How nanoparticles could change the way we treat cancer | Joy Wolfram

Prevodilac: Milica Costa Lektor: Ivana Korom

It was a Sunday afternoon back in April of this year.

Bila je nedelja popodne u aprilu ove godine.

My phone was ringing,

Zazvonio mi je telefon.

I picked it up.

Javila sam se.

The voice said, "It's Rebecca.

Glas je rekao: "Rebeka je.

I'm just calling to invite you

Htela sam samo da te pozovem

to my funeral."

na moju sahranu."

I said, "Rebecca, what are you talking about?"

Rekla sam: "Rebeka, o čemu govoriš?"

She said, "Joy, as my friend, you have to let me go.

Rekla je: "Džoj, prijatelj si mi, moraš me pustiti.

It's my time."

Vreme je."

The next day, she was dead.

Sledećeg dana, umrla je.

Rebecca was 31 years old when she died.

Rebeka je imala 31 godinu kada je umrla.

She had an eight-year struggle with breast cancer.

Vodila je osmogodišnju bitku sa kancerom dojke.

It came back three times.

Tri puta se vraćao.

I failed her.

Izneverila sam je.

The scientific community failed her.

Naučna zajednica ju je izneverila.

And the medical community failed her.

Medicinska zajednica ju je izneverila.

And she's not the only one.

Ona nije jedina.

Every five seconds,

Svakih pet sekundi, neko umre od kancera.

someone dies of cancer.

Today, we medical researchers are committed

Danas, mi medicinski istraživači smo posvećeni

to having Rebecca and people like her

da Rebeka i ljudi poput nje

be one of the last patients that we fail.

budu među poslednjim pacijentima koje smo izneverili.

The US government alone has spent over 100 billion on cancer research

Američka vlada sama je uložila

preko 100 milijardi na istraživanja kancera od 1970-ih,

since the 1970s,

with limited progress in regards to patient survival,

sa ograničenim uspehom u preživljavanju pacijenata,

especially for certain types of very aggressive cancers.

pogotovo određenih vrsta vrlo agresivnih kancera.

So we need a change because, clearly,

Zato nam je potrebna promena, jer, očigledno,

what we've been doing so far has not been working.

sve što smo do sada radili ne uspeva.

And what we do in medicine is to send out firefighters,

Mi u medicini šaljemo vatrogasce,

because cancer is like a big fire.

jer kancer je kao veliki požar.

And these firefighters are the cancer drugs.

Ovi vatrogasci su lekovi za kancer.

But we're sending them out without a fire truck --

Ali ih šaljemo bez vatrogasnog kamiona -

so without transportation, without ladders

dakle bez transporta, bez merdevina,

and without emergency equipment.

i bez opreme za hitnu pomoć.

And over 99 percent of these firefighters never make it to the fire.

I preko 99 posto ovih vatrogasaca ne stignu od požara.

Over 99 percent of cancer drugs never make it to the tumor

Preko 99 posto lekova za kancer ne stignu do tumora

because they lack transportation and tools

jer im fali transport i oprema

to take them to the location they're aiming for.

da ih prenese do ciljane lokacije.

Turns out, it really is all about location, location, location.

Ispade da je ipak sve lokacija, lokacija, lokacija.

(Laughter)

(Smeh)

So we need a fire truck to get to the right location.

Dakle treba nam vatrogasni kamion da stignemo na pravu lokaciju.

And I'm here to tell you that nanoparticles are the fire trucks.

Ovde sam da vam kažem da su nanočestice kamioni.

We can load cancer drugs inside nanoparticles,

Možemo da utovarimo lekove za kancer unutar nanočestica,

and nanoparticles can function as the carrier

i nanočestice mogu da funkcionišu kao prenosioci

and necessary equipment

i kao neophodna oprema

to bring the cancer drugs to the heart of the tumor.

da prenesu lekove za kancer do srca tumora.

So what are nanoparticles,

Šta su to nanočestice,

and what does it really mean to be nano-sized?

i šta zaista znači biti nano veličine?

Well, there are many different types of nanoparticles

Pa, ima više različitih tipova nanočestica

made out of various materials,

koje se prave od raznih materijala,

such as metal-based nanoparticles

poput nanočestica sačinjenih od metala

or fat-based nanoparticles.

ili nanočestica sačinjenih od masti.

But to really illustrate what it means to be nano-sized,

Ali da bih stvarno ilustrovala šta znači biti nano veličine,

I took one of my hair strands

uzela sam jednu dlaku iz svoje kose

and placed it under the microscope.

i stavila je pod mikroskop.

Now, I have very thin hair,

Imam vrlo tanku kosu,

so my hair is approximately 40,000 nanometers in diameter.

te mi je kosa otprilike 40.000 nanometara u prečniku.

So this means, if we take 400 of our nanoparticles

To znači da kada bismo uzeli 400 nanočestica

and we stack them on top of each other,

i posložili jednu na drugu,

we get the thickness of a single hair strand.

dobili bismo debljinu jedne dlake.

I lead a nanoparticle laboratory to fight cancer and other diseases

Vodim laboratoriju nanočestica u borbi protiv kancera i drugih bolesti

at Mayo Clinic here in Jacksonville.

ovde u Majo klinici u Džeksonvilu.

And at Mayo Clinic,

U Majo klinici, imamo opremu da učinimo sve za pacijenta,

we really have the tools to make a difference for patients,

zahvaljujući izdašnim donacijama

thanks to the generous donations and grants to fund our research.

i grantovima koji finansiraju naše istraživanje.

And so, how do these nanoparticles manage to transport cancer drugs

Dakle, kako ove nanočestice prenose lekove za kancer

to the tumor?

do tumora?

Well, they have an extensive toolbox.

Imaju obimnu kutiju za alat.

Cancer drugs without nanoparticles are quickly washed out of the body

Lekovi za kancer bez nanočestica se brzo isperu iz tela

through the kidneys

kroz bubrege

because they're so small.

jer su premali.

So it's like water going through a sieve.

Kao voda koja protiče kroz sito.

And so they don't really have time to reach the tumor.

Tako da nemaju vremena da stignu do tumora.

Here we see an illustration of this.

Ovde vidimo ilustraciju toga.

We have the firefighters, the cancer drugs.

Imamo vatrogasce, lekove za kancer.

They're circulating in the blood,

Protiču krvotokom,

but they're quickly washed out of the body

ali su brzo isprani iz tela i ne završavaju u tumoru.

and they don't really end up inside the tumor.

But if we put these cancer drugs inside nanoparticles,

Ali ako stavimo ove lekove za kancer unutar nanočestica,

they will not get washed out by the body

neće se isprati iz tela

because the nanoparticles are too big.

jer su nanočestice prevelike.

And they will continue to circulate in the blood,

I nastaviće da protiču kroz krvotok,

giving them more time to find the tumor.

dajući im više vremena da pronađu tumor.

And here we see the cancer drug, the firefighters,

Ovde vidimo lek za kancer, vatrogasce,

inside the fire truck, the nanoparticles.

u vatrogasnom kamionu, nanočesticama.

They're circulating in the blood,

Cirkulišu krvotokom,

they don't get washed out

ne ispiraju se

and they actually end up reaching the tumor.

i konačno dosegnu tumor.

And so what other tools do nanoparticles have?

Koje druge alatke poseduju nanočestice?

Well, they can protect cancer drugs from getting destroyed inside the body.

Pa, mogu zaštititi lekove za kancer da ih telo ne uništi.

There are certain very important but sensitive drugs

Postoje izvesni veoma važni ali osetljivi lekovi

that are easily degraded by enzymes in the blood.

koji se lako rastvore enzimima u krvi.

So unless they have this nanoparticle protection,

Tako da bez zaštite koju pruža nanočestica,

they will not be able to function.

ne mogu funkcionisati.

Another nanoparticle tool are these surface extensions

Druga alatka nanočestice su ovi površinski produžeci

that are like tiny hands with fingers that grab on to the tumor

koji su kao malene ruke sa prstima koji se hvataju za tumor

and fit exactly onto it,

i odlično pasuju na njemu,

so that when the nanoparticles are circulating,

tako da kada nanočestice cirkulišu,

they can attach onto the cancer cells,

mogu se zakačiti za ćelije kancera,

buying the cancer drugs more time to do their job.

dajući lekovima za kancer vreme da odrade posao.

And these are just some of the many tools that nanoparticles can have.

Ovo su samo neke od brojnih alatki koje nanočestice poseduju.

And today,

Danas,

we have more than 10 clinically approved nanoparticles for cancer

imamo više od 10 klinički odobrenih nanočestica za kancer

that are given to patients all over the world.

koje se daju pacijentima širom sveta.

Yet, we have patients, like Rebecca, who die.

Ipak, imamo pacijente, poput Rebeke, koji umru.

So what are the major challenges and limitations

Koji su najveći izazovi i ograničenja

with currently approved nanoparticles?

kod do sada odobrenih nanočestica?

Well, a major challenge is the liver,

Pa, glavni izazov predstavlja jetra,

because the liver is the body's filtration system,

jer je jetra sistem za filtraciju u telu,

and the liver recognizes and destroys foreign objects,

i jetra prepoznaje i uništava strane objekte,

such as viruses, bacteria and also nanoparticles.

poput virusa, bakterija i nanočestica.

And the immune cells in the liver eat the nanoparticles,

Imune ćelije jetre jedu nanočestice,

preventing them from reaching the tumor.

sprečavajući ih da dosegnu tumor.

And here we see an illustration where the kidney is no longer a problem,

Ovde vidimo ilustraciju gde bubreg više nije problem,

but these fire trucks, the nanoparticles,

ali ovi vatrogasni kamioni, nanočestice,

get stuck in the liver

se zaglave u jetri

and, actually, less of them end up reaching the tumor.

i, zapravo, manji broj njih stiže do tumora.

So a future strategy to improve nanoparticles

Buduća strategija za poboljšanje nanočestica

is to temporarily disarm the immune cells in the liver.

je da se trenutno razoružaju imune ćelije jetre.

So how do we disarm these cells?

Kako da razoružamo ove ćelije?

Well, we looked at drugs that were already clinically approved

Razmotrili smo lekove koji su već klinički odobreni

for other indications

za druge bolesti

to see if any of them could stop the immune cells

da proverimo da li neki mogu obustaviti imune ćelije

from eating the nanoparticles.

da ne pojedu nanočestice.

And unexpectedly, in one of our preclinical studies,

I neočekivano, u jednoj od predkliničkih studija,

we found that a 70-year-old malaria drug

pronašli smo 70 godina star lek za malariju

was able to stop the immune cells from internalizing the nanoparticles

koji može da zaustavi imune ćelije u internalizaciji nanočestica

so that they could escape the liver

tako da one mogu izbeći jetru

and continue their journey to their goal, the tumor.

i nastaviti put ka svom cilju, tumoru.

And here we see the illustration of blocking the liver.

Ovde vidimo ilustraciju blokiranja jetre.

The nanoparticles don't go there,

Nanočestice ne idu tamo,

and they instead end up in the tumor.

i umesto toga završe u tumoru.

So, sometimes, unexpected connections are made in science

Ponekad, neočekivane veze se pojave u nauci

that lead to new solutions.

koje vode ka novim rešenjima.

Another strategy for preventing nanoparticles

Druga strategija za prevenciju nanočestica

from getting stuck in the liver

da se ne zaglave u jetri

is to use the body's own nanoparticles.

je korišćenje sopstvenih nanočestica iz tela.

Yes -- surprise, surprise.

Da - iznenađenje, iznenađenje.

You, and you and you, and all of us have a lot of nanoparticles

Ti, i ti i ti, svi mi imamo puno nanočestica

circulating in our bodies.

koje cirkulišu kroz naša tela.

And because they're part of our bodies,

I pošto su deo naših tela,

the liver is less likely to label them as foreign.

manje je verovatno da će ih jetra označiti stranima.

And these biological nanoparticles can be found in the saliva,

Ove biološke nanočestice se nalaze u pljuvačkoj,

in the blood, in the urine, in pancreatic juice.

u krvi, u urinu, u pankreatskom soku.

And we can collect them from the body

Možemo ih sakupiti iz tela

and use them as fire trucks for cancer drugs.

i koristiti kao vatrogasne kamione za lekove za kancer.

And in this case,

U ovom slučaju,

the immune cells in the liver are less likely to eat

manje je verovatno da će imune ćelije jetre pojesti

the biological nanoparticles.

biološke nanočestice.

So we're using a Trojan-horse-based concept

Koristimo koncept Trojanskog konja

to fool the liver.

da zavaramo jetru.

And here we see the biological nanoparticles

Ovde vidimo biološke nanočestice

circulating in the blood.

kako cirkulišu kroz krv.

They don't get recognized by the liver,

Jetra ih ne prepoznaje,

and they end up in the tumor.

i one završavaju u tumoru.

And in the future,

U budućnosti,

we want to exploit nature's own nanoparticles

želimo da iskoristimo prirodne nanočestice

for cancer drug delivery,

za prenos lekova za kancer,

to reduce side effects and save lives

kako bismo smanjili neželjene efekte i sačuvali živote

by preventing the cancer drugs from being in the wrong location.

sprečavajući lekove za kancer da dospeju na pogrešnu lokaciju.

However, a major problem has been:

Ipak, veliki problem je bio:

How do we isolate these biological nanoparticles in large quantities

kako izolovati ove biološke nanočestice u velikim količinama

without damaging them?

a ne oštetiti ih?

My lab has developed an efficient method for doing this.

Moja laboratorija je razvila efikasan metod za ovo.

We can process large quantities of liquids from the body

Možemo da obradimo velike količine tečnosti iz tela

to produce a highly concentrated, high-quality formulation

da proizvedemo visoko koncentrisanu, visokokvalitetnu formulu

of biological nanoparticles.

bioloških nanočestica.

And these nanoparticles are not yet in clinical use,

Ove nanočestice nisu još uvek u kliničkoj upotrebi,

because it takes an average of 12 years

jer je potrebno u proseku 12 godina

to get something from the lab

da nešto dospe iz laboratorije

to your medicine cabinet.

do vaše police za lekove.

And this is the type of challenge that requires teamwork

Ovo je vrsta izazova koji zahteva timski rad

from scientists and physicians,

naučnika i lekara,

who dedicate their lives to this battle.

koji su posvetili život ovoj bitki.

And we keep going, thanks to inspiration from patients.

Nastavljamo, inspirisani pacijentima.

And I believe that if we keep working on these nanomedicines,

Verujem da ako nastavimo sa radom na ovim nanolekovima,

we will be able to reduce harm to healthy organs,

moći ćemo da smanjimo štetu po zdrave organe,

improve quality of life

poboljšamo kvalitet života

and save future patients.

i sačuvamo buduće pacijente.

I like to imagine

Volim da zamislim

that if these treatments had been available for Rebecca,

da, da su ovi tretmani bili dostupni Rebeki,

that call from her

onaj poziv od nje

could have been an invitation

je mogao biti pozivnica

not to her funeral,

ne na njenu sahranu,

but her wedding.

već na njeno venčanje.

Thank you.

Hvala.

(Applause)

(Aplauz)