Siddharthan Chandran: Can the damaged brain repair itself?

Prevodilac: Maja Budišin Lukin Lektor: Mile Živković

I'm very pleased to be here today

Veoma mi je drago što sam danas ovde

to talk to you all about how we might repair

da bih govorio kako bismo mogli popraviti

the damaged brain,

oštećen mozak.

and I'm particularly excited by this field,

Tim područjem sam izuzetno oduševljen

because as a neurologist myself,

jer kao neurolog,

I believe that this offers one of the great ways

verujem da nudi sjajan način

that we might be able to offer hope

kojim bismo mogli ponuditi nadu

for patients who today live with devastating

pacijentima koji danas žive sa razornim

and yet untreatable diseases of the brain.

i neizlečivim bolestima mozga.

So here's the problem.

Evo ovde je problem.

You can see here the picture of somebody's brain

Tu možete da vidite sliku nečijeg mozga

with Alzheimer's disease

s Alchajmerovom bolešću

next to a healthy brain,

pored zdravog mozga.

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

Kod Alchajmerove bolesti,

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

okruženo crvenim, postoji vidljivo oštećenje - atrofija, stvaranje ožiljaka.

And I could show you equivalent pictures

Mogao bih vam pokazati jednake slike

from other disease: multiple sclerosis,

drugih bolesti: multiple skleroze (MS),

motor neuron disease, Parkinson's disease,

bolesti motoričkih nerava, Parkinsonove bolesti,

even Huntington's disease,

čak i Hantingtonove bolesti

and they would all tell a similar story.

i sve one bi vam ispričale sličnu priču.

And collectively these brain disorders represent

Svim ovim poremećajima mozga je zajedničko

one of the major public health threats of our time.

da su jedna od najvećih pretnji javnom zdravstvu našeg doba.

And the numbers here are really rather staggering.

Ovde su brojevi zaista prilično poražavajući.

At any one time, there are 35 million people today

U svakom momentu danas živi 35 miliona ljudi

living with one of these brain diseases,

s jednom od tih bolesti mozga,

and the annual cost globally

a godišnji trošak na globalnoj ravni

is 700 billion dollars.

je 700 milijardi dolara.

I mean, just think about that.

Razmislite o tome.

That's greater than one percent

To je više od jednog procenta

of the global GDP.

globalnog BDP-a.

And it gets worse,

I još se pogoršava,

because all these numbers are rising

ti brojevi su u porastu,

because these are by and large

jer su to većinom

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

bolesti starosti, a živimo duže.

So the question we really need to ask ourselves is,

Tako moramo da se zapitamo,

why, given the devastating impact of these diseases

zašto, s obzirom na razorni uticaj tih bolesti

to the individual,

na pojedinca,

never mind the scale of the societal problem,

bez obzira na obim društvenog problema,

why are there no effective treatments?

zašto nema efikasnih terapija?

Now in order to consider this,

Da biste to shvatili

I first need to give you a crash course

moraću vam dati ubrzani kurs

in how the brain works.

o funkcionisanju mozga.

So in other words, I need to tell you

Drugim rečima, moram vam ispričati

everything I learned at medical school.

sve što sam naučio na medicinskom fakultetu.

(Laughter)

(Smeh)

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

Verujte mi, neće trajati dugo.

Okay? (Laughter)

U redu? (Smeh)

So the brain is terribly simple:

Mozak je užasno jednostavan:

it's made up of four cells,

sastoji se iz četiri ćelije,

and two of them are shown here.

dve su ovde prikazane.

There's the nerve cell,

Tu je nervna ćelija,

and then there's the myelinating cell,

a zatim mijelinski omotač,

or the insulating cell.

ili izolaciona ćelija.

It's called oligodendrocyte.

Zove se oligodendrocit.

And when these four cells work together

Kada te četiri ćelije rade zajedno

in health and harmony,

u zdravoj harmoniji,

they create an extraordinary symphony of electrical activity,

stvaraju izvanrednu električnu simfoniju,

and it is this electrical activity

i ta električna aktivnost

that underpins our ability to think, to emote,

podupire našu sposobnost razmišljanja, ispoljavanja emocija

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

pamćenja, učenja, kretnji, osećaja itd.

But equally, each of these individual four cells

No, isto tako, svaka od te četiri ćelije

alone or together, can go rogue or die,

sama ili zajedno, može da zastrani ili da odumre

and when that happens, you get damage.

i kad se to dogodi, dobijete oštećenje.

You get damaged wiring.

Imate oštećeno ožičenje.

You get disrupted connections.

Imate poremećene veze.

And that's evident here with the slower conduction.

To se ogleda u sporijoj provodljivosti.

But ultimately, this damage will manifest

Na kraju će se to oštećenje jasno manifestovati,

as disease, clearly.

kao bolest.

And if the starting dying nerve cell

Ako je nervna ćelija koja počinje da odumire

is a motor nerve, for example,

motorički nerv, na primer,

you'll get motor neuron disease.

dobićete bolest motoričkih nerava.

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

Želeo bih da vam dam realnu ilustraciju

of what happens with motor neuron disease.

toga šta se događa kod bolesti motoričkih nerava.

So this is a patient of mine called John.

Ovo je moj pacijent po imenu Džon.

John I saw just last week in the clinic.

Džona sam video prošle nedelje na klinici.

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

Zamolio sam ga da nam kaže nešto o svojim problemima

that led to the initial diagnosis

koji su doveli do početne dijagnoze

of motor neuron disease.

bolesti motoričkih nerava.

John: I was diagnosed in October in 2011,

Džon: Dobio sam dijagnozu u oktobru 2011.

and the main problem was a breathing problem,

i glavni problem je bio u disanju,

difficulty breathing.

otežano disanje.

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

SČ: Ne znam da li ste sve shvatili, Džon nam je rekao

was that difficulty with breathing

da je poteškoća s disanjem

led eventually to the diagnosis

na kraju dovela do dijagnoze

of motor neuron disease.

bolesti motoričkih nerava.

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

Dakle Džon je sada 18 meseci dalje na tom putu

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

i zamolio sam ga da nam kaže nešto

his current predicament.

o svojoj trenutnoj situaciji.

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

Džon: Sada se disanje pogoršalo.

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

Osećam slabost u šakama, rukama i nogama.

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

Tako sam većinom u invalidskim kolicima.

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

SČ: Džon nam je upravo rekao da je u invalidskim kolicima

most of the time.

najvećim delom vremena.

So what these two clips show

Ova dva snimka nam pokazuju

is not just the devastating consequence of the disease,

ne samo poražavajuće posledice bolesti,

but they also tell us something about

već takođe

the shocking pace of the disease,

šokantan tempo bolesti,

because in just 18 months,

jer je za samo 18 meseci,

a fit adult man has been rendered

odrasla osoba u dobroj kondiciji postala zavisna

wheelchair- and respirator-dependent.

od invalidskih kolica i respiratora.

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

Realno gledano, Džon bi mogao biti bilo čiji otac,

brother or friend.

brat ili prijatelj.

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

Eto to se desi kada motorički nerv odumre.

But what happens when that myelin cell dies?

No, šta se desi kada odumre mijelinski omotač?

You get multiple sclerosis.

Dobijete multiplu sklerozu.

So the scan on your left

Snimak na vašoj levoj strani

is an illustration of the brain,

je ilustracija mozga,

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

to je mapa veza u mozgu,

and superimposed upon which

preko kojih su data

are areas of damage.

područja oštećenja.

We call them lesions of demyelination.

Nazivamo ih lezije demijelinizacije,

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

ali to su oštećenja i bela su.

So I know what you're thinking here.

Znam o čemu sada razmišljate.

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

Razmišljate: "O bože, ovaj je

and said he's going to talk about hope,

rekao da će govoriti o nadi,

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

a sve što nam je do sada ispričao je prilično turobna

and depressing tale."

i depresivna priča."

I've told you these diseases are terrible.

Rekao sam vam da su ove bolesti užasne.

They're devastating, numbers are rising,

One razaraju, brojevi rastu,

the costs are ridiculous, and worst of all,

troškovi su apsurdni, a najgore je od svega,

we have no treatment. Where's the hope?

što su neizlečive. Gde je tu nada?

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

No, znate šta? Mislim da nade ima.

And there's hope in this next section,

Nade ima u ovom sledećem delu,

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

ovog dela mozga kod drugog primera sa MS,

because what it illustrates

jer to ilustruje

is, amazingly, the brain can repair itself.

da mozak može sam da se popravi.

It just doesn't do it well enough.

Jedino što to radi dovoljno dobro.

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

Tu postoje dve stvari koje želim da vam pokažem.

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

Pre svega radi se o oštećenju kod ovog pacijenta sa MS.

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

Opet, to je još jedna od tih belih masa.

But crucially, the area that's ringed red

Najbitnije je svetlo plavo područje

highlights an area that is pale blue.

okruženo crvenim.

But that area that is pale blue was once white.

To svetlo plavo područje je nekad bilo belo.

So it was damaged. It's now repaired.

Bilo je oštećeno. Sada je sanirano.

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

Da budem jasan: to nije zbog lekara.

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

To je uprkos lekarima, a ne zbog njih.

This is spontaneous repair.

To je spontani popravak.

It's amazing and it's occurred

Neverovatno je i desilo se

because there are stem cells in the brain, even,

zato što postoje matične ćelije u mozgu

which can enable new myelin, new insulation,

koje mogu da stvore novi mijelin, novu izolaciju,

to be laid down over the damaged nerves.

preko oštećenih nerava.

And this observation is important for two reasons.

Ovo je važno iz dva razloga.

The first is it challenges one of the orthodoxies

Prvo zato što je suprotno dogmi,

that we learnt at medical school,

kojoj smo se učili na medicini,

or at least I did, admittedly last century,

bar ja, doduše u prošlom veku,

which is that the brain doesn't repair itself,

koja glasi da se mozak ne regeneriše,

unlike, say, the bone or the liver.

za razliku od, recimo, kosti ili jetre.

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

U stvari se regeneriše, jedino što to ne radi dovoljno dobro.

And the second thing it does,

A drugo je zato

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

što nam to daje vrlo jasan pravac u potrazi za novim terapijama -

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

hoću reći, ne morate biti genije

to know what to do here.

da biste znali šta ovde da uradite.

You simply need to find ways of promoting

Jednostavno morate pronaći načine da podstaknete

the endogenous, spontaneous repair that occurs anyway.

endogenu, spontanu sanaciju koja se i tako odvija.

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

Ako to već izvesno vreme znamo,

for some time, as we have,

što je tačno, pitanje je

why do we not have those treatments?

zašto nemamo tih terapija?

And that in part reflects the complexity

I to delimično odražava složenost

of drug development.

u razvoju lekova.

Now, drug development you might think of

Razvoj lekova možete zamisliti

as a rather expensive but risky bet,

kao prilično skup i riskantan ulog,

and the odds of this bet are roughly this:

a izgledi za taj ulog su u grubom ovakvi:

they're 10,000 to one against,

10.000 : 1,

because you need to screen about 10,000 compounds

jer je potrebno proveriti oko 10.000 jedinjenja

to find that one potential winner.

da bi se pronašao potencijalni pobednik.

And then you need to spend 15 years

Zatim morate da potrošite 15 godina

and spend over a billion dollars,

i više od milijardu dolara,

and even then, you may not have a winner.

pa čak i tada, možda nećete imati pobednika.

So the question for us is,

Dakle, pitamo se,

can you change the rules of the game

možete li promeniti pravila igre

and can you shorten the odds?

i skratiti izglede?

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

Da biste to učinili, morate promisliti

where is the bottleneck in this drug discovery?

gde je usko grlo u ovom otkrivanju leka?

And one of the bottlenecks is early in drug discovery.

Jedno od uskih grla je u početku otkrivanja leka.

All that screening occurs in animal models.

Sva ta provera se odvija na životinjskim modelima.

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

Znamo da je za pravo proučavanje čovečanstva potreban čovek,

to borrow from Alexander Pope.

prema rečima Aleksandra Poupa.

So the question is, can we study these diseases

Dakle pitanje je, možemo li proučavati ove bolesti

using human material?

koristeći ljudski materijal?

And of course, absolutely we can.

Naravno da to apsolutno možemo.

We can use stem cells,

Možemo da koristimo matične ćelije

and specifically we can use human stem cells.

i posebno ljudske matične ćelije.

And human stem cells are these extraordinary

Ljudske matične ćelije su te izvanredne

but simple cells that can do two things:

i jednostavne ćelije koje mogu da urade dve stvari:

they can self-renew or make more of themselves,

mogu da se same obnavljaju ili da se nadgrađuju,

but they can also become specialized

ali mogu takođe da se specijalizuju

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

da stvaraju kost, jetru ili, što je najvažnije, nervne ćelije,

maybe even the motor nerve cell

možda čak i motoričke nervne ćelije

or the myelin cell.

ili mijelinski omotač.

And the challenge has long been,

Izazov postoji već dugo -

can we harness the power,

da li možemo zauzdati moć,

the undoubted power of these stem cells

nespornu moć tih matičnih ćelija

in order to realize their promise

da bismo ostvarili to što one obećavaju

for regenerative neurology?

u regenerativnoj neurologiji?

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

Mislim da to sada možemo,

is because there have been several major discoveries

zbog nekoliko velikih otkrića

in the last 10, 20 years.

u poslednjih 10, 20 godina.

One of them was here in Edinburgh,

Jedno od njih je bilo ovde u Edinburgu

and it must be the only celebrity sheep, Dolly.

i to je verovatno jedina slavna ovca, Doli.

So Dolly was made in Edinburgh,

Dakle, Doli je stvorena u Edinburgu,

and Dolly was an example

i bila je primer

of the first cloning of a mammal

prvog kloniranja sisara

from an adult cell.

iz ćelije odrasle jedinke.

But I think the even more significant breakthrough

Mislim da je još važnije otkriće

for the purposes of our discussion today

za našu današnju raspravu

was made in 2006 by a Japanese scientist

napravio 2006. japanski naučnik

called Yamanaka.

po imenu Jamanaka.

And what Yamaka did,

Jamanaka je,

in a fantastic form of scientific cookery,

u fantastičnoj naučnoj kuhinji,

was he showed that four ingredients,

pokazao da četiri sastojka,

just four ingredients,

samo četiri sastojka,

could effectively convert any cell, adult cell,

mogu efikasno da pretvore bilo koju adultnu ćeliju

into a master stem cell.

u pluripotentnu matičnu ćeliju.

And the significance of this is difficult to exaggerate,

Značaj toga je teško preuveličati,

because what it means that from anybody in this room,

jer to znači da je sada od bilo koga u ovoj sobi,

but particularly patients,

a posebno od pacijenata,

you could now generate

moguće stvoriti

a bespoke, personalized tissue repair kit.

po meri personalizovan komplet tkiva za popravku.

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

Uzmete ćeliju kože, pretvorite je u pluripotentnu ćeliju

so you could then make those cells

da biste mogli da napravite one ćelije

that are relevant to their disease,

koje su relevantne za bolest,

both to study but potentially to treat.

za proučavanje i za potencijalno lečenje.

Now, the idea of that at medical school --

Ta bi ideja na medicinskom fakultetu -

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

ova se tema ponavlja, zar ne, ja ​​i medicinsko školovanje? -

would have been ridiculous,

bila smešna,

but it's an absolute reality today.

iako je to apsolutna stvarnost danas.

And I see this as the cornerstone

To vidim kao temelj

of regeneration, repair and hope.

regeneracije, popravke i nade.

And whilst we're on the theme of hope,

I dok smo kod nade,

for those of you who might have failed at school,

za vas koji možda niste uspeli u školi

there's hope for you as well,

ima nade i za vas,

because this is the school report of John Gerdon.

jer je ovo školski izveštaj Džona Gurdona.

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

Nisu ga baš previše cenili tada.

So they didn't think much of him then.

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

Možda ne znate da je dobio Nobelovu nagradu za medicinu

just three months ago.

pre samo tri meseca.

So to return to the original problem,

I da se vratimo na prvobitni problem,

what is the opportunity of these stem cells,

kakva je mogućnost tih matičnih ćelija

or this disruptive technology,

ili te disruptivne tehnologije,

for repairing the damaged brain,

za popravljanje oštećenog mozga,

which we call regenerative neurology?

koju nazivamo regenerativnom neurologijom?

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

Mislim da postoje dva načina razmišljanja o tome:

as a fantastic 21st-century drug discovery tool,

kao o fantastičnom sredstvu 21. veka za otkrivanje lekova,

and/or as a form of therapy.

i / ili kao o obliku lečenja.

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

U nastavku ću vam govoriti

in the next few moments.

nešto malo o obe stvari.

Drug discovery in a dish is how people often

Otkrivanje lekova u posudi - tako često

talk about this.

o tome ljudi govore.

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

Vrlo je jednostavno: recimo od pacijenta

let's say motor neuron disease,

koji ima bolest motoričkih nerava

you take a skin sample,

uzmete uzorak kože,

you do the pluripotent reprogramming,

uradite pluripotentno reprogramiranje,

as I've already told you,

kao što sam već rekao

and you generate live motor nerve cells.

i stvorite žive ćelije motoričkih nerava.

That's straightforward, because that's what

To je jasno, jer to

pluripotent cells can do.

pluripotentne ćelije mogu da urade.

But crucially, you can then compare their behavior

Presudno je da onda možete uporediti njihovo ponašanje

to their equivalent but healthy counterparts,

u odnosu na njihov ekvivalent, zdravi pandan,

ideally from an unaffected relative.

idealno bi bilo od zdravih rođaka.

That way, you're matching for genetic variation.

Na taj način upoređujete genetske varijacije.

And that's exactly what we did here.

Upravo to smo napravili ovde

This was a collaboration with colleagues:

u saradnji sa kolegama:

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

u Londonu, Kris Šou, u SAD-u, Stiv Finkbejner i Tom Maniatis.

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

Zanimljivo je da gledate

these are living, growing, motor nerve cells

žive, ​​rastuće, motoričke nervne ćelije

from a patient with motor neuron disease.

kod pacijenta s bolešću motoričkog neurona.

It happens to be an inherited form.

Ovo je nasleđen oblik.

I mean, just imagine that.

Zamislite samo.

This would have been unimaginable 10 years ago.

Pre 10 godina bi to bilo nezamislivo.

So apart from seeing them grow and put out processes,

Pored toga što ih vidimo kako rastu izvan procesa,

we can also engineer them so that they fluoresce,

možemo ih napraviti fluorescentnim,

but crucially, we can then track their individual health

no najvažnije je što onda možemo da pratimo njihovo pojedinačno zdravlje

and compare the diseased motor nerve cells

i upoređujemo bolesne ćelije motoričkog nerva

to the healthy ones.

sa zdravim.

And when you do all that and put it together,

A kada sve to uradite i sastavite,

you realize that the diseased ones,

shvatite da bolesne ćelije,

which is represented in the red line,

pokazane u crvenoj liniji,

are two and a half times more likely to die

imaju dva i po puta veću verovatnoću smrtnosti

than the healthy counterpart.

od zdravih.

And the crucial point about this is that you then have

Pri tom je ključno da tada imate

a fantastic assay to discover drugs,

fantastičan rezultat analize za otkrivanje lekova,

because what would you ask of the drugs,

jer to što biste tražili od leka

and you could do this through a high-throughput

možete putem visoke propusne moći

automated screening system,

automatizovanog sistema proveravanja

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

da tražite - daj mi jednu stvar:

find me a drug that will bring the red line

pronađi mi lek koji će crvenu liniju

closer to the blue line,

približiti plavoj,

because that drug will be a high-value candidate

jer će taj lek biti kandidat visoke vrednosti

that you could probably take direct to human trial

koji biste verovatno mogli dati direktno na ispitivanje na ljudima

and almost bypass that bottleneck

i skoro zaobići usko grlo

that I've told you about in drug discovery

o kom sam vam govorio u otkrivanju lekova

with the animal models,

sa životinjskim modelima,

if that makes sense. It's fantastic.

ako bi to bilo smisleno. To je fantastično.

But I want to come back

Ali vratiću se na temu

to how you might use stem cells directly

kako biste mogli koristiti matične ćelije direktno

to repair damage.

za popravljanje oštećenja.

And again there are two ways to think about this,

I tu postoje dva načina za razmišljanje,

and they're not mutually exclusive.

koji se međusobno ne isključuju.

The first, and I think in the long run

Prvi, koji mislim da će nam na duge staze

the one that will give us the biggest dividend,

dati najveću korist,

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

iako se na taj način još ne razmišlja,

is to think about those stem cells that are already

je razmisliti o onim matičnim ćelijama koje su već

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

u mozgu, što sam vam već rekao.

All of us have stem cells in the brain,

Svi mi imamo matične ćelije u mozgu,

even the diseased brain,

čak i oboleli mozak,

and surely the smart way forward

i sigurno je pametan put napred

is to find ways that you can promote and activate

pronalaženje načina da se podstaknu i aktiviraju

those stem cells in your brain already

te ćelije u vašem mozgu

to react and respond appropriately to damage

da bi reagovale i odazvale se adekvatno na oštećenja

to repair it.

u cilju popravljanja.

That will be the future.

To će biti u budućnosti.

There will be drugs that will do that.

Postojaće lekovi koji će to učiniti.

But the other way is to effectively parachute in cells,

Drugi način je da se efikasno spustite u ćelije,

transplant them in,

da ih presadite,

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

da biste zamenili umiruće ili izgubljene ćelije, čak i u mozgu.

And I want to tell you now an experiment,

Sada ću vam reći o eksperimentu,

it's a clinical trial that we did,

kliničkom ispitivanju koje smo napravili,

which recently completed,

nedavno je završeno,

which is with colleagues in UCL,

sa kolegama na UCL-u,

David Miller in particular.

posebno sa Dejvidom Milerom.

So this study was very simple.

To je vrlo jednostavna studija.

We took patients with multiple sclerosis

Uzeli smo pacijente s multiplom sklerozom

and asked a simple question:

i postavili jednostavno pitanje:

Would stem cells from the bone marrow

Da li bi se matične ćelije iz koštane srži

be protective of their nerves?

ponašale zaštitnički prema sopstvenim nervima?

So what we did was we took this bone marrow,

Tako smo uzeli koštanu srž,

grew up the stem cells in the lab,

uzgojili matične ćelije u laboratoriji,

and then injected them back into the vein.

a zatim ih ubrizgali natrag u venu.

I'm making this sound really simple.

Čini se kao da je ovo veoma jednostavno.

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

Trajalo je pet godina i puno ljudi, ok?

And it put gray hair on me

I zbog toga sam osedeo,

and caused all kinds of issues.

a izazvalo je svakakve debate.

But conceptually, it's essentially simple.

No konceptualno, to je u biti jednostavno.

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

Ubrizgali smo ih u venu.

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

Da bismo izmerili da li je bilo uspešno,

we measured the optic nerve

merili smo očni nerv

as our outcome measure.

kao naš merni rezultat.

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

To je dobra stvar za merenje u MS,

because patients with M.S. sadly suffer

jer bolesnici s MS nažalost imaju

with problems with vision --

problema s vidom -

loss of vision, unclear vision.

gubitak vida, nejasan vid.

And so we measured the size of the optic nerve

I tako smo izmerili očni nerv,

using the scans with David Miller

pomoću snimaka sa Dejvidom Milerom,

three times -- 12 months, six months,

tri puta - 12 meseci, 6 meseci

and before the infusion --

i pre infuzije -

and you can see the gently declining red line.

i vidite blago opadanje crvene linije.

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

To govori da se očni nerv skupio,

which makes sense, because their nerves are dying.

što ima smisla, jer njihovi nervi odumiru.

We then gave the stem cell infusion

Tada smo dali infuziju matičnih ćelija

and repeated the measurement twice --

i ponovili merenje dva puta -

three months and six months --

za tri i za šest meseci -

and to our surprise, almost,

i na naše iznenađenje,

the line's gone up.

linija je narasla.

That suggests that the intervention

To sugeriše da je intervencija

has been protective.

bila zaštitna.

I don't think myself that what's happened

Ne mislim da

is that those stem cells have made new myelin

su te ćelije napravile novi mijelin

or new nerves.

ili nove nerve.

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

Mislim da su podstakle

the endogenous stem cells, or precursor cells,

endogene matične ćelije, odnosno prekursorske ćelije,

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

da rade svoj posao, probude se, polože novi mijelin.

So this is a proof of concept.

Dakle, to je dokaz koncepta.

I'm very excited about that.

Vrlo sam uzbuđen zbog toga.

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

Želim još samo da završim temu sa početka svog govora

which was regeneration and hope.

koja je bila regeneracija i nada.

So here I've asked John

Pitao sam Džona

what his hopes are for the future.

čemu se nada u budućnosti.

John: I would hope that

Džon: Nadam se da

sometime in the future

će se jednom u budućnosti

through the research that you people are doing,

putem istraživanja koje radite,

we can come up with a cure

doći do leka,

so that people like me can lead a normal life.

da bi ljudi kao ja mogli normalno živeti.

SC: I mean, that speaks volumes.

SČ: Mislim da to mnogo govori.

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

Završio bih zahvalnicom Džonu -

thanking John for allowing me to share

što mi je dozvolio da podelim

his insights and these clips with you all.

njegove uvide i ove snimke sa vama.

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

Takođe bih želeo dodati Džonu i drugima

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

da lično gajim nadu za budućnost.

I do believe that the disruptive technologies

Verujem da disruptivne tehnologije

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

poput matičnih ćelija koje sam vam pokušao objasniti

do offer very real hope.

nude vrlo realnu nadu.

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

I zaista mislim da će dan kada ćemo moći da popravljamo oštećen mozak

to repair the damaged brain

is sooner than we think.

doći pre nego što mislimo.

Thank you.

Hvala.

(Applause)

(Aplauz)