A new class of drug that could prevent depression and PTSD | Rebecca Brachman

Prevodilac: Ivana Krivokuća Lektor: Tijana Mihajlović

So the first antidepressants were made from, of all things,

Prvi antidepresivi su bili napravljeni, pored svih mogućih opcija,

rocket fuel, left over after World War II.

od raketnog goriva preostalog nakon Drugog svetskog rata.

Which is fitting, seeing as today, one in five soldiers develop depression,

Što je prikladno, budući da danas svaki peti vojnik razvije depresiju,

or post-traumatic stress disorder or both.

posttraumatski stresni poremećaj ili oba.

But it's not just soldiers that are at high risk for these diseases.

Ali nisu samo vojnici pod visokim rizikom od ovih oboljenja.

It's firefighters, ER doctors, cancer patients, aid workers, refugees --

Tu spadaju i vatrogasci, lekari hitne pomoći,

pacijenti oboleli od raka, humanitarci, izbeglice -

anyone exposed to trauma or major life stress.

svako ko je izložen traumi ili velikom životnom stresu.

And yet, despite how commonplace these disorders are,

A ipak, uprkos učestalosti ovih bolesti,

our current treatments, if they work at all,

naši sadašnji tretmani, ako uopšte deluju,

only suppress symptoms.

samo potiskuju simptome.

In 1798, when Edward Jenner discovered the first vaccine --

Godine 1798, kada je Edvard Džener otkrio prvu vakcinu -

it happened to be for smallpox --

bila je to vakcina za velike boginje -

he didn't just discover a prophylactic for a disease,

nije otkrio samo jednu preventivu za određenu bolest,

but a whole new way of thinking:

već potpuno nov način razmišljanja -

that medicine could prevent disease.

da lek može da spreči bolest.

However, for over 200 years,

Međutim, više od 200 godina,

this prevention was not believed to extend to psychiatric diseases.

nije se smatralo da se ova prevencija može proširiti na psihijatrijske bolesti.

Until 2014, when my colleague and I accidentally discovered

Sve do 2014. godine,

kada smo moje kolege i ja slučajno otkrili

the first drugs that might prevent depression and PTSD.

prve lekove koji mogu sprečiti depresiju i PTSP.

We discovered the drugs in mice,

Otkrili smo te lekove na miševima

and we're currently studying whether they work in humans.

i trenutno izučavamo da li deluju na ljudima.

And these preventative psychopharmaceuticals

Ovi preventivni psihofarmaci

are not antidepressants.

nisu antidepresivi.

They are a whole new class of drug.

To je potpuno nova vrsta lekova.

And they work by increasing stress resilience,

Deluju tako što povećavaju otpornost na stres,

so let's call them resilience enhancers.

pa hajde da ih nazovemo pojačivačima otpornosti.

So think back to a stressful time that you've since recovered from.

Setite se stresnog trenutka od koga ste se u međuvremenu oporavili.

Maybe a breakup or an exam, you missed a flight.

Možda je to bio raskid, ispit ili ste zakasnili na avion.

Stress resilience is the active biological process

Otpornost na stres je aktivni biološki proces

that allows us to bounce back after stress.

koji nam omogućava da se oporavimo nakon stresa.

Similar to if you have a cold and your immune system fights it off.

Slično je tome kad imate prehladu i vaš imuni sistem se bori protiv toga.

And insufficient resilience

Nedovoljna otpornost

in the face of a significant enough stressor,

pri suočavanju sa stresorom koji je dovoljno značajan

može dovesti do psihijatrijskog poremećaja kao što je depresija.

can result in a psychiatric disorder, such as depression.

In fact, most cases of major depressive disorder

Zapravo, većinu slučajeva teže depresije

are initially triggered by stress.

prvobitno je izazvao stres.

And from what we've seen so far in mice,

Na osnovu onoga što smo do sada videli kod miševa,

resilience enhancers can protect against purely biological stressors,

pojačivači otpornosti mogu da zaštite od čisto bioloških stresora

like stress hormones,

kao što su hormoni stresa,

and social and psychological stressors, like bullying and isolation.

kao i od društvenih i psiholoških stresora kao što je maltretiranje i izolovanost.

So here is an example where we gave mice

Evo primera u kome smo miševe izlagali

three weeks of high levels of stress hormones.

visokom nivou hormona stresa tokom tri nedelje.

So, in other words, a biological stressor without a psychological component.

Dakle, drugim rečima, biološki stres bez psihološke komponente.

And this causes depressive behavior.

To izaziva depresivno ponašanje.

And if we give three weeks of antidepressant treatment beforehand,

Ako im pre toga tri nedelje dajemo tretman antidepresivima,

it has no beneficial effects.

to nema značajnog uticaja.

But a single dose of a resilience enhancer given a week before

Ali samo jedna doza pojačivača otpornosti data nedelju dana pre ovog događaja

completely prevents the depressive behavior.

potpuno sprečava depresivno ponašanje.

Even after three weeks of stress.

Čak i nakon tri nedelje stresa.

This is the first time a drug has ever been shown

Ovo je prvi put da se pokazalo da neki lek

to prevent the negative effects of stress.

sprečava negativno dejstvo stresa.

Depression and PTSD are chronic, often lifelong, clinical diseases.

Depresija i PTSP su hronične i često doživotne kliničke bolesti.

They also increase the risk of substance abuse, homelessness,

Takođe povećavaju rizik od bolesti zavisnosti, beskućništva,

heart disease, Alzheimer's, suicide.

srčanih oboljenja, Alchajmerove bolesti i samoubistva.

The global cost of depression alone is over three trillion dollars per year.

Cena lečenja samo depresije u svetu je preko tri biliona dolara godišnje.

But now, imagine a scenario where we know someone is predictively

Ali, sada zamislite scenario u kome znamo da je neko pouzdano

at high risk for exposure to extreme stress.

pod visokim rizikom od izloženosti ekstremnom stresu.

Say, a red cross volunteer going into an earthquake zone.

Recimo, volonterka Crvenog krsta koja ide u zonu zemljotresa.

In addition to the typhoid vaccine,

Pored vakcine protiv tifusa,

we could give her a pill or an injection of a resilience enhancer

možemo joj dati pilulu ili injekciju pojačivača otpornosti

before she leaves.

pre nego što ode.

So when she is held at gunpoint by looters or worse,

Time, kada pljačkaši upere oružje u nju ili se desi nešto još gore,

she would at least be protected against developing depression or PTSD

ona je makar zaštićena od razvijanja depresije ili PTSP-a

after the fact.

nakon događaja.

It won't prevent her from experiencing the stress,

To neće sprečiti da doživi stres,

but it will allow her to recover from it.

ali će joj omogućiti da se oporavi od njega.

And that's what's revolutionary here.

To je ono što je ovde revolucionarno.

By increasing resiliency,

Povećanjem otpornosti,

we can dramatically reduce her susceptibility to depression and PTSD,

možemo drastično smanjiti njenu podložnost depresiji i PTSP-u,

possibly saving her from losing her job, her home, her family or even her life.

čime je potencijalno spasavamo od gubitka posla, kuće, porodice ili čak života.

After Jenner discovered the smallpox vaccine,

Nakon što je Džener otkrio vakcinu protiv velikih boginja,

a lot of other vaccines rapidly followed.

ubrzo je usledilo mnogo drugih vakcina.

But it was over 150 years

Ali prošlo je više od 150 godina

before a tuberculosis vaccine was widely available.

dok vakcina protiv tuberkuloze nije postala široko dostupna.

Why?

Zašto?

In part because society believed

Delimično zato što je društvo verovalo

that tuberculosis made people more sensitive and creative and empathetic.

da je tuberkuloza činila ljude osetljivijim,

kreativnijim i saosećajnijim,

And that it was caused by constitution and not biology.

i da je uzrokovana duševnim sklopom, a ne biologijom.

And similar things are still said today about depression.

Slične stvari se i danas govore u vezi sa depresijom.

And just as Jenner's discovery opened the door

Kao što je i Dženerovo otkriće

otvorilo vrata svim vakcinama koje su nakon toga usledile,

for all of the vaccines that followed after,

the drugs we've discovered open the possibility of a whole new field:

lekovi koje smo otkrili otvaraju mogućnost potpuno novog polja:

preventative psychopharmacology.

preventivne psihofarmakologije.

But whether that's 15 years away,

Ali da li će se to desiti za 15

or 150 years away,

ili 150 godina,

depends not just on the science,

zavisi ne samo od nauke,

but on what we as a society choose to do with it.

već i od onoga što mi kao društvo odlučimo da uradimo sa njom.

Thank you.

Hvala.

(Applause)

(Aplauz)