Alan Russell: The potential of regenerative medicine

譯者: Yu-Ju Chiang 審譯者: Ai-Ying (Erin) Chiang

I'm going to talk to you today about

今天我所要談的主題

hopefully converting fear into hope.

期盼能在未來化恐懼為希望

When we go to the physician today --

我們去看醫生的時候

when we go to the doctor's office and we walk in,

當我們走進診療室

there are words that we just don't want to hear.

有些話是我們不想聽到的

There are words that we're truly afraid of.

有些字讓我們深深恐懼

Diabetes, cancer, Parkinson's, Alzheimer's,

像是糖尿病、癌症、帕金森氏症、阿茲海默症

heart failure, lung failure --

心臟衰竭、肺衰竭

things that we know are debilitating diseases,

這些都是大家熟知的衰退性疾病

for which there's relatively little that can be done.

對於這些疾病我們卻束手無策

And what I want to lay out for you today is

今天我所要分享的是

a different way of thinking about how to treat debilitating disease,

用新的角度來思考衰退性疾病的療法

why it's important,

這為什麼重要、

why without it perhaps our health care system will melt down

又為什麼少了它醫療體系將會瓦解

if you think it already hasn't,

要是你認為醫療體系現在還沒走到這一步

and where we are clinically today, and where we might go tomorrow,

還有目前的臨床成果和可能的未來走向

and what some of the hurdles are.

有哪些困難需要克服

And we're going to do all of that in 18 minutes, I promise.

我保證一定會在 18 分鐘內全部講完

I want to start with this slide,

讓我從這張投影片開始

because this slide sort of tells the story the way Science Magazine thinks of it.

因為這張投影片反映出「科學」期刊的看法

This was an issue from 2002

這一期發刊於 2002 年

that they published with a lot of different articles on the bionic human.

裡面發表了各種有關生化人的文章

It was basically a regenerative medicine issue.

基本上就是再生醫學專題

Regenerative medicine is an extraordinarily simple concept

再生醫學其實是個非常簡單的概念

that everybody can understand.

一般人都能理解

It's simply accelerating the pace at which the body heals itself

就是加快人體自我修復的速度

to a clinically relevant timescale.

達到在臨床上合理的時間範圍

So we know how to do this in many of the ways that are up there.

目前我們已知可行的方法很多，都在這裡

We know that if we have a damaged hip, you can put an artificial hip in.

我們知道要是髖關節損壞，就裝人工髖關節

And this is the idea that Science Magazine used on their front cover.

這就是這期 「科學」 期刊的封面所要表達的想法

This is the complete antithesis of regenerative medicine.

其實這跟再生醫學完全相反

This is not regenerative medicine.

這不是再生醫學

Regenerative medicine is what Business Week put up

這本「商業周刊」討論的才是再生醫學

when they did a story about regenerative medicine not too long ago.

不久前，他們刊出一篇有關再生醫學的文章

The idea is that instead of figuring out how to ameliorate symptoms

想法是與其想辦法改善症狀

with devices and drugs and the like --

用醫學裝置或藥物等等的

and I'll come back to that theme a few times --

這主題我們會不斷回頭討論

instead of doing that, we will regenerate lost function of the body

與其這麼做，我們不如重建身體失去的功能

by regenerating the function of organs and damaged tissue.

做法是重建損壞的器官和組織

So that at the end of the treatment,

如此一來，診程結束後

you are the same as you were at the beginning of the treatment.

我們的身體就回到治療前的狀態

Very few good ideas -- if you agree that this is a good idea --

好點子還真的不多，如果你們也覺得這想法不錯

very few good ideas are truly novel.

真正創新的好點子很少

And this is just the same.

就像我要討論的議題一樣

If you look back in history,

要是我們回想歷史

Charles Lindbergh, who was better known for flying airplanes,

以飛越大西洋成名的查爾斯．林白

was actually one of the first people

其實正是先驅者之一

along with Alexis Carrel, one of the Nobel Laureates from Rockefeller,

還有洛克斐勒醫學研究機構的諾貝爾醫學獎得主艾利克斯．卡萊爾

to begin to think about, could you culture organs?

就是他們開始思考，人工培養器官是否可行?

And they published this book in 1937,

而且在1937 年出版了這本書

where they actually began to think about,

在書中他們甚至開始考慮

what could you do in bio-reactors to grow whole organs?

要如何在生物反應器中培養出一整個器官?

We've come a long way since then.

到了今天，我們已經有了長足進步

I'm going to share with you some of the exciting work that's going on.

我現在要跟大家分享的是一些進行中的研究

But before doing that, what I'd like to do

但是在這之前，我想先與大家分享

is share my depression about the health care system

我對現今醫療體系的悲觀想法

and the need for this with you.

以及再生醫學的必要性

Many of the talks yesterday talked about

昨天的講題很多都談論到

improving the quality of life, and reducing poverty,

提升生活品質和減少貧窮發生

and essentially increasing life expectancy all around the globe.

以及真正延長全球人口的壽命

One of the challenges is that the richer we are, the longer we live.

難題之一就是我們越富裕，壽命就越長

And the longer we live, the more expensive it is

但壽命越長，開銷就越大

to take care of our diseases as we get older.

醫療照護的開銷跟壽命延長成正比

This is simply the wealth of a country

這是一張探討國家的富裕程度

versus the percent of population over the age of 65.

與 65 歲以上人口比例相關性的圖

And you can basically see that the richer a country is,

很明顯可以看出，國家越富有

the older the people are within it.

國民壽命就越長

Why is this important?

這為什麼重要？

And why is this a particularly dramatic challenge right now?

又為什麼是當下最嚴峻的考驗?

If the average age of your population is 30,

如果人口平均年齡是 30 歲

then the average kind of disease that you have to treat

那麼一般需要醫療的疾病可能是

is maybe a broken ankle every now and again,

三不五時扭傷腳踝

maybe a little bit of asthma.

也許加上點氣喘

If the average age in your country is 45 to 55,

要是國家的平均年齡是 45 到 55 歲

now the average person is looking at diabetes,

那麼普遍的疾病可能是糖尿病

early-onset diabetes, heart failure, coronary artery disease --

早發性糖尿病、心臟衰竭、心血管疾病

things that are inherently more difficult to treat,

這些疾病的治癒難度本來就較高

and much more expensive to treat.

且醫療成本也高出許多

Just have a look at the demographics in the U.S. here.

來看一下這份美國人口統計資料

This is from "The Untied States of America."

擷取自「The Untied States of America」這本書

In 1930, there were 41 workers per retiree.

在 1930 年間，每 41 個勞力人口中就有 1 個退休

41 people who were basically outside of being really sick,

這 41 個身體沒有嚴重疾病的人

paying for the one retiree who was experiencing debilitating disease.

僅需負擔這 1 個退休人口治療衰退性疾病的費用

In 2010, two workers per retiree in the U.S.

到了 2010 年，每兩個勞力人口中就有 1 人退休

And this is matched in every industrialized, wealthy country in the world.

而且全球各工業化的富裕國家都是如此

How can you actually afford to treat patients

我們要如何才能負擔醫療成本？

when the reality of getting old looks like this?

要是老化所要面對的現實就是如此？

This is age versus cost of health care.

這張圖顯示年齡與醫療照護成本之間的關係

And you can see that right around age 45, 40 to 45,

可以看出大約在 45 歲，40 到 45 歲的區間

there's a sudden spike in the cost of health care.

醫療照護成本急遽上升

It's actually quite interesting. If you do the right studies,

這其實相當有趣，在適當的統計研究下

you can look at how much you as an individual spend on your own health care,

我們可以看出自己在人生各個階段

plotted over your lifetime.

所需的醫療成本

And about seven years before you're about to die, there's a spike.

而且在死亡前 7 年會出現一個高峰

And you can actually --

我們還可以...

(Laughter)

(笑聲)

-- we won't get into that.

...我們還是不要討論這些

(Laughter)

(笑聲)

There are very few things, very few things that you can really do

其實我們真正能做的很有限

that will change the way that you can treat these kinds of diseases

要改變這些疾病的治療方式

and experience what I would call healthy aging.

同時享受我所謂的「健康老化」

I'd suggest there are four things,

我想提出 4 個想法

and none of these things include an insurance system or a legal system.

而且都跟壽險和立法無關

All those things do is change who pays.

僅僅是改變只是負擔費用的對象

They don't actually change what the actual cost of the treatment is.

實際需要的醫療成本不變

One thing you can do is not treat. You can ration health care.

我們的選擇之一就是不治療，也可以配給醫療資源

We won't talk about that anymore. It's too depressing.

我們不要再討論這方面，實在太令人沮喪了。

You can prevent.

我們可以預防

Obviously a lot of monies should be put into prevention.

當然我們應該要在預防上投入許多經費

But perhaps most interesting, to me anyway, and most important,

不過最有趣也最重要的想法可能是

is the idea of diagnosing a disease much earlier on in the progression,

儘早在症狀惡化的過程中診斷

and then treating the disease to cure the disease

進而根治疾病

instead of treating a symptom.

而不是只對症下藥

Think of it in terms of diabetes, for instance.

以糖尿病為例

Today, with diabetes, what do we do?

現在我們如何治療糖尿病?

We diagnose the disease eventually, once it becomes symptomatic,

我們要到出現症狀才能診斷出疾病

and then we treat the symptom for 10, 20, 30, 40 years.

然後再花 10、20、30、40 年來對症下藥

And we do OK. Insulin's a pretty good therapy.

結果還算可以，胰島素注射是個不錯的療法

But eventually it stops working,

不過它終究會就失去藥效

and diabetes leads to a predictable onset of debilitating disease.

而且糖尿病一定會併發衰退性疾病

Why couldn't we just inject the pancreas with something

為什麼我們不在發病初期就注射物質到胰臟

to regenerate the pancreas early on in the disease,

促進胰臟再生，

perhaps even before it was symptomatic?

或甚至在症狀出現前就這麼做呢?

And it might be a little bit expensive at the time that we did it,

這種治療一開始可能貴一點

but if it worked, we would truly be able to do something different.

不過一旦成功，我們就真正能開始嘗試變通

This video, I think, gets across the concept that I'm talking about quite dramatically.

我覺得這段影片清楚的表達我想傳達的概念

This is a newt re-growing its limb.

這是一隻在進行肢體再生的蠑螈

If a newt can do this kind of thing, why can't we?

蠑螈做得到，為什麼我們不能?

I'll actually show you some more important features

待會我會讓大家看一些更重要的

about limb regeneration in a moment.

有關肢體再生的報導

But what we're talking about in regenerative medicine

但是在再生醫學中討論的

is doing this in every organ system of the body,

是重建體內所有的器官系統

for tissues and for organs themselves.

無論是針對組織和器官

So today's reality is that if we get sick,

在現實中，要是生病了

the message is we will treat your symptoms,

醫生會治療我們的症狀

and you need to adjust to a new way of life.

而且我們必須適應新的生活方式

I would pose to you that tomorrow --

我想要讓大家看看未來

and when tomorrow is we could debate,

雖然還沒辦法確定「未來」何時會來

but it's within the foreseeable future --

不過，應該不用等太久

we will talk about regenerative rehabilitation.

我想談談再生復健

There's a limb prosthetic up here,

這是個義肢

similar actually one on the soldier

跟從戰地回來的士兵

that's come back from Iraq.

所用的類似

There are 370 soldiers that have come back from Iraq that have lost limbs.

有 370 位剛從伊拉克返國的士兵手腳截肢

Imagine if instead of facing that, they could actually

試想與其截肢, 他們其實可以

face the regeneration of that limb.

重建完整的四肢

It's a wild concept.

這是個很瘋狂的想法

I'll show you where we are at the moment in working towards that concept.

我將展示這個想法目前的進展

But it's applicable, again, to every organ system.

再次強調，這可以適用於任何器官

How can we do that?

要怎麼做到呢？

The way to do that is to develop a conversation with the body.

作法是與身體建立良好的溝通

We need to learn to speak the body's language.

我們必須學習了解人體的各種訊息

And to switch on processes that we knew how to do when we were a fetus.

且要開啟胎兒時期曾經擁有的再生能力

A mammalian fetus, if it loses a limb during the first trimester of pregnancy,

哺乳類動物的胎兒在懷孕期的頭三個月

will re-grow that limb.

失去的手腳可以重新長出來

So our DNA has the capacity to do these kinds of wound-healing mechanisms.

因此我們的 DNA 中就有這種癒合機制

It's a natural process,

這是個自然的過程

but it is lost as we age.

卻隨著年齡增長而流失

In a child, before the age of about six months,

一個未滿 6 個月的嬰兒

if they lose their fingertip in an accident,

要是意外割斷了指尖

they'll re-grow their fingertip.

可以重新長回來

By the time they're five, they won't be able to do that anymore.

不過到了 5 歲，他們就失去這種能力

So to engage in that conversation with the body,

為了能夠找回這樣的能力

we need to speak the body's language.

我們必須學會解讀身體的訊息

And there are certain tools in our toolbox that allow us to do this today.

以下是一些目前正在使用的技術

I'm going to give you an example of three of these tools

我會介紹其中的 3 種

through which to converse with the body.

透過這些技術我們可以與身體溝通

The first is cellular therapies.

第一個是細胞療法

Clearly, we heal ourselves in a natural process,

這顯然是利用癒合的自然程序

using cells to do most of the work.

用細胞進行大部分的癒合工作

Therefore, if we can find the right cells

因此，只要找到適合的細胞

and implant them in the body, they may do the healing.

然後植入人體，或許就能成功

Secondly, we can use materials.

第二種我們可以使用材料

We heard yesterday about the importance of new materials.

昨天的講題告訴我們新材料的重要性

If we can invent materials, design materials,

如果我們能從自然界合成、設計

or extract materials from a natural environment,

或提煉出新的材料

then we might be able to have those materials induce the body to heal itself.

或許就可以利用這些材料來誘發身體的癒合功能

And finally, we may be able to use smart devices

最後, 我們也許可以利用一些精巧的裝置

that will offload the work of the body and allow it to heal.

分擔身體的負擔同時讓它自行癒合

I'm going to show you an example of each of these,

我會針對各種技術舉例

and I'm going to start with materials.

先從材料開始

Steve Badylak -- who's at the University of Pittsburgh --

匹茲堡大學的學者史提夫.巴迪萊

about a decade ago had a remarkable idea.

大約在 10 年前提出一個很高明的想法

And that idea was that the small intestine of a pig,

他想利用豬的小腸

if you threw away all the cells,

要是能夠剝除小腸上所有的細胞

and if you did that in a way that allowed it to remain biologically active,

同時維持其生物活性

may contain all of the necessary factors and signals

可能可以保存必要的因子和訊號

that would signal the body to heal itself.

啟動身體的自我癒合能力

And he asked a very important question.

他同時提出一個非常重要的問題

He asked the question,

他的問題是

if I take that material, which is a natural material

這種天然的材料

that usually induces healing in the small intestine,

放在小腸通常可以誘發小腸的癒合

and I place it somewhere else on a person's body,

要是放在人體的其他地方

would it give a tissue-specific response,

是否可以針對不同組織引發正確的修復反應

or would it make small intestine if I tried to make a new ear?

還是只對小腸有用，換成耳朵就沒用了？

I wouldn't be telling you this story if it weren't compelling.

我舉的例子一定夠嚇人

The picture I'm about to show you

接下來我要展示的圖片 -- 膽小者不宜 --

is a compelling picture.

(笑聲)

(Laughter)

是很嚇人的照片

However, for those of you that are even the slightest bit squeamish --

不過對於那些膽子很小的人

even though you may not like to admit it in front of your friends --

即使你們可能不想在朋友面前承認

the lights are down. This is a good time to look at your feet,

燈光變暗了，剛好可以低頭不看

check your Blackberry, do anything other than look at the screen.

看看手機，做什麼都好，就是不要看螢幕

(Laughter)

（笑聲）

What I'm about to show you is a diabetic ulcer.

我要展示的是糖尿病足部潰瘍的照片

And although -- it's good to laugh before we look at this.

不過看到照片以後可能就笑不出來了

This is the reality of diabetes.

這就是糖尿病的真實狀況

I think a lot of times we hear about diabetics, diabetic ulcers,

我想大家常聽到糖尿病、糖尿病潰瘍

we just don't connect the ulcer with the eventual treatment,

卻不會把潰瘍和醫療上的終極手段聯想在一起

which is amputation, if you can't heal it.

要是治療無效，終極手段就是截肢

So I'm going to put the slide up now. It won't be up for long.

我現在要放上投影片，不過不會放太久

This is a diabetic ulcer. It's tragic.

這就是糖尿病足部潰瘍，真可怕

The treatment for this is amputation.

唯一的療法就是截肢

This is an older lady. She has cancer of the liver as well as diabetes,

這是一位患有肝癌和糖尿病的老婦人

and has decided to die with what' s left of her body intact.

她希望在死的時候盡量維持身體完整

And this lady decided, after a year of attempted treatment of that ulcer,

所以治療潰瘍一年後她決定

that she would try this new therapy that Steve invented.

嘗試史提夫發明的新療法

That's what the wound looked like 11 weeks later.

傷口經過 11 個星期治療之後變成這個樣子

That material contained only natural signals.

這個材料只含有天然的訊息因子

And that material induced the body to switch back on a healing response

而且可以誘發身體重新啟動

that it didn't have before.

從前沒有的癒合反應

There's going to be a couple more distressing slides for those of you --

接下來還有一些更令人不舒服的照片

I'll let you know when you can look again.

等到可以轉過頭的時候，我會叫大家

This is a horse. The horse is not in pain.

這是一匹馬。它並不感覺痛

If the horse was in pain, I wouldn't show you this slide.

要是它會痛，我就不會讓大家看這張投影片

The horse just has another nostril that's developed

這匹馬已經重建了新的鼻腔

because of a riding accident.

它因為一次騎乘意外而受傷

Just a few weeks after treatment --

治療幾星期後

in this case, taking that material, turning it into a gel,

這個案例是將新材料製成膠狀物

and packing that area, and then repeating the treatment a few times --

包覆整個受傷區域並重複幾次療程

and the horse heals up.

然後傷口就癒合了

And if you took an ultrasound of that area, it would look great.

超音波檢查顯示癒合區的狀況非常好

Here's a dolphin where the fin's been re-attached.

這是一隻重新接合魚鰭的海豚

There are now 400,000 patients around the world

現在全球已經有 40 萬名病患

who have used that material to heal their wounds.

使用這種新材料來癒合傷口

Could you regenerate a limb?

肢體再生還是天方夜譚嗎？

DARPA just gave Steve 15 million dollars to lead an eight-institution project

美國國防部先進研究計劃機構剛撥出 1500 萬補助一項 8 個研究機構參與的聯合計畫

to begin the process of asking that question.

開始嘗試探索這個問題

And I'll show you the 15 million dollar picture.

我將要大家看看價值 1500 萬的照片

This is a 78 year-old man who's lost the end of his fingertip.

這位 78歲的男子失去了指尖

Remember that I mentioned before the children who lose their fingertips.

還記得我之前提到幼兒指尖的再生能力

After treatment that's what it looks like.

這是接受治療後的樣子

This is happening today.

現在就能做到

This is clinically relevant today.

現在在臨床上可以做到

There are materials that do this. Here are the heart patches.

其他新的材料也有同樣的功能。 這是心肌修補

But could you go a little further?

還能更進一步的治療嗎？

Could you, say, instead of using material,

試想除了使用新的材料外

can I take some cells along with the material,

我們是否可以拿一些細胞結合材料

and remove a damaged piece of tissue,

清除損害的組織之後

put a bio-degradable material on there?

在患部放上人體可自行分解的材料？

You can see here a little bit of heart muscle beating in a dish.

你可以看到在培養皿裡有一小塊正在跳動的心肌

This was done by Teruo Okano at Tokyo Women's Hospital.

這是由東京婦女醫院的岡野照雄所完成的

He can actually grow beating tissue in a dish.

他真的可以在培養皿裡培養出跳動的心臟組織

He chills the dish, it changes its properties

先透過冰鎮培養皿改變組織的特性

and he peels it right out of the dish.

然後將組織從培養皿中取下

It's the coolest stuff.

這真是酷斃了

Now I'm going to show you cell-based regeneration.

現在我們來談談細胞療法

And what I'm going to show you here

我要給大家看的是

is stem cells being removed from the hip of a patient.

由患者的臀部取出幹細胞

Again, if you're squeamish, you don't want to watch.

再次提醒，要是你很膽小還是別看了

But this one's kind of cool.

不過這個也很酷

So this is a bypass operation, just like what Al Gore had,

這是一個心臟繞道手術，就是高爾剛做完的的那種

with a difference.

不同的是

In this case, at the end of the bypass operation,

這個案例手術的最後階段

you're going to see the stem cells from the patient

你將看到病患體內的幹細胞

that were removed at the beginning of the procedure

在手術開始時取出的幹細胞

being injected directly into the heart of the patient.

被直接注入病患心臟

And I'm standing up here because at one point

我站到上面來是因為稍後能看到細胞植入

I'm going to show you just how early this technology is.

我要讓大家看看這個技術還在初期階段

Here go the stem cells, right into the beating heart of the patient.

現在幹細胞直接注入病患還在跳動的心臟

And if you look really carefully,

如果大家仔細看

it's going to be right around this point

大概就在這裡

you'll actually see a back-flush.

會看到滲出液體

You see the cells coming back out.

那是幹細胞被排出來

We need all sorts of new technology, new devices,

我們需要各種新的技術和裝置

to get the cells to the right place at the right time.

設法在正確的時間將細胞注入正確的部位

Just a little bit of data, a tiny bit of data.

我這裡有一點資料，只是一點點

This was a randomized trial.

這是個隨機的試驗

At this time this was an N of 20. Now there's an N of about 100.

當時只有樣本只有 20 個，現在已經累積到 100 個了

Basically, if you take an extremely sick patient

基本上，如果一個重病患者

and you give them a bypass, they get a little bit better.

接受了繞道手術，情況會稍微好轉

If you give them stem cells as well as their bypass,

要是他們同時接受幹細胞治療

for these particular patients, they became asymptomatic.

這些特定病患症狀會完全消失

These are now two years out.

這個數據已經是兩年前的了

The coolest thing would be is if you could diagnose the disease early,

最棒的是能早期診斷出疾病

and prevent the onset of the disease to a bad state.

並預防疾病惡化的可能性

This is the same procedure, but now done minimally invasively,

這手術跟剛剛類似，但只有最低的侵入程度

with only three holes in the body where they're taking the heart

只要在心臟需手術的部位開 3 個孔

and simply injecting stem cells through a laparoscopic procedure.

然後利用內視鏡手術注入幹細胞

There go the cells.

現在幹細胞植入

We don't have time to go into all of those details,

我沒有時間詳細說明

but basically, that works too.

但基本上這個方法是可行的

You can take patients who are less sick,

症狀較輕的病患可以

and bring them back to an almost asymptomatic state

復原到幾乎無症狀的情況

through that kind of therapy.

只要接受這種手術治療

Here's another example of stem-cell therapy that isn't quite clinical yet,

這裡有另一個尚未進入臨床試驗的幹細胞療法

but I think very soon will be.

我想不久後會進行

This is the work of Kacey Marra from Pittsburgh,

這是匹茲堡大學的凱西 . 瑪拉的研究成果

along with a number of colleagues around the world.

她與世界各地的科學家合作

They've decided that liposuction fluid,

她們認為抽脂手術取出的脂肪液體

which -- in the United States, we have a lot of liposuction fluid.

我想美國最多的就是脂肪液

(Laughter)

(笑聲)

It's a great source of stem cells.

這其實是很好的幹細胞來源

Stem cells are packed in that liposuction fluid.

脂肪液中有許多幹細胞

So you could go in, you could get your tummy-tuck.

所以去整型診所抽個脂

Out comes the liposuction fluid,

就能有了這些脂肪液體

and in this case, the stem cells are isolated and turned into neurons.

在這個案例中，幹細胞被分離出來轉成神經元

All done in the lab.

全部都在實驗室完成的

And I think fairly soon, you will see patients being treated

我想在不久之後就能有患者接受治療

with their own fat-derived, or adipose-derived, stem cells.

用他們體內脂肪或脂質細胞取出的幹細胞

I talked before about the use of devices

我也提到過用精密儀器

to dramatically change the way we treat disease.

顛覆治療疾病的方式

Here's just one example before I close up.

在我總結前再提最後一個例子

This is equally tragic.

這是件令人遺憾的事

We have a very abiding and heartbreaking partnership

我們與一位在美軍手術研究機構的同事

with our colleagues at the Institute for Surgical Research in the US Army,

經歷長久但過程卻令人難過的合作關係

who have to treat the now 11,000 kids that have come back from Iraq.

他負責治療 1 萬 1 千名剛從伊拉克回來的年輕人

Many of those patients are very severely burned.

其中很多都嚴重燒傷

And if there's anything that's been learned about burn,

不過，要說我們燒傷的認識

it's that we don't know how to treat it.

就是目前無法治癒

Everything that is done to treat burn --

目前治療燒燙傷的方法

basically we do a sodding approach.

是使用皮膚移植

We make something over here,

我們從某個部位取下皮膚

and then we transplant it onto the site of the wound,

再移植到燒傷的區域

and we try and get the two to take.

然後試著讓它們相容

In this case here, a new, wearable bio-reactor has been designed --

這個案例設計出可以貼在人體上的新生物反應器

it should be tested clinically later this year at ISR --

年底 ISR 應該就會進行臨床試驗

by Joerg Gerlach in Pittsburgh.

由匹茲堡大學的耶格 . 葛萊克主持

And that bio-reactor will lay down in the wound bed.

這種生物反應器會鋪在傷口上

The gun that you see there sprays cells.

大家看到的噴槍則會噴上細胞

That's going to spray cells over that area.

將細胞均勻噴灑在傷口上

The reactor will serve to fertilize the environment,

生物反應器會供應細胞養分

deliver other things as well at the same time,

同時也是物質運輸流動的管道

and therefore we will seed that lawn,

藉此提供細胞適宜的生長環境

as opposed to try the sodding approach.

與皮膚移植兩相比較

It's a completely different way of doing it.

是個全然不同的方法

So my 18 minutes is up.

我的 18 分鐘時間到了

So let me finish up with some good news,

讓我用一個好消息做結尾

and maybe a little bit of bad news.

或許有一小部分還是壞消息

The good news is that this is happening today.

好消息是這些技術現在就能做到

It's very powerful work.

這項工程作用強大

Clearly the images kind of get that across.

那些照片很顯然讓大家體會到這點

It's incredibly difficult because it's highly inter-disciplinary.

不過卻因為是高度跨領域的工作而難度頗高

Almost every field of science engineering and clinical practice

幾乎所有科學領域及臨床醫學都牽涉到了

is involved in trying to get this to happen.

要一起嘗試讓想法成真

A number of governments, and a number of regions,

有一些國家和許多地區

have recognized that this is a new way to treat disease.

已經體認到這是一種治療疾病的新方式

The Japanese government were perhaps the first,

日本政府應該是第一個

when they decided to invest first 3 billion,

決定先在這個領域投入 30 億資金

later another 2 billion in this field.

然後再加碼 20 億

It's no coincidence.

這是必然的趨勢

Japan is the oldest country on earth in terms of its average age.

日本是世界上平均壽命最高國家之一

They need this to work or their health system dies.

因此需要讓這項研究成功，才能維持其醫療系統

So they're putting a lot of strategic investment focused in this area.

所以在這個領域砸下很多策略性的投資

The European Union, same thing.

在歐盟也一樣

China, the same thing.

中國也是

China just launched a national tissue-engineering center.

中國的國家組織工程研究中心才剛落成

The first year budget was 250 million US dollars.

第一年的研究預算就有 2 億 5 千萬美元

In the United States we've had a somewhat different approach.

美國的作法，則是有點不同。我們...

(Laughter)

(笑聲)

Oh, for Al Gore to come and be in the real world as president.

天啊，真希望高爾是美國總統！

We've had a different approach.

我們的作法不同

And the approach has basically been to just sort of fund things as they come along.

基本上就是順水推舟補助

But there's been no strategic investment

而沒有策略性投資

to bring all of the necessary things to bear and focus them in a careful way.

來負擔必要的研究條件並謹慎聚焦使用

And I'm going to finish up with a quote, maybe a little cheap shot,

我將引用一段對話做結，可能有點惡毒

at the director of the NIH, who's a very charming man.

NIH 美國衛生研究機構的主持人，人很親切

Myself and Jay Vacanti from Harvard

我與哈佛大學的傑 . 福肯帝

went to visit with him and a number of his directors of his institute

拜訪了他跟其他幾位機構裡的主任

just a few months ago,

大概就是幾個月前

to try and convince him that it was time to take just a little piece

我們試著說服他時候到了

of that 27.5 billion dollars that he's going to get next year

他可以從明年編列的 275 億預算中撥一小部分補助我們

and focus it, in a strategic way, to make sure we can accelerate the pace

用策略性方法，把錢專門用來加快研究腳步

at which these things get to patients.

讓病患早日受益

And at the end of a very testy meeting,

在這個火藥味很重的會面最後

what the NIH director said was,

NIH 的主持人只說

"Your vision is larger than our appetite."

「我們的胃口太小，吞不下你們偉大的理想」

I'd like to close by saying that no one's going to change our vision,

我想我最後要說的就是，沒有人可以改變我們的理想

but together we can change his appetite.

不過，我們合力就能撐大他的胃口

Thank you.

謝謝