Danny Hillis: Understanding cancer through proteomics

Prevodilac: Jelena Nedjic Lektor: Ivana Korom

I admit that I'm a little bit nervous here

Moram priznati da sam malo nervozan s obzirom

because I'm going to say some radical things,

da planiram da predstavim večeras veoma radikalne ideje

about how we should think about cancer differently,

koje imaju za cilj da promene naš generalni pogled na rak

to an audience that contains a lot of people

ispred veoma mnogo ljudi

who know a lot more about cancer than I do.

koji znaju znatno više o raku u poređenju sa mnom.

But I will also contest that I'm not as nervous as I should be

Ali moram priznati da nisam onoliko nervozan koliko bi se to očekivalo

because I'm pretty sure I'm right about this.

jer sam poprilično siguran da sam u pravu.

(Laughter)

(Smeh)

And that this, in fact, will be

Tvrdim da će ovo zaista biti

the way that we treat cancer in the future.

način lečenja raka u budućnosti.

In order to talk about cancer,

Kako bih mogao da pričam sa vama o raku,

I'm going to actually have to --

moraću da vam pokažem

let me get the big slide here.

ovaj ogroman slajd.

First, I'm going to try to give you a different perspective of genomics.

Pre svega, želim da vam predstavim drugačiji pogled na genomiku.

I want to put it in perspective of the bigger picture

Želim da posmatramo genomiku iz šire perspektive,

of all the other things that are going on --

koja uključuje različita znanja do kojih dolazimo

and then talk about something you haven't heard so much about, which is proteomics.

a potom želim da govorim o metodologiji o kojoj niste mnogo čuli, a to je proteomika.

Having explained those,

Mislim da ćemo, nakon objašnjenja koja će uslediti,

that will set up for what I think will be a different idea

biti spremni da govorimo o novoj i drugačijoj ideji

about how to go about treating cancer.

o lečenju raka.

So let me start with genomics.

Pa, hajde da počnemo sa objašnjenjem genomike.

It is the hot topic.

Danas je to poprilično popularna tema.

It is the place where we're learning the most.

To je oblast u kojoj najviše učimo.

This is the great frontier.

To je tehnologija koja ima velike potencijale,

But it has its limitations.

ali isto tako ima i svoja ograničenja.

And in particular, you've probably all heard the analogy

Naročito bih naglasio da ste svi vi čuli analogiju

that the genome is like the blueprint of your body,

koja govori da je vaš genom zapravo slika vašeg tela.

and if that were only true, it would be great,

I kada bi to bilo tačno, to bi bilo odlično,

but it's not.

ali nije. To je nešto

It's like the parts list of your body.

kao lista sastavnih delova vašeg tela.

It doesn't say how things are connected,

Ne govori ništa o tome kako su komponente vašeg organizma

what causes what and so on.

povezane, šta uzrokuje koji proces i tako dalje.

So if I can make an analogy,

Tako da bih ja želeo da napravim ovde jednu analogiju,

let's say that you were trying to tell the difference

recimo da vi želite da objasnite razliku

between a good restaurant, a healthy restaurant

između dobrog restorana, restorana zdrave hrane,

and a sick restaurant,

i restorana brze hrane,

and all you had was the list of ingredients

i sve što imate na raspolaganju jeste lista sastojaka

that they had in their larder.

koji pomenuti restorani imaju u svojoj ostavi.

So it might be that, if you went to a French restaurant

Tako možemo zamisliti, da ukoliko ste analizirali listu

and you looked through it and you found

sastojaka koju koristi francuski restoran i pri tome pronašli

they only had margarine and they didn't have butter,

da oni koriste samo margarin i da nemaju puter u ostavi,

you could say, "Ah, I see what's wrong with them.

mogli biste da kažete : "Ah, pa vidim zašto je ovde hrana loša.

I can make them healthy."

Mogu da im pomognem da pređu na zdrav način."

And there probably are special cases of that.

I verovatno postoje izdvojeni slučajevi kao ovaj.

You could certainly tell the difference

Mogli biste da uočite razliku

between a Chinese restaurant and a French restaurant

između kineskog i francuskog restorana

by what they had in a larder.

na osnovu liste sastojaka koje možete naći u njihovoj ostavi.

So the list of ingredients does tell you something,

Tako da vam definitivno lista sastojaka nešto govori,

and sometimes it tells you something that's wrong.

i ponekada možete na osnovu iste zaključiti šta je loše.

If they have tons of salt,

Ukoliko ste pronašli velike količine soli,

you might guess they're using too much salt, or something like that.

možete pretpostaviti da oni koriste previše soli ili nešto slično.

But it's limited,

Ali te informacije imaju limitirani kapacitet,

because really to know if it's a healthy restaurant,

jer da biste znali da li je to restoran zdrave hrane,

you need to taste the food, you need to know what goes on in the kitchen,

morate probati hranu, morate znati šta se dešava u kuhinji,

you need the product of all of those ingredients.

neophodan vam je kranji produkt koji nastaje sjedinjavanjem tih sastojaka.

So if I look at a person

Tako da ukoliko ja pogledam jednu osobu

and I look at a person's genome, it's the same thing.

i analiziram genom te osobe, to je apsolutno ista stvar.

The part of the genome that we can read

Deo genoma koji mi možemo dešifrovati

is the list of ingredients.

je ništa drugo do lista sastojaka.

And so indeed,

I naravno,

there are times when we can find ingredients

ponekada možemo naći sastojke

that [are] bad.

koji su loši.

Cystic fibrosis is an example of a disease

Cistična fibroza jeste odličan primer bolesti tog tipa

where you just have a bad ingredient and you have a disease,

gde imate loš sastojak i imate bolest

and we can actually make a direct correspondence

i mi u ovom slučaju možemo napraviti direktnu vezu

between the ingredient and the disease.

između "sastojka" i bolesti.

But most things, you really have to know what's going on in the kitchen,

Ali u većini slučajeva, vi morate znati šta se dešava u kuhinji,

because, mostly, sick people used to be healthy people --

s obzirom da su bolesni ljudi najčešće bili pre toga zdravi -

they have the same genome.

što znači da imaju isti genom.

So the genome really tells you much more

Tako da vam genom moze reći mnogo više

about predisposition.

o određenim predispozicijama.

So what you can tell

Ono sto vi možete prepoznati

is you can tell the difference between an Asian person and a European person

jeste razlika između Azijata i Evropljana

by looking at their ingredients list.

na osnovu analize njihove liste sastojaka.

But you really for the most part can't tell the difference

Ali u realnosti vi najčešće ne možete uočiti razliku

between a healthy person and a sick person --

između zdrave i bolesne osobe

except in some of these special cases.

sem u specifičnim slučajevima.

So why all the big deal

Usled čega se pravi onda velika pompa

about genetics?

oko genetike?

Well first of all,

Pa, pre svega,

it's because we can read it, which is fantastic.

mi genom možemo da "pročitamo", što je fantastično.

It is very useful in certain circumstances.

U određenim situacijama to je veoma korisno.

It's also the great theoretical triumph

Takođe, predstavlja neverovatan teoretski uspeh

of biology.

biologije.

It's the one theory

To je jedina teorija

that the biologists ever really got right.

oko koje su biolozi ikada bili u pravi.

It's fundamental to Darwin

To je fundamentalna osnova Darvinove teorije

and Mendel and so on.

kao i Mendelove teorije nasleđivanja.

And so it's the one thing where they predicted a theoretical construct.

To je otkriće kojim su biolozi u mogućnosti da predivide teorijski konstrukt.

So Mendel had this idea of a gene

Mendel je imao ideju o genima

as an abstract thing,

u apstraktnom smislu.

and Darwin built a whole theory

I Darvin je uspostavio čitavu teoriju

that depended on them existing,

koja u potpunosti zavisi od postojanja gena.

and then Watson and Crick

I kada su Vatson i Krik proučavali

actually looked and found one.

nasledne jedinice, napokon su ih i pronašli.

So this happens in physics all the time.

Ovo se dešava u fizici sve vreme.

You predict a black hole,

Vi predvidite postojanje crne rupe,

and you look out the telescope and there it is, just like you said.

pogledate kroz teleskop i pronađete je, baš kao što ste i rekli.

But it rarely happens in biology.

Ali to se retko dešava u biologiji.

So this great triumph -- it's so good,

Tako da je ovaj fantastičan trijumf - toliko fascinirajući -

there's almost a religious experience

da je to skoro religiozno iskustvo

in biology.

u biologiji.

And Darwinian evolution

I Darvinova teorije evolucije

is really the core theory.

jeste zaista centralna teorija.

So the other reason it's been very popular

I drugi razlog popularnosti genetike

is because we can measure it, it's digital.

jeste činjenica da je digitalna, genom možete da izmerite.

And in fact,

I u stvari,

thanks to Kary Mullis,

zahvaljujući Kariju Malisu,

you can basically measure your genome in your kitchen

vi možete izmeriti svoj genom u kuhinji

with a few extra ingredients.

uz pomoć nekoliko ekstra sastojaka.

So for instance, by measuring the genome,

Na primer, odgonetajući genom,

we've learned a lot about how we're related to other kinds of animals

naučili smo koliko smo srodni sa ostalim životinjskim vrstama

by the closeness of our genome,

na osnovu sličnosti naših genoma,

or how we're related to each other -- the family tree,

ili kako smo međusobno povezani - porodično stablo,

or the tree of life.

ili stablo života.

There's a huge amount of information about the genetics

Možemo doći do mnogo informacija o genetici

just by comparing the genetic similarity.

na osnovu jednostavnog poređenja genetičkih sličnosti.

Now of course, in medical application,

Naravno i primena ovih znanja u medicini,

that is very useful

je jako korisna

because it's the same kind of information

s obzirom da je to isti tip informacije

that the doctor gets from your family medical history --

koji doktor dobija analizirajući istoriju bolesti vaše famlije,

except probably,

sa tom razlikom da najverovatnije

your genome knows much more about your medical history than you do.

vaš genom zna mnogo više o vašoj istoriji bolesti od vas samih.

And so by reading the genome,

Tako da dešifrujući genom, možemo

we can find out much more about your family than you probably know.

da saznamo mnogo više o vašoj porodici nego što vi sami znate.

And so we can discover things

Tako da možemo da otkrijemo činjenice

that probably you could have found

do kojih biste i vi sami mogli doći

by looking at enough of your relatives,

ukoliko biste ispitali dovoljno vaših rođaka,

but they may be surprising.

ali te činjenice mogu da budu iznenađujuće.

I did the 23andMe thing

Ja sam uradio "23 i ja" test i

and was very surprised to discover that I am fat and bald.

bio sam veoma iznenađen kad sam otkrio da sam debeo i ćelav.

(Laughter)

(Smeh)

But sometimes you can learn much more useful things about that.

Ali ponekada možete saznati mnogo korisnije informacije o tome.

But mostly

Ali najčešće ono što je

what you need to know, to find out if you're sick,

vama potrebno da znate da li ste bolesni

is not your predispositions,

nisu vaše predispozicije, nego

but it's actually what's going on in your body right now.

ono što se zaista događa u datom trenutku u vašem telu.

So to do that, what you really need to do,

A da biste to uradili, ono što je zaista neophodno

you need to look at the things

da uradite jeste da sagledate

that the genes are producing

produkte kodirane vašim genima

and what's happening after the genetics,

i šta se dešava nizvodno od nivoa genetike.

and that's what proteomics is about.

To je ono što definiše proteomiku.

Just like genome mixes the study of all the genes,

Baš kao što genomika ispituje sve gene,

proteomics is the study of all the proteins.

proteomika se bavi izučavanjem svih proteina jednog organizma.

And the proteins are all of the little things in your body

A proteini su "radilice" vašeg organizma

that are signaling between the cells --

koje prenose informacije između ćelija

actually, the machines that are operating --

u principu mašine koje odrađuju sve funkcije organizma.

that's where the action is.

Proteini su nosioci radnih delatnosti.

Basically, a human body

U principu, ljudsko telo

is a conversation going on,

jeste komunikacija, razgovor na globalnom nivou,

both within the cells and between the cells,

i to na oba nivoa, i u ćeliji i između ćelija,

and they're telling each other to grow and to die,

i oni saopštavaju jedni drugima da rastu i da umiru.

and when you're sick,

A kada ste bolesni, to znači

something's gone wrong with that conversation.

da je došlo do greške u tom razgovoru.

And so the trick is --

Tako da je trik u tome da -

unfortunately, we don't have an easy way to measure these

na nesreću, nemamo odgovarajući način da izučavamo proteine

like we can measure the genome.

kao što možemo da izučavamo genom.

So the problem is that measuring --

Dakle, problem je u tom merenju - ukoliko

if you try to measure all the proteins, it's a very elaborate process.

probate da izmerite sve proteine, to je veoma zahtevna procedura.

It requires hundreds of steps,

To zahteva stotine pojedinačnih koraka,

and it takes a long, long time.

i zahteva mnogo, mnogo vremena.

And it matters how much of the protein it is.

I važno je koliko je proteina prisutno.

It could be very significant that a protein changed by 10 percent,

Može biti veoma značajno da je 10% proteina promenjeno,

so it's not a nice digital thing like DNA.

tako da ovde ne pričamo o finom, digitalnom fenomenu kao što je DNK.

And basically our problem is somebody's in the middle

Naš je problem da neko u samoj sredini

of this very long stage,

ovog veoma dugog procesa,

they pause for just a moment,

pauzira za samo jedan trenutak,

and they leave something in an enzyme for a second,

i ostavi nešto u enzimu na samo sekund,

and all of a sudden all the measurements from then on

i odjednom, od tog momenta sva merenja koja

don't work.

slede ne funkcionišu.

And so then people get very inconsistent results

I usled toga ljudi dobijaju veoma nekonzistentne rezultate

when they do it this way.

kada pokušaju da rade na opisani način.

People have tried very hard to do this.

Ljudi su uložili puno truda kako bi uspeli da urade ovo.

I tried this a couple of times

Ja sam probao nekoliko puta

and looked at this problem and gave up on it.

skoncentrisao se na problem i odustao od istog.

I kept getting this call from this oncologist

Ali me je jedan onkolog zvao telefonom non-stop

named David Agus.

po imenu Dejvid Agus.

And Applied Minds gets a lot of calls

I mnogi ljudi zovu "Primenjene Umove",

from people who want help with their problems,

ljudi koji žele pomoć u rešavanju svojih problema,

and I didn't think this was a very likely one to call back,

i nisam mislio da ima mogućnosti de će ovaj zvati ponovo,

so I kept on giving him to the delay list.

i tako je razgovor sa njim bio non-stop na listi čekanja.

And then one day,

I potom jednog dana,

I get a call from John Doerr, Bill Berkman

pozvaše mene Džon Doer, Bil Berkman

and Al Gore on the same day

i Al Gor istoga dana

saying return David Agus's phone call.

da mi kažu da pozovem Dejvid Agusa.

(Laughter)

(Smeh)

So I was like, "Okay. This guy's at least resourceful."

I ja pomislih: "Okej, ovaj tip barem ima puno kontakata."

(Laughter)

(smeh)

So we started talking,

Tako mi počesmo da razgovaramo,

and he said, "I really need a better way to measure proteins."

i on mi reče: "Zaista mi je neophodan bolji način da analiziram proteine."

I'm like, "Looked at that. Been there.

Ja rekoh, "Već sam razmišljao o tome. Išao sam tim stopama.

Not going to be easy."

Ovo neće biti lako."

He's like, "No, no. I really need it.

On reče: "Ali ne, ne. Meni je to zaista neophodno.

I mean, I see patients dying every day

Ja gledam pacijente kako umiru svakoga dana

because we don't know what's going on inside of them.

samo zato što mi ne razumemo šta se dešava u njihovim telima.

We have to have a window into this."

Moramo napraviti prozor koji će omogućiti da to sagledamo."

And he took me through

Onda mi je izneo specifične primere

specific examples of when he really needed it.

situacija u kojima su mu te nove metode apsolutno neophodne.

And I realized, wow, this would really make a big difference,

I ja shvatih da ovo zaista može da napravi ogromnu razliku,

if we could do it,

ukoliko bismo mogli to da odradimo.

and so I said, "Well, let's look at it."

rekao sam, "Pa, hajde da pokušamo."

Applied Minds has enough play money

"Primenjeni Umovi" imaju zaista dovoljno para u igri

that we can go and just work on something

da možemo jednostavno da radimo na problemu

without getting anybody's funding or permission or anything.

bez traženja novih sredstava i specijalnih dozvola ili bilo čega.

So we started playing around with this.

Tako da smo počeli da se zanimamo ovim.

And as we did it, we realized this was the basic problem --

I dok smo se bavili time, shvatili smo da je to osnovni problem -

that taking the sip of coffee --

upravo taj srk kafe

that there were humans doing this complicated process

činjenica da su ljudi izvršavali ovu komplikovanu proceduru

and that what really needed to be done

i da je zaista bilo neophodno

was to automate this process like an assembly line

automatizovati proces kao pokretnu traku

and build robots

i napraviti robote

that would measure proteomics.

koji bi analizirali proteomiku.

And so we did that,

I tako smo to i uradili.

and working with David,

Dok sam radio sa Dejvidom, osnovali

we made a little company called Applied Proteomics eventually,

smo malu kompaniju koju smo nazvali "Primenjena Proteomika",

which makes this robotic assembly line,

koja prozivodi robotizovanu pokretnu traku,

which, in a very consistent way, measures the protein.

koja, na veoma konzsistentan način, analizira proteine.

And I'll show you what that protein measurement looks like.

I sada ću vam pokazati kako to merenje proteina izgleda.

Basically, what we do

U principu, ono što mi radimo je

is we take a drop of blood

da uzmemo kap krvi

out of a patient,

iz pacijenta

and we sort out the proteins

i izolujemo proteine

in the drop of blood

u toj kapi krvi

according to how much they weigh,

na osnovu onoga koliko su ti proteini teški

how slippery they are,

i koliko su pokretljivi,

and we arrange them in an image.

i poređamo ih u sveobuhvatnu sliku.

And so we can look at literally

Tako da nam to omogućava da bukvalno

hundreds of thousands of features at once

analiziramo stotine hiljada karaktersitika u jednom datom

out of that drop of blood.

momentu iz samo jedne kapi krvi.

And we can take a different one tomorrow,

Sledećeg dana možemo uzeti novu kap

and you will see your proteins tomorrow will be different --

i videćete da će vaši proteini sledećeg dana biti drugačiji -

they'll be different after you eat or after you sleep.

drugačiji u zavisnosti od toga da li ste upravo jeli ili se probudili.

They really tell us what's going on there.

Govore nam o procesima koji se dešavaju u telu čoveka.

And so this picture,

Tako da ovde prikazana slika,

which looks like a big smudge to you,

koja vama izgleda kao ogromna mrlja,

is actually the thing that got me really thrilled about this

je u principu otkriće koje je mene jako uzbudilo

and made me feel like we were on the right track.

i zbog kojeg sam pomislio da smo na pravom putu.

So if I zoom into that picture,

Ukoliko ja uveličam ovu sliku,

I can just show you what it means.

mogu vam pokazati šta to zaista znači.

We sort out the proteins -- from left to right

Mi grupišemo proteine: s leva na desno

is the weight of the fragments that we're getting,

na osnovu težine fragmenata koje analiziramo.

and from top to bottom is how slippery they are.

A od vrha na dole, na osnovu njihove pokretljivosti.

So we're zooming in here just to show you a little bit of it.

Sad ćemo uveličati kako bih vam pokazao mali deo.

And so each of these lines

Svaka od ovih linija predstavlja

represents some signal that we're getting out of a piece of a protein.

u principu neku vrstu signala koju mi dobijamo od dela proteina.

And you can see how the lines occur

I isto tako možete primetiti patern linija

in these little groups of bump, bump, bump, bump, bump.

- to su male grupe sastavljene od blagih krivina, krivina, krivina, krivina.

And that's because we're measuring the weight so precisely that --

To se dešava zato što merimo težinu toliko precizno da -

carbon comes in different isotopes,

s obzriom da ugljenik ima različite izotope,

so if it has an extra neutron on it,

ukoliko ima jedan dodatni neutron,

we actually measure it as a different chemical.

mi u principu učitavamo to kao drugačiju supstancu.

So we're actually measuring each isotope as a different one.

Tako da mi beležimo svaki izotop kao drugačiji.

And so that gives you an idea

Na osnovu ovoga možete razumeti

of how exquisitely sensitive this is.

koliko je fantastično osetljiv opisani sistem.

So seeing this picture

Gledanje ove slike

is sort of like getting to be Galileo

je slično kao kada bismo bili Galilej

and looking at the stars

i gledali u zvezde kroz

and looking through the telescope for the first time,

teleskop po prvi put i iznenada

and suddenly you say, "Wow, it's way more complicated than we thought it was."

rekli, "Opa, mnogo je komplikovanije nego što smo mislili."

But we can see that stuff out there

Ali mi sada možemo da sagledamo taj mali univerzum

and actually see features of it.

i uočimo njegove karakteristike.

So this is the signature out of which we're trying to get patterns.

Ovo je skup podataka iz kojih pokušavamo da izvučemo obrasce.

So what we do with this

Ono što mi radimo sa informacijama ovog tipa

is, for example, we can look at two patients,

je da, na primer možemo analizirati dva pacijenta,

one that responded to a drug and one that didn't respond to a drug,

jednog koji je reagovao na lek i drugog koji nije,

and ask, "What's going on differently

i postaviti pitanje, "Koji je proces koji je drugačiji

inside of them?"

u organizmima ovih ljudi?"

And so we can make these measurements precisely enough

Takođe možemo da odradimo ta merenja dovoljno precizno

that we can overlay two patients and look at the differences.

da možemo da uporedimo dva pacijenta i uočimo razlike.

So here we have Alice in green

Ovde možete videti Alis u zelenom kodu

and Bob in red.

i Boba predstavljenog crvenim kodom.

We overlay them. This is actual data.

Poredimo njihove podatke. Ovo su pravi rezulati.

And you can see, mostly it overlaps and it's yellow,

Postoji puno sličnosti i obeležene su žutom bojom

but there's some things that just Alice has

ali postoje određeni proteini koje ima samo Alis

and some things that just Bob has.

i određeni proteini koje ima samo Bob.

And if we find a pattern of things

I ukoliko pronađemo šablon koji opisuje

of the responders to the drug,

grupu ljudi na koje postojeći lek ispoljava željeni

we see that in the blood,

efekat, mi vidimo to u krvi,

they have the condition

oni imaju uslove koji im

that allows them to respond to this drug.

omogućuju da uspešno odreaguju na tretman.

We might not even know what this protein is,

Mi možda čak ni ne znamo koji je to protein,

but we can see it's a marker

ali znamo da taj protein jeste marker,

for the response to the disease.

koji govori da će određeni tretman biti uspešan.

So this already, I think,

Već ovo saznanje, po mom mišljenju,

is tremendously useful in all kinds of medicine.

jeste od neopisive koristi za različite grane medicine.

But I think this is actually

Ali ja isto tako mislim da je ovo

just the beginning

tek početak razvijanja procedura

of how we're going to treat cancer.

kojima ćemo se boriti protiv raka.

So let me move to cancer.

A sada bih da pričam malo više o raku.

The thing about cancer --

Zanimljiva činjenica o kanceru je ta

when I got into this,

da kada sam ja počeo da se bavim ovim

I really knew nothing about it,

zaista nisam znao ništa o raku,

but working with David Agus,

ali radeći rame uz rame sa Dejvidom Agusom

I started watching how cancer was actually being treated

počeo sam da razumevam kako mi danas lečimo rak

and went to operations where it was being cut out.

i odlazio sam na operacije koje su imale za cilj otklanjanje raka.

And as I looked at it,

I kada sam sagledao tu proceduru,

to me it didn't make sense

to meni i nije baš imalo puno smisla,

how we were approaching cancer,

takav pristup lečenju raka.

and in order to make sense of it,

I kako bih razumeo proces lečenja,

I had to learn where did this come from.

morao sam naučiti kako smo došli do današnjih tretmana.

We're treating cancer almost like it's an infectious disease.

Borimo se protiv raka na način na koji se borimo protiv infektivnih bolesti.

We're treating it as something that got inside of you

Tretiramo ih kao nešto što vas je inficiralo

that we have to kill.

i što moramo da ubijemo.

So this is the great paradigm.

To je velika paradigma.

This is another case

Ovo je drugi primer u biologiji gde se

where a theoretical paradigm in biology really worked --

teorijskom paradigmom zaista došlo do rezultata,

was the germ theory of disease.

a to je "patogen - teorija bolesti".

So what doctors are mostly trained to do

Doktori su u najvećem broju slučajeva obučeni da

is diagnose --

uspostave dijagnozu -

that is, put you into a category

- što znači da vas oni svrstavaju u određenu kategoriju

and apply a scientifically proven treatment

i onda primene naučno odobreni tretman protiv bolesti

for that diagnosis --

za koju su postavili dijagnozu.

and that works great for infectious diseases.

To je odličan pristup u lečenju infektivnih bolesti.

So if we put you in the category

Tako da ukoliko je ustanovljeno

of you've got syphilis, we can give you penicillin.

da bolujete od sifilisa, možemo vas lečiti penicilinom.

We know that that works.

Mi znamo da je to uspešan način.

If you've got malaria, we give you quinine

Ukoliko bolujete od malarije, prepisaćemo vam kinin

or some derivative of it.

ili neki od derivata kinina.

And so that's the basic thing doctors are trained to do,

To je u principu osnovna stvar za koju su doktori obučeni.

and it's miraculous

Tako da je zapravo čudesno

in the case of infectious disease --

kako u slučajevima infektivnih bolesti -

how well it works.

ovi tretmani ekeftivno rešavaju probleme.

And many people in this audience probably wouldn't be alive

Mnogi ljudi u ovoj publici najverovatnije ne bi bili živi

if doctors didn't do this.

da lekari ne rade ovo.

But now let's apply that

Hajde da pokušamo da primenimo ovaj princip

to systems diseases like cancer.

na sistemski tip bolesti kao što je rak.

The problem is that, in cancer,

Problem je što u slučaju raka

there isn't something else

ne postoji strano telo koje treba ubiti,

that's inside of you.

koje je ušlo u vaš organizam.

It's you; you're broken.

To ste vi, vaše ćelije su nefunkcionalne.

That conversation inside of you

Komunikacija koja postoji na sistemskom nivou u vašem telu

got mixed up in some way.

je postala pometena na neki način.

So how do we diagnose that conversation?

Kako možemo da dijagnostikujemo problem u komunikaciji?

Well, right now what we do is we divide it by part of the body --

U ovom trenutku grupišemo rak prema različitm delovima tela -

you know, where did it appear? --

znate, gde se pojavio -

and we put you in different categories

i stavimo vas u različite kategorije

according to the part of the body.

na osnovu dela vašeg tela.

And then we do a clinical trial

I onda sprovedemo klinička istraživanja

for a drug for lung cancer

za lek koji pokazuje efekat na rak pluća

and one for prostate cancer and one for breast cancer,

i za lek koji deluje na rak prostate, rak dojke,

and we treat these as if they're separate diseases

i lečimo ove slučajeve kao da su različite bolesti

and that this way of dividing them

kao da ovaj način na koji grupišemo pod-tipove raka

had something to do with what actually went wrong.

ima ikakve veze sa onim što nije u redu.

And of course, it really doesn't have that much to do

I naravno, to nema baš puno veze sa tim

with what went wrong

šta je pošlo naopako.

because cancer is a failure of the system.

Jer rak je malfunkcionisanje sistema.

And in fact, I think we're even wrong

U principu, ja mislim da je potpuno pogrešno

when we talk about cancer as a thing.

pričati o raku kao o predmetu, stvari.

I think this is the big mistake.

Ja mislim da je to velika greška.

I think cancer should not be a noun.

Ja mislim da rak ne bi trebalo da bude imenica.

We should talk about cancering

Mi treba da pričamo o ovoj bolesti kao o "rakovanju"

as something we do, not something we have.

nečemu što mi sami radimo, a ne nečemu što imamo.

And so those tumors,

Različiti tumori

those are symptoms of cancer.

su simptomi raka.

And so your body is probably cancering all the time,

Tako da vaše telo verovatno "rakuje" sve vreme.

but there are lots of systems in your body

Ali postoji puno sistema u vašem telu

that keep it under control.

koji taj proces drže pod kontrolom.

And so to give you an idea

Da bih vam dao ideju

of an analogy of what I mean

analogije na koju konkretno mislim

by thinking of cancering as a verb,

kada govorim "rakovati" u vidu glagola,

imagine we didn't know anything about plumbing,

zamislite da ne znamo ništa o vodoinstalaterstvu,

and the way that we talked about it,

tako da bismo pričali o tome na sledeći način,

we'd come home and we'd find a leak in our kitchen

došli bismo kući i uočili da je u kuhinji procurela voda

and we'd say, "Oh, my house has water."

i rekli bismo, "Oh, u mojoj kući ima vode."

We might divide it -- the plumber would say, "Well, where's the water?"

Vodoinstalater bi rekao, "Pa, gde je ta voda u kući?"

"Well, it's in the kitchen." "Oh, you must have kitchen water."

"Pa, u kuhinji." "Oh, pa vi onda imate kuhinjsku vodu."

That's kind of the level at which it is.

To je plastični primer nivoa našeg sagledavanja stvari.

"Kitchen water,

"Kuhinjska voda?

well, first of all, we'll go in there and we'll mop out a lot of it.

Pa, pre svega, mi ćemo obrisati dosta vode.

And then we know that if we sprinkle Drano around the kitchen,

Isto tako znamo da ukoliko koristimo "Mr. Musculo"

that helps.

u kuhinji, to će sigurno pomoći.

Whereas living room water,

Dok u slučaju vode u dnevnoj sobi

it's better to do tar on the roof."

bolje rešenje je da popravimo krov."

And it sounds silly,

Znam da zvuči ludo,

but that's basically what we do.

ali u principu to je ono što danas radimo.

And I'm not saying you shouldn't mop up your water if you have cancer,

Ne kažem da ne treba da izbacite vodu ukoliko imate rak.

but I'm saying that's not really the problem;

Ali želim da poručim da to nije uzrok problema;

that's the symptom of the problem.

to je samo simptom problema.

What we really need to get at

Mi zaista treba da tretiramo

is the process that's going on,

proces koji se dešava,

and that's happening at the level

a taj proces se dešava na nivou

of the proteonomic actions,

proteina i njihove komunikacije,

happening at the level of why is your body not healing itself

pitanje je zašto vaše telo ne štiti sebe

in the way that it normally does?

na način na koji se to normalno dešava?

Because normally, your body is dealing with this problem all the time.

Vaše telo se suočava sa problemima ovog tipa svakog dana.

So your house is dealing with leaks all the time,

Vaša kuća se bori protiv prokišnjavanja sve vreme.

but it's fixing them. It's draining them out and so on.

Ali se i odupire prokišnjavanju. Isušuje vodu.

So what we need

Tako da je nama neophodan sada

is to have a causative model

uzročni model

of what's actually going on,

onoga što se zaista dešava.

and proteomics actually gives us

Proteomika nam pruža

the ability to build a model like that.

mogućnost da napokon izgradimo takav model.

David got me invited

Dejvid me je pozvao da održim

to give a talk at National Cancer Institute

govor na Nacionalnom Institutu Izučavanja Raka

and Anna Barker was there.

i Ana Barker je bila tamo.

And so I gave this talk

Tako sam održao taj govor

and said, "Why don't you guys do this?"

i rekao, "Zašto vi ne biste uradili ovo?"

And Anna said,

I Ana reče,

"Because nobody within cancer

"Zato što niko ko se bavi problemom raka

would look at it this way.

ne bi gledao na problem raka na ovaj način.

But what we're going to do, is we're going to create a program

Ali mi ćemo svakako uspostaviti program

for people outside the field of cancer

koji će okupiti ljude koji se ne bave rakom

to get together with doctors

i povezaćemo te stručanjake sa medicinarima

who really know about cancer

koji znaju puno o raku

and work out different programs of research."

i na taj način ćemo smisliti drugačiji program istraživanja."

So David and I applied to this program

Tako smo Dejvid i ja konkurisali za pomenuti program

and created a consortium

i stvorili konzorcijum

at USC

na Univerzitetu Južne Kalifornije

where we've got some of the best oncologists in the world

gde smo okupili neke od najboljih onkologa sveta

and some of the best biologists in the world,

i neke od najboljih biologa sveta

from Cold Spring Harbor,

iz Kold Spring Harbora

Stanford, Austin --

Stanforda, Ostina...

I won't even go through and name all the places --

Ne mogu sada navesti imena svih instituticija -

to have a research project

kako bismo odradili naučno-istraživački projekat

that will last for five years

koji će trajati pet godina sa krajnjim

where we're really going to try to build a model of cancer like this.

ciljem postavljanja modela kancera po opisanim principima.

We're doing it in mice first,

Radićemo ova istraživanja prvo na miševima.

and we will kill a lot of mice

Puno ce miševa stradati

in the process of doing this,

u toku razvijanja ovih eksperimenata

but they will die for a good cause.

ali će oni umreti za opšte dobro.

And we will actually try to get to the point

Mi ćemo u principu pokušati da dođemo do momenta

where we have a predictive model

kada imamo uspostavljeni uzročni model

where we can understand,

na osnovu kog možemo da razumemo,

when cancer happens,

kada se rak desi,

what's actually happening in there

šta se u osnovi dešava u organizmu

and which treatment will treat that cancer.

i koji specifičan tretman će biti efektan u lečenju.

So let me just end with giving you a little picture

I za sam kraj bih vam pokazao mali shematski prikaz

of what I think cancer treatment will be like in the future.

kako ja zamišljam da tretman protiv raka izgleda u budućnosti.

So I think eventually,

Ja mislim da na kraju,

once we have one of these models for people,

kada budemo imali ovakav model za ljude,

which we'll get eventually --

koji ćemo svakako na kraju imati -

I mean, our group won't get all the way there --

naša istraživačka grupa neće sama doći do cilja

but eventually we'll have a very good computer model --

ali ćemo na kraju imati veoma dobar kompjuterski model -

sort of like a global climate model for weather.

nešto kao globalni model vremenske prognoze.

It has lots of different information

Model će imati puno različitih informacija o

about what's the process going on in this proteomic conversation

procesima koji se dešavaju u toku komunikacije u

on many different scales.

proteomu na različitim nivoima.

And so we will simulate

Na taj način mi ćemo simulirati

in that model

tim modelom specifičan rak

for your particular cancer --

od kojeg osoba boluje i taj model

and this also will be for ALS,

će imati primenu i za amiotrofičnu lateralnu sklerozu (ALS)

or any kind of system neurodegenerative diseases,

ili bilo koju sistemsku neurodegenerativnu bolest,

things like that --

bolesti kao te

we will simulate

mi ćemo simulirati

specifically you,

Vas posebno, ne neku

not just a generic person,

generičku osobu, nego baš

but what's actually going on inside you.

same procese koji se odvijaju unutar vašeg tela.

And in that simulation, what we could do

I ono što možemo da uradimo u takvoj simulaciji

is design for you specifically

jeste da specifično dizajniramo

a sequence of treatments,

za Vas kombinaciju tretmana,

and it might be very gentle treatments, very small amounts of drugs.

koji mogu biti veoma blagi, veoma male doze lekova.

It might be things like, don't eat that day,

To mogu biti saveti tipa: nemojte jesti ovog dana,

or give them a little chemotherapy,

ili primenićemo malu dozu hemoterapije,

maybe a little radiation.

možda malo zračenja.

Of course, we'll do surgery sometimes and so on.

Naravno, ponekad ćemo odraditi operativni zahvat.

But design a program of treatments specifically for you

Ali ćemo dizajnirati poseban program tretmana samo za vas

and help your body

i pomoći vašem telu

guide back to health --

da se oporavi - tako ćemo

guide your body back to health.

usmeravati vaše telo ka zdravom stanju.

Because your body will do most of the work of fixing it

Jer će vaše telo odraditi najveći deo posla da reši problem

if we just sort of prop it up in the ways that are wrong.

ukoliko mu mi samo pomognemo u tome.

We put it in the equivalent of splints.

To bi bio ekvivalent metalnim udlagama.

And so your body basically has lots and lots of mechanisms

Vaš organizam ima veoma puno mehanizama

for fixing cancer,

koji se mogu uspešno boriti protiv raka

and we just have to prop those up in the right way

i mi samo treba da stimulišemo te mehanizme na pravi način

and get them to do the job.

i pokrenemo ih da ponovo počnu da rade svoj posao.

And so I believe that this will be the way

Ja sam duboko ubeđen da će ovo biti način

that cancer will be treated in the future.

na koji ćemo lečiti rak u budućnosti.

It's going to require a lot of work,

To će zahtevati mnogo, mnogo rada,

a lot of research.

mnogo istraživanja.

There will be many teams like our team

Biće mnogo timova koji kao i naš tim

that work on this.

pokušavaju da razumeju pomenuti fenomen.

But I think eventually,

Ali ja mislim da ćemo u budućnosti

we will design for everybody

biti u mogućnosti da dizajniramo

a custom treatment for cancer.

specifičan tretman protiv raka za svaki pojedinačni slučaj.

So thank you very much.

Na kraju, mnogo vam hvala.

(Applause)

(Aplauz)