Alan Russell: The potential of regenerative medicine

アラン・ラッセル： 肉体の再生

翻訳: Takako Sato 校正: Yasushi Aoki

今日 お話しするのは

I'm going to talk to you today about

願わくは恐怖を希望に変えることです

hopefully converting fear into hope.

When we go to the physician today --

私達は病院に行くと

診察室の中で

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

耳にしたくない言葉があります

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

私達が本当に恐れている言葉です

There are words that we're truly afraid of.

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

糖尿病 がん パーキンソン病 アルツハイマー病

heart failure, lung failure --

心不全 呼吸不全

things that we know are debilitating diseases,

身体を衰弱させ 対処法がほとんどないということを

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

私たちが知っている病気です

今日お話したいのは

And what I want to lay out for you today is

不治の病への 従来とは違った考え方と

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

その重要性です

why it's important,

それがなければ 医療制度は崩壊するでしょう

why without it perhaps our health care system will melt down

if you think it already hasn't,

まだ していなければの話ですが…

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

臨床医学の現在と 明日の方向性

and what some of the hurdles are.

困難な点を取り上げ

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

それをすべて18分でご紹介します

I want to start with this slide,

こちらを見てください

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

サイエンス誌の見解が表れています

バイオニックヒューマンに関する

This was an issue from 2002

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

様々な論文を集めた 2002年の特集号です

It was basically a regenerative medicine issue.

要は 再生医学特集ということです

Regenerative medicine is an extraordinarily simple concept

再生医学とは非常に簡単な概念で

that everybody can understand.

誰でも理解できます

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

自然治癒のスピードを

臨床的に意味のある速さにまで 加速するのです

to a clinically relevant timescale.

ここに挙げられている様々な方法を 我々は知っています

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

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

股関節に障害があれば 人工関節で治します

サイエンス誌の表紙で 紹介された考え方です

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

実はこれは再生医学とは正反対で

This is the complete antithesis of regenerative medicine.

再生医学とは呼びません

This is not regenerative medicine.

Regenerative medicine is what Business Week put up

ビジネスウィーク誌が 少し前に特集したのが

本当の意味の再生医学です

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

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

その概念とは 器具や薬などで

症状を改善させようとする代わりに—

with devices and drugs and the like --

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

これには後で何度か触れますが—

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

傷ついた組織や臓器の機能を 再生することで

by regenerating the function of organs and damaged tissue.

失われた体の機能を 再生するのです

治療が終了すると

So that at the end of the treatment,

健康時の体が取り戻せます

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

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

これは良いアイデアだと思いますが

very few good ideas are truly novel.

良いアイデアが本当に新しいことは 稀なものです

And this is just the same.

この考えにしてもそうです

If you look back in history,

歴史を振り返れば

有名な飛行家のチャールズ・リンドバーグは

Charles Lindbergh, who was better known for flying airplanes,

ノーベル賞を受賞した アレクシス・カレルと共に

was actually one of the first people

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

臓器の培養を

to begin to think about, could you culture organs?

最初に思いついた１人です

And they published this book in 1937,

彼らは1937年に この本を出版し

where they actually began to think about,

臓器全体を生成するのに

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

バイオリアクターがどう使えるか 考え始めました

それから我々は長い道のりを 歩んできました

We've come a long way since then.

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

進行中の素晴らしい事例を 幾つか紹介します

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

でも その前に 医療制度に対する

is share my depression about the health care system

私の不満と 再生医学の必要性を

and the need for this with you.

話したいと思います

昨日は生活の質の向上や

Many of the talks yesterday talked about

improving the quality of life, and reducing poverty,

貧困を減らすという話を たくさん聞きました

and essentially increasing life expectancy all around the globe.

それは 世界的に平均寿命を 延ばすことになります

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

問題は 裕福であるほど 寿命が長いということです

And the longer we live, the more expensive it is

寿命が延びれば 加齢と共に

to take care of our diseases as we get older.

病気の治療費も 増加するということです

This is simply the wealth of a country

これは65歳以上の人口の割合と

versus the percent of population over the age of 65.

国の豊かさの関係を示した図です

国が 裕福なほど

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

高齢者は多くなります

the older the people are within it.

Why is this important?

なぜ これが重要なのか？

And why is this a particularly dramatic challenge right now?

なぜ これが危急の難題なのか？

平均年齢が30歳の場合

If the average age of your population is 30,

then the average kind of disease that you have to treat

治療が必要な一般的な病気は

is maybe a broken ankle every now and again,

時折見られる足首の骨折や

maybe a little bit of asthma.

喘息などでしょう

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

一方 国の平均年齢が 45歳から55歳の場合

now the average person is looking at diabetes,

平均年齢の人が経験する病気として 早期発症糖尿病

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

心不全 冠動脈疾患などが 出てきます

things that are inherently more difficult to treat,

治療がより難しく

and much more expensive to treat.

医療費がより高い病気です

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

これは米国の人口統計データです

This is from "The Untied States of America."

ある本から借用した資料です

In 1930, there were 41 workers per retiree.

1930年 年金生活者１人に対し 労働者は41人

41 people who were basically outside of being really sick,

基本的に 健康には さほど問題のない41人が

paying for the one retiree who was experiencing debilitating disease.

医療費のかさむ年金生活者1人を 養っています

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

2010年の米国は 年金生活者1人に対し労働者2人

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

これは世界中の裕福な産業国 すべてに当てはまります

How can you actually afford to treat patients

高齢化の現実がこのような状態で

when the reality of getting old looks like this?

患者の治療費は どうまかなえばいいのか？

This is age versus cost of health care.

これは年齢と医療費のグラフです

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

ちょうど40～45歳のあたりで

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

医療費の急激な増加が見られます

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

興味深いですね 研究をすれば—

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

個人の医療費が年齢と共に どのように変わるか

plotted over your lifetime.

分かるんです

死の約７年前に 費用が急激に上昇します

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

And you can actually --

ここから分かるのは…

(Laughter)

（笑）

-- we won't get into that.

…よしておきましょう

(Laughter)

（笑）

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

このような病気の 治療法を変え

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

私が健康的な加齢と 呼ぶものを

and experience what I would call healthy aging.

実現できる方法は あまりありません

I'd suggest there are four things,

提案する方法は4つ

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

保険や法律に 関連したことではありません

それらは負担者を変えるだけで

All those things do is change who pays.

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

治療費に変化は出せません

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

１つの方法は 医療を制限し 治療をやめることです

こんな暗い話題はやめましょう

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

もう１つは予防です

You can prevent.

Obviously a lot of monies should be put into prevention.

予防に多くの費用を かけるべきなのは明白です

興味深く 最も重要なのは

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

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

病気の早期発見をして

and then treating the disease to cure the disease

対症療法ではなく

完治するように治療すること

instead of treating a symptom.

Think of it in terms of diabetes, for instance.

糖尿病を例に考えてみましょう

現在の糖尿病への対応とは？

Today, with diabetes, what do we do?

We diagnose the disease eventually, once it becomes symptomatic,

症状が現れてから診断がなされ

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

そして何十年と長期に渡る治療をし

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

インスリンが効くので 健康を保てますが

結局は効かなくなり

But eventually it stops working,

and diabetes leads to a predictable onset of debilitating disease.

糖尿病がどんどん身体を 弱らせる素因になります

Why couldn't we just inject the pancreas with something

症状が現れる前の 初期の段階で

to regenerate the pancreas early on in the disease,

すい臓を再生させる 注射をすることは

perhaps even before it was symptomatic?

できないでしょうか？

その時は多少費用が必要ですが

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

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

効果が出れば 違いは著しいでしょう

私が話している概念は このビデオで劇的に伝えられると思います

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

This is a newt re-growing its limb.

これは再生中のイモリの脚です

イモリに可能ならば 我々にも可能なのでは？

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

I'll actually show you some more important features

もう少し後で 手足再生に関する―

about limb regeneration in a moment.

もっと重要な事を紹介します

But what we're talking about in regenerative medicine

再生医学は

is doing this in every organ system of the body,

全ての臓器系について

for tissues and for organs themselves.

その組織や臓器自体に適用できます

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

今日の実情では 病気になった場合

the message is we will treat your symptoms,

治療されるのは症状であり

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

患者には新しい あり方への適応が求められます

I would pose to you that tomorrow --

いつ起きるのかは

and when tomorrow is we could debate,

議論の余地がありますが

but it's within the foreseeable future --

近い将来に

we will talk about regenerative rehabilitation.

再生医学を使ったリハビリが 行われるようになるでしょう

この義足は

There's a limb prosthetic up here,

similar actually one on the soldier

イラク帰還兵が 使用しているものに

that's come back from Iraq.

よく似ています

手足を失ったイラク帰還兵が 370名もいます

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

彼らが直面するのが 手足の喪失ではなく

Imagine if instead of facing that, they could actually

face the regeneration of that limb.

手足の再生であるところを 想像してみてください

It's a wild concept.

すごい考えでしょう

その発想に向けた 進行中の事例を紹介します

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

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

これもまた どの器官にも有効です

How can we do that?

その方法とは

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

肉体と会話をすること

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

肉体の言語を話し

胎児だった時に使っていたプロセスを 起動するのです

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

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

哺乳類の胎児は 妊娠３ヶ月までに手足を失っても

will re-grow that limb.

再び形成されます

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

私たちのDNAはそのような怪我を 治癒する機能を備えているのです

It's a natural process,

これは自然な能力ですが

but it is lost as we age.

成長と共に失われます

生後６ヶ月以内の 乳児であれば

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

指先を事故で失っても

if they lose their fingertip in an accident,

元通りになりますが

they'll re-grow their fingertip.

5歳児だと 元通りにはなりません

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

そこで 肉体と対話する為には

So to engage in that conversation with the body,

we need to speak the body's language.

肉体の言葉を話す必要があります

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

現在 我々はそのための道具立てを いくつか持っています

肉体と対話する能力３つの例を

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

through which to converse with the body.

お見せします

The first is cellular therapies.

１つめは細胞療法

Clearly, we heal ourselves in a natural process,

私たちは主に細胞の働きによって

using cells to do most of the work.

自然のプロセスとして 自ら治癒します

Therefore, if we can find the right cells

適切な細胞を見つけ 体に移植すれば

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

細胞が治してくれる かもしれません

Secondly, we can use materials.

２つめは物質を使うこと

We heard yesterday about the importance of new materials.

昨日 新規物質の 重要性について聞きました

If we can invent materials, design materials,

もし物質を発明したり 設計したり

or extract materials from a natural environment,

自然界から抽出することが 出来れば

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

その物質で体自身が治癒するように 誘導できるかもしれません

And finally, we may be able to use smart devices

最後に 体の機能を肩代わりして

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

体が治癒できるようにする スマートデバイスを作れるかもしれません

それぞれの例を紹介します

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

and I'm going to start with materials.

物質から始めます

ピッツバーグ大学の バディラック氏は

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

about a decade ago had a remarkable idea.

10年程前に素晴らしい事を 思いつきました

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

豚の小腸から すべての細胞を取り去っても

if you threw away all the cells,

生物学的に活性な状態に 保てるとすれば

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

残りの小腸組織に 体に治癒を促すのに必要な すべての要素と生物学的信号が

may contain all of the necessary factors and signals

含まれているかもしれない という考え方です

that would signal the body to heal itself.

And he asked a very important question.

彼はとても重要な

He asked the question,

質問をしました

if I take that material, which is a natural material

通常は小腸で治癒を誘導する 天然の物質を

that usually induces healing in the small intestine,

人体の別の部分に使えば

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

組織が特異的な反応を見せて

would it give a tissue-specific response,

耳を作り出すのか

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

それとも小腸を作り出すのか という質問です

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

興味深い話でなければ この話はしていません

The picture I'm about to show you

これからお見せする写真は…

is a compelling picture.

（スライド： 目をそらすなら今のうち）　（笑）

(Laughter)

注目に値する写真です

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

でも 友人には認めたくなくても 怖ければ

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

明かりを落とすので

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

足下を気にしたり 携帯を確認したり

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

スクリーンを見る 以外のことをして下さい

(Laughter)

（笑）

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

お見せするのは糖尿病性潰瘍です

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

笑うのは今のうちです

This is the reality of diabetes.

これが糖尿病の現実です

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

糖尿病患者や糖尿病性潰瘍のことは よく耳にしますが

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

治癒できなければ切断 という最終段階と

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

潰瘍を あまり関連づけすることは ありません

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

では始めます　 長くはありません

This is a diabetic ulcer. It's tragic.

これが糖尿病性潰瘍　 悲惨なものです

The treatment for this is amputation.

治療法は切断です

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

この66歳の女性は糖尿病の他に 肝臓がんも患っており

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

死ぬのであれば 体は傷つけずにいようと決めたのですが

1年間の潰瘍治療の末

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

バディラック氏の新しい治療法を 試すことにしました

that she would try this new therapy that Steve invented.

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

11週後の傷口の様子です

That material contained only natural signals.

その物質には 自然の信号だけが 含まれていました

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

この物質が以前には無かった 治癒反応を

that it didn't have before.

誘導しました

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

ショッキングな写真が あと数枚出てきます

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

終わったら 言いますね

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

これは馬です　 痛みは感じていません

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

そうでなければ お見せしません

The horse just has another nostril that's developed

乗馬事故に巻き込まれて

鼻孔がもう一つできてしまいました

because of a riding accident.

治療数週間後です

Just a few weeks after treatment --

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

このケースでは 物質をジェル状にして

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

傷口を覆い それを何度か繰り返して

and the horse heals up.

完治しました

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

超音波でもはっきりわかります

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

これは新しい背びれを 得たイルカです

There are now 400,000 patients around the world

世界中には現在40万人もの患者が

who have used that material to heal their wounds.

この物質を用いた怪我の治療を受けています

Could you regenerate a limb?

手足は再生できるのでしょうか？

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

この疑問の解明のため ８研究施設に渡るプロジェクトの資金として

to begin the process of asking that question.

国防省の研究機関が 1500万ドルを提供しました

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

その1500万ドルの成果です

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

これは指先を失った 78歳の男性です

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

先程 指先を失う 子どもの話をしましたね？

After treatment that's what it looks like.

これが治療後です

This is happening today.

これは現在起きていて

This is clinically relevant today.

臨床的に意味のある事です

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

これを可能にする物質もあり 心臓パッチもあります

But could you go a little further?

もう一歩先へ進んで

Could you, say, instead of using material,

物質の代わりに

can I take some cells along with the material,

物質と共に細胞を用いて

and remove a damaged piece of tissue,

傷ついた組織を取り除き

put a bio-degradable material on there?

生分解性物質の 移植は可能なのか？

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

心筋が培養皿の中で 拍動しているのがわかりますね

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

これは東京女子医大の 岡野光夫氏が手掛けました

実際に培養皿の中で 拍動する組織を生成できるのです

He can actually grow beating tissue in a dish.

培養皿を冷やすと 特性が変わり

He chills the dish, it changes its properties

and he peels it right out of the dish.

そこから はがして使うのです

It's the coolest stuff.

すごいですね

次は 細胞を使う話です

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

And what I'm going to show you here

ここで紹介するのは

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

患者の骨盤から 取り出した幹細胞です

怖がりの人向けではありませんが

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

But this one's kind of cool.

これは 結構すごいですよ

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

これはアル・ゴアが受けたような バイパス手術ですが

with a difference.

違うのは

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

ここでは バイパス手術の最後に

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

手術の開始時に取り出された 患者の幹細胞が

that were removed at the beginning of the procedure

being injected directly into the heart of the patient.

心臓に直接注射されていることです

ここに立って

And I'm standing up here because at one point

この技術がどれだけ初期段階なのかを お見せします

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

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

患者の拍動する心臓に 幹細胞が入れられています

And if you look really carefully,

注意深く見ると

it's going to be right around this point

まさにこの辺に

you'll actually see a back-flush.

逆流しているのがわかります

You see the cells coming back out.

細胞が戻って来るのが見えます

完璧な場所に 完璧なタイミングで

We need all sorts of new technology, new devices,

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

細胞を注入するには 新しい技術と装置が必要です

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

ちょっとした無作為化試験の

This was a randomized trial.

データがあります

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

被験者数は20でしたが 現在は100です

基本的に重病人にバイパス手術を行えば

Basically, if you take an extremely sick patient

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

少しだけ改善します

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

もし同じ患者に バイパス手術と

for these particular patients, they became asymptomatic.

幹細胞移植を行うと 症状はなくなります

These are now two years out.

これは 既に2年経っています

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

もし病気を早期発見し 悪化を防げれば

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

それほど最高なことはないでしょう

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

こちらは最小限の切開で行えるよう

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

体に３か所だけ穴を開け そこから腹腔鏡で

and simply injecting stem cells through a laparoscopic procedure.

心臓に幹細胞を注入します

There go the cells.

今 細胞が入っていきます

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

詳しく説明する時間はありませんが

but basically, that works too.

基本的には これもうまく行きます

You can take patients who are less sick,

症状の軽い患者は このような治療で

and bring them back to an almost asymptomatic state

ほとんど症状が無い状態へ

through that kind of therapy.

戻ります

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

もう一つの幹細胞治療の例は

もうすぐ臨床段階に 入ると思います

but I think very soon will be.

これはピッツバーグのマーラ氏が

This is the work of Kacey Marra from Pittsburgh,

along with a number of colleagues around the world.

世界中の仲間と共同で

They've decided that liposuction fluid,

脂肪吸引液で実験しています

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

アメリカには たっぷりありますからね

(Laughter)

（笑）

It's a great source of stem cells.

脂肪吸引液には

Stem cells are packed in that liposuction fluid.

幹細胞がぎっしり詰まっています

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

クリニックへ行き 脂肪吸引術を受ければ

Out comes the liposuction fluid,

脂肪吸引液が取れます

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

ここでは分離した幹細胞から 神経細胞が作られました

実験室での話です

All done in the lab.

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

もうすぐ 自分の脂肪に 由来する幹細胞で

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

治療を受ける患者が 出てくるでしょう

I talked before about the use of devices

先程 病気を治療する方法を

to dramatically change the way we treat disease.

劇的に変える器具の話をしました

Here's just one example before I close up.

おしまいに ある事例を紹介します

This is equally tragic.

これもまた悲惨です

We have a very abiding and heartbreaking partnership

米陸軍外科研究所とは 長い付き合いですが

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

とても心が痛むものがあります

彼らは現在11,000人の イラク帰還兵の治療に当たっています

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

患者の多くが 重度の火傷を負っています

Many of those patients are very severely burned.

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

火傷から学んだ事があるとすれば

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

治療法が分からないこと

Everything that is done to treat burn --

火傷治療に行われるのは

basically we do a sodding approach.

芝敷きアプローチです

こっちにあるものを取って

We make something over here,

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

火傷の部位に移植し

and we try and get the two to take.

くっつけようとします

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

このケースでは 新しい 装着できるバイオリアクターを

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

ピッツバーグの ガーラック氏が開発し

今年中に臨床試験が 行われるはずです

by Joerg Gerlach in Pittsburgh.

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

バイオリアクターを 創傷床にくっつけ

The gun that you see there sprays cells.

そして その部分に

細胞をスプレーします

That's going to spray cells over that area.

The reactor will serve to fertilize the environment,

リアクターがその環境に 栄養を供給し

deliver other things as well at the same time,

同時に他の物も運びます

and therefore we will seed that lawn,

いわば 芝に種まきが出来るのです

as opposed to try the sodding approach.

芝敷きアプローチとは反対です

It's a completely different way of doing it.

まるっきり違います

So my 18 minutes is up.

18分経ちましたので

So let me finish up with some good news,

良い報せと 悪い報せを

and maybe a little bit of bad news.

話して終わります

朗報は これが現在起きているということ

The good news is that this is happening today.

It's very powerful work.

その迫力が

Clearly the images kind of get that across.

写真で伝わりますね

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

多分野に渡る研究の為 非常に難しいのです

Almost every field of science engineering and clinical practice

科学 工学 臨床医学の分野のほとんどが

is involved in trying to get this to happen.

この実現に向けて取り組んでいます

多くの政府や地域が

A number of governments, and a number of regions,

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

これこそ新しい治療法だと認めています

The Japanese government were perhaps the first,

初めて認めたのは おそらく日本政府で

when they decided to invest first 3 billion,

30億ドルの投資を決め

later another 2 billion in this field.

後に 20億ドル追加しました

それもそのはず

It's no coincidence.

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

日本は世界一の長寿国です

これが成功しないと 日本の医療制度は崩壊するため

They need this to work or their health system dies.

彼らはこの分野に 戦略的に投資しています

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

The European Union, same thing.

ヨーロッパ連合も然り

China, the same thing.

中国も然り

China just launched a national tissue-engineering center.

中国は組織工学研究センターを 設立しました

The first year budget was 250 million US dollars.

初年度予算は2億5千万ドルでした

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

アメリカのアプローチは少し違います

(Laughter)

（笑）

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

アル・ゴアが大統領になれば 良かったのですが…

We've had a different approach.

我々のアプローチは

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

うまくいったものに 投資するやり方で

But there's been no strategic investment

新技術を生み出し 集中させる為に

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

必要なものを集める 戦略的な投資ではないのです

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

少しずるいやり方 かもしれませんが

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

国立衛生研究所（NIH）所長の言葉を 引用して終わりにします

Myself and Jay Vacanti from Harvard

私はハーバードの バカンディ氏と共に

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

NIHの研究所長たちに 会いに行きました

just a few months ago,

数か月前の事です

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

来年度予算275億ドルの中の 少しだけでも振り向けて

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

再生技術が患者に届くペースが 加速するよう

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

戦略的に注力すべきであると

at which these things get to patients.

説得するためです

And at the end of a very testy meeting,

ピリピリした会合の最後に

what the NIH director said was,

所長が言いました

"Your vision is larger than our appetite."

「君の話は壮大すぎて気が進まない」

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

我々のビジョンは 何者によっても変わりません

but together we can change his appetite.

みんなで彼の気持ちの方を 変えてやりましょう

Thank you.

ありがとう