ABOUT THE SPEAKER
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.

More profile about the speaker
Alan Russell | Speaker | TED.com
TED2006

Alan Russell: The potential of regenerative medicine

愛倫‧羅素談再生醫學

Filmed:
1,741,112 views

愛倫.羅素從事再生醫學研究。再生醫學透過誘導人體自我修復的療程,為疾病與人體損害的治療注入突破性思考。
- 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

Double-click the English transcript below to play the video.

00:26
I'm going to talk to you today今天 about
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今天我所要談的主題
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hopefully希望 converting轉換 fear恐懼 into hope希望.
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期盼能在未來化恐懼為希望
00:31
When we go to the physician醫師 today今天 --
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我們去看醫生的時候
00:34
when we go to the doctor's醫生 office辦公室 and we walk步行 in,
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當我們走進診療室
00:36
there are words that we just don't want to hear.
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有些話是我們不想聽到的
00:39
There are words that we're truly afraid害怕 of.
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有些字讓我們深深恐懼
00:41
Diabetes糖尿病, cancer癌症, Parkinson's帕金森氏, Alzheimer's老年癡呆症,
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像是糖尿病、癌症、帕金森氏症、阿茲海默症
00:45
heart failure失敗, lung failure失敗 --
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心臟衰竭、肺衰竭
00:47
things that we know are debilitating衰弱 diseases疾病,
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這些都是大家熟知的衰退性疾病
00:50
for which哪一個 there's relatively相對 little that can be doneDONE.
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對於這些疾病我們卻束手無策
00:55
And what I want to lay鋪設 out for you today今天 is
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今天我所要分享的是
00:57
a different不同 way of thinking思維 about how to treat對待 debilitating衰弱 disease疾病,
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用新的角度來思考衰退性疾病的療法
01:01
why it's important重要,
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這為什麼重要、
01:03
why without it perhaps也許 our health健康 care關心 system系統 will melt熔化 down
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又為什麼少了它醫療體系將會瓦解
01:06
if you think it already已經 hasn't有沒有,
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要是你認為醫療體系現在還沒走到這一步
01:08
and where we are clinically臨床 today今天, and where we might威力 go tomorrow明天,
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還有目前的臨床成果和可能的未來走向
01:11
and what some of the hurdles障礙 are.
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有哪些困難需要克服
01:13
And we're going to do all of that in 18 minutes分鐘, I promise諾言.
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我保證一定會在 18 分鐘內全部講完
01:16
I want to start開始 with this slide滑動,
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讓我從這張投影片開始
01:18
because this slide滑動 sort分類 of tells告訴 the story故事 the way Science科學 Magazine雜誌 thinks of it.
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因為這張投影片反映出「科學」期刊的看法
01:23
This was an issue問題 from 2002
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這一期發刊於 2002 年
01:25
that they published發表 with a lot of different不同 articles用品 on the bionic仿生 human人的.
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裡面發表了各種有關生化人的文章
01:29
It was basically基本上 a regenerative再生 medicine醫學 issue問題.
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基本上就是再生醫學專題
01:32
Regenerative再生 medicine醫學 is an extraordinarily異常 simple簡單 concept概念
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再生醫學其實是個非常簡單的概念
01:36
that everybody每個人 can understand理解.
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一般人都能理解
01:38
It's simply只是 accelerating加速 the pace步伐 at which哪一個 the body身體 heals癒合 itself本身
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就是加快人體自我修復的速度
01:42
to a clinically臨床 relevant相應 timescale時間表.
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達到在臨床上合理的時間範圍
01:46
So we know how to do this in many許多 of the ways方法 that are up there.
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目前我們已知可行的方法很多,都在這裡
01:49
We know that if we have a damaged破損 hip臀部, you can put an artificial人造 hip臀部 in.
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我們知道要是髖關節損壞,就裝人工髖關節
01:53
And this is the idea理念 that Science科學 Magazine雜誌 used on their front面前 cover.
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這就是這期 「科學」 期刊的封面所要表達的想法
01:57
This is the complete完成 antithesis對立 of regenerative再生 medicine醫學.
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其實這跟再生醫學完全相反
02:01
This is not regenerative再生 medicine醫學.
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這不是再生醫學
02:03
Regenerative再生 medicine醫學 is what Business商業 Week put up
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這本「商業周刊」討論的才是再生醫學
02:06
when they did a story故事 about regenerative再生 medicine醫學 not too long ago.
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不久前,他們刊出一篇有關再生醫學的文章
02:09
The idea理念 is that instead代替 of figuring盤算 out how to ameliorate改善 symptoms症狀
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想法是與其想辦法改善症狀
02:14
with devices設備 and drugs毒品 and the like --
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用醫學裝置或藥物等等的
02:16
and I'll come back to that theme主題 a few少數 times --
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這主題我們會不斷回頭討論
02:19
instead代替 of doing that, we will regenerate再生 lost丟失 function功能 of the body身體
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與其這麼做,我們不如重建身體失去的功能
02:23
by regenerating再生 the function功能 of organs器官 and damaged破損 tissue組織.
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做法是重建損壞的器官和組織
02:27
So that at the end結束 of the treatment治療,
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如此一來,診程結束後
02:29
you are the same相同 as you were at the beginning開始 of the treatment治療.
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我們的身體就回到治療前的狀態
02:34
Very few少數 good ideas思路 -- if you agree同意 that this is a good idea理念 --
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好點子還真的不多,如果你們也覺得這想法不錯
02:37
very few少數 good ideas思路 are truly novel小說.
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真正創新的好點子很少
02:40
And this is just the same相同.
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就像我要討論的議題一樣
02:42
If you look back in history歷史,
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要是我們回想歷史
02:44
Charles查爾斯 Lindbergh林德伯格, who was better known已知 for flying飛行 airplanes飛機,
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以飛越大西洋成名的查爾斯.林白
02:48
was actually其實 one of the first people
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其實正是先驅者之一
02:49
along沿 with Alexis亞歷克西斯 Carrel卡雷爾, one of the Nobel諾貝爾 Laureates獲獎者 from Rockefeller洛克菲勒,
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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
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to begin開始 to think about, could you culture文化 organs器官?
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就是他們開始思考,人工培養器官是否可行?
02:57
And they published發表 this book in 1937,
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而且在1937 年出版了這本書
02:59
where they actually其實 began開始 to think about,
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在書中他們甚至開始考慮
03:01
what could you do in bio-reactors生物反應器 to grow增長 whole整個 organs器官?
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要如何在生物反應器中培養出一整個器官?
03:07
We've我們已經 come a long way since以來 then.
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到了今天,我們已經有了長足進步
03:08
I'm going to share分享 with you some of the exciting扣人心弦 work that's going on.
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我現在要跟大家分享的是一些進行中的研究
03:11
But before doing that, what I'd like to do
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但是在這之前,我想先與大家分享
03:13
is share分享 my depression蕭條 about the health健康 care關心 system系統
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我對現今醫療體系的悲觀想法
03:16
and the need for this with you.
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以及再生醫學的必要性
03:18
Many許多 of the talks會談 yesterday昨天 talked about
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昨天的講題很多都談論到
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improving提高 the quality質量 of life, and reducing減少 poverty貧窮,
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提升生活品質和減少貧窮發生
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and essentially實質上 increasing增加 life expectancy期待 all around the globe地球.
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以及真正延長全球人口的壽命
03:28
One of the challenges挑戰 is that the richer更豐富 we are, the longer we live生活.
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難題之一就是我們越富裕,壽命就越長
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And the longer we live生活, the more expensive昂貴 it is
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但壽命越長,開銷就越大
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to take care關心 of our diseases疾病 as we get older舊的.
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醫療照護的開銷跟壽命延長成正比
03:39
This is simply只是 the wealth財富 of a country國家
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這是一張探討國家的富裕程度
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versus the percent百分 of population人口 over the age年齡 of 65.
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與 65 歲以上人口比例相關性的圖
03:46
And you can basically基本上 see that the richer更豐富 a country國家 is,
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很明顯可以看出,國家越富有
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the older舊的 the people are within it.
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國民壽命就越長
03:51
Why is this important重要?
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這為什麼重要?
03:53
And why is this a particularly尤其 dramatic戲劇性 challenge挑戰 right now?
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又為什麼是當下最嚴峻的考驗?
03:57
If the average平均 age年齡 of your population人口 is 30,
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如果人口平均年齡是 30 歲
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then the average平均 kind of disease疾病 that you have to treat對待
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那麼一般需要醫療的疾病可能是
04:03
is maybe a broken破碎 ankle every一切 now and again,
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三不五時扭傷腳踝
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maybe a little bit of asthma哮喘.
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也許加上點氣喘
04:06
If the average平均 age年齡 in your country國家 is 45 to 55,
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要是國家的平均年齡是 45 到 55 歲
04:10
now the average平均 person is looking at diabetes糖尿病,
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那麼普遍的疾病可能是糖尿病
04:13
early-onset早發 diabetes糖尿病, heart failure失敗, coronary冠狀動脈 artery動脈 disease疾病 --
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早發性糖尿病、心臟衰竭、心血管疾病
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things that are inherently本質 more difficult to treat對待,
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這些疾病的治癒難度本來就較高
04:19
and much more expensive昂貴 to treat對待.
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且醫療成本也高出許多
04:21
Just have a look at the demographics人口統計學 in the U.S. here.
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來看一下這份美國人口統計資料
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This is from "The Untied解開 States狀態 of America美國."
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擷取自「The Untied States of America」這本書
04:26
In 1930, there were 41 workers工人 per retiree退休.
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在 1930 年間,每 41 個勞力人口中就有 1 個退休
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41 people who were basically基本上 outside of being存在 really sick生病,
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這 41 個身體沒有嚴重疾病的人
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paying付款 for the one retiree退休 who was experiencing經歷 debilitating衰弱 disease疾病.
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僅需負擔這 1 個退休人口治療衰退性疾病的費用
04:41
In 2010, two workers工人 per retiree退休 in the U.S.
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到了 2010 年,每兩個勞力人口中就有 1 人退休
04:44
And this is matched匹配 in every一切 industrialized工業化, wealthy富裕 country國家 in the world世界.
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而且全球各工業化的富裕國家都是如此
04:50
How can you actually其實 afford給予 to treat對待 patients耐心
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我們要如何才能負擔醫療成本?
04:53
when the reality現實 of getting得到 old looks容貌 like this?
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要是老化所要面對的現實就是如此?
04:56
This is age年齡 versus cost成本 of health健康 care關心.
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這張圖顯示年齡與醫療照護成本之間的關係
04:59
And you can see that right around age年齡 45, 40 to 45,
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可以看出大約在 45 歲,40 到 45 歲的區間
05:05
there's a sudden突然 spike in the cost成本 of health健康 care關心.
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醫療照護成本急遽上升
05:10
It's actually其實 quite相當 interesting有趣. If you do the right studies學習,
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這其實相當有趣,在適當的統計研究下
05:13
you can look at how much you as an individual個人 spend on your own擁有 health健康 care關心,
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我們可以看出自己在人生各個階段
05:17
plotted繪製 over your lifetime一生.
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所需的醫療成本
05:19
And about seven years年份 before you're about to die, there's a spike.
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而且在死亡前 7 年會出現一個高峰
05:23
And you can actually其實 --
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我們還可以...
05:24
(Laughter笑聲)
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(笑聲)
05:26
-- we won't慣於 get into that.
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...我們還是不要討論這些
05:27
(Laughter笑聲)
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(笑聲)
05:31
There are very few少數 things, very few少數 things that you can really do
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其實我們真正能做的很有限
05:36
that will change更改 the way that you can treat對待 these kinds of diseases疾病
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要改變這些疾病的治療方式
05:41
and experience經驗 what I would call healthy健康 aging老化.
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同時享受我所謂的「健康老化」
05:45
I'd suggest建議 there are four things,
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我想提出 4 個想法
05:47
and none沒有 of these things include包括 an insurance保險 system系統 or a legal法律 system系統.
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而且都跟壽險和立法無關
05:51
All those things do is change更改 who pays支付.
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僅僅是改變只是負擔費用的對象
05:53
They don't actually其實 change更改 what the actual實際 cost成本 of the treatment治療 is.
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實際需要的醫療成本不變
05:57
One thing you can do is not treat對待. You can ration配給 health健康 care關心.
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我們的選擇之一就是不治療,也可以配給醫療資源
06:01
We won't慣於 talk about that anymore. It's too depressing壓抑.
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我們不要再討論這方面,實在太令人沮喪了。
06:04
You can prevent避免.
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我們可以預防
06:05
Obviously明顯 a lot of monies款項 should be put into prevention預防.
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當然我們應該要在預防上投入許多經費
06:09
But perhaps也許 most interesting有趣, to me anyway無論如何, and most important重要,
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不過最有趣也最重要的想法可能是
06:12
is the idea理念 of diagnosing診斷 a disease疾病 much earlier on in the progression級數,
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儘早在症狀惡化的過程中診斷
06:17
and then treating治療 the disease疾病 to cure治愈 the disease疾病
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進而根治疾病
06:20
instead代替 of treating治療 a symptom症狀.
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而不是只對症下藥
06:22
Think of it in terms條款 of diabetes糖尿病, for instance.
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以糖尿病為例
06:26
Today今天, with diabetes糖尿病, what do we do?
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現在我們如何治療糖尿病?
06:28
We diagnose診斷 the disease疾病 eventually終於, once一旦 it becomes symptomatic症狀,
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我們要到出現症狀才能診斷出疾病
06:31
and then we treat對待 the symptom症狀 for 10, 20, 30, 40 years年份.
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然後再花 10、20、30、40 年來對症下藥
06:35
And we do OK. Insulin's胰島素的 a pretty漂亮 good therapy治療.
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結果還算可以,胰島素注射是個不錯的療法
06:39
But eventually終於 it stops停止 working加工,
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不過它終究會就失去藥效
06:40
and diabetes糖尿病 leads引線 to a predictable可預測 onset發病 of debilitating衰弱 disease疾病.
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而且糖尿病一定會併發衰退性疾病
06:48
Why couldn't不能 we just inject注入 the pancreas胰腺 with something
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為什麼我們不在發病初期就注射物質到胰臟
06:51
to regenerate再生 the pancreas胰腺 early on in the disease疾病,
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促進胰臟再生,
06:54
perhaps也許 even before it was symptomatic症狀?
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或甚至在症狀出現前就這麼做呢?
06:57
And it might威力 be a little bit expensive昂貴 at the time that we did it,
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這種治療一開始可能貴一點
07:00
but if it worked工作, we would truly be able能夠 to do something different不同.
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不過一旦成功,我們就真正能開始嘗試變通
07:04
This video視頻, I think, gets得到 across橫過 the concept概念 that I'm talking about quite相當 dramatically顯著.
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我覺得這段影片清楚的表達我想傳達的概念
07:09
This is a newt蠑螈 re-growing再生長 its limb.
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這是一隻在進行肢體再生的蠑螈
07:13
If a newt蠑螈 can do this kind of thing, why can't we?
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蠑螈做得到,為什麼我們不能?
07:16
I'll actually其實 show顯示 you some more important重要 features特徵
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待會我會讓大家看一些更重要的
07:19
about limb regeneration再生 in a moment時刻.
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有關肢體再生的報導
07:21
But what we're talking about in regenerative再生 medicine醫學
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但是在再生醫學中討論的
07:24
is doing this in every一切 organ器官 system系統 of the body身體,
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是重建體內所有的器官系統
07:27
for tissues組織 and for organs器官 themselves他們自己.
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無論是針對組織和器官
07:34
So today's今天的 reality現實 is that if we get sick生病,
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在現實中,要是生病了
07:37
the message信息 is we will treat對待 your symptoms症狀,
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醫生會治療我們的症狀
07:40
and you need to adjust調整 to a new way of life.
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而且我們必須適應新的生活方式
07:43
I would pose提出 to you that tomorrow明天 --
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我想要讓大家看看未來
07:45
and when tomorrow明天 is we could debate辯論,
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雖然還沒辦法確定「未來」何時會來
07:47
but it's within the foreseeable可預見的 future未來 --
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不過,應該不用等太久
07:49
we will talk about regenerative再生 rehabilitation復原.
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我想談談再生復健
07:53
There's a limb prosthetic假肢 up here,
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這是個義肢
07:54
similar類似 actually其實 one on the soldier士兵
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跟從戰地回來的士兵
07:57
that's come back from Iraq伊拉克.
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所用的類似
07:59
There are 370 soldiers士兵 that have come back from Iraq伊拉克 that have lost丟失 limbs四肢.
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有 370 位剛從伊拉克返國的士兵手腳截肢
08:03
Imagine想像 if instead代替 of facing面對 that, they could actually其實
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試想與其截肢, 他們其實可以
08:06
face面對 the regeneration再生 of that limb.
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重建完整的四肢
08:08
It's a wild野生 concept概念.
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這是個很瘋狂的想法
08:10
I'll show顯示 you where we are at the moment時刻 in working加工 towards that concept概念.
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我將展示這個想法目前的進展
08:15
But it's applicable適用, again, to every一切 organ器官 system系統.
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再次強調,這可以適用於任何器官
08:17
How can we do that?
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要怎麼做到呢?
08:18
The way to do that is to develop發展 a conversation會話 with the body身體.
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作法是與身體建立良好的溝通
08:22
We need to learn學習 to speak說話 the body's身體的 language語言.
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我們必須學習了解人體的各種訊息
08:25
And to switch開關 on processes流程 that we knew知道 how to do when we were a fetus胎兒.
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且要開啟胎兒時期曾經擁有的再生能力
08:30
A mammalian哺乳動物 fetus胎兒, if it loses失去 a limb during the first trimester三個月 of pregnancy懷孕,
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哺乳類動物的胎兒在懷孕期的頭三個月
08:35
will re-grow重新長出 that limb.
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失去的手腳可以重新長出來
08:37
So our DNA脫氧核糖核酸 has the capacity容量 to do these kinds of wound-healing傷口癒合 mechanisms機制.
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因此我們的 DNA 中就有這種癒合機制
08:43
It's a natural自然 process處理,
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這是個自然的過程
08:45
but it is lost丟失 as we age年齡.
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卻隨著年齡增長而流失
08:49
In a child兒童, before the age年齡 of about six months個月,
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一個未滿 6 個月的嬰兒
08:52
if they lose失去 their fingertip指尖 in an accident事故,
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要是意外割斷了指尖
08:54
they'll他們會 re-grow重新長出 their fingertip指尖.
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可以重新長回來
08:56
By the time they're five, they won't慣於 be able能夠 to do that anymore.
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不過到了 5 歲,他們就失去這種能力
08:59
So to engage從事 in that conversation會話 with the body身體,
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為了能夠找回這樣的能力
09:02
we need to speak說話 the body's身體的 language語言.
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我們必須學會解讀身體的訊息
09:04
And there are certain某些 tools工具 in our toolbox工具箱 that allow允許 us to do this today今天.
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以下是一些目前正在使用的技術
09:09
I'm going to give you an example of three of these tools工具
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我會介紹其中的 3 種
09:12
through通過 which哪一個 to converse交談 with the body身體.
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透過這些技術我們可以與身體溝通
09:15
The first is cellular細胞的 therapies治療.
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第一個是細胞療法
09:17
Clearly明確地, we heal癒合 ourselves我們自己 in a natural自然 process處理,
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這顯然是利用癒合的自然程序
09:20
using運用 cells細胞 to do most of the work.
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用細胞進行大部分的癒合工作
09:23
Therefore因此, if we can find the right cells細胞
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因此,只要找到適合的細胞
09:25
and implant注入 them in the body身體, they may可能 do the healing復原.
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然後植入人體,或許就能成功
09:29
Secondly其次, we can use materials物料.
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第二種我們可以使用材料
09:31
We heard聽說 yesterday昨天 about the importance重要性 of new materials物料.
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昨天的講題告訴我們新材料的重要性
09:34
If we can invent發明 materials物料, design設計 materials物料,
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如果我們能從自然界合成、設計
09:37
or extract提取 materials物料 from a natural自然 environment環境,
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或提煉出新的材料
09:40
then we might威力 be able能夠 to have those materials物料 induce促使 the body身體 to heal癒合 itself本身.
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或許就可以利用這些材料來誘發身體的癒合功能
09:44
And finally最後, we may可能 be able能夠 to use smart聰明 devices設備
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最後, 我們也許可以利用一些精巧的裝置
09:47
that will offload卸載 the work of the body身體 and allow允許 it to heal癒合.
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分擔身體的負擔同時讓它自行癒合
09:52
I'm going to show顯示 you an example of each of these,
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我會針對各種技術舉例
09:54
and I'm going to start開始 with materials物料.
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先從材料開始
09:56
Steve史蒂夫 BadylakBadylak -- who's誰是 at the University大學 of Pittsburgh匹茲堡 --
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匹茲堡大學的學者史提夫.巴迪萊
09:58
about a decade ago had a remarkable卓越 idea理念.
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大約在 10 年前提出一個很高明的想法
10:01
And that idea理念 was that the small intestine of a pig,
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他想利用豬的小腸
10:05
if you threw away all the cells細胞,
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要是能夠剝除小腸上所有的細胞
10:08
and if you did that in a way that allowed允許 it to remain biologically生物 active活性,
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同時維持其生物活性
10:12
may可能 contain包含 all of the necessary必要 factors因素 and signals信號
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可能可以保存必要的因子和訊號
10:15
that would signal信號 the body身體 to heal癒合 itself本身.
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啟動身體的自我癒合能力
10:17
And he asked a very important重要 question.
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他同時提出一個非常重要的問題
10:19
He asked the question,
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他的問題是
10:20
if I take that material材料, which哪一個 is a natural自然 material材料
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這種天然的材料
10:23
that usually平時 induces誘導 healing復原 in the small intestine,
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放在小腸通常可以誘發小腸的癒合
10:26
and I place地點 it somewhere某處 else其他 on a person's人的 body身體,
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要是放在人體的其他地方
10:30
would it give a tissue-specific組織特異性 response響應,
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是否可以針對不同組織引發正確的修復反應
10:33
or would it make small intestine if I tried試著 to make a new ear?
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還是只對小腸有用,換成耳朵就沒用了?
10:37
I wouldn't不會 be telling告訴 you this story故事 if it weren't compelling引人注目.
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我舉的例子一定夠嚇人
10:42
The picture圖片 I'm about to show顯示 you
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接下來我要展示的圖片 -- 膽小者不宜 --
10:44
is a compelling引人注目 picture圖片.
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(笑聲)
10:46
(Laughter笑聲)
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是很嚇人的照片
10:48
However然而, for those of you that are even the slightest絲毫 bit squeamish過於拘謹的 --
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不過對於那些膽子很小的人
10:51
even though雖然 you may可能 not like to admit承認 it in front面前 of your friends朋友 --
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即使你們可能不想在朋友面前承認
10:54
the lights燈火 are down. This is a good time to look at your feet,
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燈光變暗了,剛好可以低頭不看
10:57
check your Blackberry黑莓, do anything other than look at the screen屏幕.
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看看手機,做什麼都好,就是不要看螢幕
11:02
(Laughter笑聲)
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(笑聲)
11:05
What I'm about to show顯示 you is a diabetic糖尿病患者 ulcer潰瘍.
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我要展示的是糖尿病足部潰瘍的照片
11:09
And although雖然 -- it's good to laugh before we look at this.
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不過看到照片以後可能就笑不出來了
11:12
This is the reality現實 of diabetes糖尿病.
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這就是糖尿病的真實狀況
11:14
I think a lot of times we hear about diabetics糖尿病, diabetic糖尿病患者 ulcers潰瘍,
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我想大家常聽到糖尿病、糖尿病潰瘍
11:17
we just don't connect the ulcer潰瘍 with the eventual最終 treatment治療,
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卻不會把潰瘍和醫療上的終極手段聯想在一起
11:22
which哪一個 is amputation切斷術, if you can't heal癒合 it.
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要是治療無效,終極手段就是截肢
11:24
So I'm going to put the slide滑動 up now. It won't慣於 be up for long.
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我現在要放上投影片,不過不會放太久
11:27
This is a diabetic糖尿病患者 ulcer潰瘍. It's tragic悲慘.
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這就是糖尿病足部潰瘍,真可怕
11:30
The treatment治療 for this is amputation切斷術.
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唯一的療法就是截肢
11:32
This is an older舊的 lady淑女. She has cancer癌症 of the liver as well as diabetes糖尿病,
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這是一位患有肝癌和糖尿病的老婦人
11:36
and has decided決定 to die with what'什麼' s left of her body身體 intact完整.
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她希望在死的時候盡量維持身體完整
11:41
And this lady淑女 decided決定, after a year of attempted嘗試 treatment治療 of that ulcer潰瘍,
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所以治療潰瘍一年後她決定
11:46
that she would try this new therapy治療 that Steve史蒂夫 invented發明.
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嘗試史提夫發明的新療法
11:49
That's what the wound傷口 looked看著 like 11 weeks later後來.
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傷口經過 11 個星期治療之後變成這個樣子
11:52
That material材料 contained only natural自然 signals信號.
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這個材料只含有天然的訊息因子
11:56
And that material材料 induced誘發 the body身體 to switch開關 back on a healing復原 response響應
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而且可以誘發身體重新啟動
12:00
that it didn't have before.
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從前沒有的癒合反應
12:02
There's going to be a couple一對 more distressing令人痛心 slides幻燈片 for those of you --
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接下來還有一些更令人不舒服的照片
12:05
I'll let you know when you can look again.
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等到可以轉過頭的時候,我會叫大家
12:07
This is a horse. The horse is not in pain疼痛.
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這是一匹馬。它並不感覺痛
12:10
If the horse was in pain疼痛, I wouldn't不會 show顯示 you this slide滑動.
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要是它會痛,我就不會讓大家看這張投影片
12:12
The horse just has another另一個 nostril鼻孔 that's developed發達
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這匹馬已經重建了新的鼻腔
12:15
because of a riding騎術 accident事故.
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它因為一次騎乘意外而受傷
12:17
Just a few少數 weeks after treatment治療 --
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治療幾星期後
12:18
in this case案件, taking服用 that material材料, turning車削 it into a gel凝膠,
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這個案例是將新材料製成膠狀物
12:21
and packing填料 that area, and then repeating重複 the treatment治療 a few少數 times --
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包覆整個受傷區域並重複幾次療程
12:25
and the horse heals癒合 up.
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然後傷口就癒合了
12:27
And if you took an ultrasound超聲 of that area, it would look great.
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超音波檢查顯示癒合區的狀況非常好
12:29
Here's這裡的 a dolphin海豚 where the fin's鰭的 been re-attached重醫附.
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這是一隻重新接合魚鰭的海豚
12:32
There are now 400,000 patients耐心 around the world世界
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現在全球已經有 40 萬名病患
12:35
who have used that material材料 to heal癒合 their wounds傷口.
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使用這種新材料來癒合傷口
12:38
Could you regenerate再生 a limb?
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肢體再生還是天方夜譚嗎?
12:41
DARPADARPA just gave Steve史蒂夫 15 million百萬 dollars美元 to lead an eight-institution八機構 project項目
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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
12:45
to begin開始 the process處理 of asking that question.
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開始嘗試探索這個問題
12:48
And I'll show顯示 you the 15 million百萬 dollar美元 picture圖片.
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我將要大家看看價值 1500 萬的照片
12:51
This is a 78 year-old man who's誰是 lost丟失 the end結束 of his fingertip指尖.
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這位 78歲的男子失去了指尖
12:54
Remember記得 that I mentioned提到 before the children孩子 who lose失去 their fingertips指尖.
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還記得我之前提到幼兒指尖的再生能力
12:58
After treatment治療 that's what it looks容貌 like.
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這是接受治療後的樣子
13:01
This is happening事件 today今天.
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現在就能做到
13:03
This is clinically臨床 relevant相應 today今天.
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現在在臨床上可以做到
13:06
There are materials物料 that do this. Here are the heart patches補丁.
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其他新的材料也有同樣的功能。 這是心肌修補
13:09
But could you go a little further進一步?
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還能更進一步的治療嗎?
13:11
Could you, say, instead代替 of using運用 material材料,
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試想除了使用新的材料外
13:13
can I take some cells細胞 along沿 with the material材料,
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我們是否可以拿一些細胞結合材料
13:15
and remove去掉 a damaged破損 piece of tissue組織,
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清除損害的組織之後
13:17
put a bio-degradable生物降解 material材料 on there?
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在患部放上人體可自行分解的材料?
13:20
You can see here a little bit of heart muscle肌肉 beating跳動 in a dish.
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你可以看到在培養皿裡有一小塊正在跳動的心肌
13:23
This was doneDONE by Teruo照雄 Okano岡野 at Tokyo東京 Women's女士的 Hospital醫院.
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這是由東京婦女醫院的岡野照雄所完成的
13:28
He can actually其實 grow增長 beating跳動 tissue組織 in a dish.
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他真的可以在培養皿裡培養出跳動的心臟組織
13:31
He chills畏寒 the dish, it changes變化 its properties性能
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先透過冰鎮培養皿改變組織的特性
13:33
and he peels it right out of the dish.
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然後將組織從培養皿中取下
13:35
It's the coolest最酷 stuff東東.
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這真是酷斃了
13:38
Now I'm going to show顯示 you cell-based細胞為主 regeneration再生.
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現在我們來談談細胞療法
13:40
And what I'm going to show顯示 you here
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我要給大家看的是
13:42
is stem cells細胞 being存在 removed去除 from the hip臀部 of a patient患者.
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由患者的臀部取出幹細胞
13:46
Again, if you're squeamish過於拘謹的, you don't want to watch.
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再次提醒,要是你很膽小還是別看了
13:48
But this one's那些 kind of cool.
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不過這個也很酷
13:49
So this is a bypass旁路 operation手術, just like what Al Gore血塊 had,
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這是一個心臟繞道手術,就是高爾剛做完的的那種
13:55
with a difference區別.
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不同的是
13:56
In this case案件, at the end結束 of the bypass旁路 operation手術,
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這個案例手術的最後階段
13:59
you're going to see the stem cells細胞 from the patient患者
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你將看到病患體內的幹細胞
14:01
that were removed去除 at the beginning開始 of the procedure程序
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在手術開始時取出的幹細胞
14:03
being存在 injected注射 directly into the heart of the patient患者.
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被直接注入病患心臟
14:07
And I'm standing常設 up here because at one point
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我站到上面來是因為稍後能看到細胞植入
14:09
I'm going to show顯示 you just how early this technology技術 is.
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我要讓大家看看這個技術還在初期階段
14:12
Here go the stem cells細胞, right into the beating跳動 heart of the patient患者.
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現在幹細胞直接注入病患還在跳動的心臟
14:15
And if you look really carefully小心,
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如果大家仔細看
14:16
it's going to be right around this point
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大概就在這裡
14:18
you'll你會 actually其實 see a back-flush反沖洗.
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會看到滲出液體
14:20
You see the cells細胞 coming未來 back out.
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那是幹細胞被排出來
14:24
We need all sorts排序 of new technology技術, new devices設備,
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我們需要各種新的技術和裝置
14:26
to get the cells細胞 to the right place地點 at the right time.
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設法在正確的時間將細胞注入正確的部位
14:31
Just a little bit of data數據, a tiny bit of data數據.
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我這裡有一點資料,只是一點點
14:33
This was a randomized隨機 trial審訊.
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這是個隨機的試驗
14:35
At this time this was an N of 20. Now there's an N of about 100.
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當時只有樣本只有 20 個,現在已經累積到 100 個了
14:39
Basically基本上, if you take an extremely非常 sick生病 patient患者
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基本上,如果一個重病患者
14:41
and you give them a bypass旁路, they get a little bit better.
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接受了繞道手術,情況會稍微好轉
14:43
If you give them stem cells細胞 as well as their bypass旁路,
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要是他們同時接受幹細胞治療
14:46
for these particular特定 patients耐心, they became成為 asymptomatic無症狀.
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這些特定病患症狀會完全消失
14:49
These are now two years年份 out.
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這個數據已經是兩年前的了
14:53
The coolest最酷 thing would be is if you could diagnose診斷 the disease疾病 early,
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最棒的是能早期診斷出疾病
14:56
and prevent避免 the onset發病 of the disease疾病 to a bad state.
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並預防疾病惡化的可能性
15:00
This is the same相同 procedure程序, but now doneDONE minimally微創 invasively,
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這手術跟剛剛類似,但只有最低的侵入程度
15:04
with only three holes in the body身體 where they're taking服用 the heart
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只要在心臟需手術的部位開 3 個孔
15:07
and simply只是 injecting注射 stem cells細胞 through通過 a laparoscopic腹腔鏡 procedure程序.
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然後利用內視鏡手術注入幹細胞
15:11
There go the cells細胞.
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現在幹細胞植入
15:12
We don't have time to go into all of those details細節,
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我沒有時間詳細說明
15:15
but basically基本上, that works作品 too.
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但基本上這個方法是可行的
15:17
You can take patients耐心 who are less sick生病,
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症狀較輕的病患可以
15:20
and bring帶來 them back to an almost幾乎 asymptomatic無症狀 state
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復原到幾乎無症狀的情況
15:24
through通過 that kind of therapy治療.
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只要接受這種手術治療
15:26
Here's這裡的 another另一個 example of stem-cell幹細胞 therapy治療 that isn't quite相當 clinical臨床 yet然而,
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這裡有另一個尚未進入臨床試驗的幹細胞療法
15:30
but I think very soon不久 will be.
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我想不久後會進行
15:32
This is the work of Kacey卡塞 Marra馬拉 from Pittsburgh匹茲堡,
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這是匹茲堡大學的凱西 . 瑪拉的研究成果
15:34
along沿 with a number of colleagues同事 around the world世界.
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她與世界各地的科學家合作
15:36
They've他們已經 decided決定 that liposuction吸脂 fluid流體,
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她們認為抽脂手術取出的脂肪液體
15:39
which哪一個 -- in the United聯合的 States狀態, we have a lot of liposuction吸脂 fluid流體.
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我想美國最多的就是脂肪液
15:42
(Laughter笑聲)
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(笑聲)
15:43
It's a great source資源 of stem cells細胞.
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這其實是很好的幹細胞來源
15:45
Stem cells細胞 are packed打包 in that liposuction吸脂 fluid流體.
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脂肪液中有許多幹細胞
15:48
So you could go in, you could get your tummy-tuck肚子抱膝.
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所以去整型診所抽個脂
15:51
Out comes the liposuction吸脂 fluid流體,
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就能有了這些脂肪液體
15:53
and in this case案件, the stem cells細胞 are isolated孤立 and turned轉身 into neurons神經元.
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在這個案例中,幹細胞被分離出來轉成神經元
15:58
All doneDONE in the lab實驗室.
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全部都在實驗室完成的
15:59
And I think fairly相當 soon不久, you will see patients耐心 being存在 treated治療
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我想在不久之後就能有患者接受治療
16:02
with their own擁有 fat-derived脂肪來源, or adipose-derived脂肪來源, stem cells細胞.
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用他們體內脂肪或脂質細胞取出的幹細胞
16:07
I talked before about the use of devices設備
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我也提到過用精密儀器
16:09
to dramatically顯著 change更改 the way we treat對待 disease疾病.
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顛覆治療疾病的方式
16:12
Here's這裡的 just one example before I close up.
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在我總結前再提最後一個例子
16:14
This is equally一樣 tragic悲慘.
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這是件令人遺憾的事
16:16
We have a very abiding守法 and heartbreaking令人心碎 partnership合夥
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我們與一位在美軍手術研究機構的同事
16:19
with our colleagues同事 at the Institute研究所 for Surgical外科 Research研究 in the US Army軍隊,
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經歷長久但過程卻令人難過的合作關係
16:23
who have to treat對待 the now 11,000 kids孩子 that have come back from Iraq伊拉克.
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他負責治療 1 萬 1 千名剛從伊拉克回來的年輕人
16:28
Many許多 of those patients耐心 are very severely嚴重 burned.
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其中很多都嚴重燒傷
16:30
And if there's anything that's been learned學到了 about burn燒傷,
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不過,要說我們燒傷的認識
16:32
it's that we don't know how to treat對待 it.
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就是目前無法治癒
16:34
Everything that is doneDONE to treat對待 burn燒傷 --
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目前治療燒燙傷的方法
16:36
basically基本上 we do a sodding該死的 approach途徑.
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是使用皮膚移植
16:39
We make something over here,
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我們從某個部位取下皮膚
16:41
and then we transplant移植 it onto the site現場 of the wound傷口,
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再移植到燒傷的區域
16:43
and we try and get the two to take.
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然後試著讓它們相容
16:45
In this case案件 here, a new, wearable穿戴式 bio-reactor生物反應器 has been designed設計 --
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這個案例設計出可以貼在人體上的新生物反應器
16:49
it should be tested測試 clinically臨床 later後來 this year at ISRISR --
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年底 ISR 應該就會進行臨床試驗
16:52
by Joerg約爾格 Gerlach格拉赫 in Pittsburgh匹茲堡.
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由匹茲堡大學的耶格 . 葛萊克主持
16:54
And that bio-reactor生物反應器 will lay鋪設 down in the wound傷口 bed.
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這種生物反應器會鋪在傷口上
16:57
The gun that you see there sprays噴霧劑 cells細胞.
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大家看到的噴槍則會噴上細胞
17:00
That's going to spray噴霧 cells細胞 over that area.
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將細胞均勻噴灑在傷口上
17:03
The reactor反應堆 will serve服務 to fertilize施肥 the environment環境,
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生物反應器會供應細胞養分
17:06
deliver交付 other things as well at the same相同 time,
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同時也是物質運輸流動的管道
17:09
and therefore因此 we will seed種子 that lawn草坪,
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藉此提供細胞適宜的生長環境
17:12
as opposed反對 to try the sodding該死的 approach途徑.
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與皮膚移植兩相比較
17:14
It's a completely全然 different不同 way of doing it.
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是個全然不同的方法
17:18
So my 18 minutes分鐘 is up.
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我的 18 分鐘時間到了
17:20
So let me finish up with some good news新聞,
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讓我用一個好消息做結尾
17:22
and maybe a little bit of bad news新聞.
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或許有一小部分還是壞消息
17:25
The good news新聞 is that this is happening事件 today今天.
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好消息是這些技術現在就能做到
17:28
It's very powerful強大 work.
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這項工程作用強大
17:30
Clearly明確地 the images圖片 kind of get that across橫過.
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那些照片很顯然讓大家體會到這點
17:32
It's incredibly令人難以置信 difficult because it's highly高度 inter-disciplinary跨學科.
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不過卻因為是高度跨領域的工作而難度頗高
17:35
Almost幾乎 every一切 field領域 of science科學 engineering工程 and clinical臨床 practice實踐
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幾乎所有科學領域及臨床醫學都牽涉到了
17:39
is involved參與 in trying to get this to happen發生.
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要一起嘗試讓想法成真
17:43
A number of governments政府, and a number of regions地區,
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有一些國家和許多地區
17:45
have recognized認可 that this is a new way to treat對待 disease疾病.
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已經體認到這是一種治療疾病的新方式
17:48
The Japanese日本 government政府 were perhaps也許 the first,
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日本政府應該是第一個
17:50
when they decided決定 to invest投資 first 3 billion十億,
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決定先在這個領域投入 30 億資金
17:53
later後來 another另一個 2 billion十億 in this field領域.
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然後再加碼 20 億
17:56
It's no coincidence巧合.
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這是必然的趨勢
17:57
Japan日本 is the oldest最老的 country國家 on earth地球 in terms條款 of its average平均 age年齡.
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日本是世界上平均壽命最高國家之一
18:00
They need this to work or their health健康 system系統 dies.
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因此需要讓這項研究成功,才能維持其醫療系統
18:05
So they're putting a lot of strategic戰略 investment投資 focused重點 in this area.
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所以在這個領域砸下很多策略性的投資
18:09
The European歐洲的 Union聯盟, same相同 thing.
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在歐盟也一樣
18:11
China中國, the same相同 thing.
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中國也是
18:13
China中國 just launched推出 a national國民 tissue-engineering組織工程 center中央.
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中國的國家組織工程研究中心才剛落成
18:15
The first year budget預算 was 250 million百萬 US dollars美元.
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第一年的研究預算就有 2 億 5 千萬美元
18:19
In the United聯合的 States狀態 we've我們已經 had a somewhat有些 different不同 approach途徑.
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美國的作法,則是有點不同。我們...
18:23
(Laughter笑聲)
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(笑聲)
18:26
Oh, for Al Gore血塊 to come and be in the real真實 world世界 as president主席.
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天啊,真希望高爾是美國總統!
18:30
We've我們已經 had a different不同 approach途徑.
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我們的作法不同
18:31
And the approach途徑 has basically基本上 been to just sort分類 of fund基金 things as they come along沿.
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基本上就是順水推舟補助
18:35
But there's been no strategic戰略 investment投資
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而沒有策略性投資
18:38
to bring帶來 all of the necessary必要 things to bear and focus焦點 them in a careful小心 way.
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來負擔必要的研究條件並謹慎聚焦使用
18:44
And I'm going to finish up with a quote引用, maybe a little cheap低廉 shot射擊,
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我將引用一段對話做結,可能有點惡毒
18:47
at the director導向器 of the NIHNIH, who's誰是 a very charming迷人 man.
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NIH 美國衛生研究機構的主持人,人很親切
18:53
Myself and Jay松鴉 Vacanti文森提 from Harvard哈佛
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我與哈佛大學的傑 . 福肯帝
18:55
went to visit訪問 with him and a number of his directors董事 of his institute研究所
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拜訪了他跟其他幾位機構裡的主任
19:00
just a few少數 months個月 ago,
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大概就是幾個月前
19:03
to try and convince說服 him that it was time to take just a little piece
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我們試著說服他時候到了
19:08
of that 27.5 billion十億 dollars美元 that he's going to get next下一個 year
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他可以從明年編列的 275 億預算中撥一小部分補助我們
19:12
and focus焦點 it, in a strategic戰略 way, to make sure we can accelerate加速 the pace步伐
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用策略性方法,把錢專門用來加快研究腳步
19:17
at which哪一個 these things get to patients耐心.
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讓病患早日受益
19:20
And at the end結束 of a very testy性急的 meeting會議,
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在這個火藥味很重的會面最後
19:22
what the NIHNIH director導向器 said was,
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NIH 的主持人只說
19:24
"Your vision視力 is larger than our appetite食慾."
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「我們的胃口太小,吞不下你們偉大的理想」
19:26
I'd like to close by saying that no one's那些 going to change更改 our vision視力,
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我想我最後要說的就是,沒有人可以改變我們的理想
19:30
but together一起 we can change更改 his appetite食慾.
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不過,我們合力就能撐大他的胃口
19:32
Thank you.
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謝謝
Translated by Yu-Ju Chiang
Reviewed by Ai-Ying (Erin) Chiang

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ABOUT THE SPEAKER
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.

More profile about the speaker
Alan Russell | Speaker | TED.com