Nina Tandon: Could tissue engineering mean personalized medicine?

Translator: Joseph Geni Reviewer: Morton Bast

翻译人员: 嘉宇 王 校对人员: Catherina Pan

I'd like to show you a video of some of the models

我想让大家看一段模特儿的影片

I work with.

他们是我的工作伙伴

They're all the perfect size, and they don't have an ounce of fat.

他们都有完美的身材，没有一丁点脂肪

Did I mention they're gorgeous?

我有说过他们超美的吗？

And they're scientific models? (Laughs)

还有他们是科学模特儿吗？ (笑声)

As you might have guessed, I'm a tissue engineer,

你们可能会猜对了，我是个组织工程学家

and this is a video of some of the beating heart

这段影片是在拍摄跳动的心脏

that I've engineered in the lab.

这是我在实验室设计的

And one day we hope that these tissues

我们希望有一天，这些组织

can serve as replacement parts for the human body.

可以当作某些人体器官的替代品

But what I'm going to tell you about today

但是我今天要跟大家说的

is how these tissues make awesome models.

是为什么这些组织能成为顶尖的模特儿(模型)

Well, let's think about the drug screening process for a moment.

好，让我们先来看看药物检验的流程

You go from drug formulation, lab testing, animal testing,

从药物配方、实验室测试、动物测试

and then clinical trials, which you might call human testing,

到临床测试，也可以称之为人体实验

before the drugs get to market.

完成这些步骤才会上市

It costs a lot of money, a lot of time,

这样的流程很花钱，很费时

and sometimes, even when a drug hits the market,

甚至有时候连已经上市的药物

it acts in an unpredictable way and actually hurts people.

都会让人体产生无法预测的反应，造成实质的伤害

And the later it fails, the worse the consequences.

而且问题发现得越晚，后果就会越严重

It all boils down to two issues. One, humans are not rats,

我们将之简化为两个问题。 第一，人类不是老鼠

and two, despite our incredible similarities to one another,

第二，尽管人和人之间的差异微乎其微

actually those tiny differences between you and I

但是我们之间这些微小的差异

have huge impacts with how we metabolize drugs

却让我们代谢药物的反应和药效

and how those drugs affect us.

有天壤之别

So what if we had better models in the lab

所以，如果说我们的实验室使用了更好的模型

that could not only mimic us better than rats

而这些模型不单只是比老鼠更接近人类

but also reflect our diversity?

还可以反映出人体的多元性呢?

Let's see how we can do it with tissue engineering.

我们来看看，组织工程学能做些什么

One of the key technologies that's really important

其中一项至关重要的关键科技

is what's called induced pluripotent stem cells.

我们称之为"诱导性多功能干细胞"

They were developed in Japan pretty recently.

最近由日本发展出来的

Okay, induced pluripotent stem cells.

好，诱导性多功能干细胞

They're a lot like embryonic stem cells

和胚胎干细胞有许多相似之处

except without the controversy.

只是前者没有道德争议性

We induce cells, okay, say, skin cells,

我们诱导细胞生长，举例来说，皮肤细胞

by adding a few genes to them, culturing them,

的方式是植入微量的基因，培养它们

and then harvesting them.

接着就可以采收

So they're skin cells that can be tricked,

所以我们可以欺骗这些皮肤细胞

kind of like cellular amnesia, into an embryonic state.

可以说是让细胞罹患失忆症，让他们变回胚胎模式

So without the controversy, that's cool thing number one.

因此没有道德争议性，这是第一个好处

Cool thing number two, you can grow any type of tissue

第二个好处是，你可以用它培养出任何的组织

out of them: brain, heart, liver, you get the picture,

大脑、心脏、肝脏，你们都知道的

but out of your cells.

都是出于自己的细胞

So we can make a model of your heart, your brain

所以我们可以做出你的心脏，你的大脑的模版

on a chip.

在晶片上

Generating tissues of predictable density and behavior

培育出密度和行为模式可预测的组织

is the second piece, and will be really key towards

是第二步骤，这个进展非常重要

getting these models to be adopted for drug discovery.

使得这些模型能应用于药物测试

And this is a schematic of a bioreactor we're developing in our lab

这张图是我们实验室正在发展的生物反应器

to help engineer tissues in a more modular, scalable way.

它能提高组织工程进行时的模式性和控制性

Going forward, imagine a massively parallel version of this

未来，你们想像一下许多台这种仪器并联在一起的样子

with thousands of pieces of human tissue.

里面有数以千计的人类组织

It would be like having a clinical trial on a chip.

就好像在晶片上面进行临床试验

But another thing about these induced pluripotent stem cells

关于诱导性多功能干细胞，还有另外一件事

is that if we take some skin cells, let's say,

那就是如果我们采集了一些皮肤细胞，例如说

from people with a genetic disease

从有遗传性疾病的人身上

and we engineer tissues out of them,

然后我们从中培育出一些组织

we can actually use tissue-engineering techniques

我们可以实际利用组织工程的技术

to generate models of those diseases in the lab.

在实验室里培育这些疾病的模型

Here's an example from Kevin Eggan's lab at Harvard.

这个例子来自Kevin Eggin在哈佛的实验室

He generated neurons

他培养出神经元

from these induced pluripotent stem cells

从诱导性多功能干细胞中

from patients who have Lou Gehrig's Disease,

样本来自Lou Gehrig症(肌肉萎缩性侧索硬化症) 的病患

and he differentiated them into neurons, and what's amazing

他将它们分化成神经元，不可思议的是

is that these neurons also show symptoms of the disease.

这些神经元也反应出该疾病的症状

So with disease models like these, we can fight back

所以有了这些疾病的模型，我们能以前所未有的速度

faster than ever before and understand the disease better

反击它们（疾病），还能以前所未有的角度

than ever before, and maybe discover drugs even faster.

了解它们，甚至能加快药物研发的脚步

This is another example of patient-specific stem cells

这是另一个例子，这种遗传性疾病干细胞

that were engineered from someone with retinitis pigmentosa.

是从自色素性视网膜炎的患者培育出来的

This is a degeneration of the retina.

这种病导致视网膜的衰退

It's a disease that runs in my family, and we really hope

这是我们家族成员常罹患的疾病，我们真的很希望

that cells like these will help us find a cure.

这类的干细胞可以帮助我们找到解药

So some people think that these models sound well and good,

因此，有些人认为这些模型看起来完美无缺

but ask, "Well, are these really as good as the rat?"

但是他们会问： "这些细胞真的跟小白鼠一样好用吗？"

The rat is an entire organism, after all,

毕竟老鼠是完整的生物体

with interacting networks of organs.

器官之间有完整的互动网路

A drug for the heart can get metabolized in the liver,

用于心脏的药会在肝脏代谢

and some of the byproducts may be stored in the fat.

而且有些药效副产品可能会储存在脂肪

Don't you miss all that with these tissue-engineered models?

这些效果在组织工程的模型上不是都看不出来吗？

Well, this is another trend in the field.

没错，这是这领域的另外一个研究趋势

By combining tissue engineering techniques with microfluidics,

将组织工程的技术与微流学结合在一起

the field is actually evolving towards just that,

实际上，这个领域正朝这个方向发展

a model of the entire ecosystem of the body,

人体全生态系统的模型

complete with multiple organ systems to be able to test

必须包含复合的器官系统才得以测试

how a drug you might take for your blood pressure

为了控制血压而服用的药物

might affect your liver or an antidepressant might affect your heart.

可能会影响你的肝脏，服用抗忧郁剂或许会影响你的心脏

These systems are really hard to build, but we're just starting to be able to get there,

这些系统很难架构，但是我们开始着手进行了

and so, watch out.

所以，等着看吧

But that's not even all of it, because once a drug is approved,

但是这还不是全部，因为一旦药物获得许可

tissue engineering techniques can actually help us develop more personalized treatments.

组织工程的技术真的能帮助我们使疗程更加符合个人需求

This is an example that you might care about someday,

未来的某天你可能需要了解这些相关资讯

and I hope you never do,

虽然我希望这一天永远不会来

because imagine if you ever get that call

因为你想像，自己可能接到了一通电话

that gives you that bad news that you might have cancer.

带来的是坏消息，你可能罹患癌症了

Wouldn't you rather test to see if those cancer drugs

你难道不想先试用那些治疗癌症的药物

you're going to take are going to work on your cancer?

看看那些药是否真的可以对抗你的癌症吗？

This is an example from Karen Burg's lab, where they're

这是Karen Burg的实验室的例子，他们那里

using inkjet technologies to print breast cancer cells

使用喷墨技术来标的乳癌细胞

and study its progressions and treatments.

并研究细胞的发展及疗效

And some of our colleagues at Tufts are mixing models

我们Tufts有几个同事正在结合不同模型

like these with tissue-engineered bone to see how cancer

例如结合那些组织工程研发的骨头，观察癌症如何

might spread from one part of the body to the next,

从身体这个区域扩散到下一个区域

and you can imagine those kinds of multi-tissue chips

你可以想像一下，那些包含多种组织的晶片

to be the next generation of these kinds of studies.

会在下个世代，成为这类研究的主流

And so thinking about the models that we've just discussed,

所以，回想我们刚刚讨论的这些模型

you can see, going forward, that tissue engineering

你会发现，未来的组织工程学

is actually poised to help revolutionize drug screening

有助于药物检验，我们努力过程的每一步

at every single step of the path:

都能使其产生突破性的变革

disease models making for better drug formulations,

疾病模型可以制作出更好的药物配方

massively parallel human tissue models helping to revolutionize lab testing,

多样而大量的人类组织模型有助于实验室测试的变革

reduce animal testing and human testing in clinical trials,

减少动物临床测试及人类临床测试

and individualized therapies that disrupt

使疗程个人化，改变我们以往的想法

what we even consider to be a market at all.

认为一套疗程适用于所有人

Essentially, we're dramatically speeding up that feedback

而我们实际的数据回馈也以戏剧化的速度增加

between developing a molecule and learning about

实验内容是培养单一分子，并研究其

how it acts in the human body.

在人体中的反应为何

Our process for doing this is essentially transforming

我们的所作所为，其实就是

biotechnology and pharmacology into an information technology,

将生物科技跟药理学转换成资讯科技

helping us discover and evaluate drugs faster,

帮助我们加快药物开发与评估的速度

more cheaply and more effectively.

减少成本，提高效率

It gives new meaning to models against animal testing, doesn't it?

比起动物试验，这样的作法更有意义，不是吗?

Thank you. (Applause)

谢谢大家(鼓掌)