Danny Hillis: Understanding cancer through proteomics

翻译人员: Xiaoqiao Xie 校对人员: Jenny Yang

I admit that I'm a little bit nervous here

我得承认我有点紧张，

because I'm going to say some radical things,

因为我将要谈谈一个很是激进的观点

about how we should think about cancer differently,

关于我们应该怎么从新的角度看癌症这个东西

to an audience that contains a lot of people

尤其是你们中很多人

who know a lot more about cancer than I do.

都是癌症专家，比我懂得多了。

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

但我也得承认我的弦绷得还不够紧，

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

因为我挺自信我是对的。

(Laughter)

（笑声）

And that this, in fact, will be

我相信，事实上，（我的观点）

the way that we treat cancer in the future.

将会是未来我们治疗癌症的途经。

In order to talk about cancer,

要谈癌症前，

I'm going to actually have to --

我其实得——

let me get the big slide here.

让我展示这张图。

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

首先，我得让你们从另一个角度看基因组学。

I want to put it in perspective of the bigger picture

我希望把基因组学放在大环境中来看

of all the other things that are going on --

在不断变化的大环境中——

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

然后我会谈谈蛋白质组学，你们可能没怎么听过。

Having explained those,

讲了这两个之后，

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

大家就好接受我的关于，

about how to go about treating cancer.

怎么治疗癌症的新观点了。

So let me start with genomics.

现在让我从基因组学开始。

It is the hot topic.

这可是热门科学。

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

从中我们学到到最多，

This is the great frontier.

可谓科学前沿。

But it has its limitations.

但是它也有美中不足之处。

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

特别是你们可能听过的一个比喻，

that the genome is like the blueprint of your body,

基因组学就像是你身体的蓝图，

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

如果真是这样就太好了。

but it's not.

可惜不然。

It's like the parts list of your body.

基因组学好比你身体中的零件列表，

It doesn't say how things are connected,

但并没有说明每件之间是怎么连接的。

what causes what and so on.

什么是因，什么是果，等等。

So if I can make an analogy,

允许我也打个比方，

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

就好比你想比较

between a good restaurant, a healthy restaurant

好吃又健康的餐馆

and a sick restaurant,

和差的餐馆，

and all you had was the list of ingredients

但你手里只有它们的佐料清单，

that they had in their larder.

它们贮藏室里有什么。

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

就好像你去一个法国餐厅，

and you looked through it and you found

你查一个遍最后发现

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

它们只用人造黄油，不用天然黄油，

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

你可能会说：“嗯，我知道问题在哪里了，

I can make them healthy."

我能让它变成健康的餐馆。”

And there probably are special cases of that.

恐怕有时确实是这种情况。

You could certainly tell the difference

你可能很容易说出

between a Chinese restaurant and a French restaurant

中国餐馆和法国餐馆之间的区别，

by what they had in a larder.

就凭它们贮藏室里有什么。

So the list of ingredients does tell you something,

所以说佐料单确实提供一些信息，

and sometimes it tells you something that's wrong.

有时它能告诉你问题出在哪里。

If they have tons of salt,

好比它们有很多食盐，

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

你恐怕能猜出他们用盐太多之类的。

But it's limited,

但是只是一些信息。

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

因为要确定一个餐馆是不是健康，

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

你得尝尝它们的食物，你得了解厨房里是怎么运作的，

you need the product of all of those ingredients.

你需要接触用所有这些佐料做成的产品。

So if I look at a person

所以如果你看一个人（是不是健康），

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

如果我只看这个人的基因组，就像（只看餐馆的佐料单）一样。

The part of the genome that we can read

我们能够从基因组看出来的，

is the list of ingredients.

也只是“佐料”列表而已。

And so indeed,

所以事实上，

there are times when we can find ingredients

有的时候我们能够看出

that [are] bad.

什么“佐料”不好。

Cystic fibrosis is an example of a disease

囊性纤维化就是这类病的一个例子，

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

只要一个“佐料”坏了就能发病，

and we can actually make a direct correspondence

这里我们真能在基因和疾病间

between the ingredient and the disease.

建立直接的联系。

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

但是大多数情况下，你真得知道厨房里是怎么回事，

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

因为绝大部分的病人都曾是健康的——

they have the same genome.

他们(得病前后的)基因组是不变的

So the genome really tells you much more

所以基因组真正告诉我们的，

about predisposition.

不过是易感性而已。

So what you can tell

光看“佐料单”你能够作出的结论

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

只不过是这个人是亚洲人，

by looking at their ingredients list.

那个人是欧洲人而已。

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

大多数的时候，病人和健康人之间的区别

between a healthy person and a sick person --

从基因组学是看不出来的——

except in some of these special cases.

除非很特别的情况下。

So why all the big deal

那为什么遗传学研究

about genetics?

这么重要呢？

Well first of all,

首先，

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

这是我们能够掌握的信息，很不容易的。

It is very useful in certain circumstances.

遗传信息在某些情况下特别有用。

It's also the great theoretical triumph

在生物学中，遗传学

of biology.

是生物理论研究上的巨大成功。

It's the one theory

它是个生物学上唯一的

that the biologists ever really got right.

所谓理论，能经得起推敲的。

It's fundamental to Darwin

它是达尔文学说的基础，

and Mendel and so on.

也是孟德尔学说和后续理论的基础。

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

他们预测出了这个理论构架。

So Mendel had this idea of a gene

孟德尔认为基因

as an abstract thing,

是抽象的。

and Darwin built a whole theory

达尔文把自己的整个学说

that depended on them existing,

建立在基因是实体的基础上。

and then Watson and Crick

接下来沃森和克瑞特

actually looked and found one.

观察发现了基因的存在。

So this happens in physics all the time.

这样的逻辑在物理学中常见。

You predict a black hole,

人们预测了黑洞的存在，

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

之后用望远镜找，发现了之前预测的黑洞。

But it rarely happens in biology.

但是这个逻辑在生物学中很少见。

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

这就是为什么这个成功如此伟大——它如此伟大——

there's almost a religious experience

几乎称得上是生物学中的

in biology.

神迹

And Darwinian evolution

而其中达尔文的进化论

is really the core theory.

称得上是理论核心。

So the other reason it's been very popular

遗传学这么广为接受的另一个原因，

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

就是我们能够测量它，它是数字化的。

And in fact,

事实上，

thanks to Kary Mullis,

感谢凯瑞莫里斯（发明了聚合酶链反应PCR的生物学家）

you can basically measure your genome in your kitchen

你能事实上测量你的基因组，就在你自己的厨房里

with a few extra ingredients.

就靠几种材料。

So for instance, by measuring the genome,

举个例子，就靠着测量基因，

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

我们已经深入理解了我们是怎么和其他动物同源的，

by the closeness of our genome,

就靠看我们和他们基因组间的相似性，

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

或者我们人类之间是怎么相联系的——家谱之类的，

or the tree of life.

或者是生物进化树。

There's a huge amount of information about the genetics

就靠着比较基因的相似性，

just by comparing the genetic similarity.

遗传学就能提供很多的信息。

Now of course, in medical application,

当然了，在医学应用方面，

that is very useful

这也是很有用的，

because it's the same kind of information

因为这是和医生从你的家族病史中

that the doctor gets from your family medical history --

得到的信息是类似的——

except probably,

只不过家族病史只是一个随机的子信息，

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

你的基因其实能解释很多的你的病史，比你能解释的还要多。

And so by reading the genome,

所以通过解读基因，

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

我们能够比你还了解你的家庭。

And so we can discover things

我们还能发现新的信息

that probably you could have found

那些你应该早知道的

by looking at enough of your relatives,

凭着观察你的亲戚们，

but they may be surprising.

但这些事情可能还是会出乎你的意料。

I did the 23andMe thing

我做了类似的一个测试，

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

很惊讶的发现我不但过胖还秃头。

(Laughter)

（笑声）

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

但有时你能得到很多有用的信息。

But mostly

多数情况下

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

发现疾病的必需的信息

is not your predispositions,

并不是你的易感性，

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

而是现时你身体的发生了什么。

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

为了发现疾病，你真需要做的，

you need to look at the things

你真需要观察的，

that the genes are producing

是你的基因的产物，

and what's happening after the genetics,

是基因组学之后的一个层次。

and that's what proteomics is about.

这正是蛋白质组学所研究的。

Just like genome mixes the study of all the genes,

就像是基因组学研究所有的基因，

proteomics is the study of all the proteins.

蛋白质组学研究所有的蛋白质。

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

这些蛋白质是你体内的小小物质

that are signaling between the cells --

它们在每个细胞间传递信息——

actually, the machines that are operating --

它们是真正操纵你身体的迷你机器。

that's where the action is.

它们是行动者。

Basically, a human body

基本上，人体

is a conversation going on,

是个

both within the cells and between the cells,

在细胞里和细胞间的持续对话，

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

细胞们告诉对方该长大还是该消失。

and when you're sick,

当你生病时，

something's gone wrong with that conversation.

这种对话就出错了。

And so the trick is --

这里的微妙之处在于——

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

不幸的是，我们没有像测试基因一样容易的方法，

like we can measure the genome.

来测试这些蛋白质。

So the problem is that measuring --

问题在于测试方法——

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

如果你试图一起测试所有的蛋白质，这是个非常复杂的过程。

It requires hundreds of steps,

需要上百个步骤，

and it takes a long, long time.

需要很长的时间。

And it matters how much of the protein it is.

蛋白质的含量也很有关系。

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

十分之一的蛋白质的量变就很要命了，

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

所以这并不是像基因一样是数码制的（分离系统）。

And basically our problem is somebody's in the middle

基本上我们的问题是，如果有人在测试蛋白质，

of this very long stage,

在长时间的操作中，

they pause for just a moment,

暂停了一下下，

and they leave something in an enzyme for a second,

把蛋白质留在蛋白酶中，就多一秒，

and all of a sudden all the measurements from then on

突然间所有的测量，从这一刻开始，

don't work.

就不再准确了。

And so then people get very inconsistent results

所以大家不断得到特别不一致的结果

when they do it this way.

因为他们是这么测量的。

People have tried very hard to do this.

大家做了很多努力来测量蛋白质，

I tried this a couple of times

我自己也做了几次实验

and looked at this problem and gave up on it.

试着克服这个问题，最后我放弃了。

I kept getting this call from this oncologist

后来我开始不断接到从大卫 艾格斯，

named David Agus.

一个癌症学家的电话。

And Applied Minds gets a lot of calls

总是有很多人给我们公司“Applied Minds”打电话

from people who want help with their problems,

不断有人要求我们帮忙，

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

我以为这个电话是不会再来的。

so I kept on giving him to the delay list.

所以我迟迟没有回他的电话。

And then one day,

直到有一天，

I get a call from John Doerr, Bill Berkman

我同一天内接到约翰 德尔，比尔 伯克曼，

and Al Gore on the same day

和埃尔 高尔的电话

saying return David Agus's phone call.

让我给大卫 艾格斯回电话。

(Laughter)

（笑声）

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

所以我想：“打就打，至少这个人聪明到会用关系网。”

(Laughter)

（笑声）

So we started talking,

这样我们开始对话，

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

他说：“我迫切需要更好的技术来测量蛋白质。”

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

我说：“我试了，也失败了。

Not going to be easy."

不是容易做的。”

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

他说：“不一样，不一样，我是真需要。

I mean, I see patients dying every day

病人天天死在我眼前

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

就因为我们不知道身体里面发生了什么。

We have to have a window into this."

我们一定要找到办法看透他们的身体。”

And he took me through

他还给我举了些例子，

specific examples of when he really needed it.

具体的病例和何时需要这个技术，

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

我才意识到，哇，如果我们能测量蛋白质的话，

if we could do it,

真的能改变命运。

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

于是我说：“好吧让我试试。”

Applied Minds has enough play money

我们公司有些积蓄，

that we can go and just work on something

是用来作初级测试的，

without getting anybody's funding or permission or anything.

不需要客户出钱或者授权。

So we started playing around with this.

于是我们就开始研发这个技术。

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

我们做的时候，意识到这里有个根源性的问题——

that taking the sip of coffee --

(实验员会)停下去喝口咖啡什么的，(导致实验中断)

that there were humans doing this complicated process

所以不该是靠人工来做这件事。

and that what really needed to be done

我们真正需要的

was to automate this process like an assembly line

是让机器做，就像是在流水线上一样，

and build robots

做出机器人

that would measure proteomics.

来替我们测试蛋白质。

And so we did that,

于是我们就这样做了。

and working with David,

和大卫合作，

we made a little company called Applied Proteomics eventually,

我们成立了一个小小的公司，定名为“蛋白组学应用公司”，

which makes this robotic assembly line,

专门做这些能够稳定测量蛋白质的

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

机器人。

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

接下来我要介绍这个测量技术是什么样的。

Basically, what we do

基本上，我们所做的是

is we take a drop of blood

从病人身上

out of a patient,

取一滴血，

and we sort out the proteins

然后检测这滴血里的

in the drop of blood

所有的蛋白质

according to how much they weigh,

根据蛋白质的不同质量，

how slippery they are,

和蛋白质的不同粘性。

and we arrange them in an image.

我们给它们画个图，

And so we can look at literally

就能从这一滴血中

hundreds of thousands of features at once

同时看到

out of that drop of blood.

成百上千个不同的信息。

And we can take a different one tomorrow,

第二天我们还可以再检测一次，

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

你能看到第二天你的蛋白质组群是不同的——

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

你吃东西或者睡觉都会改变它们。

They really tell us what's going on there.

它们是你身体里的实况报告。

And so this picture,

这就是一个图，

which looks like a big smudge to you,

看起来像是一大片污迹，

is actually the thing that got me really thrilled about this

正是让我觉得我们走对了路，

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

让我觉得无比震撼的。

So if I zoom into that picture,

如果我放大某个部分，

I can just show you what it means.

你就能看到我指的是什么。

We sort out the proteins -- from left to right

我们把蛋白质都分开了——从左到右，

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

是不同的蛋白片断的质量，

and from top to bottom is how slippery they are.

从上到下是它们的粘性。

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

我们放大图的这块，让你能看清很小的一点点。

And so each of these lines

这几条线里的每一条，

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

都代表了这片蛋白的不同信息。

And you can see how the lines occur

你能看到它们是怎么分布的，

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

都是一小组一小组的，

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

这是因为我们测量质量的方法精细到——

carbon comes in different isotopes,

能看到碳原子的不同同位素，

so if it has an extra neutron on it,

如果这个碳原子多一个少一个中子，

we actually measure it as a different chemical.

我们都能测得出来，把它们分开。

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

所以我们其实测量得到每个同位素。

And so that gives you an idea

这告诉我们

of how exquisitely sensitive this is.

这个技术有多灵敏。

So seeing this picture

我们看这张图片

is sort of like getting to be Galileo

就像是伽利略

and looking at the stars

看星星

and looking through the telescope for the first time,

第一次从望远镜中看到

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

你会感叹：“喔，这比我想象的复杂多了。”

But we can see that stuff out there

但我们能够看到这些区别，

and actually see features of it.

看到里面的信息。

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

这是个特例，我们能够通过它得到一个模式，

So what we do with this

方法是

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

比如，我们可以比较两个病人

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

一个对药物有阳性反应，另一个药物不起作用。

and ask, "What's going on differently

然后问：

inside of them?"

“他们身体内有什么不同？”

And so we can make these measurements precisely enough

通过精确的测量技术，

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

我们可以比较来看两个人的蛋白质有什么不同。

So here we have Alice in green

像这里爱丽丝的是绿色的，

and Bob in red.

鲍勃的是红的，

We overlay them. This is actual data.

让我们比较两个结果，这是真的病人的结果。

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

你能看到，绝大部分是一样的，显示黄色，

but there's some things that just Alice has

但有些蛋白是爱丽丝专有的，

and some things that just Bob has.

有的是鲍勃专有的。

And if we find a pattern of things

如果我们能发现在对药物有阳性反应的

of the responders to the drug,

病人的共性，

we see that in the blood,

我们从血液中能发现，

they have the condition

他们都有共同性

that allows them to respond to this drug.

让药物能对他们起作用，

We might not even know what this protein is,

我们可能不知道起作用的蛋白质的名字，

but we can see it's a marker

但我们能用它作为一个标志物，

for the response to the disease.

来标明对于疾病的反应。

So this already, I think,

所以这个已经是，我认为，

is tremendously useful in all kinds of medicine.

在医药学上极其有用的。

But I think this is actually

但我认为这其实只是

just the beginning

一个开始，

of how we're going to treat cancer.

将来我们要用它来治疗癌症。

So let me move to cancer.

让我来谈谈癌症。

The thing about cancer --

癌症——

when I got into this,

当我开始研究它，

I really knew nothing about it,

我什么都不知道，

but working with David Agus,

但是通过和大卫 艾格斯工作，

I started watching how cancer was actually being treated

我开始观察癌症是怎样被治疗的。

and went to operations where it was being cut out.

我还观察了手术，癌组织是怎么被取走的。

And as I looked at it,

当我研究癌症时，

to me it didn't make sense

对我来说，我们治疗癌症的方法

how we were approaching cancer,

并不正确。

and in order to make sense of it,

为了理解这个途径，

I had to learn where did this come from.

我得学习这些现今的治疗方法是怎么确定的。

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

我们治疗癌症，好像癌症是传染病一样，

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

我们治疗癌症像是癌症侵入了我们体内

that we have to kill.

我们得消灭敌人。

So this is the great paradigm.

这是为什么取走癌组织被认为是很好的模式。

This is another case

另一种情况，

where a theoretical paradigm in biology really worked --

这里生物的理论模式真的起作用了——

was the germ theory of disease.

就是疾病是细菌的理论。

So what doctors are mostly trained to do

医生都被训练

is diagnose --

来诊断疾病——

that is, put you into a category

就是把你放进一个类别里去——

and apply a scientifically proven treatment

给你用来治疗这个类别的人

for that diagnosis --

通常起作用的那个治疗方法。

and that works great for infectious diseases.

这通常对传染病是起作用的。

So if we put you in the category

如果我们把你放在这个类别中，

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

就好像你得了梅毒，我们就给你青霉素。

We know that that works.

我们知道青霉素能治好你。

If you've got malaria, we give you quinine

就好像如果你得了疟疾，我们给你奎宁，

or some derivative of it.

或者相似的药物。

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

因为这是通常医生被训练去做的。

and it's miraculous

对于传染病，

in the case of infectious disease --

这个非常管用——

how well it works.

就像是一个奇迹。

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

如果医生们不这样做，

if doctors didn't do this.

我们中的很多人恐怕活不到今天。

But now let's apply that

但是当我们把类似的治疗方法用于

to systems diseases like cancer.

像癌症那样的系统性疾病，

The problem is that, in cancer,

就有问题了。对于癌症，

there isn't something else

没有别的，

that's inside of you.

就是你出了问题。

It's you; you're broken.

是你，你有地方坏了，

That conversation inside of you

这是因为你体内的对话出了问题，

got mixed up in some way.

开始各处错误对话。

So how do we diagnose that conversation?

我们怎样解读这样的错误对话呢？

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

我们现在在做的是把癌症按照身体部分分类——

you know, where did it appear? --

你知道，按照癌症在什么地方发生——

and we put you in different categories

把你放进不同的类别里，

according to the part of the body.

那个身体部分的类别。

And then we do a clinical trial

接下来我们做医疗实验，

for a drug for lung cancer

比如对肺癌用一个药，

and one for prostate cancer and one for breast cancer,

对前列腺癌用一个药，对乳癌用一个药，

and we treat these as if they're separate diseases

我们治疗这些癌症，把它们当作是完全不同的病。

and that this way of dividing them

这样对癌症的分类方法

had something to do with what actually went wrong.

是真的按照出了什么问题来的。

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

当然了，其实这和到底什么出了问题

with what went wrong

并没有直接的关系。

because cancer is a failure of the system.

因为癌症是一个系统失灵。

And in fact, I think we're even wrong

事实上，我认为像这样把癌症当成是一件事来谈，

when we talk about cancer as a thing.

都是错误的。

I think this is the big mistake.

我认为这是个大错误。

I think cancer should not be a noun.

我看癌症，不是一个事物。

We should talk about cancering

我们应该用的词是“得癌”。

as something we do, not something we have.

是我们得的，不是我们有的。

And so those tumors,

那些癌组织，

those are symptoms of cancer.

只是“得癌”的一个症状。

And so your body is probably cancering all the time,

你的身体随时都在得癌，

but there are lots of systems in your body

但是绝大多数情况下，你的身体机构

that keep it under control.

能够不让它们发展。

And so to give you an idea

这里我给你一个概念，

of an analogy of what I mean

算是我的定义的一个比方，

by thinking of cancering as a verb,

想象癌症是一个过程，

imagine we didn't know anything about plumbing,

只要想象我们对下水管道一无所知，

and the way that we talked about it,

我们通常会这样描述：

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

我们回家，发现厨房有漏水，

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

我们就说：“我们的房子有水。”

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

我们能够粗粗分类——管道工会问：“哪里有水？”

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

“厨房里。”“那就是厨房水了。”

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

这就是我们现在对癌症的认识。

"Kitchen water,

“厨房水”，

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

首先，我们要去厨房，把水拖干净，

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

之后我们知道，在厨房里喷上

that helps.

管道清洁剂能起作用。

Whereas living room water,

如果是客厅水，

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

“屋顶防潮剂能起作用。”

And it sounds silly,

这听起来可笑，

but that's basically what we do.

但是这是我们现在用的对策。

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

我不是说得了癌症后你不该除掉“厨房水”，

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

我只是说那并不是问题的症结；

that's the symptom of the problem.

那只是问题的症状。

What we really need to get at

我们真的该解决的，

is the process that's going on,

是正在发生的症结。

and that's happening at the level

而且这个解决方案应该发生在

of the proteonomic actions,

蛋白质组互相作用的层次上，

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

发生在为什么你的身体不能自行治愈，

in the way that it normally does?

像它通常能做的？

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

通常你的身体每天都在解决这些问题。

So your house is dealing with leaks all the time,

所以说你的“房子”其实一直有漏水的问题，

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

但是它在自己解决，自己排出漏水等等。

So what we need

我们需要的

is to have a causative model

是制定出一个症结模型

of what's actually going on,

来模拟问题是怎么发生的。

and proteomics actually gives us

蛋白质组学能够提供给我们

the ability to build a model like that.

建立起这样的模型的能力。

David got me invited

大卫请我去国家癌症研究院

to give a talk at National Cancer Institute

做个讲座，

and Anna Barker was there.

安娜 巴克也在那里。

And so I gave this talk

我做了讲座，

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

然后问他们：“为什么你们不按照这个思路做？”

And Anna said,

安娜说：

"Because nobody within cancer

“因为癌症学界没有人

would look at it this way.

能从这个角度看事情。

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

但是我们想要做的，是成立一个计划署，

for people outside the field of cancer

让不在癌症学界工作的人们

to get together with doctors

来和真正对付癌症的

who really know about cancer

医生们合作，

and work out different programs of research."

发展出一个不同的研究方案。”

So David and I applied to this program

这样大卫和我就向这个计划署申请

and created a consortium

在USC（南加州大学）成立了

at USC

一个集团，

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

在那里我们有世界顶级的癌症学家，

and some of the best biologists in the world,

还有从Cold Spring Harbor（冷泉港），

from Cold Spring Harbor,

Stanford（斯坦福），Austin（奥斯汀）等多处的

Stanford, Austin --

一些世界级的生物学家——

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

我都列不出全部这些合作者们——

to have a research project

来做这个研究项目。

that will last for five years

在未来的五年，

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

我们将为癌症做一个症结模型。

We're doing it in mice first,

我们正首先在小鼠身上做这个模型。

and we will kill a lot of mice

在这个过程中，

in the process of doing this,

我们需要使用很多小鼠，

but they will die for a good cause.

但至少它们死得其所。

And we will actually try to get to the point

之后我们会到达一个阶段，

where we have a predictive model

是我们能有个预测出的模型，

where we can understand,

在这个模型里我们是真的明白

when cancer happens,

癌症是什么时候产生的，

what's actually happening in there

里面是怎么回事，

and which treatment will treat that cancer.

什么样的治疗方案能够奏效。

So let me just end with giving you a little picture

这里让我稍稍描绘一下远景，来结束这个演讲

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

谈谈我认为未来的癌症治疗方案是怎么一回事。

So I think eventually,

我认为，总有一天，

once we have one of these models for people,

当我们给每个病人都树立了正确的模型，

which we'll get eventually --

总有一天——

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

光靠我们的研究队伍是不够的——

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

但是最终我们会得到很好的计算模型——

sort of like a global climate model for weather.

像是一个全球气候模型。

It has lots of different information

这个模型包含了很多信息

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

描述蛋白质组间的对话，

on many different scales.

从不同的精确度。

And so we will simulate

这样我们就可以模拟

in that model

为你身上的那种癌症

for your particular cancer --

做出一个疾病模型来——

and this also will be for ALS,

我们也可以为ALS（肌肉萎縮性側索硬化症）

or any kind of system neurodegenerative diseases,

或者任何一种系统性的神经退化疾病做（这样的模型）

things like that --

这类的疾病——

we will simulate

我们会特别为你

specifically you,

模拟一个治疗方案，

not just a generic person,

不为其他任何人，

but what's actually going on inside you.

而是根据你身体真的在发生什么，

And in that simulation, what we could do

在这个程序里，我们能

is design for you specifically

为你特别设计

a sequence of treatments,

一系列的治疗方案

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

这些可以是非常轻微的治疗，非常微量的药量

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

好比是，这天先别吃东西，

or give them a little chemotherapy,

或者给一点点化疗，

maybe a little radiation.

一点点放射性治疗，

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

当然了，有时手术是不可避免的。

But design a program of treatments specifically for you

但是我们能够为你量身定做治疗方案，

and help your body

帮助你的身体，

guide back to health --

领着它逐渐恢复健康——

guide your body back to health.

领着你的身体恢复健康。

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

因为你的身体会尽量自己恢复，

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

只要我们在它走错路的时候扶一把，

We put it in the equivalent of splints.

只要我们能够提供支持

And so your body basically has lots and lots of mechanisms

你的身体有很多的潜力，

for fixing cancer,

自己治疗癌症。

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

我们只需要关键时刻帮一把，

and get them to do the job.

帮它回到正路上来。

And so I believe that this will be the way

我相信这将会是

that cancer will be treated in the future.

未来治疗癌症的途径。

It's going to require a lot of work,

这将需要我们不断的努力，

a lot of research.

很多很多的科研。

There will be many teams like our team

需要其他的研究队伍，像我们队伍这样的

that work on this.

一起进行这个研究。

But I think eventually,

但我相信终有一天，

we will design for everybody

我们能为每个人

a custom treatment for cancer.

量身定做治疗癌症的方案。

So thank you very much.

谢谢大家。

(Applause)

（掌声）