.

za sve neophodne stvari kako bi ih oprezno i detaljno radili i uređivali.

And I'm going to finish up with a quote, maybe a little cheap shot,

Završiti ću s jednim citatom, znam da je to možda malo jeftin trik,

at the director of the NIH, who's a very charming man.

direktora Državnog instituta za zdravstvo, veoma šarmantnog čovjeka.

Myself and Jay Vacanti from Harvard

Jay Vacanti s Harvarda i ja

went to visit with him and a number of his directors of his institute

smo otišli posjetiti njega i nekoliko direktora u tom institutu

just a few months ago,

prije samo nekoliko mjeseci,

to try and convince him that it was time to take just a little piece

da ga pokušamo uvjeriti kako je vrijeme da uzmemo samo mali dio

of that 27.5 billion dollars that he's going to get next year

od 27.5 milijardi dolara koje će dobiti sljedeće godine

and focus it, in a strategic way, to make sure we can accelerate the pace

i strateški ih fokusiramo, tako da budemo sigurni kako možemo ubrzati tempo

at which these things get to patients.

kojim ove stvari dolaze do pacijenata.

And at the end of a very testy meeting,

I na kraju veoma osornog i mrzovoljnog sastanka

what the NIH director said was,

direktor instituta je rekao:

"Your vision is larger than our appetite."

"Vaša vizija je veća od naših apetita."

I'd like to close by saying that no one's going to change our vision,

Završio bi tako da kažem kako nitko neće promijeniti našu viziju,

but together we can change his appetite.

ali da svi zajedno možemo promijeniti njegov apetit.

Thank you.

Hvala vam.