Susan Solomon: The promise of research with stem cells

Translator: Joseph Geni Reviewer: Morton Bast

Prevodilac: Jelena Nedjic Lektor: Tatjana Jevdjic

So, embryonic stem cells

Dakle, embrionalne matične ćelije

are really incredible cells.

su zaista neverovatne ćelije.

They are our body's own repair kits,

To je prosto pribor za pomoć samom našem telu.

and they're pluripotent, which means they can morph into

Te ćelije su pluripotentne, što znači da se od njih mogu razviti

all of the cells in our bodies.

sve ostale ćelije našeg tela.

Soon, we actually will be able to use stem cells

Uskoro ćemo moći da koristimo matične ćelije

to replace cells that are damaged or diseased.

za zamenu oštećenih ili obolelih ćelija u telu.

But that's not what I want to talk to you about,

Ali ne želim o tome da pričam,

because right now there are some really

jer u ovom trenutku dolazimo do

extraordinary things that we are doing with stem cells

neverovatnih otkrića u razumevanju matičnih ćelija

that are completely changing

koja će potpuno promeniti

the way we look and model disease,

način na koji izučavamo i modelujemo bolesti,

our ability to understand why we get sick,

način na koji shvatamo zašto se razboljevamo

and even develop drugs.

i način na koji pronalazimo lekove.

I truly believe that stem cell research is going to allow

Duboko verujem da će istraživanje matičnih ćelija

our children to look at Alzheimer's and diabetes

omogućiti našoj deci da Alchajmerovu bolest ili dijabetes

and other major diseases the way we view polio today,

i ostale velike bolesti današnjice, doživljavaju onako kako mi shvatamo polio,

which is as a preventable disease.

kao bolest koju je moguće sprečiti.

So here we have this incredible field, which has

Tako da pričamo o neverovatnim otkrićima,

enormous hope for humanity,

koja nose ogromnu nadu za ljudsku vrstu,

but much like IVF over 35 years ago,

ali kao što se primena veštačke oplodnje pre 35 godina

until the birth of a healthy baby, Louise,

borila sa političkim i finansijskim problemima

this field has been under siege politically and financially.

do rođenja zdrave bebe, Luiz - slično se i sada dešava.

Critical research is being challenged instead of supported,

Kritična istraživanja se dovode u pitanje umesto da dobiju podršku,

and we saw that it was really essential to have

pa smo shvatili da je neophodno da imamo

private safe haven laboratories where this work

privatne, zaštićene laboratorije

could be advanced without interference.

i gde se može baviti ovim radom bez uplitanja sa strane.

And so, in 2005,

Tako smo 2005.

we started the New York Stem Cell Foundation Laboratory

osnovali Laboratoriju matičnih ćelija - Njujorška fondacija,

so that we would have a small organization that could

kako bismo imali malu organizciju

do this work and support it.

koja može podržati i odrađivati taj rad.

What we saw very quickly is the world of both medical

Ono što smo ubrzo shvatili je da su i medicinska istraživanja

research, but also developing drugs and treatments,

i proces pronalaženja lekova i tretmana,

is dominated by, as you would expect, large organizations,

pod apsolutnom dominacijom velikih organizacija, što biste i očekivali.

but in a new field, sometimes large organizations

Ali u novim granama nauke, ponekad te velike organizacije

really have trouble getting out of their own way,

nerado odustaju od starog načina rada,

and sometimes they can't ask the right questions,

pa nekada ne mogu da postave pravo pitanje

and there is an enormous gap that's just gotten larger

i postoji ogromna praznina, koja postaje sve veća,

between academic research on the one hand

između akademskog istraživanja sa jedne strane

and pharmaceutical companies and biotechs

i farmaceutskih i biotehnoloških kompanija

that are responsible for delivering all of our drugs

koje stoje iza proizvodnje velikog dela lekova

and many of our treatments, and so we knew that

i mnogih tretmana za naše lečenje. Znali smo da ako želimo

to really accelerate cures and therapies, we were going

zaista ubrzati pronalazak lekova i terapija, treba da

to have to address this with two things:

razmislimo o ove dve stvari:

new technologies and also a new research model.

o novim tehnologijama i o novim laboratorijskim modelima.

Because if you don't close that gap, you really are

Jer ukoliko ne prevaziđete tu prazninu,

exactly where we are today.

onda ćete se naći tu gde smo danas.

And that's what I want to focus on.

O tome želim danas da pričam.

We've spent the last couple of years pondering this,

Tokom proteklih par godina to smo detaljno analizirali

making a list of the different things that we had to do,

i pravili smo listu stvari koje treba da uradimo.

and so we developed a new technology,

Tako smo razvili novu tehnologiju,

It's software and hardware,

odgovarajući softver i hardver,

that actually can generate thousands and thousands of

koji u prinicipu može da stvori hiljade i hiljade

genetically diverse stem cell lines to create

genetički različitih matičnih ćelija koje bi mogle da se koriste za stvaranje

a global array, essentially avatars of ourselves.

globalnog niza, pravih avatara nas samih.

And we did this because we think that it's actually going

To smo uradili jer smatramo da će nam ta tehnologija

to allow us to realize the potential, the promise,

omogućiti da iskoristimo potencijal, obećanje

of all of the sequencing of the human genome,

koje stoji iza sekvenciranja humanog genoma.

but it's going to allow us, in doing that,

Omogućiće nam da

to actually do clinical trials in a dish with human cells,

odradimo klinička istraživanja sa humanim ćelijama u posudi,

not animal cells, to generate drugs and treatments

dakle ne na životinjskim ćelijama, kako bismo došli do lekova i tretmana,

that are much more effective, much safer,

koji su efektniji, sigurniji,

much faster, and at a much lower cost.

brži i zahtevaju mnogo manje novca.

So let me put that in perspective for you

Sada bih vam to predstavila u svetlu

and give you some context.

određenih saznanja.

This is an extremely new field.

Ovo je zaista novo polje izučavanja.

In 1998, human embryonic stem cells

Humane matične ćelije su identifikovane 1998.

were first identified, and just nine years later,

i samo devet godina kasnije

a group of scientists in Japan were able to take skin cells

grupa naučnika u Japanu je uspela da od ćelija kože

and reprogram them with very powerful viruses

uz pomoć moćnih virusa napravi

to create a kind of pluripotent stem cell

jednu vrstu pluripotentnih matičnih ćelija

called an induced pluripotent stem cell,

koje se nazivaju indukovane pluripotentne matične ćelije,

or what we refer to as an IPS cell.

a mi ih nazivamo iPM ćelije.

This was really an extraordinary advance, because

Ovo je bilo otkriće koje pomera granice,

although these cells are not human embryonic stem cells,

bez obzira što te ćelije nisu humane matične ćelije,

which still remain the gold standard,

koje zaista jesu zlatni standard,

they are terrific to use for modeling disease

one su odlično oruđe za modelovanje bolesti,

and potentially for drug discovery.

i moguće čak i za otkrivanje lekova.

So a few months later, in 2008, one of our scientists

Nekoliko meseci kasnije u 2008. jedan od naših naučnika

built on that research. He took skin biopsies,

je nastavio sa tim istraživanjem. Uzeo je uzorke biopsija kože,

this time from people who had a disease,

ovog puta od ljudi koji su bolovali

ALS, or as you call it in the U.K., motor neuron disease.

od ALS-a ili kako je u Britaniji poznata - bolest motornih neurona.

He turned them into the IPS cells

Potom je od njih napravio iPM ćelije

that I've just told you about, and then he turned those

o kojima sam vam upravo pričala, a onda je ove iPM ćelije,

IPS cells into the motor neurons that actually

pretvorio u motorne neurone,

were dying in the disease.

koji su i sami umirali od te bolesti.

So basically what he did was to take a healthy cell

Tako da je on u principu od zdrave ćelije

and turn it into a sick cell,

napravio bolesnu ćeliju

and he recapitulated the disease over and over again

i uspeo je da reprodukuje nebrojeno puta bolest

in the dish, and this was extraordinary,

u laboratorijskoj posudi. To je vanserijsko otkriće,

because it was the first time that we had a model

jer smo po prvi put imali u rukama

of a disease from a living patient in living human cells.

model bolesti, od živog pacijenta i živih humanih ćelija.

And as he watched the disease unfold, he was able

Dok je posmatrao tok bolesti, došao je do zaključka

to discover that actually the motor neurons were dying

da u stvari motorni neuroni umiru

in the disease in a different way than the field

u ovoj bolesti na drugačiji način u odnosu na ono

had previously thought. There was another kind of cell

što se pre toga mislilo. Postojao je još jedan tip ćelija

that actually was sending out a toxin

koje su izlučivale otrov

and contributing to the death of these motor neurons,

koji je doprinosio smrti tih motornih neurona,

and you simply couldn't see it

a to niste mogli da uvidite,

until you had the human model.

dok niste baratali sa humanim modelom.

So you could really say that

Tako da slobodno možete reći

researchers trying to understand the cause of disease

da su oni istraživači koji pokušavaju da razumeju uzrok bolesti,

without being able to have human stem cell models

a da pri tome nemaju model od humanih matičnih ćelija,

were much like investigators trying to figure out

prilično nalik istraživačima koji pokušavaju da shvate

what had gone terribly wrong in a plane crash

šta se loše desilo u avionskoj nesreći,

without having a black box, or a flight recorder.

a da pri tome nemaju crnu kutiju ili snimak leta.

They could hypothesize about what had gone wrong,

Oni mogu da postave hipoteze o tome šta se loše desilo,

but they really had no way of knowing what led

ali nikako ne mogu zasigurno znati

to the terrible events.

šta je dovelo do tih strašnih događaja.

And stem cells really have given us the black box

Matične ćelije zaista jesu crne kutije

for diseases, and it's an unprecedented window.

raznih bolesti, a to je neopisivo značajan prozor.

It really is extraordinary, because you can recapitulate

To je vanserijski značajno jer možete da imitirate

many, many diseases in a dish, you can see

mnoge, mnoge bolesti u laboratoriji,

what begins to go wrong in the cellular conversation

možete uvideti šta se pogrešno dešava u komunikaciji između ćelija

well before you would ever see

mnogo pre nego što uvidite

symptoms appear in a patient.

same simptome kod pacijenta.

And this opens up the ability,

Ovo otvara mogućnost

which hopefully will become something that

koja će, nadamo se, uskoro postati

is routine in the near term,

rutinska stvar -

of using human cells to test for drugs.

mogućnost upotrebe humanih ćelija za potrebe testiranja lekova.

Right now, the way we test for drugs is pretty problematic.

U ovom momentu, način na koji ispitujemo lekove je prilično problematičan.

To bring a successful drug to market, it takes, on average,

Da bi lek izašao na tržište, danas je u proseku potrebno

13 years — that's one drug —

13 godina - a to je samo jedan lek,

with a sunk cost of 4 billion dollars,

u sam proces se uloži oko 4 milijarde dolara,

and only one percent of the drugs that start down that road

a samo 1% lekova koji uđu u sistem provere

are actually going to get there.

izađu na tržište.

You can't imagine other businesses

Ne možete zamisliti ni jedan posao

that you would think of going into

koji biste spremno započeli,

that have these kind of numbers.

ukoliko raspolažete ovim brojkama.

It's a terrible business model.

To je loš poslovni model.

But it is really a worse social model because of

U suštini, to je još lošiji socijalni model,

what's involved and the cost to all of us.

usled onoga što je u to uključeno i cene koju za to plaćamo.

So the way we develop drugs now

Danas pronalazimo lekove tako što

is by testing promising compounds on --

testiramo jedinjenja koja obećavaju na ...

We didn't have disease modeling with human cells,

nismo raspolagali modelima bolesti od humanih ćelija,

so we'd been testing them on cells of mice

tako da smo ih testirali na ćelijama miševa

or other creatures or cells that we engineer,

ili drugih stvorenja ili ćelija koje mi napravimo,

but they don't have the characteristics of the diseases

ali one ne ispoljavaju osobine bolesti

that we're actually trying to cure.

koje pokušavamo da izlečimo.

You know, we're not mice, and you can't go into

Znate, nismo miševi, a ne možete prosto

a living person with an illness

iz osobe koja boluje

and just pull out a few brain cells or cardiac cells

uzeti nekoliko ćelija mozga ili ćelija srca

and then start fooling around in a lab to test

i onda pokušati u laboratoriji da isprobate

for, you know, a promising drug.

delovanje obećavajućeg leka.

But what you can do with human stem cells, now,

Ali ono što vam matične ćelije danas omogućavaju

is actually create avatars, and you can create the cells,

je da stvorite avatare, možete stvoriti ćelije

whether it's the live motor neurons

bilo da su u pitanju živi motorni neuroni

or the beating cardiac cells or liver cells

ili ćelije srca koje pulsiraju ili ćelije jetre

or other kinds of cells, and you can test for drugs,

ili drugi tipovi ćelija i možete testirati lekove,

promising compounds, on the actual cells

obećavajuća jedinjenja na pravim ćelijama

that you're trying to affect, and this is now,

na koje i želite da utičete.

and it's absolutely extraordinary,

Ovo je zaista važno

and you're going to know at the beginning,

jer ćete na samom početku mnogo znati,

the very early stages of doing your assay development

u vrlo ranim stadijumima razvoja vašeg eksperimenta

and your testing, you're not going to have to wait 13 years

i testiranja, nećete morati da čekate 13 godina

until you've brought a drug to market, only to find out

dok lek ne izađe na tržište,

that actually it doesn't work, or even worse, harms people.

da saznate da u stvari ne odrađuje posao ili još gore, da nanosi štetu ljudima.

But it isn't really enough just to look at

Zaista nije dovoljno da samo analizirate

the cells from a few people or a small group of people,

ćelije koje su izolovane iz nekoliko ljudi ili grupe ljudi,

because we have to step back.

ovde treba da zastanemo.

We've got to look at the big picture.

Moramo sagledati širu sliku.

Look around this room. We are all different,

Pogledaje okolo. Svi smo različiti,

and a disease that I might have,

bolest od koje ja možda patim,

if I had Alzheimer's disease or Parkinson's disease,

ako bih imala Alchajmerovu ili Parkinsonovu bolest,

it probably would affect me differently than if

verovatno bi drugačije uticala na mene

one of you had that disease,

nego na vas,

and if we both had Parkinson's disease,

i ukoliko bismo oboje patili od Parkinsonove bolesti,

and we took the same medication,

i uzimali iste lekove,

but we had different genetic makeup,

ali pri tome imamo drugačiji genetički materijal,

we probably would have a different result,

verovatno bismo pokazali različiti rezultat.

and it could well be that a drug that worked wonderfully

Lako bi moglo da se desi da lek koji ima odličan uticaj na mene,

for me was actually ineffective for you,

uopšte ne deluje na vas

and similarly, it could be that a drug that is harmful for you

i isto tako moglo bi se desiti da lek koji je loš za vas

is safe for me, and, you know, this seems totally obvious,

dobro deluje na mene. To deluje potpuno očigledno

but unfortunately it is not the way

ali nažalost, to nije način na koji

that the pharmaceutical industry has been developing drugs

farmaceutska industrija razvija lekove

because, until now, it hasn't had the tools.

jer su do sada za to nedostajala sredstva.

And so we need to move away

Trebalo bi da zaboravimo na filozofiju

from this one-size-fits-all model.

"jedna veličina odgovara svima".

The way we've been developing drugs is essentially

Prosto način na koji smo do sada pronalazili lekove

like going into a shoe store,

podseća na kupovinu cipela u prodavnici

no one asks you what size you are, or

u kojoj vas niko ne pita za broj koji nosite,

if you're going dancing or hiking.

niti ih zanima da li idete na ples ili planinarenje.

They just say, "Well, you have feet, here are your shoes."

Samo bi rekli: "Pa, vi imate stopala, evo vam cipele."

It doesn't work with shoes, and our bodies are

To ne funkcioniše sa cipelama, a naša tela su

many times more complicated than just our feet.

mnogo komplikovanija u odnosu na naša stopala.

So we really have to change this.

Tako da zaista moramo promeniti ovo.

There was a very sad example of this in the last decade.

Desilo se nešto veoma tužno u poslednjoj deceniji, a oslikava upravo to.

There's a wonderful drug, and a class of drugs actually,

Postoji odličan lek, grupa lekova u stvari,

but the particular drug was Vioxx, and

ali ovaj specifičan lek je Vioks.

for people who were suffering from severe arthritis pain,

Ljudima koji su patili od teškog hroničnog bola izazvanog artritisom,

the drug was an absolute lifesaver,

lek je spasio život,

but unfortunately, for another subset of those people,

ali nažalost, kod jedne grupe ljudi

they suffered pretty severe heart side effects,

lek je doveo do teških komplikacija u radu srca.

and for a subset of those people, the side effects were

Kod podgrupe tih ljudi ti sporedni efekti

so severe, the cardiac side effects, that they were fatal.

su bili zaista ozbiljni, ometanje rada srca je dovelo do fatalnog ishoda.

But imagine a different scenario,

Ali zamislite drugačiji scenario,

where we could have had an array, a genetically diverse array,

gde bismo imali čitav niz uzoraka, genetički različit niz uzoraka

of cardiac cells, and we could have actually tested

ćelija srca, gde bismo mogli da zaista proverimo delovanje

that drug, Vioxx, in petri dishes, and figured out,

leka Vioksa u samim petri-šoljama i uvidimo

well, okay, people with this genetic type are going to have

da bi ljudi sa ovim genima patili

cardiac side effects, people with these genetic subgroups

od kontraindikacija, ali ljudi tačno određene genetske podgrupe

or genetic shoes sizes, about 25,000 of them,

ili genetičke veličine cipela i to oko 25 000 njih,

are not going to have any problems.

ne bi doživelo nikakav problem.

The people for whom it was a lifesaver

Ljudi kojima bi lek spasao život,

could have still taken their medicine.

bi i dalje mogli da primene lek.

The people for whom it was a disaster, or fatal,

Oni ljudi za koje bi kontraindikacije bile neprihvatljive ili fatalne

would never have been given it, and

nikada ne bi ni dobili lek.

you can imagine a very different outcome for the company,

Sada možete zamisliti potpuno drugačiji rezultat za samu kompaniju

who had to withdraw the drug.

koja je morala da povuče lek sa tržišta.

So that is terrific,

To je odlično,

and we thought, all right,

pomislili smo, u redu,

as we're trying to solve this problem,

ako pokušavamo da rešimo ovaj problem

clearly we have to think about genetics,

jasno je da moramo da razmišljamo o genetici,

we have to think about human testing,

moramo razmišljati o humanim modelima bolesti,

but there's a fundamental problem,

ali tu postoji i osnovni problem

because right now, stem cell lines,

jer su u ovom momentu, bez obzira koliko su zadivljujuće,

as extraordinary as they are,

matične ćelije

and lines are just groups of cells,

i linije tih ćelija su samo grupe ćelija,

they are made by hand, one at a time,

koje je neko ručno napravio, jednu po jednu,

and it takes a couple of months.

a za to je neophodno nekoliko meseci.

This is not scalable, and also when you do things by hand,

Ta brzina produkcije se ne može povećavati, a isto tako kada radite ručno stvari

even in the best laboratories,

čak i u najboljim laboratorijama,

you have variations in techniques,

dolazi do varijacija u tehnikama,

and you need to know, if you're making a drug,

a neophodno je da znate, ukoliko proizvodite lek,

that the Aspirin you're going to take out of the bottle

da je aspirin koji ste uzeli iz boce

on Monday is the same as the Aspirin

u ponedeljak, isti kao i aspirin koji

that's going to come out of the bottle on Wednesday.

će se naći u toj boci u sredu.

So we looked at this, and we thought, okay,

Razmislili smo o tome i zaključili da je ručni rad

artisanal is wonderful in, you know, your clothing

zaista divna stvar u proizvodnji odeće,

and your bread and crafts, but

hleba i predmeta,

artisanal really isn't going to work in stem cells,

ali ručni rad neće biti primenljiv u radu sa matičnim ćelijama.

so we have to deal with this.

Morali smo da rešimo to.

But even with that, there still was another big hurdle,

Čak i kada bismo to rešili, preostajao bi nam je još jedan veliki problem,

and that actually brings us back to

problem koji nas vraća na

the mapping of the human genome, because

mapiranje humanog genoma,

we're all different.

jer smo mi svi različiti.

We know from the sequencing of the human genome

Iz sekvenciranja ljudskog genoma

that it's shown us all of the A's, C's, G's and T's

znamo da je sastavljen od A, C, G i T slova,

that make up our genetic code,

koja čine naš genetski kod,

but that code, by itself, our DNA,

ali taj kod sam po sebi, naša DNK,

is like looking at the ones and zeroes of the computer code

je isto što i zapis gomile nula i jedinica u računarskom kodu,

without having a computer that can read it.

bez računara koji taj kod može da pročita.

It's like having an app without having a smartphone.

To bi bilo kao da imate aplikaciju, a nemate pametni telefon da je primenite.

We needed to have a way of bringing the biology

Neophodan nam je proces koji će primeniti biološka znanja

to that incredible data,

na tu ogromnu količinu podataka,

and the way to do that was to find

a način da se to uradi jeste da nađete zamenu,

a stand-in, a biological stand-in,

biološku zamenu

that could contain all of the genetic information,

koja u sebi sadrži sve te genetičke informacije,

but have it be arrayed in such a way

ali koje su na takav način poređane i utisnute

as it could be read together

da mogu biti istovremeno pročitane

and actually create this incredible avatar.

i na taj način formiraju ovaj neverovatan avatar.

We need to have stem cells from all the genetic sub-types

Nephodne su matične ćelije napravljene od svih genetičkih pod-tipova,

that represent who we are.

koje prezentuju našu sliku.

So this is what we've built.

Zato samo napravili ovo.

It's an automated robotic technology.

Ovo je automatska, robotizovana tehnologija.

It has the capacity to produce thousands and thousands

Poseduje kapacitet proizvodnje hiljada i hiljada

of stem cell lines. It's genetically arrayed.

različitih linija matičnih ćelija. A pričamo o genetičkom čipu.

It has massively parallel processing capability,

Karakteriše ga enormna mogućnost paralelnog procesovanja podataka,

and it's going to change the way drugs are discovered,

i promeniće način na koji pronalazimo lekove,

we hope, and I think eventually what's going to happen

nadamo se. Mislim da će upravo to dovesti do

is that we're going to want to re-screen drugs,

ponovnog testitranja svih lekova,

on arrays like this, that already exist,

na ovakvim biološkim uzorcima, lekova koji već postoje,

all of the drugs that currently exist,

svih lekova koji su trenutno u upotrebi,

and in the future, you're going to be taking drugs

tako da ćete u budućnosti koristiti lekove

and treatments that have been tested for side effects

čiji su mehanizmi delovanja i nuspojave delovanja

on all of the relevant cells,

provereni na odgovarajućem tipu ćelija,

on brain cells and heart cells and liver cells.

na ćelijama mozga, srca, jetre.

It really has brought us to the threshold

Ovo nas je stvarno dovelo do samog praga

of personalized medicine.

razvoja personalizovane medicine.

It's here now, and in our family,

To se u ovom momentu dešava, u mojoj porodici,

my son has type 1 diabetes,

moj sin boluje od dijabetesa tipa 1,

which is still an incurable disease,

to je i dalje neizlečiva bolest,

and I lost my parents to heart disease and cancer,

a moji roditelji su umrli od bolesti srca i raka

but I think that my story probably sounds familiar to you,

i ubeđena sam da svi delimo slične priče,

because probably a version of it is your story.

i vaša priča podseća na moju.

At some point in our lives, all of us,

U jednom trenutku u svojim životima, svi mi

or people we care about, become patients,

ili ljudi do kojih nam je stalo, postajemo pacijenti

and that's why I think that stem cell research

i baš zato smatram da je istraživanje matičnih ćelija

is incredibly important for all of us.

neverovatno važno za sve nas.

Thank you. (Applause)

Hvala vam. (Aplauz)

(Applause)

(Aplauz)