A new class of drug that could prevent depression and PTSD | Rebecca Brachman

翻译人员: Hoi Fei (Belinda) Cheung 校对人员: Tianji (Homer) Li

So the first antidepressants were made from, of all things,

治疗抑郁症和创伤后 应激障碍的药物

rocket fuel, left over after World War II.

是由第二次世界大战后 剩下的火箭燃料制成

Which is fitting, seeing as today, one in five soldiers develop depression,

对于有五分之一士兵患上抑郁症 或创伤后应激障碍的现代社会

or post-traumatic stress disorder or both.

似乎是个合适的话题

But it's not just soldiers that are at high risk for these diseases.

事实上，士兵不是 唯一的高危族群

It's firefighters, ER doctors, cancer patients, aid workers, refugees --

消防员，急诊医生，癌症患者， 援助者，难民

anyone exposed to trauma or major life stress.

以及面对创伤或巨大压力的人， 都有患病的可能

And yet, despite how commonplace these disorders are,

尽管这些病症很常见

our current treatments, if they work at all,

现时的治疗方法，假设有效

only suppress symptoms.

也只能到抑制症状的程度

In 1798, when Edward Jenner discovered the first vaccine --

1798年, 爱德华·詹纳发明了第一支疫苗

it happened to be for smallpox --

用于预防天花

he didn't just discover a prophylactic for a disease,

他不单发现了预防疾病的药物

but a whole new way of thinking:

更开创了崭新的思考方式：

that medicine could prevent disease.

药物可以预防疾病

However, for over 200 years,

可是，在之后的二百多年里

this prevention was not believed to extend to psychiatric diseases.

民众认为预防式药物 不能拓展治疗到精神疾病

Until 2014, when my colleague and I accidentally discovered

直到2014年， 我和 同僚意外地发现了

the first drugs that might prevent depression and PTSD.

首个或可预防抑郁症和 创伤后应激障碍的药物

We discovered the drugs in mice,

药是从老鼠中发现的

and we're currently studying whether they work in humans.

我们正研究在人类身上的作用

And these preventative psychopharmaceuticals

这类预防性精神药物

are not antidepressants.

不等于抗抑郁药

They are a whole new class of drug.

而是一种全新类别的药

And they work by increasing stress resilience,

能增加压力复原力

so let's call them resilience enhancers.

姑且将它命名为 复原力增强剂

So think back to a stressful time that you've since recovered from.

回想一下，你上次 遇到压力的时候——

Maybe a breakup or an exam, you missed a flight.

可能是经历了分手， 考试，错过了飞机

Stress resilience is the active biological process

压力复原是一个有效的生理过程

that allows us to bounce back after stress.

令人从压力中恢复过来

Similar to if you have a cold and your immune system fights it off.

这过程类似感冒后免疫 系统会进行抵抗

And insufficient resilience

当抗复原力不足够

in the face of a significant enough stressor,

来面对巨大压力源时

can result in a psychiatric disorder, such as depression.

就会导致精神疾病，例如抑郁症

In fact, most cases of major depressive disorder

事实上，大部分严重抑郁症的个案

are initially triggered by stress.

都是由压力引起的

And from what we've seen so far in mice,

我们从老鼠中看到

resilience enhancers can protect against purely biological stressors,

复原力增强剂可以 抵抗生理压力源

like stress hormones,

例如压力激素

and social and psychological stressors, like bullying and isolation.

以及社会及心里压力源， 例如被欺凌和孤立

So here is an example where we gave mice

我们在老鼠上做了个测试

three weeks of high levels of stress hormones.

老鼠连续三周接受 大量压力激素

So, in other words, a biological stressor without a psychological component.

也就是说，纯粹只有生理压力源， 没有任何心理压力源的成分、

And this causes depressive behavior.

结果是老鼠表现出抑郁症状

And if we give three weeks of antidepressant treatment beforehand,

即使在事前已提供了 三星期的抗抑郁药

it has no beneficial effects.

也沒有任何作用

But a single dose of a resilience enhancer given a week before

但在一周前注射一剂 复原力增强剂

completely prevents the depressive behavior.

就能完全预防抑郁

Even after three weeks of stress.

即使是压力已经持续三周

This is the first time a drug has ever been shown

这是史上首次有药物

to prevent the negative effects of stress.

能有效地预防压力 所带来的负面影响

Depression and PTSD are chronic, often lifelong, clinical diseases.

抑郁症和创伤后应激障碍都属于慢性， 甚至是终身的临床病

They also increase the risk of substance abuse, homelessness,

患者会增加滥用药物，无家可归，

heart disease, Alzheimer's, suicide.

心脏病， 阿尔茨海默症， 自杀的几率

The global cost of depression alone is over three trillion dollars per year.

光是忧抑郁症全球每年所 产生的费用就超过三兆美元。

But now, imagine a scenario where we know someone is predictively

到了今天，假设有 这么一个情况：

at high risk for exposure to extreme stress.

我们预先得知某人会 处于高压力的环境。

Say, a red cross volunteer going into an earthquake zone.

比如说，一位红十字会志愿者 到地震灾区救援

In addition to the typhoid vaccine,

除了为她提供伤寒疫苗，

we could give her a pill or an injection of a resilience enhancer

我们也可以在她出发前提供

复原力增强剂的药丸或注射剂。

before she leaves.

So when she is held at gunpoint by looters or worse,

这样，即使她在枪口下遭到掠夺， 甚至是遇到更严重的情况，

she would at least be protected against developing depression or PTSD

至少，在事后可以防止

患上抑郁症和创伤后应激障碍。

after the fact.

It won't prevent her from experiencing the stress,

虽然这药不能让患者 避免经历受创，

but it will allow her to recover from it.

但可以使患者从创伤中复原。

And that's what's revolutionary here.

称得上是个革命性的改变。

By increasing resiliency,

只要增强复原力

we can dramatically reduce her susceptibility to depression and PTSD,

就能大幅地减少患上 忧郁症和创伤后应激障碍的机率

possibly saving her from losing her job, her home, her family or even her life.

避免发生失去工作，家庭，亲人， 甚至性命的情況。

After Jenner discovered the smallpox vaccine,

詹纳发现首支天花疫苗后

a lot of other vaccines rapidly followed.

不同类型的疫苗如 雨后春笋般出现

But it was over 150 years

但过了150年

before a tuberculosis vaccine was widely available.

肺结核疫苗才能被广泛使用

Why?

为什么？

In part because society believed

部分原因的是，人们相信肺结核

that tuberculosis made people more sensitive and creative and empathetic.

能让患者变得更敏感， 有创意，及富同情心，

And that it was caused by constitution and not biology.

他们相信这是个人体质造成的， 和生物学没有关系。

And similar things are still said today about depression.

对于抑郁症， 也有坊间相似的传闻。

And just as Jenner's discovery opened the door

正如詹纳的发现

for all of the vaccines that followed after,

为日后的疫苗发明， 打开了一扇门，

the drugs we've discovered open the possibility of a whole new field:

而新发明的药物开创了领域的先河

preventative psychopharmacology.

也就是预防性精神药理学。

But whether that's 15 years away,

至于结果是要等15年

or 150 years away,

还是150年，

depends not just on the science,

不只是取决於科学

but on what we as a society choose to do with it.

还在於我们的社会如何看待处理。

Thank you.

谢谢。

(Applause)

(掌声）