Khalil Ramadi: Electronic pills that could transform how we treat disease | TED Fellows

譯者: Chung Hin Tam 審譯者: Amanda Zhu

[SHAPE YOUR FUTURE]

For decades, scientists have tried to use brain modulation

to treat neurological disorders.

Techniques usually involved sticking wires onto our head,

then helmets that immobilized our head

［塑造你的未來］

and zapping our brain with magnetic or electrical pulses.

幾十年來，科學家一直 嘗試調節大腦神經活動

Given what we now know about the millions of circuits that our brain has,

來治療神經系統疾病。

他們用的方法通常是 把電線黏在我們頭上，

this was much like trying to fix a pothole by resurfacing the entire road.

然後用頭套固定我們頭部，

並且用磁脈衝或電脈衝 電擊我們大腦。

Brain modulation can actually come in different forms.

就我們目前對大腦 數百萬個迴路的認識，

The brain connects with all organs in our bodies through neurons,

much like an octopus' tentacles.

剛提到的方法就像是為了修補 一個路面坑洞而把整條路重新鋪過。

This means that diabetes, cancer, autoimmune disorders can all be induced,

實際上，調節大腦神經活動 有不同的方法。

affected and exacerbated by the brain and the nervous system.

大腦透過神經元 與體內所有器官相連，

This also means that brain modulation can be achieved

像是章魚的觸手。

這代表大腦和神經系統可能會誘導 糖尿病、癌症、自體免疫性疾病出現，

through different parts of the body

by zapping organs and limbs with electrodes

that have usually been implanted with drills and scalpels.

也可能會影響病情發展，或者令其惡化。

Today, however, brain modulation doesn't have to be so invasive.

這也顯示了大腦神經的調節

Some of my colleagues at MIT

可以透過身體的不同部位做到。

have discovered that a potential therapy for Alzheimer's

做法是用鑽子和手術刀 將電極植入到器官和四肢內，

could be watching light of a certain wavelength

再加以電擊。

flash at a particular frequency.

然而，現在要調節腦神經 其實不需要用這種高侵入性的方法。

This is an example of something I like to call a bionudge --

我在麻省理工學院的一些同事

simple techniques that target specific circuits in our bodies

發現了一個可能治療 阿茲海默氏症的方法。

這方法只需要病人看著特定波長、 特定頻率的閃光。

to achieve a certain outcome,

like using light to slow degeneration and Alzheimer's.

這是我所謂「生物刺激」的一個例子，

Let me show you an example of a really simple bionudge.

In 10 seconds, I'm going to cause neurons in your pretectal area to light up

一個針對我們體內特定迴路 的簡單技術，

and then I'll stimulate your amygdala and hippocampus to surprise you.

以達到想要的功效，

就像用光來減慢身體退化 和緩和阿茲海默氏症一樣。

Finally, your arcuate nucleus to make you feel hungry.

讓我給你看「生物刺激」的 一個非常簡單的例子。

在 10 秒後，我會激活 在你頂蓋前區的神經元，

Bionudges don't need to be shocking or jarring,

然後刺激你的杏仁核 和海馬體，讓你大吃一驚，

They just need to be designed to activate or silence a specific brain circuit.

最後再刺激你的弓狀核， 讓你感到飢餓。

Combining bionudges in a certain order

can allow us to use them for a more targeted purpose.

「生物刺激」不一定要產生 明顯的衝擊或震動，

My team and I at MIT developed microdevices

只要能激活或緩和 特定的大腦迴路就可以了。

similar in shape and size to a pill that can be swallowed like we do pills

以特定的先後順序 給予多種「生物刺激」

and contain electronics

to deliver little bursts of electrical or chemical stimuli --

可以讓我們將用途設定得更精準。

我和我在麻省理工學院的團隊 開發了個微型裝置，

bionudges -- to our gut.

它的形狀和大小像顆藥丸， 可以像吃藥一樣吞下去。

Our gut is the largest interface of our body with the outside world.

It has an incredible combination of tissues all working together.

這裝置内還有些電子元件，

可以發出微弱的電流刺激或化學刺激

It houses enteroendocrine cells

that sense what we eat

——生物刺激——來刺激我們的腸胃道。

and induce the release of hormones that can regulate hunger and metabolism.

在我們的身體裡， 腸胃道是和外界接觸的最大介面，

It houses immune cells that sense the microbiome

腸胃道結合種類繁複的組織共同運作；

while preventing bacteria from entering our body.

其中包括了腸内分泌細胞，

And neurons -- lots and lots of neurons.

這種細胞能感知我們在吃什麼，

並誘導身體釋放調節飢餓感 和新陳代謝的荷爾蒙。

This is why certain sugary or salty foods can ramp up dopamine levels in our brain

腸胃道也有免疫細胞， 它們可以偵察到微生物群落，

and make us feel quite good after eating them.

預防細菌進入我們的身體。

Our electronic pills can be designed to reside in the gut for days to weeks,

腸胃裡還有神經元， 很多很多的神經元。

delivering bionudges to neurons along the GI tract.

這就是為什麼某些含糖食物或鹹食 可以使我們大腦中的多巴胺增加，

Depending on the shape and strength of these electrical impulses,

讓我們吃完這些食物之後感覺很好。

they can either affect hormone levels in our blood

我們的電子藥丸可以在腸胃道中 停留數天到數週，

or travel up to our brain

where they can activate or silence specific brain circuits

以「生物刺激」 沿著腸胃道刺激神經元。

that control hunger, metabolism and arousal.

「生物刺激」的電脈衝 會因形狀和強度不同，

Much like we did just a few minutes ago.

而可能影響我們血液中的賀爾蒙濃度，

Using our devices, we could stimulate the stomach

或傳導到我們的大腦中控制飢餓感、 新陳代謝和性興奮的腦迴路，

to tackle nausea or influence satiety

or the intestine to change the way we digest things like glucose

然後激活或減緩這些腦迴路的活動，

by affecting absorption of nutrients in food.

就像我們幾分鐘前所做的一樣。

This could mean new, noninvasive therapies for the 34 million diabetics in the US

透過我們的裝置，

我們還可以刺激胃部， 舒緩反胃或影響飽足感，

and 650 million obese population worldwide.

或以此裝置刺激腸道， 影響食物中養分的吸收，

We could even affect things like inflammation in the brain,

進而改變我們消化 葡萄糖等養分的方式。

slowing down degeneration for the almost 60 million patients

這會是一種新的非侵入性療法， 能幫助美國 3,400 萬糖尿病患者

with Parkinson's or Alzheimer's around the world.

和全球 6.5 億的肥胖人口，

By being super specific, we can avoid side effects,

甚至還可以影響腦部發炎反應，

unlike most of our drugs.

And in this way we can control appetite, nutrient digestion, hormone levels,

幫助世界各地近 6,000 萬的 帕金森氏症或阿茲海默氏症患者，

減緩他們的腦部退化。

even happiness and reward.

This is exciting.

最具體地說，用這個裝置 可以避免很多副作用，

Bionudges are more targeted than medicines and less invasive than surgery.

而大多數藥物都有副作用。

如此我們就可以控制食慾、 營養的消化、賀爾蒙濃度，

Neuromodulation therapies could be a new gold standard in health care.

甚至幸福感和滿足的酬賞感。

I'd like to leave you with an image:

真令人振奮！

「生物刺激」比藥物更有針對性， 侵入性也比手術小。

a single pill, not filled with drugs or chemicals,

but with electronics and microdevices

神經調節療法可能會成爲 新的醫療保健黃金標準。

that deliver little bursts of energy to our gut.

我想給你一個畫面：

This pill can treat Parkinson's, Alzheimer's, diabetes or obesity,

一顆藥丸，裝的不是藥物或化學品，

all without any chronic drugs, completely noninvasively.

而是可以向我們的腸道

發出陣陣微弱能量的 電子元件和微型裝置。

No drill, no surgery, no hospital stay.

這顆藥丸可以用來治療帕金森氏症、 阿茲海默氏症、糖尿病或肥胖症，

This is how medicine could be.

This is how medicine should be.

不需任何長期藥物輔助， 完全不具侵入性。

Thank you.

不用鑽孔，不用手術，也不用住院。

這就是醫療的可能性，

醫療就應該是這樣子。

謝謝。