Mark Kendall: Demo: A needle-free vaccine patch that's safer and way cheaper

翻译人员: Kelly Tang 校对人员: Xuwen Zhu

It's a pleasure to be here

我非常高兴能来到

in Edinburgh, Scotland,

苏格兰的爱丁堡--

the birthplace of the needle and syringe.

这个针和注射器诞生的地方。

Less than a mile from here in this direction,

1853年，就在从这个方向出去不到1英里远的地方，

in 1853 a Scotsman

一位苏格兰人

filed his very first patent on the needle and syringe.

首次申请了针和注射器的专利。

His name was Alexander Wood,

他的名字叫亚历山大·伍德（Alexander Wood），

and it was at the Royal College of Physicians.

他是在皇家医师学院孕育出这项发明的。

This is the patent.

这个就是他当时申请的专利。

What blows my mind when I look at it even today

令我感到不可思议的是

is that it looks almost identical

现在看当时的发明，

to the needle in use today.

依然觉得它和我们今天使用的针几乎一模一样。

Yet, it's 160 years old.

然而，它已经出现了160年。

So we turn to the field of vaccines.

让我们来看看疫苗。

Most vaccines are delivered with

大多数的疫苗都是由针和注射器，

the needle and syringe, this 160-year-old technology.

这个已有160年历史的器材来完成注射的 。

And credit where it's due -- on many levels,

疫苗接种从很多意义上来说

vaccines are a successful technology.

都是一项成功的技术。

After clean water and sanitation,

继清洁水和卫生设施之后，

vaccines are the one technology that has increased

疫苗接种是对延长人类寿命

our life span the most.

贡献最大的一项技术。

That's a pretty hard act to beat.

这一点很难被超越。

But just like any other technology,

然而，和其他任何技术一样，

vaccines have their shortcomings,

疫苗接种也有它的不足之处。

and the needle and syringe

而针头注射，

is a key part within that narrative --

这一古老的技术

this old technology.

就是其中主要的问题所在。

So let's start with the obvious:

让我们从最明显的说起：

Many of us don't like the needle and syringe.

我们中的很多人都不喜欢针和注射器。

I share that view.

我也是这样的。

However, 20 percent of the population

然而，20%的人口都有

have a thing called needle phobia.

针头恐惧症，

That's more than disliking the needle;

这可不仅仅是不喜欢针头那么简单。

that is actively avoiding being vaccinated

这些人会因为对针头的恐惧

because of needle phobia.

而极其排斥接种疫苗。

And that's problematic in terms of the rollout of vaccines.

这就给疫苗的普及带来很多问题。

Now, related to this is another key issue,

和这个相关的还有另一个主要问题，

which is needlestick injuries.

那就是针头伤害。

And the WHO has figures

根据世界卫生组织的数据表明

that suggest about 1.3 million deaths per year

每年约有130万人死于

take place due to cross-contamination

由针头伤害造成的

with needlestick injuries.

交叉污染。

These are early deaths that take place.

它造成了很多人的早死。

Now, these are two things that you probably may have heard of,

这两个关于针和注射器的不足之处

but there are two other shortcomings

你们可能听说过，

of the needle and syringe you may not have heard about.

但是还有另外两个你们可能还没听说过。

One is it could be holding back

一个是它在免疫反应上

the next generation of vaccines

阻碍了

in terms of their immune responses.

新一代疫苗的研制。

And the second is that it could be responsible

另一个是它可能是造成冷链问题的原因，

for the problem of the cold chain that I'll tell you about as well.

冷链问题我稍后会讲到。

I'm going to tell you about some work

接下来我要跟你们讲一讲

that my team and I are doing in Australia

我和我的团队在澳大利亚昆士兰大学

at the University of Queensland

就解决这四个问题的技术

on a technology designed to tackle those four problems.

所做的一些研究。

And that technology is called the Nanopatch.

这项技术叫做纳米贴片(Nanopatch)。

Now, this is a specimen of the Nanopatch.

这是纳米贴片的一个样品。

To the naked eye

肉眼来看

it just looks like a square

它像是比邮票小的

smaller than a postage stamp,

一个小方片。

but under a microscope

但是在显微镜下，

what you see are thousands of tiny projections

你将会看到成千上万的微小的突出物。

that are invisible to the human eye.

它们是无法被人眼看到的。

And there's about 4,000 projections

与针相比，

on this particular square compared to the needle.

这个小方片上有大约4000个突出物。

And I've designed those projections

我之所以设计这些突出物，有一个关键的原因

to serve a key role, which is to work with the skin's immune system.

是为了能让它们和皮肤的免疫系统相适应。

So that's a very important function

这是纳米贴片的

tied in with the Nanopatch.

一个非常重要的功能。

Now we make the Nanopatch

在制作纳米贴片时

with a technique

我们采用了一个技术，

called deep reactive ion etching.

叫做深反应离子蚀刻技术。

And this particular technique is one that's been borrowed

这一特别的技术

from the semiconductor industry,

是我们从半导体工业借鉴来的。

and therefore is low cost

因此它非常便宜，

and can be rolled out in large numbers.

可以大规模生产。

Now we dry-coat vaccines to the projections of the Nanopatch

我们将疫苗涂在纳米贴片的突出物上，

and apply it to the skin.

之后将它置于皮肤上。

Now, the simplest form of application

置于皮肤最简单的方式

is using our finger,

是用我们的手指，

but our finger has some limitations,

但是我们的手指有一些局限性，

so we've devised an applicator.

因此我们设计了一个辅助器。

And it's a very simple device --

这个辅助器使用起来非常简单--

you could call it a sophisticated finger.

你可以叫它高级手指。

It's a spring-operated device.

它是由弹簧控制的。

What we do is when we apply the Nanopatch to the skin as so --

我们要做的就是像这样

(Click) --

将纳米贴片打在皮肤上，

immediately a few things happen.

这样一下子有几件事情发生。

So firstly, the projections on the Nanopatch

首先，纳米贴片上的突出物

breach through the tough outer layer

穿透了坚硬的皮肤表层，

and the vaccine is very quickly released --

之后疫苗被迅速释放--

within less than a minute, in fact.

事实上过程不到一分钟。

Then we can take the Nanopatch off

之后我们就可以将纳米贴片取下来，

and discard it.

把它丢掉。

And indeed we can make a reuse of the applicator itself.

但是我们可以重复使用辅助器。

So that gives you an idea of the Nanopatch,

这就是纳米贴片的工作原理，

and immediately you can see some key advantages.

我们能立马看到它的几个主要优势。

We've talked about it being needle-free --

它没有针头，

these are projections that you can't even see --

你甚至无法看到这些突出物。

and, of course, we get around

因此我们也就解决了

the needle phobia issue as well.

针头恐惧症这个问题。

Now, if we take a step back and think about

现在，我们退后一步想一想

these other two really important advantages:

它其它两个非常重要的优势：

One is improved immune responses through delivery,

一是它通过特殊的接种方式提高了免疫反应，

and the second is getting rid of the cold chain.

二是它没有冷链要求。

So let's start with the first one, this immunogenicity idea.

让我们先从第一个说起，即免疫原性的概念。

It takes a little while to get our heads around,

这是一个较难理解的概念，

but I'll try to explain it in simple terms.

但是我会试着用简单的语言解释它。

So I'll take a step back and explain to you

我现在退回一步，用一种简单的方式

how vaccines work in a simple way.

告诉你疫苗是如何工作的。

So vaccines work by introducing into our body

疫苗是将一个叫做抗原的东西

a thing called an antigen

注射到我们的体内，

which is a safe form of a germ.

而抗原是病菌的一种安全形式。

Now that safe germ, that antigen,

这一安全的病菌，即抗原

tricks our body into mounting an immune response,

之后诱使我们的身体产生免疫反应，

learning and remembering how to deal with intruders.

并学习和记忆如何对抗入侵者。

When the real intruder comes along

当真正的入侵者到来的时候，

the body quickly mounts an immune response

身体会迅速调动起

to deal with that vaccine

之前用于对抗疫苗的免疫反应

and neutralizes the infection.

来消除感染。

So it does that well.

它就是这么有效。

Now, the way it's done today with the needle and syringe,

而我们今天大多数的疫苗接种

most vaccines are delivered that way --

都是由针和注射器，

with this old technology and the needle.

这一古老的器具完成的。

But it could be argued that the needle is holding back our immune responses;

然而针可以说阻碍了我们的免疫反应，

it's missing our immune sweet spot in the skin.

因为它无法到达皮肤上最好的免疫位置。

To describe this idea,

为了更好地理解这一概念，

we need to take a journey through the skin,

我们需要先了解下皮肤。

starting with one of those projections

我们先从其中一个突出物

and applying the Nanopatch to the skin.

和将纳米贴片置于皮肤上的过程说起。

And we see this kind of data.

我们会看到这样一种情况，

Now, this is real data --

这是真实的情况--

that thing that we can see there is one projection

纳米贴片上的一个突出物

from the Nanopatch that's been applied to the skin

已经进入到了皮肤，

and those colors are different layers.

不同的颜色代表着不同的组织层。

Now, to give you an idea of scale,

关于它有多大我可以给你们一个参照，

if the needle was shown here, it would be too big.

如果图片里是针的话，

It would be 10 times bigger

它将会是屏幕的10倍大，

than the size of that screen, going 10 times deeper as well.

并且还要有10倍深。

It's off the grid entirely.

它已经完全在坐标之外了。

You can see immediately that we have those projections in the skin.

你能立马看到这些突出物已经在皮肤里了。

That red layer is a tough outer layer of dead skin,

红色的那一层是坏死皮肤的外部硬层，

but the brown layer and the magenta layer

但是棕色和紫色的那两层

are jammed full of immune cells.

却充满了免疫细胞。

As one example, in the brown layer

举个例子，在棕色层中

there's a certain type of cell called a Langerhans cell --

有一类特定细胞叫做朗格汉斯细胞，

every square millimeter of our body

我们身体里的每平方毫米

is jammed full of those Langerhans cells,

都充满了这些朗格汉斯细胞，

those immune cells, and there's others shown as well

即免疫细胞，

that we haven't stained in this image.

其它细胞也有，只是未在图片中染色出来。

But you can immediately see that the Nanopatch

但是你能立马看到纳米贴片

achieves that penetration indeed.

确实完成了需要的穿透。

We target thousands upon thousands of these particular cells

我们只占用了皮肤表面

just residing within a hair's width

一根头发的宽度，

of the surface of the skin.

就达到了那些成千上万的特殊细胞。

Now, as the guy that's invented this thing and designed it to do that,

作为纳米贴片的发明者和设计者，

I found that exciting. But so what?

我觉得这一点非常令人激动。

So what if you've targeted cells?

但是那又怎样？你能达到那些细胞又怎样？

In the world of vaccines, what does that mean?

对疫苗来说这意味着什么？

The world of vaccines is getting better.

当今疫苗领域在不断发展进步，

It's getting more systematic.

它正变得更具系统性。

However, you still don't really know

然而，在你撸起袖子、

if a vaccine is going to work

开始接种疫苗、

until you roll your sleeves up

接着等待之前，

and vaccinate and wait.

你仍然不知道疫苗是否会有效。

It's a gambler's game even today.

它在今天看来依然是一场赌博游戏。

So, we had to do that gamble.

我们也需要做这样的赌博。

We obtained an influenza vaccine,

当我们拿到一株流感疫苗，

we applied it to our Nanopatches

将它涂在我们的纳米贴片上，

and we applied the Nanopatches to the skin,

再将贴片置于皮肤上，

and we waited --

然后我们就等着--

and this is in the live animal.

因为我们是应用在活体中。

We waited a month,

我们等了一个月，

and this is what we found out.

这是我们发现的。

This is a data slide showing the immune responses

这一份数据显示了

that we've generated with a Nanopatch

和针注射到肌肉里相比，

compared to the needle and syringe into muscle.

使用纳米贴片产生的免疫反应。

So on the horizontal axis we have the dose shown in nanograms.

横坐标代表着以毫微克为单位的剂量大小。

On the vertical axis we have the immune response generated,

纵坐标代表着所产生的免疫反应。

and that dashed line indicates the protection threshold.

短划线则代表着保护临界值。

If we're above that line it's considered protective;

如果在那个线上，则意味着是受保护的；

if we're below that line it's not.

如果在线下，则是不受保护的。

So the red line is mostly below that curve

我们能看到，红色的线大多时候都在线下；

and indeed there's only one point that is achieved with the needle that's protective,

实际上用针注射的时候只有一个点是在线上，即具有保护性，

and that's with a high dose of 6,000 nanograms.

那是当剂量高达6,000毫微克的时候。

But notice immediately the distinctly different curve

与之相比，我们能立马注意到

that we achieve with the blue line.

那条蓝色的线则有着非常大的差别。

That's what's achieved with the Nanopatch;

那是我们用纳米贴片得到的结果；

the delivered dose of the Nanopatch is

不同的纳米贴片剂量呈现出了

a completely different immunogenicity curve.

一个完全不同的免疫原性线。

That's a real fresh opportunity.

这意味着一个全新的机会。

Suddenly we have a brand new lever

在疫苗领域中

in the world of vaccines.

我们突然有了一个全新的杠杆。

We can push it one way,

我们可以这样子，

where we can take a vaccine that works but is too expensive

当一种疫苗有效但是太贵，

and can get protection

我们可以只用针注射剂量的百分之一

with a hundredth of the dose compared to the needle.

便可以达到保护的效果。

That can take a vaccine that's suddenly 10 dollars down to 10 cents,

这样原本10元钱的疫苗现在只需要1角钱，

and that's particularly important within the developing world.

这对发展中国家来说尤其重要。

But there's another angle to this as well --

我们也可以从这个角度来看--

you can take vaccines that currently don't work

你可以使用目前看来无效的疫苗，

and get them over that line

然后让它超过那条线，

and get them protective.

这样它们就具有保护性了。

And certainly in the world of vaccines

这在疫苗领域中

that can be important.

当然是非常重要的。

Let's consider the big three:

让我们来看看困扰世界的三大主要问题：

HIV, malaria, tuberculosis.

艾滋病, 疟疾和结核病。

They're responsible for about 7 million deaths per year,

它们每年造成大约700万人口死亡，

and there is no adequate vaccination method for any of those.

并且它们中的任何一个都没有足够的疫苗应对方法。

So potentially, with this new lever that we have with the Nanopatch,

因此，有了纳米贴片所带来的杠杆作用，

we can help make that happen.

我们将使疫苗成为可能。

We can push that lever to help get those candidate vaccines over the line.

我们可以通过杠杆使这些候选疫苗越过这条线。

Now, of course, we've worked within my lab

当然，在实验室里，

with many other vaccines that have attained

我们还对其它的疫苗进行了实验，

similar responses and similar curves to this,

并得到了和流感疫苗

what we've achieved with influenza.

相似的反应结果和类似的曲线。

I'd like to now switch to talk about

现在我要再讲讲

another key shortcoming of today's vaccines,

当今疫苗的另一个主要缺陷。

and that is the need to maintain the cold chain.

那就是要保持冷链处理。

As the name suggests -- the cold chain --

“冷链”，顾名思义

it's the requirements of keeping a vaccine right from production

就是指从疫苗生产

all the way through to when the vaccine is applied,

到使用的整个过程中

to keep it refrigerated.

都要保持低温处理。

Now, that presents some logistical challenges

这就给物流带来了一些挑战，

but we have ways to do it.

但是我们有办法解决它。

This is a slightly extreme case in point

这是一个有点极端的例子，

but it helps illustrate the logistical challenges,

但是它能帮助解释

in particular in resource-poor settings,

尤其是在资源贫乏的环境中，

of what's required to get vaccines

使疫苗持续保持在低温状态

refrigerated and maintain the cold chain.

所面临的物流方面的挑战。

If the vaccine is too warm the vaccine breaks down,

如果疫苗的温度太高，它就会失效。

but interestingly it can be too cold

但是有意思的是，

and the vaccine can break down as well.

如果疫苗的温度太低，它也会失效。

Now, the stakes are very high.

目前，疫苗的失效率很高。

The WHO estimates that within Africa,

据世界卫生组织估计，

up to half the vaccines used there

在非洲有高达一半的疫苗

are considered to not be working properly

并没有正常发挥作用，

because at some point the cold chain has fallen over.

因为冷链在某一环节遭到破坏。

So it's a big problem, and it's tied in with the needle and syringe

这是由针和注射器引起的一个很大的问题，

because it's a liquid form vaccine, and when it's liquid it needs the refrigeration.

因为疫苗如果是液体的，它就需要冷藏。

A key attribute of our Nanopatch

而纳米贴片的一个主要特点就是

is that the vaccine is dry,

疫苗是干燥的，

and when it's dry it doesn't need refrigeration.

当它是干燥的时候，它就无需冷藏。

Within my lab we've shown that we can keep

我们经过实验发现，

the vaccine stored at 23 degrees Celsius

干燥的疫苗在被置于23摄氏度长达一年多的时间内

for more than a year without any loss in activity at all.

没有任何效用丧失的情况出现。

That's an important improvement.

这是一个非常重要的改进。

(Applause)

(掌声)

We're delighted about it as well.

我们对这一改进也非常激动。

And the thing about it is that we have well and truly proven

然而，尽管我们在实验室中已经完完全全地

the Nanopatch within the laboratory setting.

验证了纳米贴片的应用性，

And as a scientist, I love that and I love science.

作为一名科学家，我很爱这一点，我也热爱科学；

However, as an engineer,

然而， 作为一名工程师，

as a biomedical engineer

一名生物医学工程师，

and also as a human being,

同时也是芸芸众生中的一员，

I'm not going to be satisfied

我将不会对这一发现感到满意，

until we've rolled this thing out, taken it out of the lab

除非我们能把它应用在现实生活中，

and got it to people in large numbers

让芸芸众生都能从中受益，

and particularly the people that need it the most.

尤其是那些最需要这项技术的人们。

So we've commenced this particular journey,

这就是我们为什么开始从事接下来的这一项事业，

and we've commenced this journey in an unusual way.

而且是以一种不同寻常的方式。

We've started with Papua New Guinea.

我们选择先从巴布亚新几内亚开始应用这一新技术。

Now, Papua New Guinea is an example of a developing world country.

巴布亚新几内亚是一个典型的发展中国家。

It's about the same size as France,

它和法国的国土面积相近。

but it suffers from many of the key barriers

但它却面临着当今疫苗领域

existing within the world of today's vaccines.

存在的许多主要问题。

There's the logistics:

他们的物流情况是这样的:

Within this country there are only 800 refrigerators to keep vaccines chilled.

全国只有800个冷藏箱用于冷藏疫苗。

Many of them are old, like this one in Port Moresby, many of them are breaking down

许多冷藏箱已经非常旧了，例如莫尔兹比港的这一个。还有很多就要不能用了。

and many are not in the Highlands where they are required.

很多还不在需要疫苗的新几内亚高地地区。

That's a challenge.

这是一个很大的挑战。

But also, Papua New Guinea has the world's highest incidence of HPV,

同时， 巴布亚新几内亚也是世界上乳头状瘤病毒发病率最高的国家。

human papillomavirus, the cervical cancer [risk factor].

它是子宫颈癌发生的风险因素。

Yet, that vaccine is not available in large numbers

然而，针对此类疾病的疫苗还未能被大量使用，

because it's too expensive.

因为它太昂贵了。

So for those two reasons, with the attributes of the Nanopatch,

因此基于这两个原因，

we've got into the field and worked with the Nanopatch,

再加上纳米贴片自身的特点，

and taken it to Papua New Guinea

我们将纳米贴片带到巴布亚新几内亚，

and we'll be following that up shortly.

并很快将会对其结果进行追踪。

Now, doing this kind of work is not easy.

做这样的一项事业不容易，

It's challenging,

它非常具有挑战性，

but there's nothing else in the world I'd rather be doing.

但是世界上再没有其它事情让我们更想去做。

And as we look ahead

展望未来，

I'd like to share with you a thought:

我想要跟你们分享一个预见:

It's the thought of a future where

在未来，

the 17 million deaths per year

每年有1700万人口死于传染病

that we currently have due to infectious disease

这一我们目前面临的残酷现实

is a historical footnote.

将会永远被封存在历史当中。

And it's a historical footnote that has been achieved

这是由于我们拥有了

by improved, radically improved vaccines.

更有效、更强大的疫苗。

Now standing here today in front of you

今天我站在你们面前，

at the birthplace of the needle and syringe,

站在这个针和注射器诞生、

a device that's 160 years old,

并距今已有160年历史的地方，

I'm presenting to you an alternative approach

向你们展示另一个颠覆疫苗领域的新技术，

that could really help make that happen --

那就是纳米贴片技术--

and it's the Nanopatch with its attributes of being needle-free, pain-free,

它没有针头，不会带来疼痛，

the ability for removing the cold chain and improving the immunogenicity.

无需冷藏，并能提升免疫原性。

Thank you.

谢谢！

(Applause)

(掌声)