The key to a better malaria vaccine | Faith Osier

譯者: Lilian Chiu 審譯者: Helen Chang

There are 200 million clinical cases

每年，在非洲都有兩億個

of falciparum malaria in Africa every year,

惡性瘧疾的臨床案例，

resulting in half a million deaths.

造成五十萬人死亡。

I would like to talk to you about malaria vaccines.

我想要和各位談的是瘧疾疫苗。

The ones that we have made to date are simply not good enough.

目前我們已經製造出來的疫苗，

就是還不夠好。

Why?

為什麼？

We've been working at it for 100 plus years.

我們已經花了超過 一百年的時間在疫苗上。

When we started, technology was limited.

一開始，科技很有限。

We could see just a tiny fraction of what the parasite really looked like.

我們看到的只是寄生蟲

真正樣貌的極小一部分。

Today, we are awash with technology,

現今，處處都是科技、

advanced imaging and omics platforms --

先進成像技術，以及組學平台——

genomics, transcriptomics, proteomics.

基因組學、轉錄組學、 蛋白質組學。

These tools have given us a clearer view

這些工具讓我們能更清楚看到

of just how complex the parasite really is.

寄生蟲實際上有多麼複雜。

However, in spite of this,

然而，儘管如此，

our approach to vaccine design has remained pretty rudimentary.

我們的疫苗設計方法

仍然停留在很初階的程度。

To make a good vaccine, we must go back to basics

若要做出好的疫苗， 我們必須要回到基礎，

to understand how our bodies handle this complexity.

去了解我們的身體 如何處理這種複雜性。

People who are frequently infected with malaria

經常感染到瘧疾的人

learn to deal with it.

學會處理瘧疾。

They get the infection, but they don't get ill.

他們會被感染，但他們不會生病。

The recipe is encoded in antibodies.

秘方就藏在抗體當中。

My team went back to our complex parasite,

我的團隊回頭研究複雜的寄生蟲，

probed it with samples from Africans who had overcome malaria

從已經克服了瘧疾的非洲人 身上取得樣本來探究，

to answer the question:

希望能回答這個問題：

"What does a successful antibody response look like?"

「成功的抗體反應 看起來是什麼樣子的？」

We found over 200 proteins,

我們找到超過兩百種蛋白質，

many of which are not on the radar for malaria vaccines.

當中有許多種還沒 被瘧疾疫苗注意到。

My research community may be missing out important parts of the parasite.

我的研究圈可能遺漏了 寄生蟲的某些重要部分。

Until recently, when one had identified a protein of interest,

直到最近，當一種讓人 感興趣的蛋白質被找出來時，

they tested whether it might be important for a vaccine

他們測試看它對於疫苗是否重要，

by conducting a cohort study.

用的方法是群體研究。

This typically involved about 300 participants in a village in Africa,

這項研究涉及了非洲 一個村落中約三百位受試者，

whose samples were analyzed to see

研究分析他們的樣本，

whether antibodies to the protein would predict who got malaria

看看這種蛋白質的抗體 是否能用來預測

誰得了瘧疾、誰沒有得。

and who did not.

In the past 30 years,

在過去三十年，

these studies have tested a small number of proteins

這些研究已經測試了幾種蛋白質，

in relatively few samples

用的樣本數量相對比較少，

and usually in single locations.

且通常只在單一地點測試。

The results have not been consistent.

結果並沒有一致性。

My team essentially collapsed 30 years of this type of research

基本上，我的團隊是把

三十年的這類研究通通摺疊起來，

into one exciting experiment, conducted over just three months.

成為一項讓人興奮的實驗， 只花了三個月的時間進行。

Innovatively, we assembled 10,000 samples

我們以創新的方式， 組合一萬個樣本，

from 15 locations in seven African countries,

這些樣本來自七個非洲國家的 十五個不同地點，

spanning time, age and the variable intensity

包含非洲發生瘧疾的各時間點、

of malaria experienced in Africa.

年齡層，以及變數強度。

We used omics intelligence to prioritize our parasite proteins,

我們用組學智慧

來排定寄生蟲蛋白質的優先順序，

synthesize them in the lab

在實驗室中合成它們，簡言之，

and in short, recreated the malaria parasite on a chip.

我們在一片晶片上 重建瘧疾寄生蟲。

We did this in Africa, and we're very proud of that.

我們在非洲做了這些， 我們感到非常驕傲。

(Applause)

（掌聲）

The chip is a small glass slide,

晶片是一片小的玻璃載片，

but it gives us incredible power.

但它給我們很大的能力。

We simultaneously gathered data on over 100 antibody responses.

我們同時收集

超過一百種抗體反應的資料。

What are we looking for?

我們在找什麼？

The recipe behind a successful antibody response,

成功抗體反應背後的秘方，

so that we can predict what might make a good malaria vaccine.

有了它，我們就能預測 用什麼能製造出好的瘧疾疫苗。

We're also trying to figure out

我們也試圖找出

exactly what antibodies do to the parasite.

抗體對寄生蟲會有什麼影響。

How do they kill it?

它們如何殺死寄生蟲？ 它們從多個角度攻擊嗎？

Do they attack from multiple angles? Is there synergy?

它們會協力嗎？你需要多少抗體？

How much antibody do you need?

Our studies suggest that having a bit of one antibody won't be enough.

我們的研究指出，

只有少量的一種抗體是不夠的。

It might take high concentrations of antibodies

可能會需要高濃度的抗體

against multiple parasite proteins.

來對抗多種寄生蟲蛋白質。

We're also learning that antibodies kill the parasite in multiple ways,

我們也發現，抗體會以 多種方式殺死寄生蟲，

and studying any one of these in isolation may not adequately reflect reality.

只單獨研究其中一種，

可能無法適當地反映出真實狀況。

Just like we can now see the parasite in greater definition,

就如同現在我們會用 更廣的定義來看待寄生蟲，

my team and I are focused

我和我的團隊把焦點放在去了解

on understanding how our bodies overcome this complexity.

我們的身體如何克服這種複雜度。

We believe that this could provide the breakthroughs that we need

我們相信這個答案能協助我們突破，

to make malaria history through vaccination.

讓我們能用疫苗將瘧疾送入歷史。

Thank you.

謝謝。

(Applause)

（掌聲）

(Cheers)

（歡呼）

(Applause)

（掌聲）

Shoham Arad: OK, how close are we actually to a malaria vaccine?

休哈姆阿拉德：我們現在 有多接近成功研發瘧疾疫苗？

Faith Osier: We're just at the beginning of a process

費絲奧西：我們還在 一個過程的開端，

to try and understand what we need to put in the vaccine

試圖了解我們需要 在疫苗中加入什麼，

before we actually start making it.

接下來才能真正開始製造疫苗。

So, we're not really close to the vaccine, but we're getting there.

所以我們其實離疫苗並不近， 但我們在朝那裡前進。

SA: And we're hopeful.

休：而我們抱有希望。 費：而我們抱有希望。

FO: And we're very hopeful.

SA: Tell me about SMART, tell me what does it stand for

休：跟我們談談 SMART， 它是什麼的縮寫？

and why is it important to you?

為什麼它對你這麼重要？

FO: So SMART stands for South-South Malaria Antigen Research Partnership.

費：SMART 代表的是

南南瘧疾抗原研究合夥集團。

The South-South is referring to us in Africa,

南南指的是非洲的我們，

looking sideways to each other in collaboration,

以從旁協助彼此的方式來合作，

in contrast to always looking to America and looking to Europe,

而不是總是要 指望美國、指望歐洲，

when there is quite some strength within Africa.

在非洲本身就有不少長處。

So in SMART,

在 SMART，除了我們的目標，

apart from the goal that we have, to develop a malaria vaccine,

也就是開發瘧疾疫苗，

we are also training African scientists,

我們也會訓練非洲科學家，

because the burden of disease in Africa is high,

因為在非洲，疾病的負擔很高，

and you need people who will continue to push the boundaries

在非洲，需要有人持續不斷

in science, in Africa.

把科學的界線向外推。

SA: Yes, yes, correct.

休：是的，是的，沒錯。

(Applause)

（掌聲）

OK, one last question.

好，最後一個問題。

Tell me, I know you mentioned this a little bit,

告訴我，我知道 你剛才有提到一點點，

but how would things actually change if there were a malaria vaccine?

但，如果研發出了瘧疾疫苗， 會帶來什麼改變？

FO: We would save half a million lives every year.

費：每年我們可以 拯救五十萬人的性命。

Two hundred million cases.

兩千萬個案例。

It's estimated that malaria costs Africa 12 billion US dollars a year.

據估計，非洲一年就要花

120 億美金的成本在瘧疾上。

So this is economics.

所以，這是經濟。非洲會繁榮。

Africa would simply thrive.

SA: OK. Thank you, Faith.

休：好，謝謝你， 費絲，非常謝謝你。

Thank you so much.

(Applause)

（掌聲）