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.
今天我所要談的主題 期盼能在未來化恐懼為希望 我們去看醫生的時候 當我們走進診療室 有些話是我們不想聽到的 有些字讓我們深深恐懼 像是糖尿病、癌症、帕金森氏症、阿茲海默症 心臟衰竭、肺衰竭 這些都是大家熟知的衰退性疾病 對於這些疾病我們卻束手無策
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.
今天我所要分享的是 用新的角度來思考衰退性疾病的療法 這為什麼重要、 又為什麼少了它醫療體系將會瓦解 要是你認為醫療體系現在還沒走到這一步 還有目前的臨床成果和可能的未來走向 有哪些困難需要克服 我保證一定會在 18 分鐘內全部講完
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.
讓我從這張投影片開始 因為這張投影片反映出「科學」期刊的看法 這一期發刊於 2002 年 裡面發表了各種有關生化人的文章 基本上就是再生醫學專題 再生醫學其實是個非常簡單的概念 一般人都能理解 就是加快人體自我修復的速度 達到在臨床上合理的時間範圍 目前我們已知可行的方法很多,都在這裡 我們知道要是髖關節損壞,就裝人工髖關節 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. 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.
其實這跟再生醫學完全相反 這不是再生醫學 這本「商業周刊」討論的才是再生醫學 不久前,他們刊出一篇有關再生醫學的文章 想法是與其想辦法改善症狀 用醫學裝置或藥物等等的 這主題我們會不斷回頭討論 與其這麼做,我們不如重建身體失去的功能 做法是重建損壞的器官和組織 如此一來,診程結束後 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 -- 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.
好點子還真的不多,如果你們也覺得這想法不錯 真正創新的好點子很少 就像我要討論的議題一樣 要是我們回想歷史 以飛越大西洋成名的查爾斯.林白 其實正是先驅者之一 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 就是他們開始思考,人工培養器官是否可行? 而且在1937 年出版了這本書 在書中他們甚至開始考慮 要如何在生物反應器中培養出一整個器官? 到了今天,我們已經有了長足進步 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 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.
但是在這之前,我想先與大家分享 我對現今醫療體系的悲觀想法 以及再生醫學的必要性 昨天的講題很多都談論到 提升生活品質和減少貧窮發生 以及真正延長全球人口的壽命 難題之一就是我們越富裕,壽命就越長 但壽命越長,開銷就越大 醫療照護的開銷跟壽命延長成正比
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.
這是一張探討國家的富裕程度 與 65 歲以上人口比例相關性的圖 很明顯可以看出,國家越富有 國民壽命就越長 這為什麼重要? 又為什麼是當下最嚴峻的考驗? 如果人口平均年齡是 30 歲 那麼一般需要醫療的疾病可能是 三不五時扭傷腳踝 也許加上點氣喘 要是國家的平均年齡是 45 到 55 歲 那麼普遍的疾病可能是糖尿病 早發性糖尿病、心臟衰竭、心血管疾病 這些疾病的治癒難度本來就較高 且醫療成本也高出許多
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?
來看一下這份美國人口統計資料 擷取自「The Untied States of America」這本書 在 1930 年間,每 41 個勞力人口中就有 1 個退休 這 41 個身體沒有嚴重疾病的人 僅需負擔這 1 個退休人口治療衰退性疾病的費用 到了 2010 年,每兩個勞力人口中就有 1 人退休 而且全球各工業化的富裕國家都是如此 我們要如何才能負擔醫療成本? 要是老化所要面對的現實就是如此?
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)
這張圖顯示年齡與醫療照護成本之間的關係 可以看出大約在 45 歲,40 到 45 歲的區間 醫療照護成本急遽上升 這其實相當有趣,在適當的統計研究下 我們可以看出自己在人生各個階段 所需的醫療成本 而且在死亡前 7 年會出現一個高峰 我們還可以... (笑聲) ...我們還是不要討論這些 (笑聲)
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.
其實我們真正能做的很有限 要改變這些疾病的治療方式 同時享受我所謂的「健康老化」 我想提出 4 個想法 而且都跟壽險和立法無關 僅僅是改變只是負擔費用的對象 實際需要的醫療成本不變
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.
我們的選擇之一就是不治療,也可以配給醫療資源 我們不要再討論這方面,實在太令人沮喪了。 我們可以預防 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, 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.
不過最有趣也最重要的想法可能是 儘早在症狀惡化的過程中診斷 進而根治疾病 而不是只對症下藥 以糖尿病為例 現在我們如何治療糖尿病? 我們要到出現症狀才能診斷出疾病 然後再花 10、20、30、40 年來對症下藥 結果還算可以,胰島素注射是個不錯的療法 不過它終究會就失去藥效 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 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.
為什麼我們不在發病初期就注射物質到胰臟 促進胰臟再生, 或甚至在症狀出現前就這麼做呢? 這種治療一開始可能貴一點 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. 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.
我覺得這段影片清楚的表達我想傳達的概念 這是一隻在進行肢體再生的蠑螈 蠑螈做得到,為什麼我們不能? 待會我會讓大家看一些更重要的 有關肢體再生的報導 但是在再生醫學中討論的 是重建體內所有的器官系統 無論是針對組織和器官 在現實中,要是生病了 醫生會治療我們的症狀 而且我們必須適應新的生活方式
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.
我想要讓大家看看未來 雖然還沒辦法確定「未來」何時會來 不過,應該不用等太久 我想談談再生復健 這是個義肢 跟從戰地回來的士兵 所用的類似 有 370 位剛從伊拉克返國的士兵手腳截肢 試想與其截肢, 他們其實可以 重建完整的四肢 這是個很瘋狂的想法 我將展示這個想法目前的進展
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.
再次強調,這可以適用於任何器官 要怎麼做到呢? 作法是與身體建立良好的溝通 我們必須學習了解人體的各種訊息 且要開啟胎兒時期曾經擁有的再生能力 哺乳類動物的胎兒在懷孕期的頭三個月 失去的手腳可以重新長出來 因此我們的 DNA 中就有這種癒合機制 這是個自然的過程 卻隨著年齡增長而流失 一個未滿 6 個月的嬰兒 要是意外割斷了指尖 可以重新長回來 不過到了 5 歲,他們就失去這種能力
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.
為了能夠找回這樣的能力 我們必須學會解讀身體的訊息 以下是一些目前正在使用的技術 我會介紹其中的 3 種 透過這些技術我們可以與身體溝通
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.
第一個是細胞療法 這顯然是利用癒合的自然程序 用細胞進行大部分的癒合工作 因此,只要找到適合的細胞 然後植入人體,或許就能成功 第二種我們可以使用材料 昨天的講題告訴我們新材料的重要性 如果我們能從自然界合成、設計 或提煉出新的材料 或許就可以利用這些材料來誘發身體的癒合功能 最後, 我們也許可以利用一些精巧的裝置 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, 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?
我會針對各種技術舉例 先從材料開始 匹茲堡大學的學者史提夫.巴迪萊 大約在 10 年前提出一個很高明的想法 他想利用豬的小腸 要是能夠剝除小腸上所有的細胞 同時維持其生物活性 可能可以保存必要的因子和訊號 啟動身體的自我癒合能力 他同時提出一個非常重要的問題 他的問題是 這種天然的材料 放在小腸通常可以誘發小腸的癒合 要是放在人體的其他地方 是否可以針對不同組織引發正確的修復反應 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. 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)
我舉的例子一定夠嚇人 接下來我要展示的圖片 -- 膽小者不宜 -- (笑聲) 是很嚇人的照片 不過對於那些膽子很小的人 即使你們可能不想在朋友面前承認 燈光變暗了,剛好可以低頭不看 看看手機,做什麼都好,就是不要看螢幕 (笑聲)
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.
我要展示的是糖尿病足部潰瘍的照片 不過看到照片以後可能就笑不出來了 這就是糖尿病的真實狀況 我想大家常聽到糖尿病、糖尿病潰瘍 卻不會把潰瘍和醫療上的終極手段聯想在一起 要是治療無效,終極手段就是截肢 我現在要放上投影片,不過不會放太久 這就是糖尿病足部潰瘍,真可怕 唯一的療法就是截肢 這是一位患有肝癌和糖尿病的老婦人 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, 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.
所以治療潰瘍一年後她決定 嘗試史提夫發明的新療法 傷口經過 11 個星期治療之後變成這個樣子 這個材料只含有天然的訊息因子 而且可以誘發身體重新啟動 從前沒有的癒合反應
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.
接下來還有一些更令人不舒服的照片 等到可以轉過頭的時候,我會叫大家 這是一匹馬。它並不感覺痛 要是它會痛,我就不會讓大家看這張投影片 這匹馬已經重建了新的鼻腔 它因為一次騎乘意外而受傷 治療幾星期後 這個案例是將新材料製成膠狀物 包覆整個受傷區域並重複幾次療程 然後傷口就癒合了 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. 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.
這是一隻重新接合魚鰭的海豚 現在全球已經有 40 萬名病患 使用這種新材料來癒合傷口 肢體再生還是天方夜譚嗎? 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 開始嘗試探索這個問題
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.
我將要大家看看價值 1500 萬的照片 這位 78歲的男子失去了指尖 還記得我之前提到幼兒指尖的再生能力 這是接受治療後的樣子 現在就能做到 現在在臨床上可以做到 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? 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.
還能更進一步的治療嗎? 試想除了使用新的材料外 我們是否可以拿一些細胞結合材料 清除損害的組織之後 在患部放上人體可自行分解的材料? 你可以看到在培養皿裡有一小塊正在跳動的心肌 這是由東京婦女醫院的岡野照雄所完成的 他真的可以在培養皿裡培養出跳動的心臟組織 先透過冰鎮培養皿改變組織的特性 然後將組織從培養皿中取下 這真是酷斃了
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.
現在我們來談談細胞療法 我要給大家看的是 由患者的臀部取出幹細胞 再次提醒,要是你很膽小還是別看了 不過這個也很酷 這是一個心臟繞道手術,就是高爾剛做完的的那種 不同的是 這個案例手術的最後階段 你將看到病患體內的幹細胞 在手術開始時取出的幹細胞 被直接注入病患心臟 我站到上面來是因為稍後能看到細胞植入 我要讓大家看看這個技術還在初期階段 現在幹細胞直接注入病患還在跳動的心臟 如果大家仔細看 大概就在這裡 會看到滲出液體 那是幹細胞被排出來 我們需要各種新的技術和裝置 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. 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.
我這裡有一點資料,只是一點點 這是個隨機的試驗 當時只有樣本只有 20 個,現在已經累積到 100 個了 基本上,如果一個重病患者 接受了繞道手術,情況會稍微好轉 要是他們同時接受幹細胞治療 這些特定病患症狀會完全消失 這個數據已經是兩年前的了 最棒的是能早期診斷出疾病 並預防疾病惡化的可能性
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.
這手術跟剛剛類似,但只有最低的侵入程度 只要在心臟需手術的部位開 3 個孔 然後利用內視鏡手術注入幹細胞 現在幹細胞植入 我沒有時間詳細說明 但基本上這個方法是可行的 症狀較輕的病患可以 復原到幾乎無症狀的情況 只要接受這種手術治療
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.
這裡有另一個尚未進入臨床試驗的幹細胞療法 我想不久後會進行 這是匹茲堡大學的凱西 . 瑪拉的研究成果 她與世界各地的科學家合作 她們認為抽脂手術取出的脂肪液體 我想美國最多的就是脂肪液 (笑聲) 這其實是很好的幹細胞來源 脂肪液中有許多幹細胞 所以去整型診所抽個脂 就能有了這些脂肪液體 在這個案例中,幹細胞被分離出來轉成神經元 全部都在實驗室完成的 我想在不久之後就能有患者接受治療 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 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.
我也提到過用精密儀器 顛覆治療疾病的方式 在我總結前再提最後一個例子 這是件令人遺憾的事 我們與一位在美軍手術研究機構的同事 經歷長久但過程卻令人難過的合作關係 他負責治療 1 萬 1 千名剛從伊拉克回來的年輕人 其中很多都嚴重燒傷
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.
不過,要說我們燒傷的認識 就是目前無法治癒 目前治療燒燙傷的方法 是使用皮膚移植 我們從某個部位取下皮膚 再移植到燒傷的區域 然後試著讓它們相容 這個案例設計出可以貼在人體上的新生物反應器 年底 ISR 應該就會進行臨床試驗 由匹茲堡大學的耶格 . 葛萊克主持 這種生物反應器會鋪在傷口上 大家看到的噴槍則會噴上細胞 將細胞均勻噴灑在傷口上 生物反應器會供應細胞養分 同時也是物質運輸流動的管道 藉此提供細胞適宜的生長環境 與皮膚移植兩相比較 是個全然不同的方法
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.
我的 18 分鐘時間到了 讓我用一個好消息做結尾 或許有一小部分還是壞消息 好消息是這些技術現在就能做到 這項工程作用強大 那些照片很顯然讓大家體會到這點 不過卻因為是高度跨領域的工作而難度頗高 幾乎所有科學領域及臨床醫學都牽涉到了 要一起嘗試讓想法成真
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.
有一些國家和許多地區 已經體認到這是一種治療疾病的新方式 日本政府應該是第一個 決定先在這個領域投入 30 億資金 然後再加碼 20 億 這是必然的趨勢 日本是世界上平均壽命最高國家之一 因此需要讓這項研究成功,才能維持其醫療系統 所以在這個領域砸下很多策略性的投資 在歐盟也一樣 中國也是 中國的國家組織工程研究中心才剛落成 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. (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.
美國的作法,則是有點不同。我們... (笑聲) 天啊,真希望高爾是美國總統! 我們的作法不同 基本上就是順水推舟補助 而沒有策略性投資 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, 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.
我將引用一段對話做結,可能有點惡毒 NIH 美國衛生研究機構的主持人,人很親切 我與哈佛大學的傑 . 福肯帝 拜訪了他跟其他幾位機構裡的主任 大概就是幾個月前 我們試著說服他時候到了 他可以從明年編列的 275 億預算中撥一小部分補助我們 用策略性方法,把錢專門用來加快研究腳步 讓病患早日受益 在這個火藥味很重的會面最後 NIH 的主持人只說 「我們的胃口太小,吞不下你們偉大的理想」 我想我最後要說的就是,沒有人可以改變我們的理想 不過,我們合力就能撐大他的胃口 謝謝