Aaron Morris: How your body could become its own diagnostic lab | TED Fellows

翻译人员: Jiasi Hao 校对人员: Carol Wang

[SHAPE YOUR FUTURE]

[塑造你的未来]

(Slam) Ow!

（砰！） 我的妈！

As anyone who’s stubbed a toe in the dark

在黑暗里撞到过脚趾

or spent an hour searching for their keys knows

或是曾花一小时找钥匙的人知道，

we're often limited by what we can or cannot see.

我们时常受限于 自身看到或看不到的东西。

In fact, even our own bodies can be black boxes.

实际上，甚至我们的身体， 也可以是黑匣子。

Today, I want to take you through a vision of health care

今天，我想带你了解 科学家和工程师们，包括我，

that scientists and engineers, myself included, are building.

正在构建的一个医疗保健愿景。

We are creating a diagnostic lab inside your body

我们正在创造一个 位于身体内部的诊断实验室，

that can provide a continuous analysis of your health

这个实验室 可以持续提供健康分析报告，

so that we can better see what's happening in patients.

从而我们能更好地了解病人的情况。

Currently, if someone is sick,

最近，如果一个人病了，

we may diagnose them by using a biopsy

我们或许可以通过活检 进行诊断——

to bring disease tissue outside the body where we can see it.

也就是将病变组织取到身体外 我们能看到的地方。

We do this if we suspect, for instance, that a growth might be cancerous.

如果有怀疑病因，才会进行活检， 比如细胞生长可能出现癌变。

Unfortunately, this approach can't work all the time

不幸的是，由于以下两个主要问题，

because of two major problems.

这种方法并不通用。

First, some tissues, like brains or spinal cords,

首先，大脑或脊髓等组织

can't be routinely biopsied.

是无法进行常规活检的。

And second, doctors often don't know which tissue is causing the problem,

其次，医生通常不知道 哪个组织出了问题，

so they don't know what to biopsy.

因此他们无法判断 针对哪个组织进行活检。

So far, we've dealt with these issues using external medical tests,

时至今日，为解决上述问题， 我们借助体外测试，

like MRIs or blood tests.

例如磁共振成像或血液测试。

These provide a broad overview of the health of a patient,

这些测试可以为病人健康 提供一个宽泛的概览，

but they can't see the molecular and cellular changes

但是，它们无法检测到

发生在组织内部的分子和细胞变化，

that occur within tissues,

and they certainly can't provide enough information

并且无法在症状出现之前

to proactively treat patients before symptoms develop.

给予足够的信息用以积极治疗。

This is unfortunate

这很不幸，

because it's these invisible changes that ultimately cause disease.

因为这些看不见的变化 最终会导致疾病。

Our inability to measure these changes

我们对测量这些变化的束手无策

results in a disparity between what we can see on a test

造成了差异——

我们在测试结果上看到的问题

and what we know is happening in patients.

和我们所了解的病人症状的差异。

Let's take multiple sclerosis as an example.

让我用多发性硬化症（MS）举例。

In MS, which is an autoimmune disease,

MS 是一种自身免疫性疾病，

the immune system attacks two specific tissues:

免疫系统会攻击两个特定组织：

the brain and the spinal cord,

大脑和脊髓，

resulting in damage and in some cases, paralysis.

因此造成损害， 有些病例则致瘫痪。

Now, we obviously can't catch MS by routinely biopsying people's brains,

现在，我们显然无法通过对人脑 进行常规活检来诊断 MS ，

where there would be abundant and active disease-inducing cells.

即使在人脑处可能聚集着 大量且活跃的病变细胞。

And we can't catch it using a blood test

而且我们无法用血液测试来诊断 MS ，

because the MS-inducing cells are so rare and inactive in the blood

因为血液中含有的 MS 病变细胞 很少且不活跃，

that we simply can't see them.

我们单纯就看不到它们。

Even brain imaging technologies like MRI can't provide the information we need

即使磁共振成像检查这类脑成像技术 也无法提供充足的信息

to be proactive about MS.

让我们积极预防 MS 。

So we need to rethink how we see.

所以我们需要重新思考“看”的方式，

My coworkers at the University of Michigan and I decided to do just that.

我和我在密歇根大学的同事 就决定做这件事。

Instead of taking an outside-in approach to diagnostics,

与前面说的 从外到内的诊断方式不同，

we're taking an inside-out approach.

我们正在使用由内至外的方式。

We are creating implantable sites

我们正在创造可植入的部位——

that have similarities to other sites in the body,

它们和身体的其它部位 具有相似性，

and will improve our vision by giving us real-time access

并能通过对病变组织的 分子和细胞信息的实时访问

to molecular and cellular information about diseased tissues.

来改善我们的“视野”。

These insights will enable us to predict the onset of disease

对于这些信息的洞察 能使我们预测发病时间，

and even identify therapies likely to work in an individual patient.

甚至分辨出对某一位病人 哪种治疗手段可能有效。

So what does this inside-out approach look like?

所以这种由内至外的方法 到底是怎样的？

Step one is to engineer new tissues just under the skin.

第一步就是在皮肤下 设计新的组织。

These tissues have similarities to other inaccessible sites in the body,

这些新组织和身体中其它 无法接触到的部分，如大脑或肺部，

like the brain or the lungs.

有着相似之处。

By implanting a porous plastic disk made of FDA-approved biomaterials,

通过植入由 FDA 批准的生物材料 制成的多孔塑料盘，

I can harness the body's natural responses to allow cells to migrate into the disk,

我可以利用身体的自然反应 把细胞转移到塑料盘中，

survive at the site and form a tissue.

在盘中得以生存并形成组织。

Eventually, we're left with an engineered tissue

最终，我们得到了 一个携带集成免疫细胞的

with integrated immune cells,

工程组织，

just the cells we need for diagnosis.

只是我们诊断所需的细胞。

Although these tissues are complex and chronically inflamed,

尽管这些组织十分复杂 且长期处于发炎状态，

they're also innocuous

但它们是无害的，

and after a few weeks, nearly imperceptible.

在植入的几周后 几乎无法察觉到它们的存在。

Our engineered tissues contain information not present in the blood,

我们的工程组织 可以检测到血液无法显示的信息，

and they can help bridge the gap

并且能填补

between what we can see on a traditional test

我们在传统测试中看到的

and cellular changes we know occur in disease.

以及我们所知晓的细胞病变的差异。

Step two is to read this signal.

第二步，就是阅读这个信号。

Currently, I could take a biopsy of my engineered site and analyze it

因为我把这些工程组织 就植在皮肤之下，

because I made them accessible just under the skin.

所以我可以在这个部位 做活检并进行分析。

But it would certainly be better

但当然如果我们能使用

if we could incorporate and read a sensor noninvasively.

无创感应器并读取它的数字会更棒。

Within the next decade,

在未来 10 年内，

rapidly converging technologies could enable diagnosis at such an implant

快速发展的融合技术 可以利用简单的检测器

by harnessing simple detectors,

促进对上述的植入方式的诊断，

like a blood pressure cuff or smartwatch does now.

好比如今的 血压袖带和智能手表，

The mechanisms for diagnosing and monitoring disease

诊断和监测疾病的机制

could be as simple as opening an app, like Candy Crush on your phone.

可以和打开你手机上的 应用程序一样简单。

Step three is to harness the huge array of knowledge

第三步，利用广泛的

in fields like engineering and material science

工程和材料科学等领域的知识，

to improve these implants and our ability to read their data.

来改进这些植入设备 以及我们从中读取信息的能力。

Eventually, tens, if not hundreds of individual engineered tissues

最终，如果不是上百个， 也有几十个个性化携带集成感应器的

with integrated sensors

工程组织

may be implantable with a single application.

或许可以通过 一个简单的应用程序植入。

Now, this approach to diagnosis is unconventional, to be sure,

现在，可以确定的是 这个诊断方法非常创新，

but it is robust.

但也是稳健的。

So far, my colleagues and I have used it

至今，我和我的同事 已经用这个方法

to diagnose models of metastatic cancer,

来诊断各种疾病的模型——

type 1 diabetes, multiple sclerosis and organ transplant rejection.

例如转移性癌症、 1 型糖尿病、 多发性硬化症和器官移植排斥。

But this is just the beginning of what we can see.

但这只是我们所“看”的开端。

With continuous improvements,

随着方法的不断改进，

we will be able to truly create

我们将能真正地创建

a diagnostic lab inside your body

一个可以提供连续健康报告的

that provides a continuous analysis of your health.

体内诊断实验室。

By changing how we see what's going wrong in patients,

通过改变我们看到患者问题的方式，

we will be able to diagnose and treat diseases better

我们便可以达到一个前所未有的

and faster than ever before.

诊断和治疗疾病的质量和速度。

If you're willing to rethink how you see,

如果你愿意重新思考“看”的方式，

you may be surprised what comes into view.

你或许会为自己看到的风景 感到惊讶。

Thank you.

谢谢。