Could we treat spinal cord injuries with asparagus? | Andrew Pelling

譯者: Bruce Sung 審譯者: Helen Chang

So I'm here today surrounded by all these fruits and vegetables,

今天我在這裡 坐在一堆蔬果之中，

because these are the subjects of my experiments.

因為它們是我實驗的對象。

Now, bear with me for just a second,

先容我花點時間從頭說起，

but about a decade ago

大約十年前，

my team started to rethink how we make materials

我的研究團隊開始重新思考 如何製作新材料

for reconstructing damaged or diseased human tissues,

用來重建人體受傷病損害的組織，

and we made the totally unexpected discovery

結果我們有了完全出乎意料的發現

that plants could be used for this purpose.

也就是植物可以做這個用途。

In fact, we invented a way to take these plants

其實，我們發明了一種 處理植物的方式，

and strip them of all their DNA and their cells,

去除它們所有的 DNA 和細胞，

leaving behind natural fibers.

只保留天然纖維。

And these fibers could then be used as a scaffold

再以這些纖維作為支架，

for reconstructing living tissue.

來重建活組織。

Now I know this is a little weird,

我知道這有點怪，

but in our very first proof-of-concept experiment,

但我們所做的第一個 概念驗證實驗，

we took an apple,

便是拿蘋果，

carved it into the shape of a human ear,

雕成人類耳朵的形狀，

and then we took that ear-shaped scaffold,

然後將這個耳朵形狀的支架

sterilized it, processed it

消毒，做處理

and coaxed human cells to grow inside of it.

並誘導人類細胞在其中生長。

We then took the next step and implanted it,

接著我們將它移植，

and we were able to demonstrate

藉以展示

that the scaffolds stimulated the formation of blood vessels,

這些支架刺激了血管的形成，

allowing the heart to keep them alive.

進而能靠心臟存活。

So not too long after these discoveries were taking place,

有了那些發現後不久，

I was at home cooking asparagus for dinner,

有一回我在家煮蘆筍當晚餐，

and after cutting the ends off,

在切去了蘆筍頭之後，

I was noticing that the stalks were full of these microchanneled vascular bundles.

我注意到這些蘆筍的莖裡 佈滿了微通道的維管束。

And it really reminded me

這讓我想到了

of a whole body of bioengineering effort aimed at treating spinal cord injury.

生物工程所投注於 脊髓損傷治療的大量努力。

Up to half a million people per year suffer from this type of injury,

每年有多達五百萬人受這種傷，

and the symptoms can range from pain and numbness

症狀由痛、麻

to devastating traumas

到嚴重創傷

that lead to a complete loss of motor function and independence.

所導致的完全喪失 運動機能及自理能力。

對於這類型的癱瘓，

And in these forms of paralysis,

there's no accepted treatment strategy,

目前還沒有可接受的治療策略，

but one possible solution

但有種可能的解決方式，

might be the use of a scaffold that has microchannels

便是採用含有微通道的支架，

which may guide regenerating neurons.

來引導神經元的再生。

So, could we use the asparagus and its vascular bundles

所以，我們可以使用 蘆筍和它的維管束

to repair a spinal cord?

來修復脊髓嗎？

This is a really dumb idea.

這是個很笨的主意。

First of all, humans aren't plants.

首先，人類不是植物。

Our cells have not evolved to grow on plant polymers,

我們的細胞還沒進化到 能生長在植物聚合物上，

and plant tissues have no business being found in your spinal cord.

而且你的脊髓裡不該有植物組織。

And secondly,

其次，

ideally these types of scaffolds should disappear over time,

在理想情況下， 這樣的支架應該隨時間消失，

leaving behind natural, healthy tissue.

只留下天然、健康的組織。

But plant-based scaffolds don't do that,

但植物做成的支架不會消失，

because we lack the enzymes to break them down.

因為我們缺乏分解它們的酵素。

Funnily enough,

有意思的是，

these properties were exactly why we were having so much success.

這些特性恰好是 我們能成功的原因。

Over the course of many experiments,

經過無數次的實驗，

we were able to demonstrate

我們可以展示

that the inertness of plant tissue is exactly why it's so biocompatible.

正是植物組織的惰性 使它具有高度的生物相容性。

In a way, the body almost doesn't even see it,

可以說身體幾乎看不見它的存在，

but regenerating cells benefit from its shape and stability.

而它的形狀和穩定性 卻有益於細胞再生。

Now this is all well and good,

雖然這些都很好，

but I constantly felt this weight of doubt

但每想到脊髓

我還是難免有所遲疑。

when it came to thinking about spinal cords.

So many scientists were using materials from traditional sources,

許多科學家採用傳統來源的材料，

like synthetic polymers and animal products --

像是合成聚合體以及動物產品 --

even human cadavers.

甚至人類的屍體。

I felt like a complete outsider

我覺得自己全然是局外人，

with no real right to work on such a hard problem.

根本沒資格來研究這樣的難題。

But because of this doubt,

然而正是因為這樣的自我懷疑，

I surrounded myself with neurosurgeons and clinicians,

讓我去找來許多 神經外科醫師和臨床醫師，

生物化學家和生物工程師，

biochemists and bioengineers,

and we started to plan experiments.

一起開始做實驗計劃。

The basic idea is that we would take an animal,

基本的構想是找一隻動物，

anesthetize it,

將牠麻醉，

expose its spinal cord

露出牠的脊髓，

and sever it in the thoracic region,

在脊索胸區切斷，

rendering the animal a paraplegic.

使牠後軀麻痺。

We would then implant an asparagus scaffold

我們接著植入一個蘆筍支架

置於被切斷的脊髓中

between the severed ends of the spinal cord

to act as a bridge.

作為橋接。

Now this is crucially important.

這是至關重要的。

We're only using asparagus.

我們只用了蘆筍。

We're not adding stem cells or electrical stimulation

我們沒加入任何幹細胞或電流刺激

or exoskeletons

或外骨骼

or physical therapy

或物理治療

or pharmaceuticals.

或藥物。

We're simply investigating

我們只是單純在研究

if the microchannels in the scaffold alone

是否單靠支架中的微通道

are enough to guide the regeneration of neurons.

便足以引導神經元再生。

And here are the main results.

主要的結果如下。

In this video, you can see an animal about eight weeks after being paralyzed.

影片中的動物 已經癱瘓了大約八週。

你可以看到牠後腿不能動，

You can see she can't move her back legs,

牠也沒法支撐起自己。

and she can't lift herself up.

Now I know how difficult this video is to watch.

我知道這影片讓人不忍卒睹。

My team struggled every day with these types of experiments,

我的團隊每天 做這種實驗都要掙扎，

and we constantly asked ourselves why we were doing this ...

一直問自己為什麼要做這個 ...

until we started to observe something extraordinary.

直到我們開始觀察到 非同尋常的東西。

這是一隻接受過移植的動物。

This is an animal that received an implant.

Now she's not walking perfectly,

雖然牠走路並不完美，

but she's moving those back legs

但牠的後腿已經能動

and she's even starting to lift herself up.

牠甚至也開始能撐起自己的身體。

在跑步機上，

And on a treadmill,

you can see those legs moving in a coordinated fashion.

你可以看見那些腿的協調動作。

These are crucial signs of recovery.

這些都是復原的關鍵跡象。

我們還有很多工作要做，

Now we still have a lot of work to do,

and there are a lot of questions to answer,

也還有許多疑問要解答，

but this is the first time anyone has shown

但這是首次有人展示

that plant tissues can be used to repair such a complex injury.

可以利用植物組織來修復 如此複雜的損傷。

Even so, we've been sitting on this data for over five years.

儘管如此，我們把這個數據 壓了超過五年才公布出來。

Doubt drove us to repeat these experiments again and again,

存疑使我們一再重複這些實驗，

to the point of almost bankrupting my lab.

做到我實驗室幾乎破產。

But I kept pushing,

但我不放棄，

because I knew these results could be the start of something extraordinary.

因為我知道這些結果 將會開啟非凡的將來。

And what's just as exciting

同樣令人興奮的是

is that my company is now translating these discoveries into the clinic --

我的公司正在將 這些發現轉入臨床 --

into the real world.

也就是現實世界中。

This technology has just been designated a breakthrough medical device by the FDA.

這個技術剛剛被 FDA 認定為 一項突破性的醫療裝置。

And this designation means

這項認定意味著

that right now we're in the midst of planning human clinical trials

我們現在正在計劃做人體臨床實驗

set to begin in about two years.

目標訂在兩年後開始。

So I'd like to show you a prototype

我要請大家來看這個原型

of one of our state-of-the-art spinal cord implants.

那是我們最先進的脊髓植體之一。

It's still made from asparagus

它仍是以蘆筍製成

and contains all of those microchannels.

裡頭全是那些微通道。

And you can see that it moves and bends

大家看得到它能動能彎

and has the same feel as human tissue.

有和人體組織一樣的的觸感。

你知道，

And you know,

I think the real innovation is that we're now able to design

我想真正的創新在於我們可以

將植物組織的架構和結構 設計或編排得

or program the architecture and structure of plant tissues in such a way

that they could direct cell growth to address an unmet medical need.

可以導引細胞生長， 來解決尚未滿足的醫療需求。

As scientists,

身為科學家，

we spend our lives living on a knife's edge.

我們一生都活在刀口上。

On the one hand,

從一方面來說，

it's our job to fundamentally broaden the horizons

我們的職責是從根本上拓展

of human knowledge,

人類的知識。

but at the same time, we're trained to doubt --

但同時我們又被 訓練成要去質疑 --

to doubt our data, to doubt our experiments,

質疑我們的資料， 質疑我們的實驗，

to doubt our own conclusions.

也質疑我們自己所做的結論.

We spend our lives crushed under the weight

我們一生背負這個重擔

of constant, unrelenting, never-ending anxiety, uncertainty and self-doubt.

承擔不斷的、無情的、無止境的 焦慮、不確定和自我懷疑。

And this is something I really struggle with.

這是我一直很掙扎的地方。

But I think almost every scientist can tell you

但我想幾乎每位科學家都能告訴你

about the time they ignored those doubts

他們曾不顧所有的質疑

and did the experiment that would never work.

去做不可能成功的實驗。

And the thing is, every now and then,

而結果呢，三不五時地

one of those experiments works out.

偏偏就有些實驗成功了。

The challenge we face is that while doubt can be destructive

我們面對的挑戰在於儘管質疑

to your mental health,

對我們的精神健康有害，

it's also the reason why scientific rigor is such a potent tool for discovery.

卻也將科學嚴謹造就成 強而有力的探索工具。

It forces us to ask the difficult questions

它迫使我們去問難解答的問題

and repeat experiments.

又將實驗一做再做。

一點也不容易。

Nothing about that is easy.

And often it becomes our responsibility

我們經常不得不挑起這個重任

to bear the burden of the hard and sometimes heart-wrenching experiment.

去進行艱難而又令人痛心的實驗。

This ultimately leads to the creation of new knowledge,

這最終促成了新知識的產生，

and in some really rare cases,

而且在一些非常罕見的情況下，

the type of innovation that just might change a person's life.

也會造就可以改變人生的創新。

Thank you.

謝謝大家。