Nina Tandon: Could tissue engineering mean personalized medicine?

Translator: Joseph Geni Reviewer: Morton Bast

譯者: Cheng An Yang 審譯者: Ho-chung Chou

I'd like to show you a video of some of the models

我想讓大家看一段模特兒的影片

I work with.

他們是我的工作夥伴

They're all the perfect size, and they don't have an ounce of fat.

他們都有完美的身材，各個穠纖合度

Did I mention they're gorgeous?

我有說過他們超美的嗎？

And they're scientific models? (Laughs)

還有他們是科學模特兒嗎？(笑聲)

As you might have guessed, I'm a tissue engineer,

你們可能會猜我是個組織工程學家吧

and this is a video of some of the beating heart

然後這段影片是在拍攝跳動的心臟

that I've engineered in the lab.

這是我在實驗室設計的

And one day we hope that these tissues

我們希望有一天，這些組織

can serve as replacement parts for the human body.

可以當作某些人體器官的替代品

But what I'm going to tell you about today

但是我今天要跟大家說的

is how these tissues make awesome models.

是為什麼這些組織能成為頂尖的模特兒(模型)

Well, let's think about the drug screening process for a moment.

好，讓我們先來看看藥物檢驗的流程

You go from drug formulation, lab testing, animal testing,

從藥物配方、實驗室測試、動物測試

and then clinical trials, which you might call human testing,

到臨床測試，也可以稱之為人體實驗

before the drugs get to market.

完成這些步驟才會上市

It costs a lot of money, a lot of time,

這樣的流程很花錢，很費時

and sometimes, even when a drug hits the market,

甚至有時候連已經上市的藥物

it acts in an unpredictable way and actually hurts people.

都會讓人體產生無法預測的反應，造成實質的傷害

And the later it fails, the worse the consequences.

而且問題發現得越晚，後果就會越嚴重

It all boils down to two issues. One, humans are not rats,

我們將之簡化為兩個問題。第一，人類不是老鼠

and two, despite our incredible similarities to one another,

第二，儘管人和人之間的差異微乎其微

actually those tiny differences between you and I

但是我們之間這些微小的差異

have huge impacts with how we metabolize drugs

卻讓我們代謝藥物的反應和藥效

and how those drugs affect us.

有天壤之別

So what if we had better models in the lab

所以，如果說我們的實驗室使用了更好的模型

that could not only mimic us better than rats

而這些模型不單只是比老鼠更接近人類

but also reflect our diversity?

還可以反映出人體的多元性呢?

Let's see how we can do it with tissue engineering.

我們來看看，組織工程學能做些什麼

One of the key technologies that's really important

其中一項至關重要的關鍵科技

is what's called induced pluripotent stem cells.

我們稱之為"誘導性多功能幹細胞"

They were developed in Japan pretty recently.

最近由日本發展出來的

Okay, induced pluripotent stem cells.

好，誘導性多功能幹細胞

They're a lot like embryonic stem cells

和胚胎幹細胞有許多相似之處

except without the controversy.

只是沒有道德爭議性

We induce cells, okay, say, skin cells,

我們誘導細胞生長，舉例來說，皮膚細胞

by adding a few genes to them, culturing them,

的方式是植入微量的基因，培養它們

and then harvesting them.

接著就可以採收

So they're skin cells that can be tricked,

所以我們可以欺騙這些皮膚細胞

kind of like cellular amnesia, into an embryonic state.

可以說是讓細胞罹患失憶症，讓他們變回胚胎模式

So without the controversy, that's cool thing number one.

因此沒有道德爭議性，這是第一個好處

Cool thing number two, you can grow any type of tissue

第二個好處是，你可以用它培養出任何的組織

out of them: brain, heart, liver, you get the picture,

大腦、心臟、肝臟，你們都知道的

but out of your cells.

都是出於自己的細胞

So we can make a model of your heart, your brain

所以我們可以做出你的心臟，你的大腦的模版

on a chip.

在晶片上

Generating tissues of predictable density and behavior

培育出密度和行為模式可預測的組織

is the second piece, and will be really key towards

是第二步驟，這個進展非常重要

getting these models to be adopted for drug discovery.

使得這些模型能應用於藥物測試

And this is a schematic of a bioreactor we're developing in our lab

這張圖是我們實驗室正在發展的生物反應器

to help engineer tissues in a more modular, scalable way.

它能提高組織工程進行時的模式性和控制性

Going forward, imagine a massively parallel version of this

未來，你們想像一下許多台這種儀器並聯在一起的樣子

with thousands of pieces of human tissue.

裡面有數以千計的人類組織

It would be like having a clinical trial on a chip.

就好像在晶片上面進行臨床試驗

But another thing about these induced pluripotent stem cells

關於誘導性多功能幹細胞，還有另外一件事

is that if we take some skin cells, let's say,

那就是如果我們採集了一些皮膚細胞，例如說

from people with a genetic disease

從有遺傳性疾病的人身上

and we engineer tissues out of them,

然後我們從中培育出一些組織

we can actually use tissue-engineering techniques

我們可以實際利用組織工程的技術

to generate models of those diseases in the lab.

在實驗室裡培育這些疾病的模型

Here's an example from Kevin Eggan's lab at Harvard.

這個例子來自Kevin Eggin在哈佛的實驗室

He generated neurons

他培養出神經元

from these induced pluripotent stem cells

從誘導性多功能幹細胞中

from patients who have Lou Gehrig's Disease,

樣本來自Lou Gehrig症 (肌肉萎縮性側索硬化症) 的病患

and he differentiated them into neurons, and what's amazing

他將它們分化成神經元，不可思議的是

is that these neurons also show symptoms of the disease.

這些神經元也反應出該疾病的症狀

So with disease models like these, we can fight back

所以有了這些疾病的模型，我們能以前所未有的速度

faster than ever before and understand the disease better

反擊它們，還能以前所未有的角度

than ever before, and maybe discover drugs even faster.

了解它們，甚至能加快藥物研發的腳步

This is another example of patient-specific stem cells

這是另一個例子，這種遺傳性疾病幹細胞

that were engineered from someone with retinitis pigmentosa.

培育自色素性視網膜炎的患者

This is a degeneration of the retina.

這種病是視網膜的衰退

It's a disease that runs in my family, and we really hope

這是我們家族成員常罹患的疾病，我們真的很希望

that cells like these will help us find a cure.

這類的幹細胞可以幫助我們找到解藥

So some people think that these models sound well and good,

因此，有些人認為這些模型看起來完美無缺

but ask, "Well, are these really as good as the rat?"

但是他們會問： "這些細胞真的跟小白鼠一樣好用嗎？"

The rat is an entire organism, after all,

畢竟老鼠是完整的生物體

with interacting networks of organs.

器官之間有完整的互動網路

A drug for the heart can get metabolized in the liver,

用於心臟的藥會在肝臟代謝

and some of the byproducts may be stored in the fat.

而且有些藥效副產品可能會儲存在脂肪

Don't you miss all that with these tissue-engineered models?

這些效果在組織工程的模型上不是都看不出來嗎？

Well, this is another trend in the field.

沒錯，這是這領域的另外一個研究趨勢

By combining tissue engineering techniques with microfluidics,

將組織工程的技術與微流學結合在一起

the field is actually evolving towards just that,

實際上，這個領域正朝這個方向發展

a model of the entire ecosystem of the body,

人體全生態系統的模型

complete with multiple organ systems to be able to test

必須包含複合的器官系統才得以測試

how a drug you might take for your blood pressure

為了控制血壓而服用的藥物

might affect your liver or an antidepressant might affect your heart.

可能會影響你的肝臟，服用抗憂鬱劑或許會影響你的心臟

These systems are really hard to build, but we're just starting to be able to get there,

這些系統很難架構，但是我們開始著手進行了

and so, watch out.

所以，等著看吧

But that's not even all of it, because once a drug is approved,

但是這還不是全部，因為一旦藥物獲得許可

tissue engineering techniques can actually help us develop more personalized treatments.

組織工程的技術真的能幫助我們 使療程更符合個人需求

This is an example that you might care about someday,

未來的某天你可能需要了解這些相關資訊

and I hope you never do,

但是我希望這一天永遠不會來

because imagine if you ever get that call

因為你想像，自己可能接到了一通電話

that gives you that bad news that you might have cancer.

帶來的是壞消息，你可能罹患癌症了

Wouldn't you rather test to see if those cancer drugs

你難道不想先試用那些治療癌症的藥物

you're going to take are going to work on your cancer?

看看那些藥是否真的可以對抗你的癌症嗎？

This is an example from Karen Burg's lab, where they're

這是Karen Burg的實驗室的例子，他們那裏

using inkjet technologies to print breast cancer cells

使用噴墨技術來標的乳癌細胞

and study its progressions and treatments.

並研究細胞的發展及療效

And some of our colleagues at Tufts are mixing models

我們Tufts有幾個同事正在結合不同模型

like these with tissue-engineered bone to see how cancer

例如結合那些組織工程研發的骨頭，觀察癌症如何

might spread from one part of the body to the next,

從身體這個區域擴散到下一個區域

and you can imagine those kinds of multi-tissue chips

你可以想像一下，那些包含多種組織的晶片

to be the next generation of these kinds of studies.

會在下個世代，成為這類研究的主流

And so thinking about the models that we've just discussed,

所以，回想我們剛剛討論的這些模型

you can see, going forward, that tissue engineering

你會發現，未來的組織工程學

is actually poised to help revolutionize drug screening

有助於藥物檢驗，我們努力過程的每一步

at every single step of the path:

都能使其產生突破性的變革

disease models making for better drug formulations,

疾病模型可以製作出更好的藥物配方

massively parallel human tissue models helping to revolutionize lab testing,

多樣而大量的人類組織模型 有助於實驗室測試的變革

reduce animal testing and human testing in clinical trials,

減少動物臨床測試及人類臨床測試

and individualized therapies that disrupt

使療程個人化，改變我們以往的想法

what we even consider to be a market at all.

認為一套療程適用於所有人

Essentially, we're dramatically speeding up that feedback

而我們實際的數據回饋 也以戲劇化的速度增加

between developing a molecule and learning about

實驗內容是培養單一分子，並研究其

how it acts in the human body.

在人體中的反應為何

Our process for doing this is essentially transforming

我們的所作所為，其實就是

biotechnology and pharmacology into an information technology,

將生物科技跟藥理學轉換成資訊科技

helping us discover and evaluate drugs faster,

幫助我們加快藥物開發與評估的速度

more cheaply and more effectively.

減少成本，提高效率

It gives new meaning to models against animal testing, doesn't it?

比起動物試驗，這樣的作法更有意義，不是嗎?

Thank you. (Applause)

謝謝大家 (鼓掌)