I'm going to talk to you today about hopefully converting fear into hope. When we go to the physician today -- when we go to the doctor's office and we walk in, there are words that we just don't want to hear. There are words that we're truly afraid of. Diabetes, cancer, Parkinson's, Alzheimer's, heart failure, lung failure -- things that we know are debilitating diseases, for which there's relatively little that can be done.
Danas ću vam govoriti o nečemu što će, nadamo se, pretvoriti naše strahove u nadu. Danas, kada idemo kod liječnika, i kada uđemo u ordinaciju, postoje neke riječi koje jednostavno ne želimo čuti. To su riječi kojih se zaista bojimo. Dijabetis, rak, Parkinsonova, Alzheimerova, srčani problemi, plućni problemi. To su stvari za koje znamo da su opasne, i kod kojih možemo učiniti relativno malo.
And what I want to lay out for you today is a different way of thinking about how to treat debilitating disease, why it's important, why without it perhaps our health care system will melt down if you think it already hasn't, and where we are clinically today, and where we might go tomorrow, and what some of the hurdles are. And we're going to do all of that in 18 minutes, I promise.
Ono što vam želim danas pokazati je drugačiji način u tretiranju teških, iscrpljujućih bolesti te zašto je on važan. Zašto će se bez njega naš sustav možda, urušiti, ako mislite da se već nije. Što možemo danas liječiti, gdje ćemo biti sutra i koje su neke prepreke. I napravit ćemo sve to u 18 minuta, obećajem.
I want to start with this slide, because this slide sort of tells the story the way Science Magazine thinks of it. This was an issue from 2002 that they published with a lot of different articles on the bionic human. It was basically a regenerative medicine issue. Regenerative medicine is an extraordinarily simple concept that everybody can understand. It's simply accelerating the pace at which the body heals itself to a clinically relevant timescale. So we know how to do this in many of the ways that are up there. We know that if we have a damaged hip, you can put an artificial hip in. And this is the idea that Science Magazine used on their front cover.
Želio bih početi s ovom slikom, jer ova slika na neki način pokazuje što Science Magazin misli o ovome. Ovo je broj iz 2002. koji su izdali s mnogo članaka o bioničkom čovjeku. U osnovi, to je bio broj o regenerativnoj medicini. Regenerativna medicina je izvanredno jednostavna metoda koju svatko može razumjeti. Radi se jednostavno o ubrzavanju brzine kojom se tijelo samo liječi na razinu koja nam je relevantna za postupak liječenja. Znamo kako raditi ovo na mnoge načine koji su prikazani ovdje. Znamo da ako imamo bolesni kuk, kako ga možemo zamijeniti umjetnim. To je ideja koju je Science Magazin koristio na njihovoj naslovnici.
This is the complete antithesis of regenerative medicine. This is not regenerative medicine. Regenerative medicine is what Business Week put up when they did a story about regenerative medicine not too long ago. The idea is that instead of figuring out how to ameliorate symptoms with devices and drugs and the like -- and I'll come back to that theme a few times -- instead of doing that, we will regenerate lost function of the body by regenerating the function of organs and damaged tissue. So that at the end of the treatment, you are the same as you were at the beginning of the treatment.
To je potpuna suprotnost regenerativnoj medicini. To nije regenerativna medicina. Regenerativna medicina je ovo što je Business Week stavio na naslovnicu kada su, ne tako davno, radili priču o regenerativnoj medicini. Radi se o tome da, umjesto da smišljamo kako popraviti simptome uređajima, lijekovima i takvim stvarima -- vratit ću se na ovo nekoliko puta -- umjesto da činimo to, regenerirat ćemo izgubljene funkcije tijela regenerirajući funkcije organa i oštećenog tkiva. Na taj način da ste na kraju tretmana jednaki kao na početku tretmana.
Very few good ideas -- if you agree that this is a good idea -- very few good ideas are truly novel. And this is just the same. If you look back in history, Charles Lindbergh, who was better known for flying airplanes, was actually one of the first people along with Alexis Carrel, one of the Nobel Laureates from Rockefeller, to begin to think about, could you culture organs? And they published this book in 1937, where they actually began to think about, what could you do in bio-reactors to grow whole organs? We've come a long way since then. I'm going to share with you some of the exciting work that's going on.
Jako malo dobrih ideja -- ako se složite kako je ovo dobra ideja -- jako malo dobrih ideja su stvarno nove. Tako je i s ovom. Ako pogledamo u prošlost, Charles Lindbergh -- poznatiji po letenju avionima -- je ustvari jedan od prvih ljudi koji je, zajedno s Alexis Carrel, jednim od Nobelovaca iz Rockefellera, počeo razmišljati o mogućnosti uzgoja organa. Tako su 1937. izdali svoju knjigu u kojoj su ustvari počeli razmišljati što se može napraviti u bio-reaktorima kako bi se uzgojili čitavi organi? Od tada smo prošli dugačak put. Podijelit ću s vama dio uzbudljivog rada koji je u tijeku.
But before doing that, what I'd like to do is share my depression about the health care system and the need for this with you. Many of the talks yesterday talked about improving the quality of life, and reducing poverty, and essentially increasing life expectancy all around the globe. One of the challenges is that the richer we are, the longer we live. And the longer we live, the more expensive it is to take care of our diseases as we get older.
Ali prije nego što to učinim, volio bih učiniti jednu stvar, a to je podijeliti svoje nezadovoljstvo u vezi zdravstvenog sustava i njegovu potrebu sa svima vama. Jučer smo čuli mnoge govore o poboljšanju kvalitete života i smanjivanju siromaštva. U stvari o produženju očekivane životne dobi diljem svijeta. Jedan od izazova je -- što smo bogatiji to dulje živimo. I što dulje živimo, skuplje je brinuti se o našim zdravstvenim problemima kako starimo.
This is simply the wealth of a country versus the percent of population over the age of 65. And you can basically see that the richer a country is, the older the people are within it. Why is this important? And why is this a particularly dramatic challenge right now? If the average age of your population is 30, then the average kind of disease that you have to treat is maybe a broken ankle every now and again, maybe a little bit of asthma. If the average age in your country is 45 to 55, now the average person is looking at diabetes, early-onset diabetes, heart failure, coronary artery disease -- things that are inherently more difficult to treat, and much more expensive to treat.
U stvari, radi se o bogatstvu države protiv postotka populacije starije od 65 godina. Tako možete vidjeti kako što je zemlja bogatija njezino stanovništvo je starije. Zašto je to važno? I zašto je to posebno dramatičan izazov upravo sada? Ako je prosječna dob vašeg stanovništva 30 godina tada su prosječne bolesti koje trebate liječiti možda svako toliko slomljeni gležanj, možda malo astme. Ako je prosječna dob u vašoj zemlji između 45 i 55 godina, tada se prosječna osoba suočava s dijabetesom, ranim dijabetesom, problemima sa srcem, krvožilnim bolestima. Stvarima koje je sve teže, a ujedno i mnogo skuplje liječiti.
Just have a look at the demographics in the U.S. here. This is from "The Untied States of America." In 1930, there were 41 workers per retiree. 41 people who were basically outside of being really sick, paying for the one retiree who was experiencing debilitating disease. In 2010, two workers per retiree in the U.S. And this is matched in every industrialized, wealthy country in the world. How can you actually afford to treat patients when the reality of getting old looks like this?
Pogledajte samo stanovništvo SAD na ovom prikazu. Ovo je iz Sjedinjenih Američkih Država. 1930. odnos je bio 41 radnik po umirovljeniku. Znači, 41 osoba koje su u osnovi bile više manje zdrave, plaćaju za tog jednog umirovljenika koji ima ozbiljnu bolest. 2010. u SAD-u taj je odnos 2 radnika po umirovljeniku. Isti trend vidimo u svim bogatim, industrijaliziranim zemljama na svijetu. Kako uopće možemo priuštiti tretman pacijentima kada u stvarnosti starenje izgleda ovako?
This is age versus cost of health care. And you can see that right around age 45, 40 to 45, there's a sudden spike in the cost of health care. It's actually quite interesting. If you do the right studies, you can look at how much you as an individual spend on your own health care, plotted over your lifetime. And about seven years before you're about to die, there's a spike. And you can actually -- (Laughter) -- we won't get into that. (Laughter)
Ovdje vidimo odnos godina i zdravstvenih troškova. Možete vidjeti kako negdje oko 45. godine, 40. do 45. događa nagli porast troškova. Zapravo je to prilično zanimljivo -- ako ispravno vodite istraživanje, možete vidjeti koliko vi kao individualac trošite na zdravstvenu njegu u odnosu na vašu dob. Otprilike sedam godina prije nego umrete pojavi se vrhunac troškova. Zapravo možete -- (Smijeh) -- nećemo ulaziti u to. (Smijeh)
There are very few things, very few things that you can really do that will change the way that you can treat these kinds of diseases and experience what I would call healthy aging. I'd suggest there are four things, and none of these things include an insurance system or a legal system. All those things do is change who pays. They don't actually change what the actual cost of the treatment is.
Postoji jako malo stvari, zbilja malo stvari koje možete učiniti koje će promijeniti način tretiranja ovakvih bolesti i pružiti vam ono što bih nazvao zdravom starošću. Ja bih preporučio četiri stvari. I nijedna od njih ne uključuje osiguranje ili zakone. Te stvari samo mijenjaju onoga tko plaća. U stvari, one ne mijenjaju stvarnu cijenu liječenja.
One thing you can do is not treat. You can ration health care. We won't talk about that anymore. It's too depressing. You can prevent. Obviously a lot of monies should be put into prevention.
Jedna stvar koju možete je ne liječiti. Možemo racionalizirati zdravstvenu skrb. Nećemo više govoriti o tome. Previše je deprimirajuće. Možete preventirati bolesti. Očito je kako bi puno novca trebalo biti uloženo u prevenciju.
But perhaps most interesting, to me anyway, and most important, is the idea of diagnosing a disease much earlier on in the progression, and then treating the disease to cure the disease instead of treating a symptom. Think of it in terms of diabetes, for instance. Today, with diabetes, what do we do? We diagnose the disease eventually, once it becomes symptomatic, and then we treat the symptom for 10, 20, 30, 40 years. And we do OK. Insulin's a pretty good therapy. But eventually it stops working, and diabetes leads to a predictable onset of debilitating disease.
Ali možda najzanimljivija, barem meni osobno, i najvažnija je ideja dijagnosticiranja bolesti puno ranije u razvoju i na taj način liječili bi bolest umjesto da liječimo simptome. Uzmimo, na primjer, dijabetes. Što danas činimo s dijabetesom? Dijagnosticiramo bolest uglavnom tek kada se pojave simptomi i onda liječimo simptome 10, 20, 30, 40 godina. I to nam ide sasvim dobro. Inzulin je prilično dobra terapija. Ali prije ili kasnije on prestaje djelovati i dijabetes tada vodi do pojave težih, opasnijih bolesti.
Why couldn't we just inject the pancreas with something to regenerate the pancreas early on in the disease, perhaps even before it was symptomatic? And it might be a little bit expensive at the time that we did it, but if it worked, we would truly be able to do something different.
Zašto ne možemo samo ubrizgati nešto u gušteraču tako da se ona regenerira u ranom stadiju bolesti, možda čak i prije pojave samih simptoma? Možda bi to i bilo skupo u tom trenutku, ali ako bi to djelovalo, zaista bi bili u mogućnosti napraviti razliku.
This video, I think, gets across the concept that I'm talking about quite dramatically. This is a newt re-growing its limb. If a newt can do this kind of thing, why can't we? I'll actually show you some more important features about limb regeneration in a moment. But what we're talking about in regenerative medicine is doing this in every organ system of the body, for tissues and for organs themselves. So today's reality is that if we get sick, the message is we will treat your symptoms, and you need to adjust to a new way of life.
Mislim kako ovaj video prilično dramatično pokazuje koncept o kojem govorim. Ovo je daždevnjak koji regenerira svoj ud. Ako daždevnjak može činiti nešto takvo, zašto ne možemo i mi? Ubrzo ću vam pokazati neke važnije stvari u vezi regeneracije djelova tijela. Ali ono o čemu govorimo u regenerativnoj medicini je kako se ovo događa u svakom organskom sustavu u tijelu, na razini samih tkiva i organa. Današnja stvarnost je da ako se razbolimo kažu vam kako će liječiti vaše simptome, te da se trebate prilagoditi na novi način života.
I would pose to you that tomorrow -- and when tomorrow is we could debate, but it's within the foreseeable future -- we will talk about regenerative rehabilitation. There's a limb prosthetic up here, similar actually one on the soldier that's come back from Iraq. There are 370 soldiers that have come back from Iraq that have lost limbs. Imagine if instead of facing that, they could actually face the regeneration of that limb. It's a wild concept. I'll show you where we are at the moment in working towards that concept.
Rekao bih kako ćemo sutra -- a možemo raspravljati kada će to sutra biti, ali to je u doglednoj budućnosti -- govoriti o regenerativnoj rehabilitaciji. Ovdje vidite protezu za nogu, sličnu onima koje nose vojnici koji su se vratili iz Iraka... 370 vojnika se vratilo iz Iraka s amputacijom. Zamislite da umjesto toga, oni mogu regenerirati taj ud. To je luda ideja. Pokazati ću vam gdje smo danas došli u radu prema toj ideji.
But it's applicable, again, to every organ system. How can we do that? The way to do that is to develop a conversation with the body. We need to learn to speak the body's language. And to switch on processes that we knew how to do when we were a fetus. A mammalian fetus, if it loses a limb during the first trimester of pregnancy, will re-grow that limb. So our DNA has the capacity to do these kinds of wound-healing mechanisms. It's a natural process, but it is lost as we age. In a child, before the age of about six months, if they lose their fingertip in an accident, they'll re-grow their fingertip. By the time they're five, they won't be able to do that anymore.
Ali to je primjenjivo na sve organe. Kako to možemo ostvariti? Način da to učinimo je razviti vrstu komunikacije s tijelom. Trebamo naučiti govoriti govor tijela. I uključiti procese koje smo mogli raditi kada smo bili fetus. Ako fetus sisavca izgubi ud tijekom prvog tromjesečja trudnoće on će mu ponovo izrasti. Znači naša DNA ima mogućnost ovakvih metoda izlječenja. To je prirodan proces, ali se gubi kako starimo. Ako dijete, u dobi oko šest mjeseci, izgubi vrh prsta u nesreći, on će im ponovo izrasti. Do dobi od pet godina, oni to više neće moći.
So to engage in that conversation with the body, we need to speak the body's language. And there are certain tools in our toolbox that allow us to do this today. I'm going to give you an example of three of these tools through which to converse with the body.
Znači, kako bi mogli komunicirati s tijelom, moramo govoriti govor tijela. A alati kojima danas raspolažemo omogućavaju nam to. Pokazati ću vam primjer tri takva alata pomoću kojih razgovaramo s tijelom.
The first is cellular therapies. Clearly, we heal ourselves in a natural process, using cells to do most of the work. Therefore, if we can find the right cells and implant them in the body, they may do the healing. Secondly, we can use materials. We heard yesterday about the importance of new materials. If we can invent materials, design materials, or extract materials from a natural environment, then we might be able to have those materials induce the body to heal itself. And finally, we may be able to use smart devices that will offload the work of the body and allow it to heal.
Prvi je stanična terapija. Očito, liječimo se u prirodnom procesu, koristeći stanice da obave najveći dio posla. Ako možemo naći prave stanice i usaditi ih u tijelo, one nas možda mogu liječiti. Drugi način su materijali. Jučer smo čuli o važnosti novih materijala. Ako možemo izmisliti, kreirati ili izvući materijale iz njihovog prirodnog okruženja, onda bi možda mogli inducirati liječenje pomoću tih materijala. Konačno, mogli bi koristiti pametne uređaje koji će preuzeti rad tijela i omogućiti mu da se izliječi.
I'm going to show you an example of each of these, and I'm going to start with materials. Steve Badylak -- who's at the University of Pittsburgh -- about a decade ago had a remarkable idea. And that idea was that the small intestine of a pig, if you threw away all the cells, and if you did that in a way that allowed it to remain biologically active, may contain all of the necessary factors and signals that would signal the body to heal itself. And he asked a very important question. He asked the question, if I take that material, which is a natural material that usually induces healing in the small intestine, and I place it somewhere else on a person's body, would it give a tissue-specific response, or would it make small intestine if I tried to make a new ear?
Pokazati ću vam primjer za svaku od tih metoda, a početi ću s materijalima. Steve Badylak -- sa sveučilišta u Pittsburgu -- je prije otprilike deset godina imao nevjerovatnu ideju. Ideja je bila da tanko crijevo svinje, ako odbacite sve stanice, i ako to napravite tako da ono ostane biološki aktivno, može sadržavati sve potrebne faktore i signale koji signaliziraju tijelu da se samoliječi. On je postavio važno pitanje. Pitao se je, ako uzmem taj materijal, koji je prirodan, i koji obično potiče oporavak u tankom crijevu, i stavim ga negdje drugdje u tijelu, hoće li ono reagirati s tim specifičnim tkivom, ili će mi napraviti tanko crijevo umjesto uha?
I wouldn't be telling you this story if it weren't compelling. The picture I'm about to show you is a compelling picture. (Laughter) However, for those of you that are even the slightest bit squeamish -- even though you may not like to admit it in front of your friends -- the lights are down. This is a good time to look at your feet, check your Blackberry, do anything other than look at the screen. (Laughter)
Ne bih vam govorio ovu priču da nije zanimljiva. Slika koju ću vam pokazati -- (Smijeh) -- je "zanimljiva" slika. Ipak, za sve one među vama koji su barem malo gadljivi -- čak i ako to ne želite priznati pred vašim prijateljima -- svjetla su ugašena. Ovo bi bio dobar trenutak da spustite pogled na vaše noge, provjerite svoj Blackberry, učinite bilo što osim gledanja u ekran. (Smijeh)
What I'm about to show you is a diabetic ulcer. And although -- it's good to laugh before we look at this. This is the reality of diabetes. I think a lot of times we hear about diabetics, diabetic ulcers, we just don't connect the ulcer with the eventual treatment, which is amputation, if you can't heal it. So I'm going to put the slide up now. It won't be up for long. This is a diabetic ulcer. It's tragic. The treatment for this is amputation. This is an older lady. She has cancer of the liver as well as diabetes, and has decided to die with what' s left of her body intact.
Ono što ću vam pokazati je dijabetsko stopalo. I -- iako se je dobro smijati prije nego to vidimo. Ovo je stvarnost dijabetesa. Mislim kako puno puta kada čujemo o dijabetesu i dijabetskom stopalu jednostavno ne povezujemo to sa konačnim tretmanom, a to je amputacija, ako ne uspije izliječenje. Sada ću pokazati fotografiju. Neće biti na ekranu dugo. Ovo je dijabetsko stopalo. To je tragično. Tretman za ovo je amputacija. Ovo je starija gospođa. Uz dijabetes ima i rak jetre i odlučila je umrijeti s očuvanim tijelom.
And this lady decided, after a year of attempted treatment of that ulcer, that she would try this new therapy that Steve invented. That's what the wound looked like 11 weeks later. That material contained only natural signals. And that material induced the body to switch back on a healing response that it didn't have before.
Ta je gospođa, nakon godine pokušaja liječenja stopala, odlučila probati jednu tu novu terapiju koju je Steve izmislio. Ovako je rana izgledala nakon 11 tjedana. Taj je materijal sadržavao samo prirodne signale. I taj je materijal potaknuo tijelo da uključi svoje mehanizme izliječenja koji su bili isključeni.
There's going to be a couple more distressing slides for those of you -- I'll let you know when you can look again. This is a horse. The horse is not in pain. If the horse was in pain, I wouldn't show you this slide. The horse just has another nostril that's developed because of a riding accident. Just a few weeks after treatment -- in this case, taking that material, turning it into a gel, and packing that area, and then repeating the treatment a few times -- and the horse heals up. And if you took an ultrasound of that area, it would look great.
Biti će još uznemirujućih slika, za one među vama -- reći ću vam kada možete gledati. Ovo je konj. Njega ne boli. Da ga u boli, ne bih vam pokazivao ovu sliku. Konju se razvila još jedna nosnica zbog nezgode na jahanju. Nakon samo nekoliko tjedana liječenja -- u ovom slučaju, uzimanje materijala, pretvaranja u gel, ispunjavanja tog područja i ponavljanja tretmana nekoliko puta -- konj se odlično oporavio. I da ste napravili ultrazvuk tog područja izgleda¸lo bi odlično.
Here's a dolphin where the fin's been re-attached. There are now 400,000 patients around the world who have used that material to heal their wounds. Could you regenerate a limb? DARPA just gave Steve 15 million dollars to lead an eight-institution project to begin the process of asking that question.
Ovo je dupin kojemu je peraja ponovo učvršćena. Danas imamo oko 400,000 pacijenata diljem svijeta koji koriste taj materijal za liječenje svojih ozljeda. Je li moguće regenerirati ud? DARPA (vojna agencija za razvoj novih tehnologija) upravo je dala Steveu 15 milijuna dolara i vodstvo nad osam institucija da počne istraživati to područje.
And I'll show you the 15 million dollar picture. This is a 78 year-old man who's lost the end of his fingertip. Remember that I mentioned before the children who lose their fingertips. After treatment that's what it looks like. This is happening today. This is clinically relevant today. There are materials that do this. Here are the heart patches.
Pokazati ću vam sliku od 15 milijuna dolara. Ovo je muškarac od 78 godina koji je izgubio vrh jagodice prsta. Sjaćate se što sam vam prije rekao o djeci kojima se to dogodi. Ovo je taj prst nakon tretmana. Ovo se događa danas. Ovo je danas medicinski važno. Postoje materijali koji mogu ovo. Postoje zakrpe.
But could you go a little further? Could you, say, instead of using material, can I take some cells along with the material, and remove a damaged piece of tissue, put a bio-degradable material on there? You can see here a little bit of heart muscle beating in a dish. This was done by Teruo Okano at Tokyo Women's Hospital. He can actually grow beating tissue in a dish. He chills the dish, it changes its properties and he peels it right out of the dish. It's the coolest stuff.
Ali, možemo li ići još malo dalje? Možemo li, recimo, umjesto korištenja materijala, mogu li uzeti neke stanice s materijalom, ukloniti oštećeno tkivo i staviti taj biorazgradivi materijal na to mjesto? Ovdje možete vidjeti mali dio srca kako lupa u posudi. Ovo je napravio Teruo Okano iz Ženske bolnice u Tokiju. On može uzgojiti živo, kucajuće tkivo u posudi. Na kraju ohladi posudu, ona promijeni svojstva i stanice se ogule sa posude. To je fantastična stvar.
Now I'm going to show you cell-based regeneration. And what I'm going to show you here is stem cells being removed from the hip of a patient. Again, if you're squeamish, you don't want to watch. But this one's kind of cool. So this is a bypass operation, just like what Al Gore had, with a difference. In this case, at the end of the bypass operation, you're going to see the stem cells from the patient that were removed at the beginning of the procedure being injected directly into the heart of the patient. And I'm standing up here because at one point I'm going to show you just how early this technology is. Here go the stem cells, right into the beating heart of the patient. And if you look really carefully, it's going to be right around this point you'll actually see a back-flush. You see the cells coming back out. We need all sorts of new technology, new devices, to get the cells to the right place at the right time.
Sada bih vam pokazao regeneraciju baziranu na stanicama. Ono što ću vam pokazati su matične stanice koje se izvuku iz kuka pacijenta. Još jednom, ako ste gadljivi, ne želite ovo gledati. Ali ovo je na neki način fora. Znači, ovo je postavljenje premosnice, kao što je Al Gore imao, ali s razlikom. U ovom slučaju, na kraju operacije prijemosnice vidjeti ćete matične stanice pacijenta, koje su bile izvučene na početku, i ubrizgane direktno u srce pacijenta. A ja stojim ovdje gore jer ću vam u jednom trenutku pokazati koliko je nova ova tehnologija. Evo matičnih stanica, direktno u pulsirajuće srce pacijenta. I ako pogledate zbilja pažljivo, negdje oko ovog područja primjetit ćete vraćanje. Vidite kako se stanice vraćaju van. Trebamo mnogo novih tehnologija i novih uređaja kako bi doveli stanice na pravo mjesto u pravo vrijeme.
Just a little bit of data, a tiny bit of data. This was a randomized trial. At this time this was an N of 20. Now there's an N of about 100. Basically, if you take an extremely sick patient and you give them a bypass, they get a little bit better. If you give them stem cells as well as their bypass, for these particular patients, they became asymptomatic. These are now two years out. The coolest thing would be is if you could diagnose the disease early, and prevent the onset of the disease to a bad state.
Imamo malo podataka, tako malo podataka. Ovo je bio pokus. U to vrijeme ovo je bio 20. pacijent. Danas ih je oko 100. Ukratko, ako uzmete jako bolesnog čovjeka i ugradite im premosnicu bude im malo bolje. Ako im uz premosnicu date i matične stanice, ovi pacijenti, oni izgube simptome. To postoji već dvije godine. Najbolja stvar bi bila mogućnost rane dijagnoze i prevencije prelaska bolesti u lošu fazu.
This is the same procedure, but now done minimally invasively, with only three holes in the body where they're taking the heart and simply injecting stem cells through a laparoscopic procedure. There go the cells. We don't have time to go into all of those details, but basically, that works too. You can take patients who are less sick, and bring them back to an almost asymptomatic state through that kind of therapy.
Ovo je ista stvar, samo minimalno invazivno, sa samo tri otvora u tijelu kroz koje se dođe do srca i jednostavno, laparoskopijom ubrizga matične stanice. Evo vidimo stanice. Nemamo vremena za ići u ovo detaljno, ali, u osnovi, i to funkcionira. Možete uzeti pacijente koji imaju blaže simptome i vratiti ih nazad do stanja u kojem gotovo i nemaju simptome, kroz ovakvu terapiju.
Here's another example of stem-cell therapy that isn't quite clinical yet, but I think very soon will be. This is the work of Kacey Marra from Pittsburgh, along with a number of colleagues around the world. They've decided that liposuction fluid, which -- in the United States, we have a lot of liposuction fluid. (Laughter) It's a great source of stem cells. Stem cells are packed in that liposuction fluid. So you could go in, you could get your tummy-tuck. Out comes the liposuction fluid, and in this case, the stem cells are isolated and turned into neurons. All done in the lab. And I think fairly soon, you will see patients being treated with their own fat-derived, or adipose-derived, stem cells.
Evo još jednog primjera terapije matičnim stanicama; još nije u kliničkoj fazi, ali mislim kako će ubrzo biti. Ovo je djelo Kacey Marre iz Pittsburga, uz kolege širom svijeta. Oni su shvatili kako liposukcijska tekućina, koje -- u SAD-u, imamo mnogo liposukcijske tekućine. (Smijeh) To je sjajan izvor matičnih stanica. Matične stanice se nalaze u liposukcijskoj tekućini. Tako da možete ići zategnuti trbuh. Izvuku vam liposukcijsku tekućinu, i u ovom slučaju, matične stanice su izolirane i pretvorene u neurone. Sve to u laboratoriju. I mislim kako ćemo prilično brzo vidjeti pacijente tretirane vlastitim matičnim stanicama iz masnog tkiva.
I talked before about the use of devices to dramatically change the way we treat disease. Here's just one example before I close up. This is equally tragic. We have a very abiding and heartbreaking partnership with our colleagues at the Institute for Surgical Research in the US Army, who have to treat the now 11,000 kids that have come back from Iraq. Many of those patients are very severely burned.
Spomenuo sam korištenje uređaja da dramatično promijenimo način na koji liječimo bolesti. Ovdje je jedan primjer, prije nego završim. Ovo je jednako tragično. Imamo trajno i veoma emotivno partnerstvo s našim kolegama u Institutu za kirurška istraživanja (IKI) pri Američkoj vojsci, koji moraju tretirati 11,000 djece koja su se vratila iz Iraka. Mnogi od njih imaju strašne opekline.
And if there's anything that's been learned about burn, it's that we don't know how to treat it. Everything that is done to treat burn -- basically we do a sodding approach. We make something over here, and then we transplant it onto the site of the wound, and we try and get the two to take. In this case here, a new, wearable bio-reactor has been designed -- it should be tested clinically later this year at ISR -- by Joerg Gerlach in Pittsburgh. And that bio-reactor will lay down in the wound bed. The gun that you see there sprays cells. That's going to spray cells over that area. The reactor will serve to fertilize the environment, deliver other things as well at the same time, and therefore we will seed that lawn, as opposed to try the sodding approach. It's a completely different way of doing it.
I ako smo išta naučili o opeklinama, to je da ih ne znamo liječiti. Sve što se radi u tretiranju opeklina -- u osnovi radimo po principu presađivanja. Napravimo nešto ondje, i to onda transplantiramo na mjesto opekline, i onda pokušavamo da se ta dva dijela prihvate. Za ovo je razvijen novi, nosivi bio-reaktor -- trebao bi biti klinički testiran kasnije ove godine u IKI -- koji je djelo Joerga Gerlacha iz Pittsburga. Taj bio-reaktor će biti postavljen na samu ozljedu. Ovim pištoljem će se raspršivati stanice. Stanice će biti raspršene po tom cijelom području. Reaktor će služiti kao hranjiva podloga u tom području, radeći mnoge stvari u isto vrijeme, i na taj način ćemo uzgajati kožu na samoj opeklini, umjesto da koristimo presađivanje. To je potpuno drugačiji način.
So my 18 minutes is up. So let me finish up with some good news, and maybe a little bit of bad news. The good news is that this is happening today. It's very powerful work. Clearly the images kind of get that across. It's incredibly difficult because it's highly inter-disciplinary. Almost every field of science engineering and clinical practice is involved in trying to get this to happen.
Mojih 18 minuta je pri kraju. Dopustite mi da završim dobrim vijestima, i s možda malo loših. Dobra vijest je kako se sve ovo događa danas. To je jako moćan i važan rad. Slike su to zaista pokazale. Zbog multidisciplinarnog pristupa to je nevjerovatno težak posao. Gotovo sva područja znanstvenog inžinjerstva i kliničkih pokusa su uključena u pokušaju ostvarivanja ovoga.
A number of governments, and a number of regions, have recognized that this is a new way to treat disease. The Japanese government were perhaps the first, when they decided to invest first 3 billion, later another 2 billion in this field. It's no coincidence. Japan is the oldest country on earth in terms of its average age. They need this to work or their health system dies. So they're putting a lot of strategic investment focused in this area. The European Union, same thing. China, the same thing. China just launched a national tissue-engineering center. The first year budget was 250 million US dollars.
Nekoliko vlada, i nekoliko regija, je prepoznalo ovaj novi način liječenja. Japanska vlada je vjerovatno bila prva kada su odlučili investirati prve tri milijarde, a onda i još dvije milijarde u ovo područje. To nije slučajnost. Japan je najstarija zemlja na svijetu po prosječnoj dobi stanovništva. Oni trebaju ovo ili će se njihov zdravstveni sustav srušiti. Tako imaju mnogo strateških investicija u ovom polju. Ista stvar je u Europskoj uniji. Kina, također. Kinezi su upravo otvorili nacionalni center za inžinjering tkiva. Budžet za prvu godinu je bio 250 milijuna američkih dolara.
In the United States we've had a somewhat different approach. (Laughter) Oh, for Al Gore to come and be in the real world as president. We've had a different approach. And the approach has basically been to just sort of fund things as they come along. But there's been no strategic investment to bring all of the necessary things to bear and focus them in a careful way.
U SAD-u smo imali ponešto drugačiji pristup. Mi -- (Smijeh) -- eh, da Al Gore dođe i stvarno bude predsjednik. Mi smo imali drugačiji pristup. A taj pristup je u osnovi, financiranje stvari kako koja dođe. Ali nemamo strateških investicija za sve neophodne stvari kako bi ih oprezno i detaljno radili i uređivali.
And I'm going to finish up with a quote, maybe a little cheap shot, at the director of the NIH, who's a very charming man. Myself and Jay Vacanti from Harvard went to visit with him and a number of his directors of his institute just a few months ago, to try and convince him that it was time to take just a little piece of that 27.5 billion dollars that he's going to get next year and focus it, in a strategic way, to make sure we can accelerate the pace at which these things get to patients. And at the end of a very testy meeting, what the NIH director said was, "Your vision is larger than our appetite." I'd like to close by saying that no one's going to change our vision, but together we can change his appetite. Thank you.
Završiti ću s jednim citatom, znam da je to možda malo jeftin trik, direktora Državnog instituta za zdravstvo, veoma šarmantnog čovjeka. Jay Vacanti s Harvarda i ja smo otišli posjetiti njega i nekoliko direktora u tom institutu prije samo nekoliko mjeseci, da ga pokušamo uvjeriti kako je vrijeme da uzmemo samo mali dio od 27.5 milijardi dolara koje će dobiti sljedeće godine i strateški ih fokusiramo, tako da budemo sigurni kako možemo ubrzati tempo kojim ove stvari dolaze do pacijenata. I na kraju veoma osornog i mrzovoljnog sastanka direktor instituta je rekao: "Vaša vizija je veća od naših apetita." Završio bi tako da kažem kako nitko neće promijeniti našu viziju, ali da svi zajedno možemo promijeniti njegov apetit. Hvala vam.