TEDMED 2012
Francis Collins: We need better drugs -- now
Frensis Kolins (Francis Collins): Trebaju nam novi lekovi - sada
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Danas znamo molekularne uzroke za 4.000 bolesti, dok lečenje postoji za samo njih 250. Zašto to traje toliko dugo? Genetičar i lekar Frensis Kolins objašnjava zašto je sistematično otkriće lekova imperativ čak i za retke i složene bolesti i nudi nekoliko rešenja - kao što je učenje starih lekova novim trikovima.
Francis Collins - Geneticist, physician
A key player in the US' new brain-mapping project, Francis Collins is director of the National Institutes of Health. Full bio
A key player in the US' new brain-mapping project, Francis Collins is director of the National Institutes of Health. Full bio
Double-click the English transcript below to play the video.
00:16
So let me ask for a show of hands.
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Hajde da dignete ruke.
00:18
How many people here are over the age of 48?
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Koliko ljudi ovde
ima više od 48 godina?
ima više od 48 godina?
00:22
Well, there do seem to be a few.
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Pa, izgleda da ih ima nekoliko.
00:25
Well, congratulations,
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Čestitamo,
00:28
because if you look at this particular slide of U.S. life expectancy,
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jer ako pogledate na konkretno
ovom slajdu američkog životnog veka,
ovom slajdu američkog životnog veka,
00:31
you are now in excess of the average life span
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sada ste prešli prosečni životni vek
00:35
of somebody who was born in 1900.
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nekoga ko je rođen 1900.
00:37
But look what happened in the course of that century.
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Ali pogledajte šta se dogodilo
tokom tog veka.
tokom tog veka.
00:41
If you follow that curve,
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Ako pratite krivulju,
00:42
you'll see that it starts way down there.
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videćete da ona počinje ovde dole.
00:45
There's that dip there for the 1918 flu.
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Ovde opada zbog gripa 1918.
00:48
And here we are at 2010,
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I evo nas u 2010.
00:50
average life expectancy of a child born today, age 79,
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Prosečni životni vek
deteta rođenog danas je 79 godina.
deteta rođenog danas je 79 godina.
00:53
and we are not done yet.
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I još nismo završili.
00:55
Now, that's the good news.
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To su dobre vesti.
00:56
But there's still a lot of work to do.
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Ali ima još dosta posla da se uradi.
00:58
So, for instance, if you ask,
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Na primer, ako upitate
01:00
how many diseases do we now know
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za koliko bolesti mi sada znamo
01:02
the exact molecular basis?
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tačnu molekularnu osnovu
01:05
Turns out it's about 4,000, which is pretty amazing,
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ispostavlja se da ih je oko 4000,
što je zadivljujuće,
što je zadivljujuće,
01:08
because most of those molecular discoveries
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jer se većina tih molekularnih otkrića
01:10
have just happened in the last little while.
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dogodila nedavno.
01:13
It's exciting to see that in terms of what we've learned,
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Sa stanovišta koliko smo naučili
to je fantastično,
to je fantastično,
01:16
but how many of those 4,000 diseases
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ali koliko od tih 4000 bolesti
01:18
now have treatments available?
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danas lečimo?
01:21
Only about 250.
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Samo oko 250.
01:23
So we have this huge challenge, this huge gap.
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Tako imamo ogromni izazov, ogromni jaz.
01:25
You would think this wouldn't be too hard,
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Mogli biste pomisliti da to ne bi trebalo
da bude previše teško,
da bude previše teško,
01:28
that we would simply have the ability
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da bi jednostavno trebalo
da smo sposobni
da smo sposobni
01:30
to take this fundamental information that we're learning
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da se koristimo osnovnim znanjem
01:33
about how it is that basic biology teaches us
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naučenim iz biologije
01:36
about the causes of disease
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o uzrocima bolesti
01:38
and build a bridge across this yawning gap
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i da sagradimo most
preko zjapećeg jaza,
preko zjapećeg jaza,
01:41
between what we've learned about basic science
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između onoga što smo naučili
o osnovnoj nauci
o osnovnoj nauci
01:43
and its application,
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i njenoj primeni,
01:44
a bridge that would look maybe something like this,
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most koji bi izgledao nekako ovako,
01:48
where you'd have to put together a nice shiny way
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gde biste morali da sastavite lep svetao put
01:51
to get from one side to the other.
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kojim se prelazi s jedne strane na drugu.
01:54
Well, wouldn't it be nice if it was that easy?
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Dakle, zar ne bi bilo lepo
kad bi bilo tako lako?
kad bi bilo tako lako?
01:57
Unfortunately, it's not.
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Nažalost, nije.
01:59
In reality, trying to go from fundamental knowledge
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U stvarnosti je pokušaj prelaska
od osnovnog znanja
od osnovnog znanja
02:02
to its application is more like this.
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do njegove primene više nalik na ovo.
02:04
There are no shiny bridges.
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Nema svetlih mostova.
02:06
You sort of place your bets.
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Više je nalik ulogu u kladionici.
02:08
Maybe you've got a swimmer and a rowboat
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Možda dobijete plivača i čamac
02:10
and a sailboat and a tugboat
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i jedrilicu i remorker
02:11
and you set them off on their way,
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koje otpratite na put
02:13
and the rains come and the lightning flashes,
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i počne kiša i sevanje
02:16
and oh my gosh, there are sharks in the water
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i o moj bože, ajkule su u vodi
02:17
and the swimmer gets into trouble,
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i plivač je u nevolji
02:19
and, uh oh, the swimmer drowned
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i uh, ah, plivač se udavio
02:21
and the sailboat capsized,
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jedrilica se prevrnula,
02:24
and that tugboat, well, it hit the rocks,
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remorker se zabio u stene
02:26
and maybe if you're lucky, somebody gets across.
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i možda, ako imate sreće,
nekom uspe da pređe preko.
nekom uspe da pređe preko.
02:28
Well, what does this really look like?
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A kako to stvarno izgleda?
02:30
Well, what is it to make a therapeutic, anyway?
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Šta je uopšte to
što čini nešto terapeutskim?
što čini nešto terapeutskim?
02:32
What's a drug? A drug is made up
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Šta je lek? Lek je sačinjen
02:35
of a small molecule of hydrogen, carbon,
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od malog molekula
vodonika, ugljenika,
vodonika, ugljenika,
02:38
oxygen, nitrogen, and a few other atoms
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kiseonika, azota
i još nekoliko drugih atoma,
i još nekoliko drugih atoma,
02:40
all cobbled together in a shape,
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i sve to je isprepleteno u oblik
02:42
and it's those shapes that determine whether, in fact,
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i u stvari ti oblici određuju da li će
02:45
that particular drug is going to hit its target.
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određeni lek pogoditi svoj cilj.
02:48
Is it going to land where it's supposed to?
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Da li će sleteti tamo gde bi trebalo?
02:50
So look at this picture here -- a lot of shapes dancing around for you.
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Pogledajte ovu sliku ovde -
mnogo oblika pleše okolo za vas.
mnogo oblika pleše okolo za vas.
02:53
Now what you need to do, if you're trying to develop
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Ono što morate da uradite,
ako pokušavate da razvijete
ako pokušavate da razvijete
02:56
a new treatment for autism
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nov način lečenja autizma
02:57
or Alzheimer's disease or cancer
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ili Alchajmerove bolesti ili raka,
02:59
is to find the right shape in that mix
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je da pronađete pravi oblik
u toj mešavini
u toj mešavini
03:01
that will ultimately provide benefit and will be safe.
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koji će konačno biti od koristi
i koji će biti bezopasan.
i koji će biti bezopasan.
03:04
And when you look at what happens to that pipeline,
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I kada pogledate šta se dešava
tom cevovodu,
tom cevovodu,
03:07
you start out maybe with thousands,
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započeli ste možda s hiljadama,
03:09
tens of thousands of compounds.
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desetinama hiljada sastojaka.
03:10
You weed down through various steps
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Eliminišete ih tokom različitih koraka
03:13
that cause many of these to fail.
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što je uzrok da mnogi od njih propadnu.
03:14
Ultimately, maybe you can run a clinical trial with four or five of these,
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Na kraju ćete možda moći pokrenuti
klinički postupak za njih četiri ili pet
klinički postupak za njih četiri ili pet
03:17
and if all goes well, 14 years after you started,
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i ako sve bude u redu, posle 14 godina
od vašeg početka
od vašeg početka
03:20
you will get one approval.
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dobićete jedno odobrenje.
03:22
And it will cost you upwards of a billion dollars
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I to će vas koštati milijarde dolara,
03:24
for that one success.
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taj jedan uspeh.
03:27
So we have to look at this pipeline the way an engineer would,
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Zato moramo pogledati na taj cevovod
očima inženjera,
očima inženjera,
03:30
and say, "How can we do better?"
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pa reći: "Kako možemo raditi bolje?"
03:31
And that's the main theme of what I want to say to you this morning.
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I to je glavna tema o kojoj želim
da vam govorim danas.
da vam govorim danas.
03:34
How can we make this go faster?
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Kako to možemo ubrzati?
03:36
How can we make it more successful?
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Kako to možemo raditi uspešnije?
03:39
Well, let me tell you about a few examples
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Dozvolite da vam ispričam
o nekoliko primera
o nekoliko primera
03:40
where this has actually worked.
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koji to potvrđuju.
03:42
One that has just happened in the last few months
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Jedan, koji se dogodio nedavno,
poslednjih meseci,
poslednjih meseci,
03:45
is the successful approval of a drug for cystic fibrosis.
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je uspešno odobren lek
za cističnu fibrozu.
za cističnu fibrozu.
03:49
But it's taken a long time to get there.
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Ali stići dotle zahteva mnogo vremena.
03:51
Cystic fibrosis had its molecular cause discovered in 1989
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Za cističnu fibrozu molekularni uzrok
je otkriven 1989.
je otkriven 1989.
03:55
by my group working with another group in Toronto,
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u mojoj grupi i u saradnji
s jednom grupom iz Toronta.
s jednom grupom iz Toronta.
03:57
discovering what the mutation was in a particular gene
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Otkrili smo koja je mutacija bila
u određenom genu
u određenom genu
04:00
on chromosome 7.
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na hromozomu 7.
04:01
That picture you see there?
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Vidite tu sliku?
04:03
Here it is. That's the same kid.
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Ovde je. To je isto dete.
04:05
That's Danny Bessette, 23 years later,
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To je Deni Biset posle 23 godine,
04:09
because this is the year,
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u važnoj godini u kojoj,
04:10
and it's also the year where Danny got married,
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osim što se Deni oženio,
04:12
where we have, for the first time, the approval by the FDA
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po prvi put imamo odobrenje od FDA
04:15
of a drug that precisely targets the defect in cystic fibrosis
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za lek koji precizno pogađa nepravilnost
u cističnoj fibrozi
u cističnoj fibrozi
04:19
based upon all this molecular understanding.
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i koji je zasnovan na svom tom
molekularnom razumevanju.
molekularnom razumevanju.
04:21
That's the good news.
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To je dobra vest.
04:23
The bad news is, this drug doesn't actually treat all cases of cystic fibrosis,
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Loša vest je da taj lek ne leči
sve slučajeve cistične fibroze
sve slučajeve cistične fibroze
04:26
and it won't work for Danny, and we're still waiting
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i Deniju ne pomaže,
pa i dalje čekamo
pa i dalje čekamo
04:28
for that next generation to help him.
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sledeće generacije lekova da mu pomognu.
04:31
But it took 23 years to get this far. That's too long.
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Ali, da bi se dotle stiglo trebalo je 23 godine.
To je predugo.
To je predugo.
04:34
How do we go faster?
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Kako da idemo brže?
04:36
Well, one way to go faster is to take advantage of technology,
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Jedan način da se krene brže
je uz pomoć tehnologije,
je uz pomoć tehnologije,
04:38
and a very important technology that we depend on
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a veoma važna tehnologija,
od koje zavisimo
od koje zavisimo
04:41
for all of this is the human genome,
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za sve spomenuto, je ljudski genom,
04:43
the ability to be able to look at a chromosome,
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umeće posmatranja hromozoma,
04:46
to unzip it, to pull out all the DNA,
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njegovo otpakivanje, vađenje DNK
04:49
and to be able to then read out the letters in that DNA code,
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i mogućnost čitanja slova u tom DNK kodu,
04:51
the A's, C's, G's and T's
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A, C, G i T slova
04:54
that are our instruction book and the instruction book for all living things,
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koja su naša uputstva
i uputstva za sva živa bića,
i uputstva za sva živa bića,
04:57
and the cost of doing this,
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a za sav taj rad je cena,
04:58
which used to be in the hundreds of millions of dollars,
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koja je nekada bila
stotine miliona dolara,
stotine miliona dolara,
05:01
has in the course of the last 10 years
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u poslednjih 10 godina
05:03
fallen faster than Moore's Law, down to the point
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pala, brže od Murovog zakona, do svote
05:05
where it is less than 10,000 dollars today to have your genome sequenced, or mine,
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koja je danas manja od 10.000 dolara
za sekvenciranje vašeg ili mog genoma
za sekvenciranje vašeg ili mog genoma
05:09
and we're headed for the $1,000 genome fairly soon.
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i približavamo se genomu
od 1.000 dolara.
od 1.000 dolara.
05:13
Well, that's exciting.
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Da, to je uzbudljivo,
05:14
How does that play out in terms of application to a disease?
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ali kako je to povezano
s primenom na bolesti?
s primenom na bolesti?
05:18
I want to tell you about another disorder.
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Ispričaću vam o još jednoj nepravilnosti.
05:21
This one is a disorder which is quite rare.
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Radi se o veoma retkoj nepravilnosti.
05:23
It's called Hutchinson-Gilford progeria,
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Ime joj je Hačinson-Gilfordova progerija
05:26
and it is the most dramatic form of premature aging.
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i to je najdramatičniji oblik
prevremenog starenja.
prevremenog starenja.
05:29
Only about one in every four million kids has this disease,
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Ovu bolest ima samo jedno
u četiri miliona dece
u četiri miliona dece
05:33
and in a simple way, what happens is,
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i uprošćeno rečeno radi se o tome
05:36
because of a mutation in a particular gene,
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da se zbog mutacije u određenom genu
05:39
a protein is made that's toxic to the cell
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stvorio protein koji je toksičan za ćeliju
05:41
and it causes these individuals to age
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i obolelim osobama uzrokuje starenje
05:44
at about seven times the normal rate.
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koje je oko sedam puta brže od normalnog.
05:46
Let me show you a video of what that does to the cell.
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Pokazaću vam snimak
toga šta to radi ćeliji.
toga šta to radi ćeliji.
05:49
The normal cell, if you looked at it under the microscope,
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Normalna ćelija, ako je pogledate
pod mikroskopom
pod mikroskopom
05:53
would have a nucleus sitting in the middle of the cell,
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ima jedro u sredini ćelije
05:55
which is nice and round and smooth in its boundaries
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koje je lepo i okruglo,
pravilnih granica
pravilnih granica
05:59
and it looks kind of like that.
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i izgleda otprilike ovako.
06:01
A progeria cell, on the other hand,
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Ćelija progerije, s druge strane,
06:03
because of this toxic protein called progerin,
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zbog toksičnog proteina
po imenu progerin
po imenu progerin
06:06
has these lumps and bumps in it.
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ima ove nepravilnosti.
06:08
So what we would like to do after discovering this
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Zato je naša želja bila, posle otkrića
06:11
back in 2003
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još u 2003.,
06:13
is to come up with a way to try to correct that.
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da pokušamo da nađemo način
kako bi to ispravili.
kako bi to ispravili.
06:16
Well again, by knowing something about the molecular pathways,
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I opet, pošto se znalo nešto
o molekularnim putevima,
o molekularnim putevima,
06:20
it was possible to pick
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bilo je moguće izabrati
06:22
one of those many, many compounds that might have been useful
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jedan iz tog mnoštva sastojaka
koji bi mogao biti koristan
koji bi mogao biti koristan
06:24
and try it out.
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i isproban.
06:26
In an experiment done in cell culture
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U eksperimentu izvedenom u ćelijskoj kulturi
06:28
and shown here in a cartoon,
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i prikazanom na crtežu,
06:30
if you take that particular compound
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ako uzmete određeni sastojak
06:33
and you add it to that cell that has progeria,
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i dodate ga ćeliji s progerijom
06:36
and you watch to see what happened,
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posmatrajući šta će se dogoditi
06:38
in just 72 hours, that cell becomes,
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videćete da posle samo 72 sata
ta ćelija postaje,
ta ćelija postaje,
06:41
for all purposes that we can determine,
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za sve namene koje možemo da odredimo,
06:44
almost like a normal cell.
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skoro kao normalna ćelija.
06:45
Well that was exciting, but would it actually work in a real human being?
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Da, to je fascinantno, ali da li bi to zaista delovalo
u stvarnom ljudskom biću?
u stvarnom ljudskom biću?
06:50
This has led, in the space of only four years
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Ovo se dogodilo u periodu
od samo četiri godine
od samo četiri godine
06:53
from the time the gene was discovered to the start of a clinical trial,
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od časa otkrića gena do započinjanja
kliničkog ispitivanja
kliničkog ispitivanja
06:57
to a test of that very compound.
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za testiranje tog određenog sastojka.
06:59
And the kids that you see here
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Sva deca koju vidite ovde
07:01
all volunteered to be part of this,
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su se dobrovoljno prijavila za ovo,
07:03
28 of them,
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njih 28-oro
07:05
and you can see as soon as the picture comes up
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i videćete čim se slika pojavi
07:08
that they are in fact a remarkable group of young people
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da je to izvanredna grupa mladih ljudi
07:11
all afflicted by this disease,
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obolelih od ove bolesti,
07:13
all looking quite similar to each other.
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po izgledu svi nalik jedan na drugog.
07:15
And instead of telling you more about it,
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I umesto dalje priče o tome
07:17
I'm going to invite one of them, Sam Berns from Boston,
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pozvaću jednog od njih,
Sema Burnsa iz Bostona
Sema Burnsa iz Bostona
07:21
who's here this morning, to come up on the stage
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koji je ovde, da se popne na binu
07:23
and tell us about his experience
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i da nam kaže o svom iskustvu
07:25
as a child affected with progeria.
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deteta obolelog od progerije.
07:27
Sam is 15 years old. His parents, Scott Berns and Leslie Gordon,
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Sem ima 15 godina. Njegovi roditelji,
Skot Burns i Lesli Gordon,
Skot Burns i Lesli Gordon,
07:31
both physicians, are here with us this morning as well.
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oboje lekari, takođe su ovde sa nama.
07:33
Sam, please have a seat.
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Molim te, Sem, izvoli sesti.
07:36
(Applause)
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(Aplauz)
07:43
So Sam, why don't you tell these folks
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Sem, hajde reci ovom društvu
07:45
what it's like being affected with this condition called progeria?
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kako je to biti oboleo
od progerije?
od progerije?
07:49
Sam Burns: Well, progeria limits me in some ways.
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Sem Burns: Progerija me ograničava
u nekim stvarima.
u nekim stvarima.
07:53
I cannot play sports or do physical activities,
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Ne mogu da se bavim sportom
ili fizičkim aktivnostima,
ili fizičkim aktivnostima,
07:57
but I have been able to take interest in things
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ali bio sam u mogućnosti
da se uključim u stvari
da se uključim u stvari
08:00
that progeria, luckily, does not limit.
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koje, srećom, progerija ne ograničava.
08:03
But when there is something that I really do want to do
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Ali kada se pojavi nešto
što bih zaista želeo da uradim,
što bih zaista želeo da uradim,
08:05
that progeria gets in the way of, like marching band
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a progerija tome stoji na putu,
kao što je marširajući orkestar,
kao što je marširajući orkestar,
08:08
or umpiring, we always find a way to do it,
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ili sportsko suđenje, uvek pronađemo način
kako da to postignem
kako da to postignem
08:12
and that just shows that progeria isn't in control of my life.
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što samo pokazuje
da mi progerija ne kroji život.
da mi progerija ne kroji život.
08:15
(Applause)
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(Aplauz)
08:17
Francis Collins: So what would you like to say to researchers
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Frensis Kolins: I šta bi želeo
da poručiš istraživačima
da poručiš istraživačima
08:19
here in the auditorium and others listening to this?
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ovde u auditorijumu i ostalima koji ovo slušaju?
08:22
What would you say to them both about research on progeria
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Šta bi im svima rekao
o istraživanju progerije
o istraživanju progerije
08:25
and maybe about other conditions as well?
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i još možda o drugim bolestima?
08:27
SB: Well, research on progeria has come so far
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SB: Istraživanja progerije su otišla
toliko daleko
toliko daleko
08:30
in less than 15 years,
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za manje od 15 godina,
08:32
and that just shows the drive that researchers can have
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što samo pokazuje kakav zalet
istraživači mogu imati
istraživači mogu imati
08:36
to get this far, and it really means a lot
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da dotle stignu i to zaista mnogo znači
08:40
to myself and other kids with progeria,
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meni i drugoj deci oboleloj od progerije
08:43
and it shows that if that drive exists,
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i pokazuje da kada takav zalet postoji
08:46
anybody can cure any disease,
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otvara se mogućnost za svakoga
da izleči bilo koju bolest
da izleči bilo koju bolest
08:48
and hopefully progeria can be cured in the near future,
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i nadam se izlečivosti progerije
u bliskoj budućnosti
u bliskoj budućnosti
08:52
and so we can eliminate those 4,000 diseases
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kao i mogućnosti eliminacije
tih 4.000 bolesti
tih 4.000 bolesti
08:56
that Francis was talking about.
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o kojima je Frensis govorio.
08:59
FC: Excellent. So Sam took the day off from school today
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FK: Odlično.
Sem je izostao iz škole danas
Sem je izostao iz škole danas
09:02
to be here, and he is — (Applause) --
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da bi bio ovde, a on je
- (Aplauz) -
- (Aplauz) -
09:07
He is, by the way, a straight-A+ student in the ninth grade
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On je, onako usput, odličan učenik,
ima odlične ocene u devetom razredu
ima odlične ocene u devetom razredu
09:12
in his school in Boston.
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škole u Bostonu.
09:14
Please join me in thanking and welcoming Sam.
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Molim vas pridružite mi se u zahvalnici
i dobrodošlici Semu.
i dobrodošlici Semu.
09:16
SB: Thank you very much. FC: Well done. Well done, buddy.
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SB: Mnogo Vam hvala.
FK: Odlično je bilo drugar.
FK: Odlično je bilo drugar.
09:19
(Applause)
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(Aplauz)
09:32
So I just want to say a couple more things
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Želeo bih samo da kažem
još par stvari
još par stvari
09:34
about that particular story, and then try to generalize
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o toj priči i onda bih pokušao
da generalizujem
da generalizujem
09:37
how could we have stories of success
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o tome kako bismo
mogli imati priče o uspehu
mogli imati priče o uspehu
09:40
all over the place for these diseases, as Sam says,
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svuda za sve te bolesti, kako kaže Sem,
09:43
these 4,000 that are waiting for answers.
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za tih 4.000 koje čekaju na odgovore.
09:46
You might have noticed that the drug
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Možda ste primetili da lek
09:48
that is now in clinical trial for progeria
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za progeriju, koji je sada u kliničkom ispitivanju,
09:50
is not a drug that was designed for that.
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nije lek koji je bio za to namenjen.
09:52
It's such a rare disease, it would be hard for a company
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To je toliko retka bolest
da bi kompanijama bilo teško
da bi kompanijama bilo teško
09:55
to justify spending hundreds of millions of dollars to generate a drug.
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da opravdaju stotine miliona dolara
utrošenih za proizvodnju leka.
utrošenih za proizvodnju leka.
09:59
This is a drug that was developed for cancer.
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To je lek koji se razvijao za rak.
10:01
Turned out, it didn't work very well for cancer,
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Ispostavilo se da nije delovao
dovoljno dobro na rak,
dovoljno dobro na rak,
10:03
but it has exactly the right properties, the right shape,
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ali da ima prava svojstva, pravi oblik
10:05
to work for progeria, and that's what's happened.
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za lečenje progerije i tako se to dogodilo.
10:08
Wouldn't it be great if we could do that more systematically?
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Zar ne bi bilo bolje
kada bi to radili sistematičnije?
kada bi to radili sistematičnije?
10:11
Could we, in fact, encourage all the companies that are out there
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Zar ne bismo mogli da podržimo
postojeće kompanije
postojeće kompanije
10:15
that have drugs in their freezers
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koje imaju zamrznute lekove
10:17
that are known to be safe in humans
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za koje se zna da su bezopasni za ljude,
10:19
but have never actually succeeded in terms
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ali koji nikada nisu uspeli da
10:22
of being effective for the treatments they were tried for?
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efektivno leče ono za šta su bili namenjeni?
10:24
Now we're learning about all these new molecular pathways --
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Sada učimo o svim tim
novim molekularnim putevima -
novim molekularnim putevima -
10:27
some of those could be repositioned or repurposed,
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neki od lekova bi se mogli repozicionirati
ili koristiti za druge namene,
ili koristiti za druge namene,
10:30
or whatever word you want to use, for new applications,
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ili drugim rečima, dati im novu primenu,
10:32
basically teaching old drugs new tricks.
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naučiti stare lekove novim trikovima.
10:35
That could be a phenomenal, valuable activity.
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To bi mogla biti fenomenalna,
vredna aktivnost.
vredna aktivnost.
10:38
We have many discussions now between NIH and companies
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Postoji mnogo diskusija između Nacionalnog zdravstvenog osiguranja (NZO) i kompanija
10:41
about doing this that are looking very promising.
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2124
o tome, što je veoma ohrabrujuće.
10:43
And you could expect quite a lot to come from this.
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I mogli biste očekivati da iz toga
proiziđe prilično mnogo toga.
proiziđe prilično mnogo toga.
10:46
There are quite a number of success stories one can point to
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Postoji priličan broj priča o uspehu
koje potvrđuju
koje potvrđuju
10:49
about how this has led to major advances.
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da je to dovelo do značajnog napretka.
10:51
The first drug for HIV/AIDS
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2207
Prvi lek za sidu
10:53
was not developed for HIV/AIDS.
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1729
nije se razvijao za sidu.
10:55
It was developed for cancer. It was AZT.
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Razvijao se za rak.
To je bio AZT.
To je bio AZT.
10:58
It didn't work very well for cancer, but became
241
642159
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Nije delovao dovoljno dobro na rak,
ali je postao
ali je postao
11:00
the first successful antiretroviral,
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prvi uspešni antiretrovirusni lek
11:02
and you can see from the table there are others as well.
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i u tabeli možete videti
i sve druge takve lekove.
i sve druge takve lekove.
11:04
So how do we actually make that a more generalizable effort?
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Dakle, na koji način možemo
takve napore šire primenjivati?
takve napore šire primenjivati?
11:08
Well, we have to come up with a partnership
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2224
Za to moramo ostvariti partnerstvo
11:10
between academia, government, the private sector,
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2860
između akademskih ustanova,
vlade, privatnog sektora
vlade, privatnog sektora
11:13
and patient organizations to make that so.
247
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i udruženja pacijenata.
11:15
At NIH, we have started this new
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U okviru NZO smo osnovali
11:17
National Center for Advancing Translational Sciences.
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3200
novi Nacionalni centar
za unapređivanje prevodilačkih nauka.
za unapređivanje prevodilačkih nauka.
11:20
It just started last December, and this is one of its goals.
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664879
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Centar je počeo sa radom u decembru
i to je jedan od njegovih ciljeva.
i to je jedan od njegovih ciljeva.
11:24
Let me tell you another thing we could do.
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Dozvolite da kažem još nešto
što bismo mogli uraditi.
što bismo mogli uraditi.
11:25
Wouldn't it be nice to be able to a test a drug
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2919
Zar ne bi bilo lepo kada bismo mogli
da testiramo
da testiramo
11:28
to see if it's effective and safe
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dejstvo i bezbednost leka
11:31
without having to put patients at risk,
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2101
bez rizika za pacijente,
11:33
because that first time you're never quite sure?
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jer prvi put nismo sasvim sigurni?
11:35
How do we know, for instance, whether drugs are safe
256
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Kako mi znamo, na primer,
da li su lekovi bezopasni
da li su lekovi bezopasni
11:37
before we give them to people? We test them on animals.
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pre nego što ih damo ljudima?
Testiramo ih na životinjama.
Testiramo ih na životinjama.
11:41
And it's not all that reliable, and it's costly,
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No, to nije sasvim pouzdano, skupo je
11:43
and it's time-consuming.
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1690
i dugotrajno.
11:45
Suppose we could do this instead on human cells.
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Zamislite kada bismo mogli to raditi
na ljudskim ćelijama.
na ljudskim ćelijama.
11:48
You probably know, if you've been paying attention
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2232
Verovatno znate, ako ste obraćali pažnju
11:50
to some of the science literature
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1300
na neku naučnu literaturu,
11:51
that you can now take a skin cell
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1656
da danas možete uzeti ćeliju kože
11:53
and encourage it to become a liver cell
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i podstaći je da se pretvori u ćeliju jetre
11:56
or a heart cell or a kidney cell or a brain cell for any of us.
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ili u ćeliju srca, bubrega,
mozga, za bilo koga od nas.
mozga, za bilo koga od nas.
11:59
So what if you used those cells as your test
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Šta kada bismo te ćelije koristili za testiranje
12:02
for whether a drug is going to work and whether it's going to be safe?
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vašeg leka, kako deluje
i koliko je bezopasan?
i koliko je bezopasan?
12:05
Here you see a picture of a lung on a chip.
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Ovde vidite sliku pluća na čipu.
12:09
This is something created by the Wyss Institute in Boston,
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3521
Ovo je nešto stvoreno
na Vis institutu iz Bostona
na Vis institutu iz Bostona
12:13
and what they have done here, if we can run the little video,
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i videćemo, ako pustimo video, da su oni
12:16
is to take cells from an individual,
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uzeli ćelije od jedne osobe,
12:18
turn them into the kinds of cells that are present in the lung,
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pretvorili ih u vrstu ćelija
prisutnih u plućima
prisutnih u plućima
12:21
and determine what would happen
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i odredili šta bi se desilo
12:23
if you added to this various drug compounds
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kada bi im dodavali različite sastojke leka,
12:26
to see if they are toxic or safe.
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da bi ustanovili da li su toksični
ili bezopasni.
ili bezopasni.
12:29
You can see this chip even breathes.
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Možete videti da ovaj čip čak diše.
12:31
It has an air channel. It has a blood channel.
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Ima kanal za vazduh.
Ima kanal za krv.
Ima kanal za krv.
12:34
And it has cells in between
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Između ima ćelije
12:35
that allow you to see what happens when you add a compound.
279
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2438
uz pomoć kojih vidite šta se dešava
kada dodajete sastojak.
kada dodajete sastojak.
12:38
Are those cells happy or not?
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1772
Da li su te ćelije srećne ili nisu?
12:39
You can do this same kind of chip technology
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3031
Možete napraviti istu vrstu
tehnologije čipova
tehnologije čipova
12:42
for kidneys, for hearts, for muscles,
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2209
za bubrege, srce, mišiće,
12:45
all the places where you want to see whether a drug
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za sva mesta ako želite da ustanovite
da li će lek
da li će lek
12:47
is going to be a problem, for the liver.
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2281
biti problematičan za jetru.
12:49
And ultimately, because you can do this for the individual,
285
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3048
I na kraju, zato što to možete raditi individualno,
12:52
we could even see this moving to the point
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2214
uviđamo da se taj proces bliži fazi
12:55
where the ability to develop and test medicines
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3441
u kojoj će mogućnost
razvoja i testiranja lekova
razvoja i testiranja lekova
12:58
will be you on a chip, what we're trying to say here is
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3186
biti na vašem čipu, odnosno
šta pokušavamo reći ovde je
šta pokušavamo reći ovde je
13:01
the individualizing of the process of developing drugs
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3501
individualizacija postupka za razvoj lekova
13:05
and testing their safety.
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2248
i za testiranje njihove bezbednosti.
13:07
So let me sum up.
291
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Dozvolite mi da rezimiram.
13:09
We are in a remarkable moment here.
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2260
Mi smo u značajnom trenutku ovde.
13:11
For me, at NIH now for almost 20 years,
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2103
Po meni u NZO za poslednjih 20 godina
13:13
there has never been a time where there was more excitement
294
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2601
nikada nije bilo više oduševljenja
13:16
about the potential that lies in front of us.
295
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2585
u vezi sa mogućnostima ispred nas.
13:18
We have made all these discoveries
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1792
Došli smo do svih tih otkrića
13:20
pouring out of laboratories across the world.
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2365
koja teku iz laboratorija širom sveta.
13:22
What do we need to capitalize on this? First of all, we need resources.
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3362
Šta nam treba za kapitalizaciju toga?
Prvo, potrebni su nam resursi.
Prvo, potrebni su nam resursi.
13:26
This is research that's high-risk, sometimes high-cost.
299
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3555
To je istraživanje koje je jako rizično,
ponekad jako skupo.
ponekad jako skupo.
13:29
The payoff is enormous, both in terms of health
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1971
Isplativost je ogromna,
kako u smislu zdravlja
kako u smislu zdravlja
13:31
and in terms of economic growth. We need to support that.
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tako i u smislu privrednog rasta.
Moramo tome dati podršku.
Moramo tome dati podršku.
13:34
Second, we need new kinds of partnerships
302
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2301
Drugo, potrebna su nam
nove vrste partnerstva
nove vrste partnerstva
13:36
between academia and government and the private sector
303
801081
2221
između akademskih ustanova,
vlade, privatnog sektora
vlade, privatnog sektora
13:39
and patient organizations, just like the one I've been describing here,
304
803302
3347
i udruženja pacijenata,
baš kao ona koja sam opisivao ovde,
baš kao ona koja sam opisivao ovde,
13:42
in terms of the way in which we could go after repurposing new compounds.
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u smislu načina na koji bi mogli davati
nove svrhe novim sastojcima.
nove svrhe novim sastojcima.
13:46
And third, and maybe most important, we need talent.
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Treće i možda najvažnije je to
da nam je potreban talenat.
da nam je potreban talenat.
13:49
We need the best and the brightest
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Potrebni su nam najbolji i najpametniji
13:51
from many different disciplines to come and join this effort --
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u mnogim različitim disciplinama,
da dođu i da se pridruže tim naporima -
da dođu i da se pridruže tim naporima -
13:54
all ages, all different groups --
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svih starosnih doba,
iz svih različitih grupa -
iz svih različitih grupa -
13:56
because this is the time, folks.
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jer, ljudi, sada je čas.
13:58
This is the 21st-century biology that you've been waiting for,
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Ovo je biologija 21. veka na koju ste čekali
14:02
and we have the chance to take that
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i imamo šansu da je prihvatimo
14:04
and turn it into something which will, in fact,
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i pretvorimo u nešto što će zaista
14:07
knock out disease. That's my goal.
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zatreti bolesti.
To je moj cilj.
To je moj cilj.
14:09
I hope that's your goal.
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Nadam se da je i vaš cilj.
14:11
I think it'll be the goal of the poets and the muppets
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Mislim da će to biti cilj pesnika i lutaka
14:14
and the surfers and the bankers
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i surfera i bankara
14:16
and all the other people who join this stage
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i svih drugih ljudi
koji se pridruže na ovoj pozornici,
koji se pridruže na ovoj pozornici,
14:18
and think about what we're trying to do here
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i razmislite šta pokušavamo ovde da uradimo
14:20
and why it matters.
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i zbog čega je to važno.
14:21
It matters for now. It matters as soon as possible.
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Važno je sada.
Važno je što pre je moguće.
Važno je što pre je moguće.
14:24
If you don't believe me, just ask Sam.
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Ako ne verujete meni, pitajte Sema.
14:27
Thank you all very much.
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Mnogo vam hvala svima.
14:28
(Applause)
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(Aplauz)
ABOUT THE SPEAKER
Francis Collins - Geneticist, physicianA key player in the US' new brain-mapping project, Francis Collins is director of the National Institutes of Health.
Why you should listen
In 2000 the world saw the first working draft of the human genome, and that's in no small part thanks to Francis Collins. Under his directorship at the National Human Genome Research Institute, the Human Genome Project was finished, a complete mapping of all 20,500 genes in the human genome, with a high-quality, reference sequence published in April 2003.
In 2009 President Obama nominated Collins as the director of the National Institutes of Health, and later that year he was confirmed by the U.S. Senate. In March 2013, Collins helped Obama introduce the BRAIN Initiative, an ambitious, well-funded program to map the human brain. Read more about the BRAIN Initiative >>
Collins is also a self-described serious Christian and the author of several books on science and faith, including The Language of God: A Scientist Presents Evidence for Belief.
Francis Collins | Speaker | TED.com