This tiny particle could roam your body to find tumors | Sangeeta Bhatia

Prevodilac: Jasmina Francuski Lektor: Ivana Krivokuća

In the space that used to house one transistor,

U prostor koji je nekad bio potreban da se smesti jedan tranzistor,

we can now fit one billion.

sad možemo smestiti jednu milijardu.

That made it so that a computer the size of an entire room

Tako kompjuter veličine čitave jedne sobe

now fits in your pocket.

sad stane u vaš džep.

You might say the future is small.

Može se reći da je budućnost mala.

As an engineer,

Kao inženjer,

I'm inspired by this miniaturization revolution in computers.

nadahnuta sam ovom revolucijom minijaturizacije kompjutera.

As a physician,

Kao lekar,

I wonder whether we could use it to reduce the number of lives lost

pitam se da li je možemo upotrebiti da smanjimo broj izgubljenih života

due to one of the fastest-growing diseases on Earth:

zbog jedne od najraširenijih bolesti na svetu:

cancer.

raka.

Now when I say that,

Kad to kažem,

what most people hear me say is that we're working on curing cancer.

ono što mnogi pomisle jeste da radimo na izlečenju raka.

And we are.

I radimo.

But it turns out

Međutim, ispostavlja se

that there's an incredible opportunity to save lives

da postoji neverovatna mogućnost da se spasu životi

through the early detection and prevention of cancer.

ranim otkrivanjem i prevencijom raka.

Worldwide, over two-thirds of deaths due to cancer are fully preventable

Širom sveta, preko dve trećine smrti od raka su potpuno preventabilne

using methods that we already have in hand today.

uz pomoć metoda koje već danas imamo na raspolaganju.

Things like vaccination, timely screening

To su stvari poput vakcinacije, pravovremenih pregleda

and of course, stopping smoking.

i, naravno, prestanka pušenja.

But even with the best tools and technologies that we have today,

Ipak, čak i uz pomoć najboljih alata i tehnologija koje danas imamo,

some tumors can't be detected

neke tumore je nemoguće otkriti

until 10 years after they've started growing,

sve do 10 godina nakon što su počeli da rastu,

when they are 50 million cancer cells strong.

kada su jačine 50 miliona kancerogenih ćelija.

What if we had better technologies

Šta ako bismo imali bolja sredstva

to detect some of these more deadly cancers sooner,

za ranije otkrivanje nekih od ovih smrtonosnih kancera,

when they could be removed,

dok ih je moguće ukloniti,

when they were just getting started?

kad tek počnu da rastu?

Let me tell you about how miniaturization might get us there.

Reći ću vam kako nas minijaturizacija može dovesti do toga.

This is a microscope in a typical lab

Ovo je mikroskop u tipičnoj laboratoriji

that a pathologist would use for looking at a tissue specimen,

koji bi patolog koristio za posmatranje uzorka nekog tkiva

like a biopsy or a pap smear.

kao što su biopsija ili papa test.

This $7,000 microscope

Ovaj mikroskop vredan 7 000 dolara

would be used by somebody with years of specialized training

koristio bi neko s dugogodišnjom specijalističkom obukom

to spot cancer cells.

da opaža ćelije raka.

This is an image from a colleague of mine at Rice University,

Ovo je slika od jedne moje koleginice sa Univerziteta Rajs,

Rebecca Richards-Kortum.

Rebeke Ričards Kortum.

What she and her team have done is miniaturize that whole microscope

Ona i njen tim su smanjili čitav taj mikroskop

into this $10 part,

na ovaj deo vredan deset dolara,

and it fits on the end of an optical fiber.

koji staje na kraj jednog optičkog vlakna.

Now what that means is instead of taking a sample from a patient

To znači da umesto uzimanja uzorka od pacijenta

and sending it to the microscope,

i njegovog slanja pod mikroskop,

you can bring the microscope to the patient.

moguće je doneti mikroskop do pacijenta.

And then, instead of requiring a specialist to look at the images,

A onda, umesto zahteva da specijalista pogleda slike,

you can train the computer to score normal versus cancerous cells.

moguće je obučiti kompjuter da obeleži normalne ćelije naspram kancerogenih.

Now this is important,

Ovo je važno,

because what they found working in rural communities,

jer ono što su otkrili radeći u ruralnim zajednicama,

is that even when they have a mobile screening van

jeste da, čak i kad postoji pokretni kombi za preglede

that can go out into the community and perform exams

kojim se može otići na teren i izvršiti pregled

and collect samples

i sakupiti uzorci

and send them to the central hospital for analysis,

koji se šalju na analizu u centralnu bolnicu,

that days later,

nekoliko dana kasnije,

women get a call with an abnormal test result

žene dobiju poziv zbog abnormalnih rezultata testa

and they're asked to come in.

i zamole ih da dođu.

Fully half of them don't turn up because they can't afford the trip.

Polovina njih se ne pojavi jer ne mogu da priušte put.

With the integrated microscope and computer analysis,

Uz pomoć integrisanog mikroskopa i kompjuterske analize,

Rebecca and her colleagues have been able to create a van

Rebeka i njene kolege su uspeli da naprave kombi

that has both a diagnostic setup and a treatment setup.

koji ima opremu i za dijagnostiku i za lečenje.

And what that means is that they can do a diagnosis

To znači da mogu da postave dijagnozu

and perform therapy on the spot,

i daju terapiju na licu mesta,

so no one is lost to follow up.

tako da nikog ne izgube u pratećem postupku.

That's just one example of how miniaturization can save lives.

To je samo jedan primer kako minijaturizacija može spasiti živote.

Now as engineers,

Kao inženjeri,

we think of this as straight-up miniaturization.

o ovom razmišljamo kao o direktnoj minijaturizaciji.

You took a big thing and you made it little.

Uzmemo jednu veliku stvar i načinimo je malom.

But what I told you before about computers

Ono što sam vam ranije rekla za kompjutere

was that they transformed our lives

jeste da su nam oni transformisali živote

when they became small enough for us to take them everywhere.

onda kad su postali dovoljno mali da bismo ih mogli svuda poneti.

So what is the transformational equivalent like that in medicine?

Koji je transformacioni ekvivalent tome u medicini?

Well, what if you had a detector

Šta ako bismo imali detektor

that was so small that it could circulate in your body,

koji bi bio toliko mali da može da kruži u našem telu,

find the tumor all by itself

sam pronađe tumor

and send a signal to the outside world?

i pošalje signal u spoljašnji svet?

It sounds a little bit like science fiction.

Pomalo zvuči kao naučna fantastika,

But actually, nanotechnology allows us to do just that.

ali u stvari, nanotehnologija nam upravo to omogućava.

Nanotechnology allows us to shrink the parts that make up the detector

Nanotehnologija nam dopušta da smanjimo delove koji sačinjavaju detektor

from the width of a human hair,

sa širine ljudske dlake,

which is 100 microns,

što iznosi sto mikrona,

to a thousand times smaller,

na hiljadu puta manju veličinu,

which is 100 nanometers.

što iznosi sto nanometara,

And that has profound implications.

a to ima dalekosežne implikacije.

It turns out that materials actually change their properties

Ispostavlja se da materijali zapravo menjaju svoja svojstva

at the nanoscale.

na nanoskali.

You take a common material like gold,

Ako uzmemo običan materijal poput zlata

and you grind it into dust, into gold nanoparticles,

i sameljemo ga u prah, u zlatne nanočestice,

and it changes from looking gold to looking red.

promeniće izgled od zlatnog u crveni.

If you take a more exotic material like cadmium selenide --

Ako uzmemo egzotičniji materijal poput kadmijum selenida

forms a big, black crystal --

u formi velikog crnog kristala,

if you make nanocrystals out of this material

ako napravimo nanokristale od ovog materijala,

and you put it in a liquid,

stavimo to u tečnost

and you shine light on it,

i osvetlimo,

they glow.

on sija.

And they glow blue, green, yellow, orange, red,

Sija plavo, zeleno, žuto, narandžasto, crveno,

depending only on their size.

isključivo u zavisnosti od veličine.

It's wild! Can you imagine an object like that in the macro world?

Potpuno ludo! Možete li zamisliti takav predmet u makro svetu?

It would be like all the denim jeans in your closet are all made of cotton,

Kao kad bi sve farmerice u vašem ormanu bile napravljene od pamuka

but they are different colors depending only on their size.

ali bi bile različite boje, isključivo u zavisnosti od njihove veličine.

(Laughter)

(Smeh)

So as a physician,

Kao lekaru,

what's just as interesting to me

ono što mi je jednako zanimljivo

is that it's not just the color of materials

jeste to da nije samo boja materijala

that changes at the nanoscale;

koja se menja na nanoskali,

the way they travel in your body also changes.

već se menja i način na koji putuju po telu.

And this is the kind of observation that we're going to use

Ovu vrstu opažanja ćemo upotrebiti

to make a better cancer detector.

da napravimo bolji detektor za rak.

So let me show you what I mean.

Pokazaću vam šta hoću da kažem.

This is a blood vessel in the body.

Ovo je krvni sud u telu.

Surrounding the blood vessel is a tumor.

Tumor okružuje krvni sud.

We're going to inject nanoparticles into the blood vessel

Ubrizgaćemo nanočestice u taj krvni sud

and watch how they travel from the bloodstream into the tumor.

i posmatrati kako putuju iz krvotoka u tumor.

Now it turns out that the blood vessels of many tumors are leaky,

Ispostavlja se da su krvni sudovi mnogih tumora propustljivi

and so nanoparticles can leak out from the bloodstream into the tumor.

i tako nanočestice mogu iscuriti iz krvotoka u tumor.

Whether they leak out depends on their size.

Da li će iscuriti zavisi od njihove veličine.

So in this image,

Na ovoj slici,

the smaller, hundred-nanometer, blue nanoparticles are leaking out,

manje, plave čestice od sto nanometara cure,

and the larger, 500-nanometer, red nanoparticles

dok veće, crvene nanočestice od 500 nanometara

are stuck in the bloodstream.

ostaju zaglavljene u krvotoku.

So that means as an engineer,

To znači da kao inženjer,

depending on how big or small I make a material,

u zavisnosti od toga koliko velikim ili malim napravim materijal,

I can change where it goes in your body.

mogu da odredim kuda će on otići u vašem telu.

In my lab, we recently made a cancer nanodetector

U mojoj laboratoriji, nedavno smo napravili nanodetektor raka

that is so small that it could travel into the body and look for tumors.

koji je toliko mali da može da putuje po telu i traži tumore.

We designed it to listen for tumor invasion:

Koncipirali smo ga tako da traži invaziju tumora:

the orchestra of chemical signals that tumors need to make to spread.

skup hemijskih signala koje tumori moraju da odaju da bi se širili.

For a tumor to break out of the tissue that it's born in,

Da bi se tumor proširio van tkiva na kom je rođen,

it has to make chemicals called enzymes

mora da proizvede hemikalije po imenu enzimi

to chew through the scaffolding of tissues.

da bi progrizao svoj put kroz tkiva.

We designed these nanoparticles to be activated by these enzymes.

Napravili smo ove nanočestice tako da ih ovi enzimi aktiviraju.

One enzyme can activate a thousand of these chemical reactions in an hour.

Jedan enzim može aktivirati hiljadu ovakvih hemijskih reakcija na sat.

Now in engineering, we call that one-to-a-thousand ratio

U inženjeringu, to nazivamo odnosom jedan prema hiljadu,

a form of amplification,

to je vrsta uvećanja

and it makes something ultrasensitive.

koja čini nešto izuzetno osetljivim.

So we've made an ultrasensitive cancer detector.

Tako smo napravili izuzetno osetljivi detektor raka.

OK, but how do I get this activated signal to the outside world,

U redu, ali kako ovaj aktivirani signal dovodimo do spoljašnjeg sveta

where I can act on it?

gde možemo preduzeti nešto?

For this, we're going to use one more piece of nanoscale biology,

Za ovo, upotrebićemo još jedan deo biologije na nanoskali

and that has to do with the kidney.

koji ima veze s bubrezima.

The kidney is a filter.

Bubreg je filter.

Its job is to filter out the blood and put waste into the urine.

Posao mu je da filtrira krv i otpatke pošalje u urin.

It turns out that what the kidney filters

Ispostavlja se da ono što bubrezi isfiltriraju

is also dependent on size.

takođe zavisi od veličine.

So in this image, what you can see

Na ovoj slici, možete videti

is that everything smaller than five nanometers

da sve ono što je manje od pet nanometara

is going from the blood, through the kidney, into the urine,

ide iz krvi, kroz bubreg, u urin,

and everything else that's bigger is retained.

a sve drugo što je veće, ostaje.

OK, so if I make a 100-nanometer cancer detector,

Dakle, ako napravim detektor za rak od sto nanometara

I inject it in the bloodstream,

i ubrizgam ga u krvotok,

it can leak into the tumor where it's activated by tumor enzymes

on može da prodre u tumor gde ga aktiviraju enzimi tumora

to release a small signal

da bi otpustio mali signal

that is small enough to be filtered out of the kidney

koji je dovoljno mali da bi ga bubreg isfiltrirao

and put into the urine,

i poslao u urin.

I have a signal in the outside world that I can detect.

Imam signal u spoljnom svetu koji mogu detektovati.

OK, but there's one more problem.

U redu, ali postoji još jedan problem.

This is a tiny little signal,

Ovo je maleni signal,

so how do I detect it?

pa kako ću ga onda otkriti?

Well, the signal is just a molecule.

Signal je samo jedan molekul.

They're molecules that we designed as engineers.

To su molekuli koje smo napravili kao inženjeri.

They're completely synthetic, and we can design them

Oni su u potpunosti sintetički i možemo ih koncipirati

so they are compatible with our tool of choice.

tako da budu kompatibilni sa alatom po našem izboru.

If we want to use a really sensitive, fancy instrument

Ako želimo da koristimo stvarno osetljiv, luksuzni instrument

called a mass spectrometer,

koji se zove maseni spektometar,

then we make a molecule with a unique mass.

onda ćemo napraviti molekul jedinstvene mase.

Or maybe we want make something that's more inexpensive and portable.

Ili želimo da napravimo nešto manje skupo, a prenosivo.

Then we make molecules that we can trap on paper,

Onda ćemo napraviti molekule koje možemo zadržati na papiru,

like a pregnancy test.

poput testa za trudnoću.

In fact, there's a whole world of paper tests

U stvari, postoji čitav svet papirnih testova

that are becoming available in a field called paper diagnostics.

koji postaju dostupni u oblasti koja se zove papirna dijagnostika.

Alright, where are we going with this?

U redu, kud nas ovo vodi?

What I'm going to tell you next,

Ono što ću vam sledeće reći,

as a lifelong researcher,

kao dugogodišnji istraživač,

represents a dream of mine.

predstavlja moj san.

I can't say that's it's a promise;

Ne mogu reći da je to obećanje;

it's a dream.

to je san.

But I think we all have to have dreams to keep us pushing forward,

No, mislim da svi moramo imati snove koji će nas terati napred,

even -- and maybe especially -- cancer researchers.

čak i - ili možda, naročito - istraživači raka.

I'm going to tell you what I hope will happen with my technology,

Reći ću vam šta se nadam da će se desiti s mojom tehnologijom

that my team and I will put our hearts and souls

čemu ćemo se moj tim i ja i srcem i dušom posvetiti

into making a reality.

da bi postalo stvarnost.

OK, here goes.

Dakle, evo ga.

I dream that one day,

Sanjam da će jednog dana,

instead of going into an expensive screening facility

umesto odlaska u skupu ustanovu za skrining

to get a colonoscopy,

da bi se uradila kolonoskopija,

or a mammogram,

mamogram

or a pap smear,

ili papa test,

that you could get a shot,

da ćemo moći dobiti injekciju,

wait an hour,

sačekati sat vremena

and do a urine test on a paper strip.

i uraditi test urina pomoću papirne trake.

I imagine that this could even happen

Mislim da se ovo može uraditi

without the need for steady electricity,

čak i bez potrebe za stabilnom strujom

or a medical professional in the room.

ili medicinskim osobljem u prostoriji.

Maybe they could be far away

Možda bi oni mogli biti daleko

and connected only by the image on a smartphone.

i povezani samo slikom na pametnom telefonu.

Now I know this sounds like a dream,

Znam da ovo zvuči kao san,

but in the lab we already have this working in mice,

ali u laboratoriji ovo već funkcioniše na miševima,

where it works better than existing methods

funkcioniše bolje od postojećih metoda

for the detection of lung, colon and ovarian cancer.

za otkrivanje raka pluća, debelog creva i jajnika.

And I hope that what this means

Nadam se da ovo znači

is that one day we can detect tumors in patients

da ćemo jednog dana moći otkrivati tumore kod pacijenata

sooner than 10 years after they've started growing,

pre nego što prođe deset godina od početka njihovog rasta,

in all walks of life,

u svim slojevima društva,

all around the globe,

širom sveta,

and that this would lead to earlier treatments,

a da će ovo dovesti do ranijeg lečenja,

and that we could save more lives than we can today,

i da ćemo moći spasiti više života nego što možemo danas,

with early detection.

ranim otkrivanjem.

Thank you.

Hvala vam.

(Applause)

(Aplauz)