Khalil Ramadi: Electronic pills that could transform how we treat disease | TED Fellows

翻译人员: Wanting Zhong 校对人员: Jiasi Hao

[SHAPE YOUR FUTURE]

For decades, scientists have tried to use brain modulation

to treat neurological disorders.

Techniques usually involved sticking wires onto our head,

then helmets that immobilized our head

【塑造你的未来】

and zapping our brain with magnetic or electrical pulses.

数十年以来，科学家们一直试图

使用脑调制来治疗神经系统疾病。

Given what we now know about the millions of circuits that our brain has,

这些技术通常要 往我们头上插电线、

this was much like trying to fix a pothole by resurfacing the entire road.

用头盔把头固定住，

然后用磁脉冲或电脉冲刺激大脑。

Brain modulation can actually come in different forms.

鉴于我们现在 对大脑中数百万个回路的了解，

The brain connects with all organs in our bodies through neurons,

much like an octopus' tentacles.

这就像是试图通过重铺整条路 来修理一处坑洞。

This means that diabetes, cancer, autoimmune disorders can all be induced,

脑调制其实有各种不同形式。

affected and exacerbated by the brain and the nervous system.

大脑通过神经元 和我们身体中所有器官相连，

This also means that brain modulation can be achieved

就像是章鱼的触手一样。

这意味着大脑和神经系统 有可能诱发、影响和加剧

through different parts of the body

by zapping organs and limbs with electrodes

糖尿病、癌症 和自身免疫性疾病。

that have usually been implanted with drills and scalpels.

Today, however, brain modulation doesn't have to be so invasive.

这也意味着大脑调制

Some of my colleagues at MIT

可以通过身体的不同部位来实现——

have discovered that a potential therapy for Alzheimer's

使用电极刺激器官和四肢，

could be watching light of a certain wavelength

这些电极往往需要 用电钻和手术刀植入。

flash at a particular frequency.

然而，今天的脑调制 创伤性已不必这么强了。

This is an example of something I like to call a bionudge --

我在麻省理工大学的一些同事

simple techniques that target specific circuits in our bodies

发现了阿茨海默症的一种潜在疗法

可以是观看某个特定波长

to achieve a certain outcome,

like using light to slow degeneration and Alzheimer's.

以特定频率闪烁的光。

我想把这样的例子 称为 “生物助推”——

Let me show you an example of a really simple bionudge.

In 10 seconds, I'm going to cause neurons in your pretectal area to light up

即，为了达到某个结果

而针对我们身体中 特定回路的简单技术。

and then I'll stimulate your amygdala and hippocampus to surprise you.

例如使用光 来延缓神经退行和阿茨海默症。

Finally, your arcuate nucleus to make you feel hungry.

让我给你展示一个 非常简单的生物助推的例子。

在十秒钟内，我会让你 前顶盖区域的神经元亮起来，

Bionudges don't need to be shocking or jarring,

然后我会刺激你的杏仁体与海马体， 让你吓一跳。

They just need to be designed to activate or silence a specific brain circuit.

最后，刺激你的弓状核， 让你感到饥饿。

Combining bionudges in a certain order

can allow us to use them for a more targeted purpose.

生物助推不必令人产生不适 （例如受到惊吓或是刺耳疼痛），

My team and I at MIT developed microdevices

只需将它们设计得能激活 或抑制某个特定的脑回路。

similar in shape and size to a pill that can be swallowed like we do pills

以一定顺序组合生物助推，

and contain electronics

to deliver little bursts of electrical or chemical stimuli --

就能让我们将其用于 更有针对性的目的。

我和我在麻省理工的团队 研发出了微型设备，

bionudges -- to our gut.

形状大小都与药丸相仿， 可以像药丸一样吞下去。

Our gut is the largest interface of our body with the outside world.

It has an incredible combination of tissues all working together.

其中含有电子元件

能将少量电或化学刺激——

It houses enteroendocrine cells

that sense what we eat

生物助推——传递到我们的肠道中。

and induce the release of hormones that can regulate hunger and metabolism.

消化道是我们身体对外界最大的接口。

It houses immune cells that sense the microbiome

其中有很多难以置信的组织 共同协作运转：

while preventing bacteria from entering our body.

例如肠内分泌细胞，

And neurons -- lots and lots of neurons.

能感知我们吃了什么，

并促使释放 能调节饥饿感和代谢的激素。

This is why certain sugary or salty foods can ramp up dopamine levels in our brain

再例如免疫细胞，能感知微生物组，

and make us feel quite good after eating them.

同时防止细菌进入体内。

Our electronic pills can be designed to reside in the gut for days to weeks,

还有神经元——很多很多神经元。

delivering bionudges to neurons along the GI tract.

这就是为什么某些甜味或咸味食物 能提升大脑中的多巴胺浓度，

Depending on the shape and strength of these electrical impulses,

让我们在食用之后感觉良好。

they can either affect hormone levels in our blood

我们的电子药丸被设计成 可在消化道内停留数日到数周，

or travel up to our brain

where they can activate or silence specific brain circuits

期间对沿消化道的神经元 提供生物助推。

that control hunger, metabolism and arousal.

根据这些电脉冲的形状和强度，

Much like we did just a few minutes ago.

它们可以影响血液中的激素浓度，

Using our devices, we could stimulate the stomach

或是被传递至大脑，

to tackle nausea or influence satiety

在那里激活或抑制

or the intestine to change the way we digest things like glucose

能控制饥饿、代谢与唤起的 特定脑回路。

by affecting absorption of nutrients in food.

就像我们几分钟前展示的那样。

This could mean new, noninvasive therapies for the 34 million diabetics in the US

我们可以使用这种设备刺激胃部

以解决恶心或影响饱腹感；

and 650 million obese population worldwide.

或刺激肠道，通过影响 对食物中营养成分的吸收

We could even affect things like inflammation in the brain,

改变我们对葡萄糖等物质的消化方式。

slowing down degeneration for the almost 60 million patients

这意味着该新型无创式疗法 有望使美国 3400 万糖尿病患者

with Parkinson's or Alzheimer's around the world.

和全世界 6.5 亿肥胖人口受益。

By being super specific, we can avoid side effects,

我们甚至能影响大脑炎症这类问题，

unlike most of our drugs.

And in this way we can control appetite, nutrient digestion, hormone levels,

为全世界近 6000 万名 帕金森症或阿茨海默症患者

even happiness and reward.

减缓神经退行进程。

This is exciting.

和大多数药物截然不同，

Bionudges are more targeted than medicines and less invasive than surgery.

该疗法极高的特异性能避免副作用。

通过这种方法，我们可以控制食欲、 营养消化、激素水平，

Neuromodulation therapies could be a new gold standard in health care.

甚至幸福感和奖励。

I'd like to leave you with an image:

这很激动人心。

生物助推的针对性比药物更强， 创伤性比手术更低。

a single pill, not filled with drugs or chemicals,

but with electronics and microdevices

神经调制疗法可以成为 医疗领域新的黄金标准。

that deliver little bursts of energy to our gut.

我想为大家留下这幅图景：

This pill can treat Parkinson's, Alzheimer's, diabetes or obesity,

一颗药丸，里面填充的 不是药物或化学物质，

all without any chronic drugs, completely noninvasively.

而是电子元件和微型设备，

能向肠道传递小型能量脉冲。

No drill, no surgery, no hospital stay.

这颗药丸能治疗帕金森症、 阿茨海默症、糖尿病或肥胖症，

This is how medicine could be.

This is how medicine should be.

全部不需要任何长期药物 且彻底无创。

Thank you.

不需要电钻、手术、住院。

这是医学可能成为的模样。

这也是医学应当成为的模样。

谢谢。