TED2010
William Li: Can we eat to starve cancer?
Ali lahko s hrano izstradamo raka?
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William Li predstavlja nov način razmišljanja o zdravljenju raka: antiangiogenezo, usmerjen boj proti razraščanju krvnih žil, ki hranijo tumor. Bistven (in najboljši) prvi korak: jesti je treba hrano, ki preprečuje raka in ga tako premagati na njegovem lastnem terenu.
William Li - Cancer researcher
William Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting. Full bio
William Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting. Full bio
Double-click the English transcript below to play the video.
00:17
Good afternoon.
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Dober dan.
00:19
There's a medical revolution happening all around us,
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Okoli nas se dogaja medicinska revolucija.
00:22
and it's one that's going to help us conquer
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Pomagala nam bo premagati
00:24
some of society's most dreaded conditions,
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nekatere bolezni, ki se jih najbolj bojimo,
00:26
including cancer.
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kot je rak.
00:28
The revolution is called angiogenesis,
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Revolucija se imenuje angiogeneza.
00:31
and it's based on the process
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Temelji na procesu,
00:33
that our bodies use to grow blood vessels.
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s katerim naše telo razrašča krvne žile.
00:36
So why should we care about blood vessels?
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Zakaj bi nas krvne žile sploh zanimale?
00:38
Well, the human body is literally packed with them:
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Človeško telo je dobesedno prepredeno z njimi.
00:41
60,000 miles worth in a typical adult.
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Povprečen odrasel človek jih ima okoli 96.000 km.
00:44
End to end, that would form a line
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Po dolžini bi tvorile črto,
00:46
that would circle the earth twice.
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ki bi dvakrat obkrožila Zemljo.
00:49
The smallest blood vessels are called capillaries;
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Najmanjše krvne žile so kapilare.
00:52
we've got 19 billion of them in our bodies.
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V telesu jih je 19 milijard.
00:55
And these are the vessels of life, and,
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Kapilare prinašajo življenje.
00:58
as I'll show you,
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Kot vam bom pokazal,
01:00
they can also be the vessels of death.
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pa lahko prinašajo tudi smrt.
01:03
Now the remarkable thing about blood vessels
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Posebnost krvnih žil je,
01:05
is that they have this ability
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da se lahko prilagodijo okolju,
01:07
to adapt to whatever environment they're growing in.
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v katerem rastejo.
01:09
For example, in the liver they form channels
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V jetrih, na primer, tvorijo kanale
01:11
to detoxify the blood;
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za razstrupljanje krvi.
01:13
in the lung they line air sacs for gas exchange;
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V pljučih obdajajo pljučne mešičke za izmenjavo plinov.
01:16
in muscle they corkscrew so that muscles can contract
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Spiralaste kapilare v mišicah omogočajo
01:18
without cutting off circulation;
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krčenje mišic brez prekinjene prekrvavitve.
01:21
and in nerves they course along like power lines,
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V živčnem sistemu so kot električna napeljava,
01:23
keeping those nerves alive.
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ki ohranja živčna vlakna pri življenju.
01:25
We get most of these blood vessels
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Večina krvnih žil se razvije,
01:27
when we're actually still in the womb,
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ko smo še v maternici.
01:29
And what that means is that as adults,
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To pomeni, da pri odraslih
01:32
blood vessels don't normally grow.
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krvne žile načeloma ne rastejo,
01:34
Except in a few special circumstances:
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razen v nekaterih posebnih okoliščinah.
01:38
In women, blood vessels grow every month
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Pri ženskah rastejo krvne žile vsak mesec,
01:40
to build the lining of the uterus;
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saj tvorijo sluznico maternice.
01:42
during pregnancy, they form the placenta,
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Med nosečnostjo tvorijo posteljico,
01:44
which connects mom and baby.
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ki povezuje mamo in otroka.
01:47
And after injury, blood vessels
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Po poškodbi morajo krvne žile
01:49
actually have to grow under the scab
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zrasti pod krasto,
01:51
in order to heal a wound.
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da se rana zaceli.
01:53
And this is actually what it looks like,
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To je videti tako.
01:55
hundreds of blood vessels
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Na stotine krvnih žil
01:57
all growing toward the center of the wound.
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raste proti središču rane.
01:59
So the body has the ability to regulate
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Naše telo je torej zmožno uravnavati
02:02
the amount of blood vessels that are present at any given time.
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število krvnih žil.
02:05
It does this through an elaborate
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To počne z izpopolnjenim
02:07
and elegant system of checks and balances,
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in elegantnim procesom samouravnavanja,
02:09
stimulators and inhibitors of angiogenesis,
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s spodbujevalci in z zaviralci angiogeneze.
02:12
such that, when we need a brief burst of blood vessels,
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Če nenadoma potrebujemo več krvnih žil,
02:15
the body can do this by releasing stimulators,
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telo sprosti spodbujevalce - beljakovine,
02:18
proteins called angiogenic factors
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ki se imenujejo angiogeni faktorji.
02:20
that act as natural fertilizer
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Ti delujejo kot naravno gnojilo
02:22
and stimulate new blood vessels to sprout.
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in spodbudijo rast novih krvnih žil.
02:24
And when those excess vessels are no longer needed,
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Ko dodatnih krvnih žil ne potrebujemo več,
02:26
the body prunes them back to baseline
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jih telo skrči do osnovnega nivoja
02:29
using naturally occurring inhibitors of angiogenesis.
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z uporabo naravnih zaviralcev angiogeneze.
02:33
Now there are other situations where we start beneath the baseline
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Včasih pa začnemo pod osnovnim nivojem,
02:35
and we need to grow more blood vessels just to get back to normal levels --
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in potrebujemo nove krvne žile, da dosežemo normalno količino.
02:38
for example, after an injury --
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Po poškodbi, na primer.
02:40
and a body can do that too,
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Telo zmore tudi to,
02:42
but only to that normal level,
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vendar samo do normalnega nivoja,
02:44
that set point.
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do normalnega stanja.
02:46
But what we now know is that for a number of diseases,
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A pri številnih boleznih
02:49
there are defects in the system
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pride do napak v sistemu,
02:51
where the body can't prune back extra blood vessels
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ko telo ne more odstraniti dodatnih krvnih žil
02:54
or can't grow enough new ones
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ali ustvariti dovolj novih
02:56
in the right place at the right time.
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ob pravem času na pravem mestu.
02:58
And in these situations, angiogenesis
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V teh primerih angiogeneza
03:00
is out of balance.
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ni več v ravnotežju.
03:02
And when angiogenesis is out of balance,
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Če angiogeneza ni uravnotežena,
03:04
a myriad of diseases result.
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se pojavijo številne bolezni.
03:06
For example, insufficient angiogenesis --
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Nezadostna angiogeneza
03:08
not enough blood vessels --
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oziroma premalo krvnih žil,
03:10
leads to wounds that don't heal, heart attacks,
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lahko povzroči razjede, srčno kap,
03:13
legs without circulation, death from stroke,
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moteno prekrvavitev nog, smrt zaradi kapi
03:15
nerve damage.
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ali poškodbe živčnega sistema.
03:17
And on the other end, excessive angiogenesis --
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Po drugi strani pretirana angiogeneza,
03:19
too many blood vessels -- drives disease,
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preveč krvnih žil, požene bolezen.
03:22
and we see this in cancer, blindness,
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To vidimo pri raku, slepoti,
03:24
arthritis, obesity,
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artritisu, debelosti,
03:26
Alzheimer's disease.
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alzheimerjevi bolezni.
03:28
In total, there are more than 70 major diseases
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Skupaj poznamo več kot 70 težkih bolezni,
03:31
affecting more than a billion people worldwide,
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ki prizadanejo več kot milijardo ljudi na svetu.
03:34
that all look on the surface to be different from one another,
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Na prvi pogled so videti različne,
03:36
but all actually share
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vendar imajo v resnici vse
03:38
abnormal angiogenesis
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skupen imenovalnik -
03:40
as their common denominator.
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nepravilno angiogenezo.
03:42
And this realization is allowing us
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To spoznanje nam omogoča,
03:44
to reconceptualize
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da na te bolezni
03:46
the way that we actually approach these diseases
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pogledamo z novega vidika:
03:48
by controlling angiogenesis.
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z nadzorom angiogeneze.
03:51
Now I'm going to focus on cancer
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Zdaj se bom osredotočil na raka,
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because angiogenesis is a hallmark of cancer,
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kajti angiogeneza je značilnost raka,
03:56
every type of cancer.
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vsake vrste raka.
03:58
So here we go.
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Pa začnimo.
04:00
This is a tumor: dark, gray, ominous mass
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To je tumor, temna, siva, grozeča snov,
04:02
growing inside a brain.
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ki raste v možganih.
04:04
And under the microscope, you can see
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Pod mikroskopom lahko vidite
04:06
hundreds of these brown staining blood vessels,
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stotine rjavo obarvanih krvnih žil,
04:08
capillaries that are feeding cancer cells,
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kapilar, ki hranijo rakave celice
04:10
bringing oxygen and nutrients.
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s kisikom in hranljivimi snovmi.
04:13
But cancers don't start out like this.
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A rak na začetku ni videti tak.
04:15
And, in fact, cancers don't start out
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V resnici rak na začetku
04:17
with a blood supply.
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ne dobiva krvi.
04:19
They start out as small, microscopic nests of cells
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Začne se kot mikroskopsko majhni skupki celic,
04:22
that can only grow to
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ki lahko zrastejo do največ
04:24
one half a cubic millimeter in size;
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pol kubičnega milimetra.
04:27
that's the tip of a ballpoint pen.
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To je velikost konice kemičnega svinčnika.
04:29
Then they can't get any larger because they don't have a blood supply,
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Ne morejo se večati, ker niso prekrvavljeni,
04:31
so they don't have enough oxygen or nutrients.
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torej nimajo dovolj kisika in hranljivih snovi.
04:34
In fact, we're probably forming these
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Takšni mikroskopski tumorji verjetno
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microscopic cancers all the time in our body.
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nastajajo v našem telesu ves čas.
04:40
Autopsy studies from people who died in car accidents
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Obdukcije žrtev prometnih nesreč
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have shown that about 40 percent of women
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so pokazale, da ima okoli 40 % žensk,
04:46
between the ages of 40 and 50
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starih od 40 do 50 let,
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actually have microscopic
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v dojkah prisotne
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cancers in their breasts,
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mikroskopske tumorje.
04:52
about 50 percent of men in their 50s and 60s
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Okoli 50 % moških, starih od 50 do 70 let,
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have microscopic prostate cancers,
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ima mikroskopske tumorje na prostati.
04:57
and virtually 100 percent of us,
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Pravzaprav bomo pri 70. letih
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by the time we reach our 70s,
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prav vsi tukaj
05:01
will have microscopic cancers growing in our thyroid.
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imeli mikroskopskega raka ščitnice.
05:04
Yet, without a blood supply,
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A brez oskrbe s krvjo
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most of these cancers
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večina teh tumorjev
05:08
will never become dangerous.
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nikoli ne bo postala nevarna.
05:10
Dr. Judah Folkman, who was my mentor
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Dr. Judah Folkman, moj mentor
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and who was the pioneer of the angiogenesis field,
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in začetnik področja angiogeneze,
05:15
once called this "cancer without disease."
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je to poimenoval „rak brez bolezni“.
05:19
So the body's ability to balance angiogenesis,
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Sposobnost telesa, da uravnava angiogenezo,
05:22
when it's working properly,
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če ta pravilno deluje,
05:24
prevents blood vessels from feeding cancers.
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preprečuje žilam, da bi hranile tumor.
05:26
And this turns out to be
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Kot kaže, je to
05:28
one of our most important defense mechanisms
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eden najpomembnejših obrambnih mehanizmov
05:31
against cancer.
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proti raku.
05:33
In fact, if you actually block angiogenesis
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Če ustavimo angiogenezo
05:35
and prevent blood vessels from ever reaching cancer cells,
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in krvnim žilam preprečimo dostop do rakavih celic,
05:37
tumors simply can't grow up.
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tumorji enostavno ne morejo rasti.
05:39
But once angiogenesis occurs,
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Ko pa se sproži angiogeneza,
05:41
cancers can grow exponentially.
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začne rak eksponentno rasti.
05:44
And this is actually how
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Tako se tumor spremeni
05:46
a cancer goes from being
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iz neškodljivega
05:48
harmless to deadly.
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v smrtno nevarnega.
05:50
Cancer cells mutate
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Rakave celice se spremenijo.
05:52
and they gain the ability to release
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Začnejo oddajati veliko
05:54
lots of those angiogenic factors, natural fertilizer,
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angiogenih faktorjev, naravnih spodbujevalcev.
05:56
that tip the balance in favor of blood vessels
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To sproži rast krvnih žil,
05:58
invading the cancer.
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ki prodirajo v tumor.
06:00
And once those vessels invade the cancer,
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Ko krvne žile prodrejo v tumor,
06:02
it can expand, it can invade local tissues.
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se ta lahko razširi in napade sosednja tkiva.
06:05
And the same vessels that are feeding tumors
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Krvne žile, ki hranijo tumor,
06:07
allow cancer cells to exit into the circulation
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mu tudi omogočijo vstop v krvni obtok
06:10
as metastases.
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v obliki metastaz.
06:12
And, unfortunately, this late stage of cancer
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Na žalost je ta pozni stadij raka tisti,
06:15
is the one at which it's most likely
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ki bo najverjetneje
06:17
to be diagnosed,
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diagnosticiran.
06:19
when angiogenesis is already turned on
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Angiogeneza že poteka
06:21
and cancer cells are growing like wild.
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in rakave celice rastejo kot nore.
06:25
So, if angiogenesis
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Če je angiogeneza torej
06:27
is a tipping point
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prelomna točka
06:29
between a harmless cancer and a harmful one,
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med nenevarnim in nevarnim rakom,
06:32
then one major part of the angiogenesis revolution
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je pomen revolucije angiogeneze
06:35
is a new approach to treating cancer
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nov pristop k zdravljenju raka:
06:37
by cutting off the blood supply.
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prekiniti moramo oskrbo s krvjo.
06:40
We call this antiangiogenic therapy,
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To je antiangiogena terapija.
06:43
and it's completely different from chemotherapy
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Je popolnoma drugačna od kemoterapije,
06:45
because it selectively aims
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ker cilja izključno krvne žile,
06:47
at the blood vessels that are feeding the cancers.
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ki hranijo raka.
06:50
And we can do this because
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To je mogoče,
06:52
tumor blood vessels are unlike normal, healthy vessels
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ker so tumorske žile drugačne od zdravih krvnih žil,
06:54
we see in other places of the body:
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ki jih najdemo v drugih delih telesa.
06:56
They're abnormal;
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So nepravilne,
06:58
they're very poorly constructed;
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slabo oblikovane,
07:00
and, because of that, they're highly vulnerable
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in ravno zato zelo dovzetne
07:02
to treatments that target them.
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za ciljno zdravljenje.
07:05
In effect, when we give cancer patients
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Če rakave bolnike zdravimo
07:07
antiangiogenic therapy --
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z antiangiogeno terapijo -
07:09
here, an experimental drug for a glioma,
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npr. s poskusnim zdravilom za gliom,
07:12
which is a type of brain tumor --
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ki je vrsta možganskega tumorja -
07:14
you can see that there are dramatic changes that occur
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lahko opazimo dramatične spremembe,
07:17
when the tumor is being starved.
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saj tumor izstradamo.
07:19
Here's a woman with a breast cancer
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Ta ženska ima raka na dojki
07:21
being treated with the antiangiogenic drug called Avastin,
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in prejema antiangiogeno zdravilo Avastin,
07:24
which is FDA approved.
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ki ga je odobrila Ameriška agencija za zdravila.
07:26
And you can see that the halo of blood flow
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Vidite lahko, da je sij pretoka krvi
07:29
disappears after treatment.
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po zdravljenju izginil.
07:32
Well, I've just shown you
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Ravnokar sem vam pokazal
07:34
two very different types of cancer
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dve popolnoma različni vrsti raka,
07:36
that both responded to antiangiogenic therapy.
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ki se odzivata na antiangiogeno terapijo.
07:39
So, a few years ago, I asked myself,
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Pred nekaj leti sem se vprašal:
07:41
"Can we take this one step further
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Ali gremo lahko en korak dalje
07:43
and treat other cancers,
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in zdravimo druge vrste raka,
07:45
even in other species?"
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morda celo druge vrste živih bitij?
07:49
So here is a nine year-old boxer named Milo
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Na sliki je devetletni bokser Milo,
07:51
who had a very aggressive tumor
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ki je imel na rami
07:53
called a malignant neurofibroma growing on his shoulder.
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zelo agresiven tumor, maligni nevrofibrom.
07:56
It invaded into his lungs.
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Prodrl je do pljuč.
07:58
His veterinarian only gave him three months to live.
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Veterinar mu je napovedal tri mesece življenja.
08:00
So we created a cocktail of antiangiogenic drugs
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Pripravili smo mešanico antiangiogenih zdravil,
08:03
that could be mixed into his dog food
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ki smo jo primešali pasji hrani,
08:05
as well as an antiangiogenic cream
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in antiangiogeno kremo
08:07
that could be applied on the surface of the tumor.
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za mazanje površine tumorja.
08:10
And within a few weeks of treatment,
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Po nekaj tednih zdravljenja
08:12
we were able to slow down that cancer's growth
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smo upočasnili rast raka do te mere,
08:15
such that we were ultimately able to extend milo's survival
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da smo Milu podaljšali življenje
08:18
to six times what the veterinarian had initially predicted,
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kar za šestkrat glede na prognozo,
08:21
all with a very good quality of life.
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hkrati pa ohranili kakovost njegovega življenja.
08:24
And we subsequently treated more than 600 dogs.
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Po tem smo zdravili več kot 600 psov.
08:27
We have about a 60 percent response rate
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Uspešni smo v približno 60 % primerov.
08:29
and improved survival for these pets
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Tako imajo psi, ki so jih skoraj uspavali,
08:31
that were about to be euthanized.
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večjo možnost preživetja.
08:34
So let me show you a couple of
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Rad bi vam pokazal
08:36
even more interesting examples.
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še dva zanimiva primera.
08:38
This is 20-year-old dolphin living in Florida,
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To je dvajsetletna delfinka s Floride
08:40
and she had these lesions in her mouth
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z razjedami v ustih,
08:42
that, over the course of three years,
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ki so se v treh letih
08:44
developed into invasive squamous cell cancers.
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razvile v invazivno obliko kožnega raka.
08:47
So we created an antiangiogenic paste.
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Pripravili smo antiangiogeno kremo.
08:50
We had it painted on top of the cancer
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Trikrat na teden smo jo
08:52
three times a week.
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nanesli na površino tumorja.
08:54
And over the course of seven months,
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V sedmih mesecih
08:56
the cancers completely disappeared,
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je rak popolnoma izginil
08:58
and the biopsies came back as normal.
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in rezultati biopsije so bili normalni.
09:02
Here's a cancer growing on the lip
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Na sliki vidimo tumor na ustnici
09:04
of a Wuarter horse named Guinness.
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jahalnega konja Guinessa.
09:06
It's a very, very deadly type of cancer called an angiosarcoma.
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To je smrtno nevarna vrsta raka, ki se imenuje angiosarkom.
09:09
It had already spread to his lymph nodes,
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Razširil se je že na limfne žleze,
09:11
so we used an antiangiogenic skin cream for the lip
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zato smo uporabili antiangiogeno kremo za ustnico
09:14
and an oral cocktail, so we could treat from the inside
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in mešanico zdravil, da smo lahko
09:17
as well as the outside.
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konja zdravili notranje in zunanje.
09:19
And over the course of six months,
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Po šestih mesecih
09:21
he experienced a complete remission.
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se je rak popolnoma umaknil.
09:24
And here he is six years later,
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Tukaj ga vidimo šest let pozneje -
09:27
Guinness, with his very happy owner.
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Guiness s svojo srečno lastnico.
09:30
(Applause)
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(aplavz)
09:33
Now, obviously, antiangiogenic therapy
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Antiangiogeno terapijo lahko
09:35
could be used for a wide range of cancers.
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uporabimo za številne vrste raka.
09:38
And, in fact, the first pioneering treatments
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Prve terapije za ljudi
09:40
for people, as well as dogs,
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in za pse
09:42
are already becoming available.
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so že na voljo.
09:44
There's 12 different drugs, 11 different cancer types.
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Imamo 12 različnih zdravil za 11 različnih vrst raka,
09:47
But the real question is:
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a pravo vprašanje je:
09:49
How well do these work in practice?
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Kako učinkovita so v praksi?
09:51
So here's actually the patient survival data
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To so podatki o preživetju bolnikov
09:54
from eight different types of cancer.
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za osem različnih vrst raka.
09:56
The bars represent survival time
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Grafikon kaže preživetje v letih
09:58
taken from the era
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iz obdobja, ko smo
10:00
in which there was only chemotherapy,
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imeli na voljo le kemoterapijo,
10:02
or surgery, or radiation available.
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operacijo ali obsevanje.
10:05
But starting in 2004,
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Od leta 2004,
10:07
when antiangiogenic therapies first became available,
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od prve uporabe antiangiogene terapije,
10:09
well you can see that there has been
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se je, kot vidite,
10:11
a 70 to 100 percent
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preživetje bolnikov podaljšalo
10:13
improvement in survival
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za od 70 do 100 odstotkov
10:15
for people with kidney cancer, multiple myeloma,
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za bolnike z rakom ledvic, kostnega mozga,
10:18
colorectal cancer, and gastrointestinal stromal tumors.
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debelega črevesa in danke ter rakom prebavil.
10:22
That's impressive.
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To je res velik uspeh.
10:24
But for other tumors and cancer types,
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A pri drugih vrstah raka
10:27
the improvements have only been modest.
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je prišlo le do skromnega izboljšanja.
10:30
So I started asking myself,
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Zato sem se vprašal:
10:32
"Why haven't we been able to do better?"
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"Zakaj nismo dosegli več?"
10:35
And the answer, to me, is obvious;
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Odgovor mi je popolnoma jasen:
10:37
we're treating cancer too late in the game,
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zato ker zdravimo raka prepozno,
10:39
when it's already established
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ko se je že razvil
10:41
and, oftentimes, it's already spread or metastasized.
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in pogosto že razširil v obliki metastaz.
10:44
And as a doctor, I know
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Kot zdravnik vem,
10:46
that once a disease progresses to an advanced stage,
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da je ozdravitev težka,
10:49
achieving a cure
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če ne celo nemogoča,
10:51
can be difficult, if not impossible.
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ko bolezen enkrat napreduje.
10:54
So I went back to the biology
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Zato sem se vrnil
10:56
of angiogenesis
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k biologiji angiogeneze
10:58
and started thinking:
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in začel razmišljati:
11:00
Could the answer to cancer
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Ali bi lahko raka premagali
11:02
be preventing angiogenesis,
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z zaustavitvijo angiogeneze?
11:05
beating cancer at its own game
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Ali lahko premagamo raka,
11:07
so the cancers could never become dangerous?
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še preden postane nevaren?
11:11
This could help healthy people
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To bi lahko pomagalo tako zdravim ljudem
11:13
as well as people who've already beaten cancer
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kakor tistim, ki so že
11:15
once or twice
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premagali raka in želijo
11:17
and want to find a way to keep it from coming back.
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preprečiti njegovo ponovitev.
11:20
So to look for a way to prevent angiogenesis in cancer,
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Hotel sem preprečiti angiogenezo pri raku,
11:23
I went back to look at cancer's causes.
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zato sem si ponovno ogledal vzroke raka.
11:25
And what really intrigued me
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Zanimanje mi je zbudilo dejstvo,
11:27
was when I saw that diet
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da predstavlja prehrana
11:29
accounts for 30 to 35 percent
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kar od 30 do 35 odstotkov
11:31
of environmentally caused cancers.
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zunanjih dejavnikov, ki povzročajo raka.
11:34
Now, the obvious thing is to think about
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Najprej bi seveda pomislili,
11:36
what we could remove from our diet, what to strip out, take away.
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kaj naj umaknemo, odstranimo iz prehrane.
11:40
But I actually took a completely opposite approach
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Jaz pa sem se tega lotil ravno obratno:
11:43
and began asking: What could we be adding to our diet
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kaj naj dodamo prehrani,
11:46
that's naturally antiangiogenic,
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kaj je naravno antiangiogeno zdravilo,
11:49
that could boost the body's defense system
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ki lahko izboljša obrambni mehanizem telesa
11:51
and beat back those blood vessels that are feeding cancers?
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in premaga krvne žile, ki hranijo tumor?
11:54
In other words, can we eat to starve cancer? (Laughter)
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Ali lahko s hrano izstradamo raka?
11:58
Well, the answer's yes,
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Odgovor je - da.
12:00
and I'm going to show you how.
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Pokazal vam bom, kako.
12:02
Our search for this
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Raziskava nas je popeljala
12:04
has taken us to the market, the farm and to the spice cabinet,
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na tržnico, na kmetije in med začimbe,
12:07
because what we've discovered
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saj smo odkrili,
12:09
is that mother nature has laced a large number
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da je mati narava številnim
12:11
of foods and beverages and herbs
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živilom, pijačam in zeliščem
12:13
with naturally occurring inhibitors
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dodala naravne zaviralce
12:15
of angiogenesis.
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angiogeneze.
12:17
So here's a test system we developed.
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To je naš testni sistem.
12:19
At the center is a ring from which hundreds of blood vessels
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V središču je krog, iz katerega rastejo
12:21
are growing out in a starburst fashion.
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krvne žile kot eksplozija zvezde.
12:23
And we can use this system
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To lahko uporabimo
12:25
to test dietary factors
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za testiranje učinkovin iz prehrane
12:27
at concentrations that are obtainable by eating.
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v količinah, ki jih dobimo s hrano.
12:30
So let me show you what happens when we put in
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Poglejmo, kaj se zgodi,
12:32
an extract from red grapes.
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če dodamo izvleček rdečega grozdja.
12:35
The active ingredient's resveratrol,
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Učinkovina se imenuje resveratrol.
12:37
it's also found in red wine.
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Nahaja se tudi v rdečem vinu.
12:39
This inhibits abnormal angiogenesis
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Resveratrol zavira nepravilno angiogenezo
12:42
by 60 percent.
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za 60 odstotkov.
12:44
Here's what happens when we added an extract from strawberries;
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To se zgodi, če dodamo izvleček jagod.
12:47
it potently inhibits angiogenesis.
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Močno zavira angiogenezo.
12:50
And extract from soybeans.
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Še izvleček soje.
12:54
And here is a growing list of our
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To je vedno daljši seznam
12:56
antiangiogenic foods and beverages
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antiangiogenih živil in pijače,
12:58
that we're interested in studying.
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ki jih želimo preučiti.
13:00
For each food type,
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Različne vrste hrane imajo
13:02
we believe that there are different potencies
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različno močan učinek,
13:04
within different strains and varietals.
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glede na vrsto ali sorto rastline.
13:07
And we want to measure this because,
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To bi radi izmerili.
13:09
well, while you're eating a strawberry
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Ko jeste jagode
13:11
or drinking tea,
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ali pijete čaj,
13:13
why not select the one that's most potent
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se splača izbrati najbolj učinkovito
13:15
for preventing cancer.
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vrsto za preprečevanje raka.
13:17
So here are four different teas that we've tested.
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To so štiri vrste čaja, ki smo jih testirali.
13:20
They're all common ones:
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Vsi so precej običajni:
13:22
Chinese jasmine, Japanese sencha,
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kitajski jasminov čaj, japonski sencha,
13:24
Earl Grey and a special blend that we prepared.
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Earl Grey in naša posebna mešanica.
13:26
And you can see clearly
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Jasno lahko vidite,
13:28
that the teas vary in their potency
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da so različno učinkoviti,
13:30
from less potent to more potent.
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nekateri bolj, drugi manj.
13:33
But what's very cool
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Najboljše odkritje pa je,
13:35
is when we actually combined the two
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da je mešanica
13:37
less potent teas together,
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dveh manj močnih čajev,
13:39
the combination, the blend,
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nova kombinacija,
13:41
is more potent than either one alone.
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močnejša od vsakega posebej.
13:44
This means there's food synergy.
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Sinergija hrane torej obstaja.
13:49
Here's some more data from our testing.
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Še nekaj podatkov iz naših poskusov.
13:51
Now, in the lab, we can simulate tumor angiogenesis
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V laboratoriju lahko simuliramo angiogenezo tumorja,
13:54
represented here in a black bar.
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ki jo predstavlja črna črta.
13:56
And using this system, we can test the potency of cancer drugs.
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Tako lahko preverimo učinkovitost zdravil proti raku.
13:59
So the shorter the bar,
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Krajša črta pomeni
14:01
less angiogenesis, that's good.
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manj angiogeneze, kar je dobro.
14:04
And here are some common drugs
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To pa je nekaj običajnih zdravil,
14:06
that have been associated with reducing the risk
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ki so povezana z zmanjšanjem tveganja
14:08
of cancer in people.
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za nastanek raka pri ljudeh.
14:10
Statins, nonsteroidal anti-inflammatory drugs
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Statini, nesteroidna protivnetna zdravila
14:12
and a few others,
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in še nekaj drugih -
14:14
they inhibit angiogenesis too.
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tudi ta zdravila zavirajo angiogenezo.
14:17
And here are the dietary factors
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Pa poglejmo še živila
14:19
going head to head against these drugs.
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in jih primerjajmo z zdravili.
14:22
You can see, they clearly hold their own
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Kot vidite, so jim kos,
14:24
and, in some cases, they're more potent
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v nekaterih primerih
14:26
than the actual drugs.
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so celo učinkovitejša od zdravil.
14:28
Soy, parsley, garlic,
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Soja, peteršilj, česen,
14:30
grapes, berries;
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grozdje, jagodičevje.
14:32
I could go home and cook a tasty meal
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Vsakdo lahko doma skuha slasten obrok
14:34
using these ingredients.
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iz teh sestavin.
14:36
So imagine if we could create
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Predstavljajte si
14:38
the world's first rating system
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prvo svetovno lestvico
14:40
in which we could score foods
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za ocenjevanje hrane
14:42
according to their antiangiogenic,
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glede na njene antiangiogene lastnosti,
14:44
cancer-preventative properties.
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ki preprečujejo raka.
14:46
And that's what we're doing right now.
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To pripravljamo zdaj.
14:49
Now, I've shown you a bunch of lab data,
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Pokazal sem vam laboratorijske podatke,
14:51
and so the real question is:
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a pravo vprašanje je:
14:53
What is the evidence in people
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Ali je kakšen dokaz,
14:55
that eating certain foods can reduce
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da uživanje določene hrane
14:57
angiogenesis in cancer?
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zmanjša angiogenezo pri raku?
15:00
Well, the best example I know
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Najboljši primer, ki ga poznam,
15:02
is a study of 79,000 men
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je študija, v kateri so 20 let
15:04
followed over 20 years,
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spremljali 79.000 moških:
15:06
in which it was found that men who consumed
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pri moških, ki so jedli
15:08
cooked tomatoes two to three times a week
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kuhan paradižnik dva- do trikrat na teden,
15:10
had up to a 50 percent reduction
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se je tveganje raka na prostati
15:13
in their risk of developing prostate cancer.
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zmanjšalo za do 50 odstotkov.
15:16
Now, we know that tomatoes are a good source of lycopene,
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Paradižnik je dober vir likopena,
15:19
and lycopene is antiangiogenic.
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likopen pa je antiangiogen.
15:22
But what's even more interesting from this study
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Še bolj zanimivo v tej študiji je,
15:24
is that in those men who did develop prostate cancer,
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da so moški, pri katerih se je rak prostate razvil,
15:27
those who ate more servings of tomato sauce
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vendar so pogosto jedli paradižnikovo omako,
15:30
actually had fewer blood vessels
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imeli manj krvnih žil,
15:32
feeding their cancer.
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ki so hranile raka.
15:34
So this human study is a prime example
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Ta študija na ljudeh je odličen primer,
15:36
of how antiangiogenic substances
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kako lahko antiangiogene snovi,
15:38
present in food and consumed at practical levels
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ki so prisotne v hrani, in jih pojemo,
15:41
can impact on cancer.
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vplivajo na raka.
15:43
And we're now studying
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Zdaj z Deanom Ornishem, Kalifornijsko univerzo in Univerzo Tufts
15:45
the role of a healthy diet
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proučujemo vlogo
15:47
with Dean Ornish at UCSF and Tufts University
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zdrave prehrane in
15:50
on the role of this healthy diet on markers of angiogenesis
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njen vpliv na markerje angiogeneze,
15:53
that we can find in the bloodstream.
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ki jih lahko najdemo v krvi.
15:56
Now, obviously, what I've shared with you has some far-ranging implications,
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Naša dognanja imajo daljnosežne posledice,
15:59
even beyond cancer research.
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ne samo za raziskave raka.
16:01
Because if we're right, it could impact on consumer education,
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Če imamo prav, bo to vplivalo na izobraževanje potrošnikov,
16:04
food services, public health
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gostinstvo, javno zdravstvo
16:06
and even the insurance industry.
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in celo na zavarovalnice.
16:08
And, in fact, some insurance companies
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Nekatere zavarovalnice so
16:10
are already beginning to think along these lines.
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že začele razmišljati v to smer.
16:12
Check out this ad from Blue Cross Blue Shield of Minnesota.
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Poglejte oglas zavarovalnice Blue Cross Blue Shield iz Minnesote.
16:16
And for many people around the world,
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Za mnoge ljudi na svetu
16:18
dietary cancer prevention
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je preventiva s prehrano
16:20
may be the only practical solution
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morda edina praktična rešitev,
16:22
because not everybody can afford expensive end-stage cancer treatments,
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saj si ne morejo vsi privoščiti dragega zdravljenja,
16:25
but everybody could benefit from
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a vsakomur lahko koristi zdrava prehrana,
16:27
a healthy diet based on local, sustainable,
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ki temelji na antiangiogeni hrani,
16:30
antiangiogenic crops.
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pridelani lokalno in sonaravno.
16:33
Now, finally,
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Za konec še to:
16:35
I've talked to you about food,
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govoril sem o hrani
16:37
and I've talked to you about cancer,
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in govoril sem o raku.
16:39
so there's just one more disease that I have to tell you about
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Omeniti moram le še eno bolezen
16:42
and that's obesity.
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in to je debelost.
16:44
Because it turns out that
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Ugotovili smo namreč,
16:46
adipose tissue, fat,
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da je adipozno tkivo, maščobno tkivo,
16:48
is highly angiogenesis dependent.
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močno odvisno od angiogeneze.
16:50
And, like a tumor, fat grows when blood vessels grow.
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Kot tumor tudi maščobno tkivo raste zaradi krvnih žil.
16:53
So the question is: Can we shrink fat
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Ali torej lahko zmanjšamo maščobno tkivo tako,
16:56
by cutting off its blood supply?
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da mu prekinemo oskrbo s krvjo?
16:58
So the top curve shows the body weight
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Zgornja krivulja kaže težo
17:01
of a genetically obese mouse
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genetsko debele miške,
17:03
that eats nonstop
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ki brez prestanka jé,
17:05
until it turns fat, like this furry tennis ball.
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dokler se ne spremeni v kosmato žogico.
17:09
And the bottom curve is the weight of a normal mouse.
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Spodnja krivulja je teža normalne miške.
17:12
If you take the obese mouse and give it
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Če debeli miški damo nekaj,
17:14
an angiogenesis inhibitor, it loses weight.
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kar zavira angiogenezo, shujša.
17:16
Stop the treatment, gains the weight back.
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Če prekinemo zdravljenje, se spet zredi.
17:18
Restart the treatment, loses the weight again.
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Ponovimo zdravljenje, spet shujša.
17:20
Stop the treatment, it gains the weight back.
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Prekinemo zdravljenje, se spet zredi.
17:22
And, in fact, you can cycle the weight up and down
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Tako lahko spreminjamo njeno težo
17:24
simply by inhibiting angiogenesis.
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samo z uravnavanjem angiogeneze.
17:27
So this approach that we're taking for cancer prevention
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Način, s katerim preprečujemo raka,
17:29
may also have an application
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lahko uporabimo
17:31
for obesity.
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tudi za zdravljenje debelosti.
17:33
The really, truly interesting thing about this
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Resnično zanimivo pri tem pa je,
17:35
is that we can't take these obese mice
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da debele miške
17:37
and make them lose more weight
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ne morejo shujšati za več,
17:39
than what the normal mouse's weight is supposed to be.
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kot je normalna mišja teža.
17:42
In other words, we can't create supermodel mice.
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Torej ne moremo ustvariti mišjih supermanekenk.
17:44
(Laughter)
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(smeh)
17:46
And this speaks to the role of angiogenesis
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To dokazuje pomen angiogeneze
17:48
in regulating healthy set points.
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pri uravnavanju zdravega, normalnega stanja telesa.
17:51
Albert Szent-Gyorgi once said that,
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Nobelovec Albert Szent-Gyorgi je dejal:
17:53
"Discovery consists of seeing what everyone has seen,
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„Odkritje je videti to, kar so videli vsi,
17:56
and thinking what no one has thought."
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in pomisliti nekaj, česar ni pomislil nihče.“
17:58
I hope I've convinced you
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Upam, da sem vas prepričal,
18:00
that, for diseases like cancer, obesity and other conditions,
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da nam pri boleznih, kot so rak, debelost in druge,
18:03
that there may be a great power
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lahko izredno pomaga,
18:05
in attacking their common denominator: angiogenesis.
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če se lotimo skupnega imenovalca, angiogeneze.
18:08
And that's what I think the world needs now. Thank you.
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Menim, da svet to zdaj potrebuje. Hvala.
18:11
(Applause)
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(aplavz)
18:22
June Cohen: I have a quick question for you. So these drugs aren't exactly ...
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Ta zdravila torej niso ravno ...
18:25
they're not exactly in mainstream cancer treatments right now.
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Trenutno niso ravno standarden način zdravljenja raka.
18:28
For anyone out here who has cancer,
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Kaj bi priporočili
18:30
what would you recommend?
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bolnikom z rakom?
18:32
Do you recommend pursuing these treatments now, for most cancer patients?
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Naj večina bolnikov poskusi ta zdravila?
18:35
William Li: So there are antiangiogenic treatments
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Na trgu so že antiangiogena zdravila,
18:37
that are FDA approved,
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ki jih je odobrila Ameriška agencija za zdravila.
18:39
and if you're a cancer patient
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Bolniki z rakom,
18:41
or working for one or advocating for one,
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njihovi sorodniki ali zastopniki -
18:43
you should ask about them.
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vsekakor povprašajte po njih.
18:45
And there are many clinical trials.
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Potekajo tudi številne klinične raziskave.
18:48
The Angiogenesis Foundation is following almost 300 companies,
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Ameriška fundacija za angiogenezo spremlja skoraj 300 podjetij,
18:51
and there are about 100 more
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v pripravi pa je tudi
18:53
drugs in that pipeline.
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okoli 100 novih zdravil.
18:55
So consider the approved ones,
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Razmislite o obstoječih zdravilih,
18:57
look for clinical trials,
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poiščite klinične raziskave,
18:59
but then between what the doctor can do for you,
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a poleg zdravstvene oskrbe
19:01
we need to start asking what can we do for ourselves.
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se vprašajte tudi, kaj lahko sami storite.
19:03
And this is one of the themes that I'm talking about
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O tem govorim:
19:05
is we can empower ourselves to do the things
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lahko se ozavestimo in naredimo zase to,
19:07
that doctors can't do for us,
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česar zdravniki ne morejo.
19:09
which is to use knowledge and take action.
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Uporabimo torej znanje in ukrepajmo.
19:11
And if Mother Nature has given us some clues,
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Mati narava nam je pustila sledi
19:14
we think that there might be a new future
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in menimo, da je prihodnost
19:16
in the value of how we eat.
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morda v kakovostni hrani.
19:18
And what we eat is really our chemotherapy three times a day.
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Naša hrana je trikrat na dan naša kemoterapija.
19:21
JC: Right. And along those lines,
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V zvezi s tem me zanima,
19:23
for people who might have risk factors for cancer,
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ali ljudem s povišanim tveganjem za raka
19:26
would you recommend pursuing any treatments sort of prophylactically
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priporočate preventivno zdravljenje
19:29
or simply pursuing the right diet
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ali le pravo prehrano
19:31
with lots of tomato sauce?
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z veliko paradižnikove omake?
19:33
WL: Well, you know, there's abundant epidemiological evidence.
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Epidemiološki dokazi so številni.
19:36
And I think in the information age,
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Mislim, da v informacijski dobi
19:38
it doesn't take long to go to a credible source
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ne potrebujete veliko časa za iskanje verodostojnega vira,
19:40
like PubMed, the National Library of Medicine,
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kot je Nacionalna medicinska knjižnica Pubmed,
19:42
to look for epidemiological studies
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in poiščete epidemiološke raziskave
19:44
for cancer risk reduction
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o zmanjšanju tveganja raka
19:46
based on diet and based on common medications.
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s pravo prehrano in običajnimi zdravili.
19:49
And that's certainly something that anybody can look into.
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To vsekakor lahko vsakdo razišče sam.
19:51
JC: Okay. Well, thank you so much.
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Najlepša hvala.
19:53
(Applause)
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(aplavz)
ABOUT THE SPEAKER
William Li - Cancer researcherWilliam Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting.
Why you should listen
Many of society’s most devastating diseases -- cancer, cardiovascular disease, diabetes and Alzheimer’s, to name a few -- share a common denominator: faulty angiogenesis, the body’s growth of new capillary blood vessels. Given excessive or insufficient blood vessel growth, serious health issues arise. While researching under Harvard surgeon Judah Folkman, who pioneered the study of angiogenesis, Li learned how angiogenesis-based medicine helps patients overcome numerous diseases by restoring the balance of blood-vessel growth.
Li co-founded the Angiogenesis Foundation in 1994. The foundation’s Project ENABLE -- a global system that integrates patients, medical experts and healthcare professionals -- democratizes the spread and implementation of knowledge about angiogenesis-based medicines, diet and lifestyle. Some 40,000 physicians have been educated on new treatments, ranging from cancer care to wound care, by the foundation’s faculty of medical experts, and they are bringing new, lifesaving and disease-preventing techniques to people around the world.
William Li | Speaker | TED.com