What the sugar coating on your cells is trying to tell you | Carolyn Bertozzi

250,899 views ・ 2017-09-10

TED


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譯者: Lilian Chiu 審譯者: Helen Chang
00:12
This is a talk about sugar and cancer.
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這是一場關於糖和癌症的演說。
00:15
I became interested in sugar when I was in college.
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我在大學時對糖產生了興趣。
00:19
Not this kind of sugar.
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不是這種糖。
00:20
It was the sugar that our biology professors taught us about
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是生物學教授上課時教的那種糖,
00:25
in the context of the coating of your cells.
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包裹著你的細胞的那種糖。
00:30
Maybe you didn't know that your cells are coated with sugar.
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也許你不知道你的細胞 被糖所包裹著。
00:34
And I didn't know that, either,
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我本來也不知道,
00:36
until I took these courses in college,
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到大學時修了這些課程才學到。
00:38
but back then --
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但是當時──
00:39
and this was in, let's just call it the 1980s --
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那時是……我們姑且 就說是 1980 年代吧──
00:44
people didn't know much about why our cells are coated with sugar.
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人們並不知道為什麼 我們的細胞會被糖所包裹。
00:48
And when I dug through my notes, what I noticed I had written down
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而當我翻閱我的筆記時, 我發現我記下的是:
00:52
is that the sugar coating on our cells is like the sugar coating
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細胞上所包裹的糖, 就像是花生 M&M 豆
00:57
on a peanut M and M.
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外面的糖衣。
00:59
And people thought the sugar coating on our cells
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人們認為,包裹著我們細胞的糖衣
01:02
was like a protective coating
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就像是一層保護塗層,
01:04
that somehow made our cells stronger or tougher.
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以某種方式讓我們的細胞 更強壯或更堅韌。
01:08
But we now know, many decades later,
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但幾十年之後的現在,
01:10
that it's much more complicated than that,
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我們知道答案並沒有這麼簡單,
01:13
and that the sugars on our cells are actually very complex.
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包裹我們細胞的糖其實非常複雜。
01:19
And if you could shrink yourself down to a little miniature airplane
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如果你把自己縮小成一架迷你飛機,
01:24
and fly right along the surface of your cells,
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然後沿著你的細胞表面飛行,
01:28
it might look something like this --
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你可能會看到這樣的景象──
01:30
with geographical features.
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有著地理特徵。
01:32
And now, the complex sugars are these trees and bushes --
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複雜的糖就像這些樹和灌木──
01:37
weeping willows that are swaying in the wind
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隨風搖動、隨波移動
01:39
and moving with the waves.
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的垂柳,
01:41
And when I started thinking about all these complex sugars
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當我開始思考這些複雜的糖,
01:45
that are like this foliage on our cells,
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它們就像是我們細胞上的葉子,
01:48
it became one of the most interesting problems that I encountered
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對於我這個生物學家兼化學家來說,
01:51
as a biologist and also as a chemist.
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它變成了我遇過最有趣的問題之一。
01:55
And so now we tend to think about the sugars
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現在我們傾向將佈滿在
01:58
that are populating the surface of our cells
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細胞的表面上的糖視為
02:01
as a language.
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是一種語言。
02:04
They have a lot of information stored in their complex structures.
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有大量的訊息儲存在 它們複雜的結構中。
02:08
But what are they trying to tell us?
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但它們想要告訴我們什麼呢?
02:12
I can tell you that we do know some information
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我可以告訴各位,我們確實知道一些
02:15
that comes from these sugars,
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來自這些糖的訊息,
02:17
and it's turned out already to be incredibly important
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且這些訊息對於醫學界的重要性
02:20
in the world of medicine.
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也已經被證明。
02:22
For example, one thing your sugars are telling us
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例如,你的糖能告訴 我們的其中一項資訊
02:26
is your blood type.
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是你的血型。
02:28
So your blood cells, your red blood cells, are coated with sugars,
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你的血細胞,你的紅血球細胞, 是被糖所包裹住的,
02:33
and the chemical structures of those sugars determine your blood type.
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而這些糖的化學結構 決定了你的血型。
02:37
So for example, I know that I am blood type O.
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比如,我知道我的血型是 O 型。
02:41
How many people are also blood type O?
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有多少人也是 O 型?
02:44
Put your hands up.
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請舉手。
02:46
It's a pretty common one,
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這種血型很常見,
02:47
so when so few hands go up, either you're not paying attention
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舉手的人這麼少, 若不是你們沒認真聽,
就是你們不知道自己的血型, 兩種情況都不太好。
02:50
or you don't know your blood type, and both of those are bad.
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02:53
(Laughter)
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(笑聲)
02:54
But for those of you who share the blood type O with me,
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不過如果你和我一樣是 O 型,
02:56
what this means is that we have this chemical structure
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這意味著我們的血細胞表面的
02:59
on the surface of our blood cells:
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化學結構是這樣的:
03:02
three simple sugars linked together to make a more complex sugar.
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三個單醣連在一起, 形成一個更複雜的糖。
03:05
And that, by definition, is blood type O.
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這就是 O 型的定義。
03:09
Now, how many people are blood type A?
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有多少人的血型是 A 型?
03:12
Right here.
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在這裡。
03:13
That means you have an enzyme in your cells
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這意味著你的細胞裡有一種酶,
03:16
that adds one more building block,
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它會增加一塊積木,
03:19
that red sugar,
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也就是那紅色糖,
03:20
to build a more complex structure.
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來建立更複雜的結構。
03:22
And how many people are blood type B?
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有多少人的血型是 B 型?
03:26
Quite a few.
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還不少。
03:27
You have a slightly different enzyme than the A people,
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你們的酶和 A 型的人略有不同,
03:30
so you build a slightly different structure,
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所以建出來的結構也略有不同,
03:32
and those of you that are AB
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至於 AB 型的人,
03:34
have the enzyme from your mother, the other enzyme from your father,
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則有分別來自母親和父親的酶,
03:37
and now you make both of these structures in roughly equal proportions.
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你所建立的這兩種結構, 在比例上是大約各半。
03:41
And when this was figured out,
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直到上個世紀,這個現象
03:43
which is now back in the previous century,
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才被發現,
03:46
this enabled one of the most important medical procedures in the world,
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因為它,才會有世界上 最重要的醫療手術之一,
03:50
which, of course, is the blood transfusion.
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當然,也就是輸血。
03:52
And by knowing what your blood type is,
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知道了自己的血型,
03:54
we can make sure, if you ever need a transfusion,
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當你需要輸血時,我們就可以確保
03:57
that your donor has the same blood type,
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你的捐血者和你有同樣的血型,
03:59
so that your body doesn't see foreign sugars,
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這樣你的身體才不會發現 有外來的糖進入,
04:03
which it wouldn't like and would certainly reject.
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它不喜歡外來的糖,一定會排斥。
04:07
What else are the sugars on the surface of your cells trying to tell us?
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你細胞表面的糖, 還能告訴我們什麼資訊?
04:12
Well, those sugars might be telling us that you have cancer.
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那些糖還可能還可以 告訴我們你得了癌症。
04:18
So a few decades ago,
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幾十年前,
04:20
correlations began to emerge from the analysis of tumor tissue.
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針對腫瘤組織所做的分析, 開始發現了相關性。
04:26
And the typical scenario is a patient would have a tumor detected,
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最典型的情況是: 當一名患者被檢測出腫瘤,
04:30
and the tissue would be removed in a biopsy procedure
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會進行活組織切片來切除組織,
04:34
and then sent down to a pathology lab
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該組織接著會被送到病理實驗室,
04:37
where that tissue would be analyzed to look for chemical changes
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在那裡進行分析,尋找化學變化,
04:41
that might inform the oncologist about the best course of treatment.
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這些變化或許能幫助 腫瘤學家斷定最適合的療程。
04:46
And what was discovered from studies like that
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這類研究的發現是,
04:49
is that the sugars have changed
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當細胞由健康轉成病態時,
04:52
when the cell transforms from being healthy to being sick.
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糖也會發生變化。
04:58
And those correlations have come up again and again and again.
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而這些相關性一而再、 再而三地出現。
05:04
But a big question in the field has been: Why?
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但實做上的一個大問題是:為什麼?
05:08
Why do cancers have different sugars? What's the importance of that?
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為何癌症會有不同的糖? 其重要性何在?
05:13
Why does it happen, and what can we do about it if it does turn out
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它為何發生?
若它真的和疾病的進程有關, 我們又能做什麼呢?
05:16
to be related to the disease process?
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05:21
So, one of the changes that we study
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我們所研究的各項變化之一,
05:24
is an increase in the density of a particular sugar
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就是一種特定糖的密度增加,
05:30
that's called sialic acid.
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這種糖叫「唾液酸」。
05:33
And I think this is going to be one of the most important sugars
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我認為它將是我們這個時代
最重要的糖其中的一種,
05:37
of our times,
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05:38
so I would encourage everybody to get familiar with this word.
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所以我建議大家都熟悉一下這個詞。
05:43
Sialic acid is not the kind of sugar that we eat.
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唾液酸不是我們吃的那種糖。
05:46
Those are different sugars.
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那些是不同的糖。
05:48
This is a kind of sugar that is actually found
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實際上,在你體內的所有細胞上,
05:51
at certain levels on all of the cells in your body.
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都可找到一定量的這種糖。
05:54
It's actually quite common on your cells.
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它在你的細胞上其實很常見。
05:58
But for some reason,
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但由於某種原因,
06:00
cancer cells, at least in a successful, progressive disease,
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癌細胞……至少在疾病 成功進展的情況下,
06:05
tend to have more sialic acid
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癌細胞的唾液酸量通常會多於
06:08
than a normal, healthy cell would have.
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正常健康細胞的唾液酸量。
06:11
And why?
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為什麼呢?
06:12
What does that mean?
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這意味著什麼?
06:15
Well, what we've learned
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我們所知道的是,
06:16
is that it has to do with your immune system.
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這和你的免疫系統有關。
06:20
So let me tell you a little bit about the importance of your immune system
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所以,讓我先告訴各位 免疫系統在癌症中的重要性。
06:24
in cancer.
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06:25
And this is something that's, I think, in the news a lot these days.
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我想,這陣子在新聞中 也有不少相關報導。
06:29
You know, people are starting to become familiar with the term
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人們開始越來越熟悉這個詞:
06:32
"cancer immune therapy."
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「癌症免疫治療」。
06:34
And some of you might even know people
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甚至在座可能就有人認識
06:36
who are benefiting from these very new ways of treating cancer.
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這些新式癌症療法的受益者。
06:41
What we now know is that your immune cells,
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我們現在知道,你的免疫細胞,
06:44
which are the white blood cells coursing through your bloodstream,
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也就是在你血液中 流動的白血球細胞,
06:48
protect you on a daily basis from things gone bad --
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每天保護著你,避免壞事發生──
06:53
including cancer.
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包括癌症。
06:55
And so in this picture,
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在這張圖片中,
06:57
those little green balls are your immune cells,
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這些綠色的球體就是你的免疫細胞,
07:00
and that big pink cell is a cancer cell.
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而那個粉紅色大細胞則是個癌細胞。
07:04
And these immune cells go around and taste all the cells in your body.
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這些免疫細胞四處巡邏, 品嚐你體內的所有細胞。
07:08
That's their job.
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那是它們的職責。
07:10
And most of the time, the cells taste OK.
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大多數情況下,細胞嚐起來沒問題。
07:13
But once in a while, a cell might taste bad.
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但偶爾,某個細胞 可能嚐起來不太對。
07:16
Hopefully, that's the cancer cell,
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但願那就是癌細胞,
07:18
and when those immune cells get the bad taste,
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當這些免疫細胞嚐到不對的味道,
07:20
they launch an all-out strike and kill those cells.
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它們會傾巢而出,殺死這些細胞。
07:24
So we know that.
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我們知道這些。
07:25
We also know that if you can potentiate that tasting,
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我們也知道,如果你能 賦與那種品嚐行為力量,
07:30
if you can encourage those immune cells to actually take a big old bite
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如果你能鼓勵那些免疫細胞狠狠地咬
07:33
out of a cancer cell,
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癌細胞一大口,
07:35
you get a better job protecting yourself from cancer every day
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你每天就更能保護自己免於癌症,
07:38
and maybe even curing a cancer.
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甚至還可能治癒癌症。
07:41
And there are now a couple of drugs out there in the market
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目前市面上有幾種用來
07:44
that are used to treat cancer patients
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治療癌症病人的藥,
07:46
that act exactly by this process.
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正是利用這個過程來產生作用。
07:49
They activate the immune system
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它們會活化免疫系統,
07:51
so that the immune system can be more vigorous
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讓免疫系統更強而有力,
07:53
in protecting us from cancer.
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保護我們免於癌症。
07:55
In fact, one of those drugs
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事實上,這些藥物的其中一種,
07:57
may well have spared President Jimmy Carter's life.
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很可能救了總統吉米卡特的命。
08:01
Do you remember, President Carter had malignant melanoma
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記得嗎,卡特總統 得了惡性黑色素瘤,
08:05
that had metastasized to his brain,
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癌細胞轉移到他的腦部,
08:08
and that diagnosis is one that is usually accompanied by numbers
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那種診斷通常還會帶著一個數字,
08:12
like "months to live."
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「剩幾個月可活」。
08:14
But he was treated with one of these new immune-stimulating drugs,
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但是他接受了一種 免疫系統刺激藥物的治療,
08:19
and now his melanoma appears to be in remission,
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現在他的黑色素瘤顯然已經緩解,
08:22
which is remarkable,
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這結果很了不起,
08:24
considering the situation only a few years ago.
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畢竟他幾年前的狀況還是非常糟的。
08:27
In fact, it's so remarkable
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事實上,這結果了不起到
08:29
that provocative statements like this one:
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引發了這段陳述:
08:32
"Cancer is having a penicillin moment," people are saying,
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「癌症也有了盤尼西林的時刻」,
人們對於這些新的 免疫治療藥物如是說。
08:36
with these new immune therapy drugs.
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08:38
I mean, that's an incredibly bold thing to say about a disease
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用這樣的方式形容一種我們長年對抗
08:41
which we've been fighting for a long time
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且通常都打不贏的疾病,
08:43
and mostly losing the battle with.
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是相當大膽的。
08:46
So this is very exciting.
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所以這很讓人興奮。
08:48
Now what does this have to do with sugars?
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那麼,這與糖有什麼關係呢?
08:51
Well, I'll tell you what we've learned.
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讓我告訴各位我們目前所知道的。
08:54
When an immune cell snuggles up against a cancer cell to take a taste,
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當一個免疫細胞靠向一個 癌細胞,去品嚐它的味道時,
09:01
it's looking for signs of disease,
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它是在尋找疾病的徵兆,
09:03
and if it finds those signs,
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如果它能找到這種徵兆,
09:05
the cell gets activated and it launches a missile strike and kills the cell.
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這細胞就會被活化, 發動飛彈攻擊,殺死癌細胞。
09:11
But if that cancer cell has a dense forest of that sugar, sialic acid,
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但若癌細胞上覆蓋了一層由那種糖, 也就是唾液酸,所組成的茂密樹林,
09:17
well, it starts to taste pretty good.
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那它嚐起來的味道就會是好的。
09:21
And there's a protein on immune cells that grabs the sialic acid,
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在免疫細胞上有個蛋白質 會抓住唾液酸,
09:25
and if that protein gets held at that synapse
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如果那蛋白質被卡在免疫細胞
09:29
between the immune cell and the cancer cell,
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和癌症細胞之間的突觸上,
09:32
it puts that immune cell to sleep.
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就會讓免疫細胞進入睡眠。
09:35
The sialic acids are telling the immune cell,
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如果唾液酸告訴免疫細胞說:
09:38
"Hey, this cell's all right. Nothing to see here, move along.
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「嘿,這個細胞沒問題。 沒什麼好看的,走開。
09:42
Look somewhere else."
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去看其他地方。」
09:44
So in other words,
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換言之,
09:45
as long as our cells are wearing a thick coat of sialic acid,
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只要我們的細胞覆蓋著 很厚一層的唾液酸,
09:51
they look fabulous, right?
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它們看起來就很好,對嗎?
09:53
It's amazing.
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那很驚人。
09:56
And what if you could strip off that coat
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如果你能夠剝除包裹的外層,
09:59
and take that sugar away?
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把糖給去除掉呢?
10:01
Well, your immune system
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那麼,你的免疫系統
10:04
might be able to see that cancer cell for what it really is:
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就有可能看見癌症細胞的真面目:
10:09
something that needs to be destroyed.
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該被摧毀的目標。
10:12
And so this is what we're doing in my lab.
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我們在我的實驗室中就在做這個。
10:15
We're developing new medicines
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我們正在開發新的藥,
10:17
that are basically cell-surface lawnmowers --
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基本上可以說是 細胞表面用的除草機,
10:21
molecules that go down to the surface of these cancer cells
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分子會前往這些癌症細胞的表面,
10:25
and just cut off those sialic acids,
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把那些唾液酸通通除掉,
10:28
so that the immune system can reach its full potential
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這麼一來,免疫系統就能發揮全力,
10:32
in eliminating those cancer cells from our body.
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消滅掉我們身體中的癌症細胞。
10:36
So in closing,
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最後結尾,
10:39
let me just remind you again:
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讓我再次提醒各位:
10:41
your cells are coated with sugars.
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你們的細胞都被糖所包裹著。
10:44
The sugars are telling cells around that cell
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糖會告訴那細胞附近的其他細胞
10:49
whether the cell is good or bad.
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那細胞是好的或是壞的。
10:52
And that's important,
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那很重要,
10:53
because our immune system needs to leave the good cells alone.
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因為我們的免疫系統 得要放過好的細胞。
10:56
Otherwise, we'd have autoimmune diseases.
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不然我們就會有自體免疫疾病了。
11:00
But once in a while, cancers get the ability
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但偶爾,癌症有能力可以
11:03
to express these new sugars.
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展現出這些新的糖。
11:04
And now that we understand
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現在我們知道
11:06
how those sugars mesmerize the immune system,
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那些糖是如何迷惑免疫系統的,
11:09
we can come up with new medicines to wake up those immune cells,
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我們就能做出新的藥 來喚醒那些免疫細胞,
11:13
tell them, "Ignore the sugars, eat the cell
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告訴它們:「別理會那些糖, 去吃那細胞,
11:16
and have a delicious snack, on cancer."
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在癌症上面吃頓美味的點心。」
11:20
Thank you.
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謝謝大家。
11:21
(Applause)
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(掌聲)
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