The Future of Early Cancer Detection? | Jorge Soto | TED Talks

Prevodilac: Olivera Uzelac Lektor: Mile Živković

Almost a year ago,

Pre oko godinu dana,

my aunt started suffering back pains.

moja tetka je počela da oseća bol u leđima.

She went to see the doctor

Otišla je kod lekara

and they told her it was a normal injury

gde su joj rekli da je to uobičajena povreda

for someone who had been playing tennis

za nekoga ko je igrao tenis

for almost 30 years.

skoro 30 godina.

They recommended that she do some therapy,

Preporučili su joj terapiju,

but after a while she wasn't feeling better,

ali posle nekog vremena nije se osećala bolje

so the doctors decided to do further tests.

pa su lekari odlučili da urade druge testove.

They did an x-ray

Uradili su rendgen

and discovered an injury in her lungs,

i otkrili povredu u njenim plućima,

and at the time they thought that the injury

za koju su tada smatrali

was a strain in the muscles and tendons

da je istegnuće mišića i tetiva

between her ribs,

između njenih rebara.

but after a few weeks of treatment,

Ali nakon nekoliko nedelja lečenja,

again her health wasn't getting any better.

i dalje nije bilo napretka.

So finally, they decided to do a biopsy,

Stoga su odlučili da urade biopsiju

and two weeks later,

i posle dve nedelje,

the results of the biopsy came back.

dobili smo rezultate.

It was stage 3 lung cancer.

Imala je rak pluća u trećem stadijumu.

Her lifestyle was almost free of risk.

Uglavnom je vodila zdrav način života.

She never smoked a cigarette,

Nikada nije pušila,

she never drank alcohol,

nikada nije pila alkohol,

and she had been playing sports

i skoro polovinu života

for almost half her life.

se bavila sportom.

Perhaps, that is why it took them almost six months

Možda im je zbog toga trebalo skoro šest meseci

to get her properly diagnosed.

za tačnu dijagnozu.

My story might be, unfortunately,

Moja priča je verovatno, nažalost,

familiar to most of you.

poznata većini vas.

One out of three people sitting in this audience

Jednoj od tri osobe koje sede u publici

will be diagnosed with some type of cancer,

biće dijagnostikovana neka vrsta raka,

and one out of four

i jedna od četiri

will die because of it.

će od toga umreti.

Not only did that cancer diagnosis

Dijagnoza raka nije samo promenila

change the life of our family,

život naše porodice,

but that process of going

već je zbog tog procesa

back and forth with new tests,

stalnog testiranja,

different doctors describing symptoms,

različitih lekara i opisa simptoma

discarding diseases over and over,

kao i odbacivanja dijagnoza iznova i iznova

was stressful and frustrating,

bio stresan i frustrirajući,

especially for my aunt.

posebno za moju tetku.

And that is the way cancer diagnosis has been done

To je način na koji se radi dijagnoza raka

since the beginning of history.

od početka istorije.

We have 21st-century medical treatments and drugs

Imamo savremene medicinske metode i lekove

to treat cancer,

za lečenje raka,

but we still have 20th-century procedures

ali su procedure i procesi za dijagnozu raka zastareli,

and processes for diagnosis, if any.

ako uopšte i postoje.

Today, most of us have to wait for symptoms

Danas, većina nas mora da čeka na pojavu simptoma

to indicate that something is wrong.

da bi se utvrdilo da nešto nije u redu.

Today, the majority of people still don't have access

Većina ljudi danas, nema pristup

to early cancer detection methods,

metodima ranog otkrivanja raka,

even though we know

iako znamo

that catching cancer early

da je rano otkrivanje raka

is basically the closest thing we have

najbliža stvar koju imamo

to a silver bullet cure against it.

efikasnom leku protiv raka.

We know that we can change this in our lifetime,

Znamo da ovo možemo da uradimo za života,

and that is why my team and I

i zato smo moj tim i ja

have decided to begin this journey,

odlučili da započnemo ovo putovanje,

this journey to try to make cancer detection

putovanje koje je pokušaj da otkrivanje raka

at the early stages

u ranim stadijumima

and monitoring the appropriate response at the molecular level

i posmatranje odgovarajućih indikatora na molekularnom nivou

easier, cheaper, smarter

bude lakše, jeftinije, pametnije

and more accessible than ever before.

i dostupnije više nego ikad.

The context, of course,

U kontekstu,

is that we're living at a time

živimo u vremenu

where technology is disrupting our present

u kojem tehnologija veoma brzo

at exponential rates,

menja našu sadašnjost,

and the biological realm is no exception.

i oblast biologije nije izuzetak.

It is said today that biotech is advancing

Kažu da biotehnologija danas napreduje

at least six times faster than the growth rate

bar šest puta brže od stope rasta

of the processing power of computers.

moći obrade računara.

But progress in biotech

Napredak u biotehnologiji

is not only being accelerated,

je ne samo ubrzan,

it is also being democratized.

već i demokratizovan.

Just as personal computers or the Internet

Dok su lični računari,

or smartphones leveled the playing field

internet ili pametni telefoni izjednačili mogućnosti

for entrepreneurship, politics or education,

u preduzetništvu, politici ili obrazovanju,

recent advances have leveled it up for biotech progress as well,

skorašnji pomak je isto ovo uradio za napredak biotehnologije.

and that is allowing

To je omogućavanje

multidisciplinary teams like ours

multidisciplinarnim timovima kao što je naš

to try to tackle and look at these problems

da se pozabave i sagledaju ove probleme

with new approaches.

drugačijim pristupima.

We are a team of scientists and technologists

Mi smo tim naučnika i tehnologa

from Chile, Panama,

iz Čilea, Paname,

Mexico, Israel and Greece,

Meksika, Izraela i Grčke,

and based on recent scientific discoveries,

i na osnovu nedavnih naučnih otkrića

we believe that we have found

mislimo da smo pronašli

a reliable and accurate way

pouzdan i tačan način

of detecting several types of cancer

otkrivanja više tipova raka u ranim stadijumima

at the very early stages through a blood sample.

preko uzorka krvi.

We do it by detecting a set of very small molecules

Ovo smo postigli otkrivanjem grupe veoma sitnih molekula

that circulate freely in our blood

koji se slobodno kreću u krvotoku

called microRNAs.

i nazivaju se mikroRNK.

To explain what microRNAs are

Kako bismo objasnili šta je mikroRNK

and their important role in cancer,

i njenu značajnu ulogu za rak

I need to start with proteins,

moram da krenem od proteina,

because when cancer is present in our body,

jer kad je rak prisutan u našem telu

protein modification is observed

posmatra se modifikacija proteina

in all cancerous cells.

u svim kancerogenim ćelijama.

As you might know,

Kao što već možda znate,

proteins are large biological molecules

proteini su veliki biološki molekuli

that perform different functions within our body,

koji obavljaju različite funkcije unutar tela

like catalyzing metabolic reactions

kao što je katalizacija metaboličkih reakcija,

or responding to stimuli

reagovanje na nadražaje

or replicating DNA,

ili replikacija DNK,

but before a protein is expressed or produced,

ali pre ekspresije i stvaranja proteina

relevant parts of its genetic code

bitni delovi

present in the DNA

genetičkog koda koji su prisutni u DNK

are copied into the messenger RNA,

se kopiraju u transportnu RNK,

so this messenger RNA

kako bi transportna RNK

has instructions on how to build a specific protein,

imala instrukcije za građenje odeđenog proteina

and potentially it can build hundreds of proteins,

i mogla da izgradi stotine proteina

but the one that tells them when to build them

ali ona koja govori kad da ih grade

and how many to build

i koliko

are microRNAs.

je mikroRNK.

So microRNAs are small molecules

MikroRNK se sastoji od malih molekula

that regulate gene expression.

koji regulišu ekspresiju gena.

Unlike DNA, which is mainly fixed,

Za razliku od DNK, koja je uglavnom nepromenljiva,

microRNAs can vary depending on internal

mikroRNK može da varira bilo kad

and environmental conditions at any given time,

u zavisnosti od unutrašnjih i spoljašnjih uslova,

telling us which genes are actively expressed at that particular moment.

i govori nam koji geni aktivno učestvuju u ekspresiji u tom trenu.

And that is what makes microRNAs

Zato je mikroRNK

such a promising biomarker for cancer,

tako obećavajući biomarker za rak,

because as you know,

jer kao što znate,

cancer is a disease of altered gene expression.

rak je bolest promenjene ekspresije gena.

It is the uncontrolled regulation of genes.

Ono je nekontrolisana regulacija gena.

Another important thing to consider

Još jedna bitna stvar za razmatranje

is that no two cancers are the same,

je da nijedna dva raka nisu ista,

but at the microRNA level, there are patterns.

ali na nivou mikroRNK, postoje šabloni.

Several scientific studies have shown

Nekoliko naučnih istraživanja su pokazala

that abnormal microRNA expression levels

da nivo abnormalne ekspresije mikroRNK

varies and creates a unique, specific pattern

varira i stvara jedinstveni i specifični šablon

for each type of cancer,

za svaki tip raka,

even at the early stages,

čak i u ranim stadijumima,

reflecting the progression of the disease,

i time prikazuje napredak bolesti

and whether it's responding to medication

i da li reaguje na lečenje

or in remission,

ili je u remisiji,

making microRNAs a perfect,

što čini mikroRNK savršenim,

highly sensitive biomarker.

vrlo osetljivim biomarkerom.

However, the problem with microRNAs

Problem sa mikroRNK je što ne možemo koristiti

is that we cannot use existing DNA-based technology

postojeću tehnologiju koja je zasnovana na DNK

to detect them in a reliable way,

kako bismo ih otkrili na pouzdan način,

because they are very short sequences of nucleotides,

zato što su one veoma kratki nizovi nukleotida

much smaller than DNA.

mnogo manji od DNK.

And also, all microRNAs are very similar to each other,

Takođe, sve mikroRNK su međusobno jako slične,

with just tiny differences.

sa jako malim razlikama.

So imagine trying to differentiate two molecules,

Zamislite da treba da razlikujete dva izuzetno slična

extremely similar, extremely small.

i veoma mala molekula.

We believe that we have found a way to do so,

Mislimo da smo pronašli način da to uradimo,

and this is the first time that we've shown it in public.

i ovo je prvi put da ga prikazujemo u javnosti.

Let me do a demonstration.

Demonstriraću vam.

Imagine that next time you go to your doctor

Zamislite da sledeći put kad odete kod lekara

and do your next standard blood test,

i uradite vašu standardnu analizu krvi,

a lab technician extracts a total RNA,

laborant izoluje totalnu RNK,

which is quite simple today,

nešto što je veoma jednostavno danas,

and puts it in a standard 96-well plate like this one.

i stavi je u mikroploču sa 96 determinacija, kao što je ova.

Each well of these plates

Svaka determinacija ovih ploča

has specific biochemistry that we assign,

sadrži biohemiju koju smo mi odredili,

that is looking for a specific microRNA,

koja traži određenu mikroRNK

acting like a trap that closes

i ponaša se kao zamka koja se zatvara

only when the microRNA is present in the sample,

tek onda kad je mikroRNK prisutna u uzorku,

and when it does, it will shine with green color.

u tom trenutku, zasvetli zelenom bojom.

To run the reaction,

Da bi pokrenuli reakciju

you put the plate inside a device like this one,

ploču stavite u uređaj kao što je ovaj,

and then you can put your smartphone on top of it.

a zatim na vrh i svoj pametni telefon.

If we can have a camera here

Nek kamera zumira ovde

so you can see my screen.

kako biste videli moj ekran.

A smartphone is a connected computer

Pametan telefon je umrežen računar

and it's also a camera,

ali i fotoaparat,

good enough for our purpose.

dovoljno dobar za naše namere.

The smartphone is taking pictures,

Telefon fotografiše,

and when the reaction is over,

i kada se reakcija završi,

it will send the pictures

poslaće slike

to our online database for processing

u našu bazu podataka na internetu radi obrade

and interpretation.

i tumačenja podataka.

This entire process lasts around 60 minutes,

Ceo proces traje otprilike 60 minuta,

but when the process is over,

ali kada se završi,

wells that shine are matched with the specific microRNAs

determinacije koje sijaju poklapaju se sa određenim mikroRNK

and analyzed in terms of how much and how fast

i analiziraju se u pogledu toga koliko su i koliko brzo

they shine.

zasijale.

And then, when this entire process is over,

Kada se ceo taj proces završi,

this is what happens.

ovo se desi.

This chart is showing the specific microRNAs

Tabela pokazuje određene mikroRNK

present in this sample

prisutne u uzorku

and how they reacted over time.

i njihovu reakciju tokom vremena.

Then, if we take this specific pattern of microRNA

Ako uzmemo ovaj određeni šablon mikroRNK

of this person's samples

iz uzorka ove osobe

and compare it with existing scientific documentation

i uporedimo ga sa postojećom naučnom dokumentacijom

that correlates microRNA patterns

koja povezuje šablone mikroRNK

with a specific presence of a disease,

sa prisutnošću određene bolesti,

this is how pancreatic cancer looks like.

ovako izgleda rak pankreasa.

This inside is a real sample

Unutra je pravi uzorak

where we just detected pancreatic cancer.

gde smo upravo otkrili rak pankreasa.

(Applause)

(Aplauz)

Another important aspect of this approach

Još jedan važan aspekat ovog pristupa

is the gathering and mining of data in the cloud,

je skupljanje i skadištenje informacija u oblaku

so we can get results in real time

kako bismo dobili rezultate u realnom vremenu

and analyze them with our contextual information.

i onda ih analizirali sa postojećom dokumentacijom.

If we want to better understand

Ako hoćemo bolje da razumemo

and decode diseases like cancer,

i dekodiramo bolesti kao što je rak

we need to stop treating them

moramo prestati da ih tretiramo

as acute, isolated episodes,

kao akutne, izolovane slučajeve

and consider and measure everything

i uzmemo u obzir i izmerimo sve

that affects our health on a permanent basis.

što trajno utiče na naše zdravlje.

This entire platform is a working prototype.

Cela ova platforma je radni prototip.

It uses state-of-the-art molecular biology,

Koristi najsavremeniju molekularnu biologiju,

a low-cost, 3D-printed device,

jeftini uređaj za štampanje u 3D-u

and data science

i nauku o podacima

to try to tackle one of humanity's toughest challenges.

kako bi pokušala da pobedi jedan od najvećih izazova za čovečanstvo.

Since we believe early cancer detection

Zato što mislimo da rano otkrivanje raka

should really be democratized,

treba da bude demokratizovano,

this entire solution costs at least 50 times less

celo ovo rešenje košta bar 50 puta manje

than current available methods,

od trenutno dostupnih metoda,

and we know that the community can help us

i znamo da nam zajednica može pomoći

accelerate this even more,

da ovo ubrzamo,

so we're making the design of the device

te je dizajn ovog uređaja

open-source.

otvorenog tipa.

(Applause)

(Aplauz)

Let me say very clearly

Hoću samo da naznačim

that we are at the very early stages,

da smo tek u ranim fazama,

but so far, we have been able

ali za sad smo uspeli

to successfully identify the microRNA pattern

da uspešno identifikujemo šablon mikroRNK

of pancreatic cancer, lung cancer,

raka pankreasa, raka pluća,

breast cancer and hepatic cancer.

raka dojke i raka jetre.

And currently, we're doing a clinical trial

Trenutno obavljamo kliničko ispitivanje

in collaboration with the German Cancer Research Center

u saradnji sa Nemačkim centrom za istaživanje raka

with 200 women for breast cancer.

sa 200 žena, za rak dojke.

(Applause)

(Aplauz)

This is the single non-invasive,

Ovo je jedini neinvanzivni

accurate and affordable test

tačan i pristupačan test

that has the potential to dramatically change

koji ima potencijal da drastično promeni

how cancer procedures and diagnostics

način na koji se rade

have been done.

procedure i dijagnoze raka.

Since we're looking for the microRNA patterns

Zato što tražimo šablone mikroRNK

in your blood at any given time,

u vašoj krvi u bilo kom trenutku,

you don't need to know which cancer you're looking for.

nema potrebe da znate koji rak tražite.

You don't need to have any symptoms.

Ne morate da imate nikakve simptome.

You only need one milliliter of blood

Treba vam samo mililitar krvi

and a relatively simple array of tools.

i prilično jednostavan izbor instrumenata.

Today, cancer detection happens mainly

Danas se dijagnoza raka radi uglavnom

when symptoms appear.

kada se pojave simptomi.

That is, at stage 3 or 4,

Odnosno u 3. ili 4. stadijumu,

and I believe that is too late.

i mislim da je tada prekasno.

It is too expensive for our families.

Preskupo je za naše porodice.

It is too expensive for humanity.

Preskupo je za čovečanstvo.

We cannot lose the war against cancer.

Ne smemo da izgubimo rat protiv raka.

It not only costs us billions of dollars,

Ne samo da nas košta milijarde dolara,

but it also costs us the people we love.

već i ljudi koje volimo.

Today, my aunt, she's fighting bravely

Moja tetka se hrabro bori

and going through this process with a very positive attitude.

i prolazi kroz ovaj proces sa veoma pozitivnim stavom.

However, I want fights like this

Ali ja hoću da ovakve bitke

to become very rare.

postanu jako retke.

I want to see the day

Hoću da dočekam dan

when cancer is treated easily

kada se rak lako leči

because it can be routinely diagnosed

jer se rutiniski može dijagnostikovati

at the very early stages,

u dosta ranim stadijumima,

and I'm certain

i siguran sam da će se

that in the very near future,

u veoma bliskoj budućnosti

because of this

zbog ovoga

and other breakthroughs that we are seeing

i drugih otkrića

every day in the life sciences,

koje vidimo svakog dana u naukama života,

the way we see cancer

naš pogled na rak

will radically change.

drastično promeniti.

It will give us the chance of detecting it early,

Imaćemo priliku da ga otkrijemo rano,

understanding it better,

bolje razumemo,

and finding a cure.

i pronađemo lek.

Thank you very much.

Hvala vam mnogo.

(Applause)

(Aplauz)