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TED2006

Alan Russell: The potential of regenerative medicine

アラン・ラッセル: 肉体の再生

February 2, 2006

アラン・ラッセルが病気や怪我を治療する際の突破口となる再生医療の話をします。身体が持つ自然の力で、失われた部位を再生する信号を送る方法が紹介されています。

Alan Russell - Medical futurist
In the fight against disease, defect and injury, Alan Russell has a novel argument: Why not engineer new tissue and organs to replace sick ones? Full bio

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Double-click the English subtitles below to play the video.
I'm going to talk to you today about
今日 お話しするのは
00:26
hopefully converting fear into hope.
願わくは恐怖を希望に変えることです
00:28
When we go to the physician today --
私達は病院に行くと
00:31
when we go to the doctor's office and we walk in,
診察室の中で
00:34
there are words that we just don't want to hear.
耳にしたくない言葉があります
00:36
There are words that we're truly afraid of.
私達が本当に恐れている言葉です
00:39
Diabetes, cancer, Parkinson's, Alzheimer's,
糖尿病 癌 パーキンソン病 アルツハイマー
00:41
heart failure, lung failure --
心不全 肺不全
00:45
things that we know are debilitating diseases,
私達の認識は 身体をむしばむ
00:47
for which there's relatively little that can be done.
対処法がほとんどない病気ということです
00:50
And what I want to lay out for you today is
今日お話したいのは
00:55
a different way of thinking about how to treat debilitating disease,
不治の病への従来とは違ったアプローチと
00:57
why it's important,
その重要性です
01:01
why without it perhaps our health care system will melt down
それがなければ 医療制度は崩壊するでしょう
01:03
if you think it already hasn't,
まだ していなければの話ですが…
01:06
and where we are clinically today, and where we might go tomorrow,
臨床の現在と 明日の方向性
01:08
and what some of the hurdles are.
問題点を取り上げ
01:11
And we're going to do all of that in 18 minutes, I promise.
以上の点を18分で紹介します
01:13
I want to start with this slide,
こちらを見てください
01:16
because this slide sort of tells the story the way Science Magazine thinks of it.
サイエンスマガジン誌の見方が表れています
01:18
This was an issue from 2002
バイオニックヒューマンに関する
01:23
that they published with a lot of different articles on the bionic human.
様々な記事を集めた2002年の特集号です
01:25
It was basically a regenerative medicine issue.
要は 再生医療特集ということです
01:29
Regenerative medicine is an extraordinarily simple concept
再生医療とは非常に簡単な概念で
01:32
that everybody can understand.
誰でも理解できます
01:36
It's simply accelerating the pace at which the body heals itself
自然治癒のスピードを医療処置のように
01:38
to a clinically relevant timescale.
加速するのです
01:42
So we know how to do this in many of the ways that are up there.
ここに挙げられている様々な方法を我々は知っています
01:46
We know that if we have a damaged hip, you can put an artificial hip in.
股関節疾患には人工関節で治します
01:49
And this is the idea that Science Magazine used on their front cover.
サイエンスマガジン誌の表紙で紹介された考え方です
01:53
This is the complete antithesis of regenerative medicine.
実はこれは再生医療とは正反対で
01:57
This is not regenerative medicine.
再生医療とは呼びません
02:01
Regenerative medicine is what Business Week put up
ビジネスウィーク誌が少し前に
02:03
when they did a story about regenerative medicine not too long ago.
特集したのが本当の再生医療です
02:06
The idea is that instead of figuring out how to ameliorate symptoms
その概念とは 器具や薬で症状を
02:09
with devices and drugs and the like --
改善させようとする代わりに
02:14
and I'll come back to that theme a few times --
これは後から触れますが
02:16
instead of doing that, we will regenerate lost function of the body
臓器や傷ついた組織の機能を再生することで
02:19
by regenerating the function of organs and damaged tissue.
失われた体の機能を再生するのです
02:23
So that at the end of the treatment,
治療が終了すると
02:27
you are the same as you were at the beginning of the treatment.
健康時の体が取り戻せます
02:29
Very few good ideas -- if you agree that this is a good idea --
これは良いアイディアだと思いますが
02:34
very few good ideas are truly novel.
良いアイディアは新しくないことが多いものです
02:37
And this is just the same.
この案も同じです
02:40
If you look back in history,
歴史を振り返れば
02:42
Charles Lindbergh, who was better known for flying airplanes,
有名な飛行家のチャールズ リンドバーグは
02:44
was actually one of the first people
ノーベル賞を受賞した―
02:48
along with Alexis Carrel, one of the Nobel Laureates from Rockefeller,
アレクシス カレルと共に 臓器の培養を
02:49
to begin to think about, could you culture organs?
最初に考えた1人です
02:53
And they published this book in 1937,
彼らは1937年に本を出版し
02:57
where they actually began to think about,
バイオリアクターで
02:59
what could you do in bio-reactors to grow whole organs?
いかに臓器を生成できるのか考え始め それ以降
03:01
We've come a long way since then.
躍進を遂げました
03:07
I'm going to share with you some of the exciting work that's going on.
進行中の素晴らしい事例を幾つか紹介します
03:08
But before doing that, what I'd like to do
でも その前に 医療制度に対する
03:11
is share my depression about the health care system
私の不満と 再生医療の必要性を
03:13
and the need for this with you.
話したいと思います
03:16
Many of the talks yesterday talked about
昨日は生活の質の向上や
03:18
improving the quality of life, and reducing poverty,
貧困を減らすという話をたくさん聞きました
03:20
and essentially increasing life expectancy all around the globe.
実質的に平均寿命を延ばすということです
03:23
One of the challenges is that the richer we are, the longer we live.
でも より裕福になれば 寿命も延びるわけで
03:28
And the longer we live, the more expensive it is
寿命が延びれば 加齢と共に
03:33
to take care of our diseases as we get older.
病気の治療費も増加するということです
03:36
This is simply the wealth of a country
これは65歳以上の人口の割合と
03:39
versus the percent of population over the age of 65.
国の豊かさの関係を示した図です
03:42
And you can basically see that the richer a country is,
国が より裕福であればあるほど
03:46
the older the people are within it.
高齢者は多くなります
03:49
Why is this important?
なぜ これが重要なのか?
03:51
And why is this a particularly dramatic challenge right now?
なぜ これが危急の難題なのか?
03:53
If the average age of your population is 30,
平均年齢が30歳だと
03:57
then the average kind of disease that you have to treat
処置が必要な平均的な病気は
03:59
is maybe a broken ankle every now and again,
時折見られる足首の骨折や
04:03
maybe a little bit of asthma.
喘息などでしょう
04:05
If the average age in your country is 45 to 55,
平均年齢が45歳から55歳になると
04:06
now the average person is looking at diabetes,
平均的なのは 早期の糖尿病
04:10
early-onset diabetes, heart failure, coronary artery disease --
心不全 冠動脈疾患などです
04:13
things that are inherently more difficult to treat,
治療がより難しく 医療費がより高い―
04:16
and much more expensive to treat.
病気が出てきます
04:19
Just have a look at the demographics in the U.S. here.
これは米国の人口統計データです
04:21
This is from "The Untied States of America."
ある本から借用した資料です
04:24
In 1930, there were 41 workers per retiree.
1930年 年金生活者1人に対し労働者は41人
04:26
41 people who were basically outside of being really sick,
基本的に健康には さほど問題のない41人が
04:30
paying for the one retiree who was experiencing debilitating disease.
医療費のかさむ年金生活者1人を養っています
04:35
In 2010, two workers per retiree in the U.S.
2010年の米国は 年金生活者1人に対し労働者2人
04:41
And this is matched in every industrialized, wealthy country in the world.
これは世界中の裕福な産業国すべてに当てはまります
04:44
How can you actually afford to treat patients
高齢化の現実がこのような状態で
04:50
when the reality of getting old looks like this?
いかに患者を治療すればいいか?
04:53
This is age versus cost of health care.
これは年齢と医療費のグラフです
04:56
And you can see that right around age 45, 40 to 45,
ちょうど40~45歳のあたりで
04:59
there's a sudden spike in the cost of health care.
医療費の急激な増加が見られます
05:05
It's actually quite interesting. If you do the right studies,
興味深いのは 研究をすれば
05:10
you can look at how much you as an individual spend on your own health care,
個人の医療費が生涯に渡ってどれだけかかるか
05:13
plotted over your lifetime.
わかるということです
05:17
And about seven years before you're about to die, there's a spike.
死の約7年前に費用が急激に上昇します
05:19
And you can actually --
ここから分かるのは…
05:23
(Laughter)
(笑)
05:24
-- we won't get into that.
…よしておきます
05:26
(Laughter)
(笑)
05:27
There are very few things, very few things that you can really do
このような病気の治療法を変え
05:31
that will change the way that you can treat these kinds of diseases
私が健康的な加齢と呼ぶものを
05:36
and experience what I would call healthy aging.
実現できる方法は あまりありません
05:41
I'd suggest there are four things,
提案する方法は4つ
05:45
and none of these things include an insurance system or a legal system.
保険や法律に関連したことではありません
05:47
All those things do is change who pays.
それらは負担者を変えるだけで
05:51
They don't actually change what the actual cost of the treatment is.
治療費に変化は出せません
05:53
One thing you can do is not treat. You can ration health care.
1つの方法は 医療を制限し 治療をやめることです
05:57
We won't talk about that anymore. It's too depressing.
こんな暗い話題はやめましょう
06:01
You can prevent.
もう1つは予防です
06:04
Obviously a lot of monies should be put into prevention.
予防に多くの費用をかけるべきなのは明白です
06:05
But perhaps most interesting, to me anyway, and most important,
興味深く 最も重要なのは
06:09
is the idea of diagnosing a disease much earlier on in the progression,
病気の早期発見をして
06:12
and then treating the disease to cure the disease
対症療法ではなく
06:17
instead of treating a symptom.
完治するように治療すること
06:20
Think of it in terms of diabetes, for instance.
糖尿病を例に考えてみましょう
06:22
Today, with diabetes, what do we do?
現在の糖尿病への対応とは?
06:26
We diagnose the disease eventually, once it becomes symptomatic,
症状が現れてから診断がなされ
06:28
and then we treat the symptom for 10, 20, 30, 40 years.
そして何十年と長期に渡る治療をし
06:31
And we do OK. Insulin's a pretty good therapy.
インスリンが効くので健康を保てますが
06:35
But eventually it stops working,
結局は効かなくなり
06:39
and diabetes leads to a predictable onset of debilitating disease.
糖尿病がどんどん身体を弱らせる素因になります
06:40
Why couldn't we just inject the pancreas with something
症状が現れる前の初期の段階で
06:48
to regenerate the pancreas early on in the disease,
すい臓を再生させる注射をすることは
06:51
perhaps even before it was symptomatic?
できないでしょうか?
06:54
And it might be a little bit expensive at the time that we did it,
その時は多少費用が必要ですが
06:57
but if it worked, we would truly be able to do something different.
効果が出れば 違いは著しいでしょう
07:00
This video, I think, gets across the concept that I'm talking about quite dramatically.
私が話している概念は このビデオで劇的に伝えられると思います
07:04
This is a newt re-growing its limb.
これは再生中のイモリの手です
07:09
If a newt can do this kind of thing, why can't we?
イモリに可能ならば 我々にも可能なのでは?
07:13
I'll actually show you some more important features
もう少し後で 手足再生に関する―
07:16
about limb regeneration in a moment.
もっと重要な事を紹介します
07:19
But what we're talking about in regenerative medicine
再生医療とは
07:21
is doing this in every organ system of the body,
体中すべての組織や
07:24
for tissues and for organs themselves.
器官全体に適用できます
07:27
So today's reality is that if we get sick,
今日の実情では 病気になった場合
07:34
the message is we will treat your symptoms,
治療されるのは症状であり 患者には
07:37
and you need to adjust to a new way of life.
新しいあり方への適応が求められます
07:40
I would pose to you that tomorrow --
いつ起きるのかは
07:43
and when tomorrow is we could debate,
議論の余地がありますが
07:45
but it's within the foreseeable future --
近い将来に
07:47
we will talk about regenerative rehabilitation.
再生医療を伴うリハビリが行われるようになるでしょう
07:49
There's a limb prosthetic up here,
この義足は
07:53
similar actually one on the soldier
イラク帰還兵が使用しているものに
07:54
that's come back from Iraq.
よく似ています
07:57
There are 370 soldiers that have come back from Iraq that have lost limbs.
手足を失ったイラク帰還兵が370名もいます
07:59
Imagine if instead of facing that, they could actually
彼らが直面するのが 手足の喪失ではなく
08:03
face the regeneration of that limb.
手足の再生であるところを想像してみてください
08:06
It's a wild concept.
興味深いですね
08:08
I'll show you where we are at the moment in working towards that concept.
その発想に向けた進行中の事例を紹介します
08:10
But it's applicable, again, to every organ system.
どの器官にも有効な方法です
08:15
How can we do that?
その方法とは
08:17
The way to do that is to develop a conversation with the body.
肉体と会話をすること
08:18
We need to learn to speak the body's language.
肉体の言語を話し
08:22
And to switch on processes that we knew how to do when we were a fetus.
胎児だった時に使っていたプロセスを起動するのです
08:25
A mammalian fetus, if it loses a limb during the first trimester of pregnancy,
哺乳類の胎児は妊娠3ヶ月までに手足を失っても
08:30
will re-grow that limb.
再び形成されます
08:35
So our DNA has the capacity to do these kinds of wound-healing mechanisms.
私たちのDNAはそのような怪我を治癒する機能を備えているのです
08:37
It's a natural process,
これは自然な能力ですが
08:43
but it is lost as we age.
成長と共に失われます
08:45
In a child, before the age of about six months,
生後6ヶ月以内の乳児であれば
08:49
if they lose their fingertip in an accident,
指先を事故で失っても
08:52
they'll re-grow their fingertip.
元通りになりますが
08:54
By the time they're five, they won't be able to do that anymore.
5歳児だと 元通りにはなりません
08:56
So to engage in that conversation with the body,
そこで 肉体と対話する為には
08:59
we need to speak the body's language.
肉体の言葉を話す必要があります
09:02
And there are certain tools in our toolbox that allow us to do this today.
現在 そのための道具立てを我々は持っています
09:04
I'm going to give you an example of three of these tools
肉体と対話する能力3つの例を
09:09
through which to converse with the body.
お見せします
09:12
The first is cellular therapies.
1つめは細胞セラピー
09:15
Clearly, we heal ourselves in a natural process,
私たちは主に細胞の働きによって
09:17
using cells to do most of the work.
自然なプロセスとして自ら治癒します
09:20
Therefore, if we can find the right cells
適切な細胞を見つけ
09:23
and implant them in the body, they may do the healing.
体に移植すれば 細胞が治してくれるかもしれません
09:25
Secondly, we can use materials.
2つめは物質を使うこと
09:29
We heard yesterday about the importance of new materials.
昨日 新物質の重要性について聞きました
09:31
If we can invent materials, design materials,
もし物質を発明したり 設計したり
09:34
or extract materials from a natural environment,
自然界から抽出することが出来れば
09:37
then we might be able to have those materials induce the body to heal itself.
その物質で体自身が治癒するように誘導できるかもしれません
09:40
And finally, we may be able to use smart devices
最後に 体の機能を肩代わりして
09:44
that will offload the work of the body and allow it to heal.
体が治癒できるようにする知的な装置を作れるかもしれません
09:47
I'm going to show you an example of each of these,
それぞれの例を紹介します
09:52
and I'm going to start with materials.
物質から始めます
09:54
Steve Badylak -- who's at the University of Pittsburgh --
ピッツバーグ大学のバディラック氏は
09:56
about a decade ago had a remarkable idea.
10年程前に素晴らしい事を思いつきました
09:58
And that idea was that the small intestine of a pig,
生物学的に活性な状態のまま 豚の小腸からすべての細胞を
10:01
if you threw away all the cells,
取り除いたなら
10:05
and if you did that in a way that allowed it to remain biologically active,
体に治癒を促すのに必要なすべての要素と信号が
10:08
may contain all of the necessary factors and signals
そこには含まれているかもしれない―
10:12
that would signal the body to heal itself.
というアイディアです
10:15
And he asked a very important question.
彼はとても重要な
10:17
He asked the question,
質問をしました
10:19
if I take that material, which is a natural material
通常は小腸で治癒を誘発する―
10:20
that usually induces healing in the small intestine,
天然の物質を取り 人の耳の部分に
10:23
and I place it somewhere else on a person's body,
移植したら 組織固有の反応を見せて
10:26
would it give a tissue-specific response,
耳を作り出すのか それとも小腸を
10:30
or would it make small intestine if I tried to make a new ear?
作り出すのか という質問です
10:33
I wouldn't be telling you this story if it weren't compelling.
興味深い話でなければ この話はしていません
10:37
The picture I'm about to show you
これからお見せする写真は…
10:42
is a compelling picture.
(スライド: 目をそらすなら今のうち) (笑)
10:44
(Laughter)
注目に値する写真です
10:46
However, for those of you that are even the slightest bit squeamish --
でも 友人には認めたくなくても
10:48
even though you may not like to admit it in front of your friends --
怖ければ 明かりを落とすので
10:51
the lights are down. This is a good time to look at your feet,
足下を気にしたり 携帯を確認したり
10:54
check your Blackberry, do anything other than look at the screen.
スクリーンを見る以外のことをして下さい
10:57
(Laughter)
(笑)
11:02
What I'm about to show you is a diabetic ulcer.
お見せするのは糖尿病性潰瘍です
11:05
And although -- it's good to laugh before we look at this.
笑うのは今のうちです
11:09
This is the reality of diabetes.
これが糖尿病の現実です
11:12
I think a lot of times we hear about diabetics, diabetic ulcers,
糖尿病や糖尿病性潰瘍はよく耳にしますが
11:14
we just don't connect the ulcer with the eventual treatment,
治癒しなければ切断 という最終段階と
11:17
which is amputation, if you can't heal it.
潰瘍をあまり関連づけすることはありません
11:22
So I'm going to put the slide up now. It won't be up for long.
では始めます 長くはありません
11:24
This is a diabetic ulcer. It's tragic.
これが糖尿病性潰瘍 悲惨なものです
11:27
The treatment for this is amputation.
治療法は切断です
11:30
This is an older lady. She has cancer of the liver as well as diabetes,
この66歳の女性は糖尿病の他に肝臓ガンも患っており
11:32
and has decided to die with what' s left of her body intact.
死ぬのであれば 体は傷つけずにいようと決めたのですが
11:36
And this lady decided, after a year of attempted treatment of that ulcer,
1年間の潰瘍治療の末 バディラック氏の
11:41
that she would try this new therapy that Steve invented.
新しい治療法を試すことにしました
11:46
That's what the wound looked like 11 weeks later.
11週後の傷口の様子です
11:49
That material contained only natural signals.
その物質には自然の信号だけが含まれていました
11:52
And that material induced the body to switch back on a healing response
この物質が以前には無かった治癒反応を
11:56
that it didn't have before.
引き起こしました
12:00
There's going to be a couple more distressing slides for those of you --
ショッキングな写真があと数枚出てきます
12:02
I'll let you know when you can look again.
終わったら 言いますね
12:05
This is a horse. The horse is not in pain.
これは馬です 痛みは感じていません
12:07
If the horse was in pain, I wouldn't show you this slide.
そうでなければ お見せしません
12:10
The horse just has another nostril that's developed
乗馬事故に巻き込まれて
12:12
because of a riding accident.
このようになってしまいました
12:15
Just a few weeks after treatment --
治療数週間後です
12:17
in this case, taking that material, turning it into a gel,
このケースでは 物質をジェル状にして
12:18
and packing that area, and then repeating the treatment a few times --
傷口を覆い それを何度か繰り返して
12:21
and the horse heals up.
完治しました
12:25
And if you took an ultrasound of that area, it would look great.
超音波でもはっきりわかります
12:27
Here's a dolphin where the fin's been re-attached.
これは新しい背びれを得たイルカです
12:29
There are now 400,000 patients around the world
世界中には現在40万人もの患者が
12:32
who have used that material to heal their wounds.
この物質を用いた怪我の治療を受けています
12:35
Could you regenerate a limb?
手足は再生できるのでしょうか?
12:38
DARPA just gave Steve 15 million dollars to lead an eight-institution project
この疑問の解明のため 8組織に渡るプロジェクトの資金として
12:41
to begin the process of asking that question.
国防省の研究機関が1500万ドルを提供しました
12:45
And I'll show you the 15 million dollar picture.
その1500万ドルの成果です
12:48
This is a 78 year-old man who's lost the end of his fingertip.
これは指先を失った78歳の男性です
12:51
Remember that I mentioned before the children who lose their fingertips.
先程 指先を失う子どもの話をしましたね?
12:54
After treatment that's what it looks like.
これが治療後です
12:58
This is happening today.
これは現在起きていて
13:01
This is clinically relevant today.
臨床的に意味のある事です
13:03
There are materials that do this. Here are the heart patches.
これを可能にする物質もあり 心臓パッチもあります
13:06
But could you go a little further?
もう一歩先へ進んで
13:09
Could you, say, instead of using material,
物質の代わりに
13:11
can I take some cells along with the material,
物質と共に細胞を用いて
13:13
and remove a damaged piece of tissue,
傷ついた組織を取り除き
13:15
put a bio-degradable material on there?
生分解性物質の移植は可能なのか?
13:17
You can see here a little bit of heart muscle beating in a dish.
心筋が培養皿で鼓動しているのがわかりますね
13:20
This was done by Teruo Okano at Tokyo Women's Hospital.
これは東京女子医大の岡野光夫氏が手掛けました
13:23
He can actually grow beating tissue in a dish.
実際に培養皿で鼓動部分を生成できるのです
13:28
He chills the dish, it changes its properties
培養皿を冷やすと 特性が変わり
13:31
and he peels it right out of the dish.
そこから剥いで使うのです
13:33
It's the coolest stuff.
すごいですね
13:35
Now I'm going to show you cell-based regeneration.
次は 細胞を使う話です
13:38
And what I'm going to show you here
ここで紹介するのは
13:40
is stem cells being removed from the hip of a patient.
患者の臀部から取り出した幹細胞です
13:42
Again, if you're squeamish, you don't want to watch.
怖がりの人向けではありませんが
13:46
But this one's kind of cool.
これは すごいですよ
13:48
So this is a bypass operation, just like what Al Gore had,
これはアルゴアが受けたようなバイパス手術ですが
13:49
with a difference.
違うのは
13:55
In this case, at the end of the bypass operation,
ここでは バイパス手術の最後に
13:56
you're going to see the stem cells from the patient
手術の初めに取り出された―
13:59
that were removed at the beginning of the procedure
患者の幹細胞が
14:01
being injected directly into the heart of the patient.
心臓に直接注射されていることです
14:03
And I'm standing up here because at one point
ここに立って この技術がどれだけ
14:07
I'm going to show you just how early this technology is.
最先端なのかをお見せします
14:09
Here go the stem cells, right into the beating heart of the patient.
患者の鼓動する心臓に幹細胞が入れられています
14:12
And if you look really carefully,
注意深く見ると
14:15
it's going to be right around this point
まさにこの辺に
14:16
you'll actually see a back-flush.
逆流しているのがわかります
14:18
You see the cells coming back out.
細胞が戻って来るのが見えます
14:20
We need all sorts of new technology, new devices,
完璧に細胞を配置するには
14:24
to get the cells to the right place at the right time.
新しい技術と装置が必要です
14:26
Just a little bit of data, a tiny bit of data.
ちょっとした無作為化試験の
14:31
This was a randomized trial.
データがあります
14:33
At this time this was an N of 20. Now there's an N of about 100.
被験者数は20でしたが 現在は100です
14:35
Basically, if you take an extremely sick patient
基本的に重病人にバイパス手術を行えば
14:39
and you give them a bypass, they get a little bit better.
少し改善するだけですが
14:41
If you give them stem cells as well as their bypass,
もし同じ患者に バイパス手術と
14:43
for these particular patients, they became asymptomatic.
幹細胞移植を行うと症状はなくなります
14:46
These are now two years out.
これは 既に2年経っています
14:49
The coolest thing would be is if you could diagnose the disease early,
もし病気を早期発見し 悪化を防げれば
14:53
and prevent the onset of the disease to a bad state.
それほど最高なことはないでしょう
14:56
This is the same procedure, but now done minimally invasively,
こちらは最小限の切開で行えるよう
15:00
with only three holes in the body where they're taking the heart
体に3か所だけ穴を開け そこから腹腔鏡で
15:04
and simply injecting stem cells through a laparoscopic procedure.
心臓に幹細胞を注入します
15:07
There go the cells.
今 入っています
15:11
We don't have time to go into all of those details,
詳しく説明する時間はありませんが
15:12
but basically, that works too.
基本的には うまく機能します
15:15
You can take patients who are less sick,
症状の軽い患者は このような治療で
15:17
and bring them back to an almost asymptomatic state
ほとんど症状が無い状態へ
15:20
through that kind of therapy.
戻ります
15:24
Here's another example of stem-cell therapy that isn't quite clinical yet,
もう一つの幹細胞治療の例は もうすぐ
15:26
but I think very soon will be.
臨床段階に入ると思います
15:30
This is the work of Kacey Marra from Pittsburgh,
これはピッツバーグのマーラ氏が
15:32
along with a number of colleagues around the world.
世界中の仲間と共同で
15:34
They've decided that liposuction fluid,
脂肪吸引流体で実験しています
15:36
which -- in the United States, we have a lot of liposuction fluid.
アメリカにはたっぷりありますからね
15:39
(Laughter)
(笑)
15:42
It's a great source of stem cells.
脂肪吸引流体には
15:43
Stem cells are packed in that liposuction fluid.
幹細胞がぎっしり詰まっています
15:45
So you could go in, you could get your tummy-tuck.
クリニックへ行き 脂肪吸引施術をすれば
15:48
Out comes the liposuction fluid,
脂肪流体が出てきます
15:51
and in this case, the stem cells are isolated and turned into neurons.
ここでは分離した幹細胞から神経細胞が作られました
15:53
All done in the lab.
実験室での話です
15:58
And I think fairly soon, you will see patients being treated
もうすぐ 自分の脂肪に由来する幹細胞で
15:59
with their own fat-derived, or adipose-derived, stem cells.
治療を受ける患者が出てくるでしょう
16:02
I talked before about the use of devices
先程 病気を治療する方法を
16:07
to dramatically change the way we treat disease.
劇的に変える器具の話をしました
16:09
Here's just one example before I close up.
締めに ある事例を紹介します
16:12
This is equally tragic.
これもまた悲惨です
16:14
We have a very abiding and heartbreaking partnership
米陸軍外科研究所とは長い付き合いですが
16:16
with our colleagues at the Institute for Surgical Research in the US Army,
とても心が痛むものがあります
16:19
who have to treat the now 11,000 kids that have come back from Iraq.
彼らは現在11,000人のイラク帰還兵の治療に当たっています
16:23
Many of those patients are very severely burned.
患者の多くが 重度の火傷を負っています
16:28
And if there's anything that's been learned about burn,
火傷から学んだ事があるとすれば
16:30
it's that we don't know how to treat it.
治療法が判らないこと
16:32
Everything that is done to treat burn --
火傷治療に行われるのは
16:34
basically we do a sodding approach.
芝敷きアプローチです
16:36
We make something over here,
こっちにあるものを取って
16:39
and then we transplant it onto the site of the wound,
火傷の部位に移植し
16:41
and we try and get the two to take.
くっつけようとします
16:43
In this case here, a new, wearable bio-reactor has been designed --
このケースでは新しく装着できるバイオリアクターを
16:45
it should be tested clinically later this year at ISR --
ピッツバーグのガーラック氏が開発し 今年中に
16:49
by Joerg Gerlach in Pittsburgh.
臨床試験が行われるはずです
16:52
And that bio-reactor will lay down in the wound bed.
バイオリアクターを創傷床にくっつけ
16:54
The gun that you see there sprays cells.
そして その部分に
16:57
That's going to spray cells over that area.
細胞をスプレーします
17:00
The reactor will serve to fertilize the environment,
リアクターがその環境を肥やし
17:03
deliver other things as well at the same time,
同時に他の物も運びます
17:06
and therefore we will seed that lawn,
そして芝に種まきが出来るのです
17:09
as opposed to try the sodding approach.
芝敷きアプローチとは反対です
17:12
It's a completely different way of doing it.
まるっきり違います
17:14
So my 18 minutes is up.
18分経ちましたので
17:18
So let me finish up with some good news,
良い報せと 悪い報せを
17:20
and maybe a little bit of bad news.
話して終わります
17:22
The good news is that this is happening today.
朗報は これが現在起きているということ
17:25
It's very powerful work.
その迫力が
17:28
Clearly the images kind of get that across.
写真で伝わりますね
17:30
It's incredibly difficult because it's highly inter-disciplinary.
多分野に渡る研究の為 非常に難しいのです
17:32
Almost every field of science engineering and clinical practice
科学 工学 臨床の分野のほとんどが
17:35
is involved in trying to get this to happen.
この実現に向けて取り組んでいます
17:39
A number of governments, and a number of regions,
多くの政府や地域が
17:43
have recognized that this is a new way to treat disease.
これこそ新しい治療法だと認めています
17:45
The Japanese government were perhaps the first,
初めて認めたのは おそらく日本政府で
17:48
when they decided to invest first 3 billion,
30億ドルの投資を決め
17:50
later another 2 billion in this field.
後に 20億ドル追加しました
17:53
It's no coincidence.
それもそのはず
17:56
Japan is the oldest country on earth in terms of its average age.
日本は世界一の長寿国です
17:57
They need this to work or their health system dies.
これが成功しないと 日本の医療制度は崩壊するため
18:00
So they're putting a lot of strategic investment focused in this area.
彼らはこの分野に戦略的に投資しています
18:05
The European Union, same thing.
ヨーロッパ連合も然り
18:09
China, the same thing.
中国も然り 中国は
18:11
China just launched a national tissue-engineering center.
組織工学研究センターを設立しました
18:13
The first year budget was 250 million US dollars.
初年度予算は2億5千万ドルでした
18:15
In the United States we've had a somewhat different approach.
アメリカのアプローチは少し違います
18:19
(Laughter)
(笑)
18:23
Oh, for Al Gore to come and be in the real world as president.
アル ゴアが大統領になれば良かったのですが…
18:26
We've had a different approach.
我々のアプローチは
18:30
And the approach has basically been to just sort of fund things as they come along.
うまくいったものに投資するやり方で
18:31
But there's been no strategic investment
新技術を生み出し 集中させる為に
18:35
to bring all of the necessary things to bear and focus them in a careful way.
必要なものを集める戦略的な投資ではないのです
18:38
And I'm going to finish up with a quote, maybe a little cheap shot,
少しずるいやり方かもしれませんが
18:44
at the director of the NIH, who's a very charming man.
国立衛生研究所(NIH)所長の言葉を引用して終わりにします
18:47
Myself and Jay Vacanti from Harvard
私はハーバードの
18:53
went to visit with him and a number of his directors of his institute
バカンディ氏と共に NIHの部門責任者たちに会いに行きました
18:55
just a few months ago,
数か月前の事です
19:00
to try and convince him that it was time to take just a little piece
来年度予算275億ドルの中の少しだけでも振り向けて
19:03
of that 27.5 billion dollars that he's going to get next year
再生技術が患者に届くペースが
19:08
and focus it, in a strategic way, to make sure we can accelerate the pace
加速するよう 戦略的に注力すべきであると
19:12
at which these things get to patients.
説得するためです
19:17
And at the end of a very testy meeting,
ピリピリした会合の最後に
19:20
what the NIH director said was,
所長が言いました
19:22
"Your vision is larger than our appetite."
“君の話は壮大すぎて気が進まない”
19:24
I'd like to close by saying that no one's going to change our vision,
我々のビジョンは何者によっても変わりません
19:26
but together we can change his appetite.
みんなで彼の気持ちの方を変えてやりましょう
19:30
Thank you.
ありがとう
19:32
Translator:Takako Sato
Reviewer:Yasushi Aoki

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Alan Russell - Medical futurist
In the fight against disease, defect and injury, Alan Russell has a novel argument: Why not engineer new tissue and organs to replace sick ones?

Why you should listen

Alan Russell is a professor of surgery -- and of chemical engineering. In crossing the two fields, he is expanding our palette of treatments for disease, injury and congenital defects. We can treat symptoms, he says, or we can replace our damaged parts with bioengineered tissue. As he puts it: "If newts can regenerate a lost limb, why can't we?"

The founding director of the McGowan Institute for Regenerative Medicine, at the University of Pittsburgh, Russell leads an ambitious biomedicine program that explores tissue engineering, stem cell research, biosurgery and artificial and biohybrid organs. They've also started testing a new kind of heart pump, figured out that Botox can help with enlarged prostate, and identified human adipose cells as having the possibility to repair skeletal muscle. In his own Russell Lab, his team has studied antimicrobial surfaces and helping to develop a therapy to reduce scarring on muscle after injury. Lately, his lab is involved in biotechnology studies in relation to chemical and biological weapons defense. 

He's also co-founder of Agentase, a company that makes an enzyme-based detector for chemical warfare agents.

The original video is available on TED.com
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