TEDMED 2010
Danny Hillis: Understanding cancer through proteomics
Deni Hilis: Proteomikom do odgonetanja tajne raka
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Deni Hilis objašnjava značajnu novu metodologiju koja ima potencijal da nam pomogne da rešimo misetrije raka: proteomiku, metodologiju koja se bavi razumevanjem strukture i funkcije proteina u našem telu. Hilis nam objašnjava da nam genomika daje informacije o listama "gradivnih blokova" koji sačinjavaju naš organizam, dok sa druge strane - proteomika odgovara na pitanje šta je genomom kodirano, koji su to "životni sastojci" u našem telu. Razumevanje biologije tih vrednih pčela našeg organizma, proteina, može dovesti do boljeg razumevanja procesa maligne transformacije.
Danny Hillis - Computer theorist
Inventor, scientist, author, engineer -- over his broad career, Danny Hillis has turned his ever-searching brain on an array of subjects, with surprising results. Full bio
Inventor, scientist, author, engineer -- over his broad career, Danny Hillis has turned his ever-searching brain on an array of subjects, with surprising results. Full bio
Double-click the English transcript below to play the video.
00:15
I admit that I'm a little bit nervous here
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Moram priznati da sam malo nervozan s obzirom
00:18
because I'm going to say some radical things,
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da planiram da predstavim večeras veoma radikalne ideje
00:21
about how we should think about cancer differently,
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koje imaju za cilj da promene naš generalni pogled na rak
00:24
to an audience that contains a lot of people
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ispred veoma mnogo ljudi
00:26
who know a lot more about cancer than I do.
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koji znaju znatno više o raku u poređenju sa mnom.
00:30
But I will also contest that I'm not as nervous as I should be
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Ali moram priznati da nisam onoliko nervozan koliko bi se to očekivalo
00:33
because I'm pretty sure I'm right about this.
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jer sam poprilično siguran da sam u pravu.
00:35
(Laughter)
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(Smeh)
00:37
And that this, in fact, will be
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Tvrdim da će ovo zaista biti
00:39
the way that we treat cancer in the future.
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način lečenja raka u budućnosti.
00:43
In order to talk about cancer,
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Kako bih mogao da pričam sa vama o raku,
00:45
I'm going to actually have to --
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moraću da vam pokažem
00:48
let me get the big slide here.
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ovaj ogroman slajd.
00:53
First, I'm going to try to give you a different perspective of genomics.
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Pre svega, želim da vam predstavim drugačiji pogled na genomiku.
00:56
I want to put it in perspective of the bigger picture
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Želim da posmatramo genomiku iz šire perspektive,
00:58
of all the other things that are going on --
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koja uključuje različita znanja do kojih dolazimo
01:01
and then talk about something you haven't heard so much about, which is proteomics.
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a potom želim da govorim o metodologiji o kojoj niste mnogo čuli, a to je proteomika.
01:04
Having explained those,
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Mislim da ćemo, nakon objašnjenja koja će uslediti,
01:06
that will set up for what I think will be a different idea
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biti spremni da govorimo o novoj i drugačijoj ideji
01:09
about how to go about treating cancer.
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o lečenju raka.
01:11
So let me start with genomics.
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Pa, hajde da počnemo sa objašnjenjem genomike.
01:13
It is the hot topic.
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Danas je to poprilično popularna tema.
01:15
It is the place where we're learning the most.
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To je oblast u kojoj najviše učimo.
01:17
This is the great frontier.
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To je tehnologija koja ima velike potencijale,
01:19
But it has its limitations.
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ali isto tako ima i svoja ograničenja.
01:22
And in particular, you've probably all heard the analogy
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Naročito bih naglasio da ste svi vi čuli analogiju
01:25
that the genome is like the blueprint of your body,
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koja govori da je vaš genom zapravo slika vašeg tela.
01:28
and if that were only true, it would be great,
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I kada bi to bilo tačno, to bi bilo odlično,
01:30
but it's not.
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ali nije. To je nešto
01:32
It's like the parts list of your body.
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kao lista sastavnih delova vašeg tela.
01:34
It doesn't say how things are connected,
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Ne govori ništa o tome kako su komponente vašeg organizma
01:36
what causes what and so on.
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povezane, šta uzrokuje koji proces i tako dalje.
01:39
So if I can make an analogy,
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Tako da bih ja želeo da napravim ovde jednu analogiju,
01:41
let's say that you were trying to tell the difference
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recimo da vi želite da objasnite razliku
01:43
between a good restaurant, a healthy restaurant
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između dobrog restorana, restorana zdrave hrane,
01:46
and a sick restaurant,
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i restorana brze hrane,
01:48
and all you had was the list of ingredients
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i sve što imate na raspolaganju jeste lista sastojaka
01:50
that they had in their larder.
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koji pomenuti restorani imaju u svojoj ostavi.
01:53
So it might be that, if you went to a French restaurant
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Tako možemo zamisliti, da ukoliko ste analizirali listu
01:56
and you looked through it and you found
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sastojaka koju koristi francuski restoran i pri tome pronašli
01:58
they only had margarine and they didn't have butter,
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da oni koriste samo margarin i da nemaju puter u ostavi,
02:00
you could say, "Ah, I see what's wrong with them.
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mogli biste da kažete : "Ah, pa vidim zašto je ovde hrana loša.
02:02
I can make them healthy."
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Mogu da im pomognem da pređu na zdrav način."
02:04
And there probably are special cases of that.
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I verovatno postoje izdvojeni slučajevi kao ovaj.
02:06
You could certainly tell the difference
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Mogli biste da uočite razliku
02:08
between a Chinese restaurant and a French restaurant
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između kineskog i francuskog restorana
02:10
by what they had in a larder.
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na osnovu liste sastojaka koje možete naći u njihovoj ostavi.
02:12
So the list of ingredients does tell you something,
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Tako da vam definitivno lista sastojaka nešto govori,
02:15
and sometimes it tells you something that's wrong.
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i ponekada možete na osnovu iste zaključiti šta je loše.
02:19
If they have tons of salt,
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Ukoliko ste pronašli velike količine soli,
02:21
you might guess they're using too much salt, or something like that.
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možete pretpostaviti da oni koriste previše soli ili nešto slično.
02:24
But it's limited,
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Ali te informacije imaju limitirani kapacitet,
02:26
because really to know if it's a healthy restaurant,
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jer da biste znali da li je to restoran zdrave hrane,
02:28
you need to taste the food, you need to know what goes on in the kitchen,
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morate probati hranu, morate znati šta se dešava u kuhinji,
02:31
you need the product of all of those ingredients.
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neophodan vam je kranji produkt koji nastaje sjedinjavanjem tih sastojaka.
02:34
So if I look at a person
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Tako da ukoliko ja pogledam jednu osobu
02:36
and I look at a person's genome, it's the same thing.
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i analiziram genom te osobe, to je apsolutno ista stvar.
02:39
The part of the genome that we can read
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Deo genoma koji mi možemo dešifrovati
02:41
is the list of ingredients.
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je ništa drugo do lista sastojaka.
02:43
And so indeed,
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I naravno,
02:45
there are times when we can find ingredients
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ponekada možemo naći sastojke
02:47
that [are] bad.
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koji su loši.
02:49
Cystic fibrosis is an example of a disease
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Cistična fibroza jeste odličan primer bolesti tog tipa
02:51
where you just have a bad ingredient and you have a disease,
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gde imate loš sastojak i imate bolest
02:54
and we can actually make a direct correspondence
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i mi u ovom slučaju možemo napraviti direktnu vezu
02:57
between the ingredient and the disease.
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između "sastojka" i bolesti.
03:00
But most things, you really have to know what's going on in the kitchen,
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Ali u većini slučajeva, vi morate znati šta se dešava u kuhinji,
03:03
because, mostly, sick people used to be healthy people --
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s obzirom da su bolesni ljudi najčešće bili pre toga zdravi -
03:05
they have the same genome.
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što znači da imaju isti genom.
03:07
So the genome really tells you much more
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Tako da vam genom moze reći mnogo više
03:09
about predisposition.
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o određenim predispozicijama.
03:11
So what you can tell
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Ono sto vi možete prepoznati
03:13
is you can tell the difference between an Asian person and a European person
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jeste razlika između Azijata i Evropljana
03:15
by looking at their ingredients list.
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na osnovu analize njihove liste sastojaka.
03:17
But you really for the most part can't tell the difference
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Ali u realnosti vi najčešće ne možete uočiti razliku
03:20
between a healthy person and a sick person --
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između zdrave i bolesne osobe
03:23
except in some of these special cases.
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sem u specifičnim slučajevima.
03:25
So why all the big deal
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Usled čega se pravi onda velika pompa
03:27
about genetics?
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oko genetike?
03:29
Well first of all,
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Pa, pre svega,
03:31
it's because we can read it, which is fantastic.
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mi genom možemo da "pročitamo", što je fantastično.
03:34
It is very useful in certain circumstances.
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U određenim situacijama to je veoma korisno.
03:37
It's also the great theoretical triumph
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Takođe, predstavlja neverovatan teoretski uspeh
03:40
of biology.
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biologije.
03:42
It's the one theory
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To je jedina teorija
03:44
that the biologists ever really got right.
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oko koje su biolozi ikada bili u pravi.
03:46
It's fundamental to Darwin
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To je fundamentalna osnova Darvinove teorije
03:48
and Mendel and so on.
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kao i Mendelove teorije nasleđivanja.
03:50
And so it's the one thing where they predicted a theoretical construct.
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To je otkriće kojim su biolozi u mogućnosti da predivide teorijski konstrukt.
03:54
So Mendel had this idea of a gene
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Mendel je imao ideju o genima
03:56
as an abstract thing,
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u apstraktnom smislu.
03:59
and Darwin built a whole theory
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I Darvin je uspostavio čitavu teoriju
04:01
that depended on them existing,
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koja u potpunosti zavisi od postojanja gena.
04:03
and then Watson and Crick
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I kada su Vatson i Krik proučavali
04:05
actually looked and found one.
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nasledne jedinice, napokon su ih i pronašli.
04:07
So this happens in physics all the time.
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Ovo se dešava u fizici sve vreme.
04:09
You predict a black hole,
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Vi predvidite postojanje crne rupe,
04:11
and you look out the telescope and there it is, just like you said.
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pogledate kroz teleskop i pronađete je, baš kao što ste i rekli.
04:14
But it rarely happens in biology.
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Ali to se retko dešava u biologiji.
04:16
So this great triumph -- it's so good,
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Tako da je ovaj fantastičan trijumf - toliko fascinirajući -
04:19
there's almost a religious experience
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da je to skoro religiozno iskustvo
04:21
in biology.
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u biologiji.
04:23
And Darwinian evolution
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I Darvinova teorije evolucije
04:25
is really the core theory.
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jeste zaista centralna teorija.
04:30
So the other reason it's been very popular
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I drugi razlog popularnosti genetike
04:32
is because we can measure it, it's digital.
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jeste činjenica da je digitalna, genom možete da izmerite.
04:35
And in fact,
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I u stvari,
04:37
thanks to Kary Mullis,
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zahvaljujući Kariju Malisu,
04:39
you can basically measure your genome in your kitchen
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vi možete izmeriti svoj genom u kuhinji
04:43
with a few extra ingredients.
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uz pomoć nekoliko ekstra sastojaka.
04:46
So for instance, by measuring the genome,
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Na primer, odgonetajući genom,
04:49
we've learned a lot about how we're related to other kinds of animals
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naučili smo koliko smo srodni sa ostalim životinjskim vrstama
04:53
by the closeness of our genome,
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na osnovu sličnosti naših genoma,
04:56
or how we're related to each other -- the family tree,
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ili kako smo međusobno povezani - porodično stablo,
04:59
or the tree of life.
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ili stablo života.
05:01
There's a huge amount of information about the genetics
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Možemo doći do mnogo informacija o genetici
05:04
just by comparing the genetic similarity.
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na osnovu jednostavnog poređenja genetičkih sličnosti.
05:07
Now of course, in medical application,
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Naravno i primena ovih znanja u medicini,
05:09
that is very useful
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je jako korisna
05:11
because it's the same kind of information
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s obzirom da je to isti tip informacije
05:14
that the doctor gets from your family medical history --
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koji doktor dobija analizirajući istoriju bolesti vaše famlije,
05:17
except probably,
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sa tom razlikom da najverovatnije
05:19
your genome knows much more about your medical history than you do.
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vaš genom zna mnogo više o vašoj istoriji bolesti od vas samih.
05:22
And so by reading the genome,
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Tako da dešifrujući genom, možemo
05:24
we can find out much more about your family than you probably know.
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da saznamo mnogo više o vašoj porodici nego što vi sami znate.
05:27
And so we can discover things
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Tako da možemo da otkrijemo činjenice
05:29
that probably you could have found
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do kojih biste i vi sami mogli doći
05:31
by looking at enough of your relatives,
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ukoliko biste ispitali dovoljno vaših rođaka,
05:33
but they may be surprising.
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ali te činjenice mogu da budu iznenađujuće.
05:36
I did the 23andMe thing
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Ja sam uradio "23 i ja" test i
05:38
and was very surprised to discover that I am fat and bald.
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bio sam veoma iznenađen kad sam otkrio da sam debeo i ćelav.
05:41
(Laughter)
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(Smeh)
05:48
But sometimes you can learn much more useful things about that.
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Ali ponekada možete saznati mnogo korisnije informacije o tome.
05:51
But mostly
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Ali najčešće ono što je
05:54
what you need to know, to find out if you're sick,
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vama potrebno da znate da li ste bolesni
05:56
is not your predispositions,
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nisu vaše predispozicije, nego
05:58
but it's actually what's going on in your body right now.
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ono što se zaista događa u datom trenutku u vašem telu.
06:01
So to do that, what you really need to do,
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A da biste to uradili, ono što je zaista neophodno
06:03
you need to look at the things
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da uradite jeste da sagledate
06:05
that the genes are producing
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produkte kodirane vašim genima
06:07
and what's happening after the genetics,
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i šta se dešava nizvodno od nivoa genetike.
06:09
and that's what proteomics is about.
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To je ono što definiše proteomiku.
06:11
Just like genome mixes the study of all the genes,
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Baš kao što genomika ispituje sve gene,
06:14
proteomics is the study of all the proteins.
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proteomika se bavi izučavanjem svih proteina jednog organizma.
06:17
And the proteins are all of the little things in your body
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A proteini su "radilice" vašeg organizma
06:19
that are signaling between the cells --
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koje prenose informacije između ćelija
06:22
actually, the machines that are operating --
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u principu mašine koje odrađuju sve funkcije organizma.
06:24
that's where the action is.
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Proteini su nosioci radnih delatnosti.
06:26
Basically, a human body
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U principu, ljudsko telo
06:29
is a conversation going on,
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jeste komunikacija, razgovor na globalnom nivou,
06:32
both within the cells and between the cells,
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i to na oba nivoa, i u ćeliji i između ćelija,
06:35
and they're telling each other to grow and to die,
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i oni saopštavaju jedni drugima da rastu i da umiru.
06:38
and when you're sick,
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A kada ste bolesni, to znači
06:40
something's gone wrong with that conversation.
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da je došlo do greške u tom razgovoru.
06:42
And so the trick is --
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Tako da je trik u tome da -
06:44
unfortunately, we don't have an easy way to measure these
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na nesreću, nemamo odgovarajući način da izučavamo proteine
06:47
like we can measure the genome.
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kao što možemo da izučavamo genom.
06:49
So the problem is that measuring --
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Dakle, problem je u tom merenju - ukoliko
06:52
if you try to measure all the proteins, it's a very elaborate process.
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probate da izmerite sve proteine, to je veoma zahtevna procedura.
06:55
It requires hundreds of steps,
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To zahteva stotine pojedinačnih koraka,
06:57
and it takes a long, long time.
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i zahteva mnogo, mnogo vremena.
06:59
And it matters how much of the protein it is.
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I važno je koliko je proteina prisutno.
07:01
It could be very significant that a protein changed by 10 percent,
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Može biti veoma značajno da je 10% proteina promenjeno,
07:04
so it's not a nice digital thing like DNA.
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tako da ovde ne pričamo o finom, digitalnom fenomenu kao što je DNK.
07:07
And basically our problem is somebody's in the middle
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Naš je problem da neko u samoj sredini
07:09
of this very long stage,
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ovog veoma dugog procesa,
07:11
they pause for just a moment,
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pauzira za samo jedan trenutak,
07:13
and they leave something in an enzyme for a second,
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i ostavi nešto u enzimu na samo sekund,
07:15
and all of a sudden all the measurements from then on
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i odjednom, od tog momenta sva merenja koja
07:17
don't work.
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slede ne funkcionišu.
07:19
And so then people get very inconsistent results
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I usled toga ljudi dobijaju veoma nekonzistentne rezultate
07:21
when they do it this way.
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kada pokušaju da rade na opisani način.
07:23
People have tried very hard to do this.
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Ljudi su uložili puno truda kako bi uspeli da urade ovo.
07:25
I tried this a couple of times
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Ja sam probao nekoliko puta
07:27
and looked at this problem and gave up on it.
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skoncentrisao se na problem i odustao od istog.
07:29
I kept getting this call from this oncologist
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Ali me je jedan onkolog zvao telefonom non-stop
07:31
named David Agus.
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po imenu Dejvid Agus.
07:33
And Applied Minds gets a lot of calls
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I mnogi ljudi zovu "Primenjene Umove",
07:36
from people who want help with their problems,
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ljudi koji žele pomoć u rešavanju svojih problema,
07:38
and I didn't think this was a very likely one to call back,
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i nisam mislio da ima mogućnosti de će ovaj zvati ponovo,
07:41
so I kept on giving him to the delay list.
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i tako je razgovor sa njim bio non-stop na listi čekanja.
07:44
And then one day,
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I potom jednog dana,
07:46
I get a call from John Doerr, Bill Berkman
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pozvaše mene Džon Doer, Bil Berkman
07:48
and Al Gore on the same day
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i Al Gor istoga dana
07:50
saying return David Agus's phone call.
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da mi kažu da pozovem Dejvid Agusa.
07:52
(Laughter)
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(Smeh)
07:54
So I was like, "Okay. This guy's at least resourceful."
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I ja pomislih: "Okej, ovaj tip barem ima puno kontakata."
07:56
(Laughter)
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(smeh)
08:00
So we started talking,
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Tako mi počesmo da razgovaramo,
08:02
and he said, "I really need a better way to measure proteins."
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i on mi reče: "Zaista mi je neophodan bolji način da analiziram proteine."
08:05
I'm like, "Looked at that. Been there.
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Ja rekoh, "Već sam razmišljao o tome. Išao sam tim stopama.
08:07
Not going to be easy."
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Ovo neće biti lako."
08:09
He's like, "No, no. I really need it.
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On reče: "Ali ne, ne. Meni je to zaista neophodno.
08:11
I mean, I see patients dying every day
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Ja gledam pacijente kako umiru svakoga dana
08:15
because we don't know what's going on inside of them.
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samo zato što mi ne razumemo šta se dešava u njihovim telima.
08:18
We have to have a window into this."
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Moramo napraviti prozor koji će omogućiti da to sagledamo."
08:20
And he took me through
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Onda mi je izneo specifične primere
08:22
specific examples of when he really needed it.
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situacija u kojima su mu te nove metode apsolutno neophodne.
08:25
And I realized, wow, this would really make a big difference,
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I ja shvatih da ovo zaista može da napravi ogromnu razliku,
08:27
if we could do it,
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ukoliko bismo mogli to da odradimo.
08:29
and so I said, "Well, let's look at it."
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rekao sam, "Pa, hajde da pokušamo."
08:31
Applied Minds has enough play money
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"Primenjeni Umovi" imaju zaista dovoljno para u igri
08:33
that we can go and just work on something
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da možemo jednostavno da radimo na problemu
08:35
without getting anybody's funding or permission or anything.
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bez traženja novih sredstava i specijalnih dozvola ili bilo čega.
08:38
So we started playing around with this.
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Tako da smo počeli da se zanimamo ovim.
08:40
And as we did it, we realized this was the basic problem --
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I dok smo se bavili time, shvatili smo da je to osnovni problem -
08:43
that taking the sip of coffee --
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upravo taj srk kafe
08:45
that there were humans doing this complicated process
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činjenica da su ljudi izvršavali ovu komplikovanu proceduru
08:47
and that what really needed to be done
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i da je zaista bilo neophodno
08:49
was to automate this process like an assembly line
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automatizovati proces kao pokretnu traku
08:52
and build robots
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i napraviti robote
08:54
that would measure proteomics.
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koji bi analizirali proteomiku.
08:56
And so we did that,
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I tako smo to i uradili.
08:58
and working with David,
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Dok sam radio sa Dejvidom, osnovali
09:00
we made a little company called Applied Proteomics eventually,
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smo malu kompaniju koju smo nazvali "Primenjena Proteomika",
09:03
which makes this robotic assembly line,
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koja prozivodi robotizovanu pokretnu traku,
09:06
which, in a very consistent way, measures the protein.
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koja, na veoma konzsistentan način, analizira proteine.
09:09
And I'll show you what that protein measurement looks like.
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I sada ću vam pokazati kako to merenje proteina izgleda.
09:13
Basically, what we do
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U principu, ono što mi radimo je
09:15
is we take a drop of blood
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da uzmemo kap krvi
09:17
out of a patient,
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iz pacijenta
09:19
and we sort out the proteins
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i izolujemo proteine
09:21
in the drop of blood
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u toj kapi krvi
09:23
according to how much they weigh,
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na osnovu onoga koliko su ti proteini teški
09:25
how slippery they are,
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i koliko su pokretljivi,
09:27
and we arrange them in an image.
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i poređamo ih u sveobuhvatnu sliku.
09:30
And so we can look at literally
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Tako da nam to omogućava da bukvalno
09:32
hundreds of thousands of features at once
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analiziramo stotine hiljada karaktersitika u jednom datom
09:34
out of that drop of blood.
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momentu iz samo jedne kapi krvi.
09:36
And we can take a different one tomorrow,
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Sledećeg dana možemo uzeti novu kap
09:38
and you will see your proteins tomorrow will be different --
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i videćete da će vaši proteini sledećeg dana biti drugačiji -
09:40
they'll be different after you eat or after you sleep.
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drugačiji u zavisnosti od toga da li ste upravo jeli ili se probudili.
09:43
They really tell us what's going on there.
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Govore nam o procesima koji se dešavaju u telu čoveka.
09:46
And so this picture,
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Tako da ovde prikazana slika,
09:48
which looks like a big smudge to you,
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koja vama izgleda kao ogromna mrlja,
09:50
is actually the thing that got me really thrilled about this
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je u principu otkriće koje je mene jako uzbudilo
09:54
and made me feel like we were on the right track.
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i zbog kojeg sam pomislio da smo na pravom putu.
09:56
So if I zoom into that picture,
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Ukoliko ja uveličam ovu sliku,
09:58
I can just show you what it means.
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mogu vam pokazati šta to zaista znači.
10:00
We sort out the proteins -- from left to right
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Mi grupišemo proteine: s leva na desno
10:03
is the weight of the fragments that we're getting,
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na osnovu težine fragmenata koje analiziramo.
10:06
and from top to bottom is how slippery they are.
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A od vrha na dole, na osnovu njihove pokretljivosti.
10:09
So we're zooming in here just to show you a little bit of it.
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Sad ćemo uveličati kako bih vam pokazao mali deo.
10:12
And so each of these lines
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Svaka od ovih linija predstavlja
10:14
represents some signal that we're getting out of a piece of a protein.
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u principu neku vrstu signala koju mi dobijamo od dela proteina.
10:17
And you can see how the lines occur
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I isto tako možete primetiti patern linija
10:19
in these little groups of bump, bump, bump, bump, bump.
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- to su male grupe sastavljene od blagih krivina, krivina, krivina, krivina.
10:23
And that's because we're measuring the weight so precisely that --
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To se dešava zato što merimo težinu toliko precizno da -
10:26
carbon comes in different isotopes,
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s obzriom da ugljenik ima različite izotope,
10:28
so if it has an extra neutron on it,
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ukoliko ima jedan dodatni neutron,
10:31
we actually measure it as a different chemical.
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mi u principu učitavamo to kao drugačiju supstancu.
10:35
So we're actually measuring each isotope as a different one.
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Tako da mi beležimo svaki izotop kao drugačiji.
10:38
And so that gives you an idea
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Na osnovu ovoga možete razumeti
10:41
of how exquisitely sensitive this is.
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koliko je fantastično osetljiv opisani sistem.
10:43
So seeing this picture
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Gledanje ove slike
10:45
is sort of like getting to be Galileo
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je slično kao kada bismo bili Galilej
10:47
and looking at the stars
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i gledali u zvezde kroz
10:49
and looking through the telescope for the first time,
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teleskop po prvi put i iznenada
10:51
and suddenly you say, "Wow, it's way more complicated than we thought it was."
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rekli, "Opa, mnogo je komplikovanije nego što smo mislili."
10:54
But we can see that stuff out there
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Ali mi sada možemo da sagledamo taj mali univerzum
10:56
and actually see features of it.
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i uočimo njegove karakteristike.
10:58
So this is the signature out of which we're trying to get patterns.
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Ovo je skup podataka iz kojih pokušavamo da izvučemo obrasce.
11:01
So what we do with this
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Ono što mi radimo sa informacijama ovog tipa
11:03
is, for example, we can look at two patients,
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je da, na primer možemo analizirati dva pacijenta,
11:05
one that responded to a drug and one that didn't respond to a drug,
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jednog koji je reagovao na lek i drugog koji nije,
11:08
and ask, "What's going on differently
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i postaviti pitanje, "Koji je proces koji je drugačiji
11:10
inside of them?"
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u organizmima ovih ljudi?"
11:12
And so we can make these measurements precisely enough
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Takođe možemo da odradimo ta merenja dovoljno precizno
11:15
that we can overlay two patients and look at the differences.
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da možemo da uporedimo dva pacijenta i uočimo razlike.
11:18
So here we have Alice in green
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Ovde možete videti Alis u zelenom kodu
11:20
and Bob in red.
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i Boba predstavljenog crvenim kodom.
11:22
We overlay them. This is actual data.
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Poredimo njihove podatke. Ovo su pravi rezulati.
11:25
And you can see, mostly it overlaps and it's yellow,
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Postoji puno sličnosti i obeležene su žutom bojom
11:28
but there's some things that just Alice has
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ali postoje određeni proteini koje ima samo Alis
11:30
and some things that just Bob has.
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i određeni proteini koje ima samo Bob.
11:32
And if we find a pattern of things
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I ukoliko pronađemo šablon koji opisuje
11:35
of the responders to the drug,
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grupu ljudi na koje postojeći lek ispoljava željeni
11:38
we see that in the blood,
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efekat, mi vidimo to u krvi,
11:40
they have the condition
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oni imaju uslove koji im
11:42
that allows them to respond to this drug.
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omogućuju da uspešno odreaguju na tretman.
11:44
We might not even know what this protein is,
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Mi možda čak ni ne znamo koji je to protein,
11:46
but we can see it's a marker
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ali znamo da taj protein jeste marker,
11:48
for the response to the disease.
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koji govori da će određeni tretman biti uspešan.
11:53
So this already, I think,
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Već ovo saznanje, po mom mišljenju,
11:55
is tremendously useful in all kinds of medicine.
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jeste od neopisive koristi za različite grane medicine.
11:58
But I think this is actually
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Ali ja isto tako mislim da je ovo
12:00
just the beginning
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tek početak razvijanja procedura
12:02
of how we're going to treat cancer.
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kojima ćemo se boriti protiv raka.
12:04
So let me move to cancer.
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A sada bih da pričam malo više o raku.
12:06
The thing about cancer --
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Zanimljiva činjenica o kanceru je ta
12:08
when I got into this,
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da kada sam ja počeo da se bavim ovim
12:10
I really knew nothing about it,
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zaista nisam znao ništa o raku,
12:12
but working with David Agus,
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ali radeći rame uz rame sa Dejvidom Agusom
12:14
I started watching how cancer was actually being treated
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počeo sam da razumevam kako mi danas lečimo rak
12:17
and went to operations where it was being cut out.
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i odlazio sam na operacije koje su imale za cilj otklanjanje raka.
12:20
And as I looked at it,
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I kada sam sagledao tu proceduru,
12:22
to me it didn't make sense
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to meni i nije baš imalo puno smisla,
12:24
how we were approaching cancer,
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takav pristup lečenju raka.
12:26
and in order to make sense of it,
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I kako bih razumeo proces lečenja,
12:29
I had to learn where did this come from.
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morao sam naučiti kako smo došli do današnjih tretmana.
12:32
We're treating cancer almost like it's an infectious disease.
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Borimo se protiv raka na način na koji se borimo protiv infektivnih bolesti.
12:36
We're treating it as something that got inside of you
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Tretiramo ih kao nešto što vas je inficiralo
12:38
that we have to kill.
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i što moramo da ubijemo.
12:40
So this is the great paradigm.
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To je velika paradigma.
12:42
This is another case
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Ovo je drugi primer u biologiji gde se
12:44
where a theoretical paradigm in biology really worked --
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teorijskom paradigmom zaista došlo do rezultata,
12:46
was the germ theory of disease.
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a to je "patogen - teorija bolesti".
12:49
So what doctors are mostly trained to do
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Doktori su u najvećem broju slučajeva obučeni da
12:51
is diagnose --
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uspostave dijagnozu -
12:53
that is, put you into a category
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- što znači da vas oni svrstavaju u određenu kategoriju
12:55
and apply a scientifically proven treatment
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i onda primene naučno odobreni tretman protiv bolesti
12:57
for that diagnosis --
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za koju su postavili dijagnozu.
12:59
and that works great for infectious diseases.
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To je odličan pristup u lečenju infektivnih bolesti.
13:02
So if we put you in the category
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Tako da ukoliko je ustanovljeno
13:04
of you've got syphilis, we can give you penicillin.
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da bolujete od sifilisa, možemo vas lečiti penicilinom.
13:07
We know that that works.
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Mi znamo da je to uspešan način.
13:09
If you've got malaria, we give you quinine
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Ukoliko bolujete od malarije, prepisaćemo vam kinin
13:11
or some derivative of it.
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ili neki od derivata kinina.
13:13
And so that's the basic thing doctors are trained to do,
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To je u principu osnovna stvar za koju su doktori obučeni.
13:16
and it's miraculous
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Tako da je zapravo čudesno
13:18
in the case of infectious disease --
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kako u slučajevima infektivnih bolesti -
13:21
how well it works.
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ovi tretmani ekeftivno rešavaju probleme.
13:23
And many people in this audience probably wouldn't be alive
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Mnogi ljudi u ovoj publici najverovatnije ne bi bili živi
13:26
if doctors didn't do this.
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da lekari ne rade ovo.
13:28
But now let's apply that
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Hajde da pokušamo da primenimo ovaj princip
13:30
to systems diseases like cancer.
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na sistemski tip bolesti kao što je rak.
13:32
The problem is that, in cancer,
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Problem je što u slučaju raka
13:34
there isn't something else
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ne postoji strano telo koje treba ubiti,
13:36
that's inside of you.
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koje je ušlo u vaš organizam.
13:38
It's you; you're broken.
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To ste vi, vaše ćelije su nefunkcionalne.
13:40
That conversation inside of you
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Komunikacija koja postoji na sistemskom nivou u vašem telu
13:44
got mixed up in some way.
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je postala pometena na neki način.
13:46
So how do we diagnose that conversation?
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Kako možemo da dijagnostikujemo problem u komunikaciji?
13:48
Well, right now what we do is we divide it by part of the body --
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U ovom trenutku grupišemo rak prema različitm delovima tela -
13:51
you know, where did it appear? --
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znate, gde se pojavio -
13:54
and we put you in different categories
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i stavimo vas u različite kategorije
13:56
according to the part of the body.
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na osnovu dela vašeg tela.
13:58
And then we do a clinical trial
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I onda sprovedemo klinička istraživanja
14:00
for a drug for lung cancer
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za lek koji pokazuje efekat na rak pluća
14:02
and one for prostate cancer and one for breast cancer,
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i za lek koji deluje na rak prostate, rak dojke,
14:05
and we treat these as if they're separate diseases
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i lečimo ove slučajeve kao da su različite bolesti
14:08
and that this way of dividing them
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kao da ovaj način na koji grupišemo pod-tipove raka
14:10
had something to do with what actually went wrong.
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ima ikakve veze sa onim što nije u redu.
14:12
And of course, it really doesn't have that much to do
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I naravno, to nema baš puno veze sa tim
14:14
with what went wrong
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šta je pošlo naopako.
14:16
because cancer is a failure of the system.
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Jer rak je malfunkcionisanje sistema.
14:19
And in fact, I think we're even wrong
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U principu, ja mislim da je potpuno pogrešno
14:21
when we talk about cancer as a thing.
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pričati o raku kao o predmetu, stvari.
14:24
I think this is the big mistake.
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Ja mislim da je to velika greška.
14:26
I think cancer should not be a noun.
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Ja mislim da rak ne bi trebalo da bude imenica.
14:30
We should talk about cancering
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Mi treba da pričamo o ovoj bolesti kao o "rakovanju"
14:32
as something we do, not something we have.
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nečemu što mi sami radimo, a ne nečemu što imamo.
14:35
And so those tumors,
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Različiti tumori
14:37
those are symptoms of cancer.
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su simptomi raka.
14:39
And so your body is probably cancering all the time,
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Tako da vaše telo verovatno "rakuje" sve vreme.
14:42
but there are lots of systems in your body
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Ali postoji puno sistema u vašem telu
14:45
that keep it under control.
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koji taj proces drže pod kontrolom.
14:47
And so to give you an idea
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Da bih vam dao ideju
14:49
of an analogy of what I mean
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analogije na koju konkretno mislim
14:51
by thinking of cancering as a verb,
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kada govorim "rakovati" u vidu glagola,
14:54
imagine we didn't know anything about plumbing,
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zamislite da ne znamo ništa o vodoinstalaterstvu,
14:57
and the way that we talked about it,
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tako da bismo pričali o tome na sledeći način,
14:59
we'd come home and we'd find a leak in our kitchen
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došli bismo kući i uočili da je u kuhinji procurela voda
15:02
and we'd say, "Oh, my house has water."
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i rekli bismo, "Oh, u mojoj kući ima vode."
15:06
We might divide it -- the plumber would say, "Well, where's the water?"
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Vodoinstalater bi rekao, "Pa, gde je ta voda u kući?"
15:09
"Well, it's in the kitchen." "Oh, you must have kitchen water."
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"Pa, u kuhinji." "Oh, pa vi onda imate kuhinjsku vodu."
15:12
That's kind of the level at which it is.
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To je plastični primer nivoa našeg sagledavanja stvari.
15:15
"Kitchen water,
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"Kuhinjska voda?
15:17
well, first of all, we'll go in there and we'll mop out a lot of it.
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Pa, pre svega, mi ćemo obrisati dosta vode.
15:19
And then we know that if we sprinkle Drano around the kitchen,
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Isto tako znamo da ukoliko koristimo "Mr. Musculo"
15:22
that helps.
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u kuhinji, to će sigurno pomoći.
15:25
Whereas living room water,
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Dok u slučaju vode u dnevnoj sobi
15:27
it's better to do tar on the roof."
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bolje rešenje je da popravimo krov."
15:29
And it sounds silly,
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Znam da zvuči ludo,
15:31
but that's basically what we do.
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ali u principu to je ono što danas radimo.
15:33
And I'm not saying you shouldn't mop up your water if you have cancer,
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Ne kažem da ne treba da izbacite vodu ukoliko imate rak.
15:36
but I'm saying that's not really the problem;
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Ali želim da poručim da to nije uzrok problema;
15:39
that's the symptom of the problem.
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to je samo simptom problema.
15:41
What we really need to get at
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Mi zaista treba da tretiramo
15:43
is the process that's going on,
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proces koji se dešava,
15:45
and that's happening at the level
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a taj proces se dešava na nivou
15:47
of the proteonomic actions,
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proteina i njihove komunikacije,
15:49
happening at the level of why is your body not healing itself
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pitanje je zašto vaše telo ne štiti sebe
15:52
in the way that it normally does?
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na način na koji se to normalno dešava?
15:54
Because normally, your body is dealing with this problem all the time.
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Vaše telo se suočava sa problemima ovog tipa svakog dana.
15:57
So your house is dealing with leaks all the time,
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Vaša kuća se bori protiv prokišnjavanja sve vreme.
16:00
but it's fixing them. It's draining them out and so on.
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Ali se i odupire prokišnjavanju. Isušuje vodu.
16:04
So what we need
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Tako da je nama neophodan sada
16:07
is to have a causative model
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uzročni model
16:11
of what's actually going on,
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onoga što se zaista dešava.
16:13
and proteomics actually gives us
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Proteomika nam pruža
16:16
the ability to build a model like that.
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mogućnost da napokon izgradimo takav model.
16:19
David got me invited
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Dejvid me je pozvao da održim
16:21
to give a talk at National Cancer Institute
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govor na Nacionalnom Institutu Izučavanja Raka
16:23
and Anna Barker was there.
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i Ana Barker je bila tamo.
16:27
And so I gave this talk
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Tako sam održao taj govor
16:29
and said, "Why don't you guys do this?"
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i rekao, "Zašto vi ne biste uradili ovo?"
16:32
And Anna said,
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I Ana reče,
16:34
"Because nobody within cancer
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"Zato što niko ko se bavi problemom raka
16:37
would look at it this way.
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ne bi gledao na problem raka na ovaj način.
16:39
But what we're going to do, is we're going to create a program
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Ali mi ćemo svakako uspostaviti program
16:42
for people outside the field of cancer
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koji će okupiti ljude koji se ne bave rakom
16:44
to get together with doctors
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i povezaćemo te stručanjake sa medicinarima
16:46
who really know about cancer
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koji znaju puno o raku
16:49
and work out different programs of research."
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i na taj način ćemo smisliti drugačiji program istraživanja."
16:53
So David and I applied to this program
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Tako smo Dejvid i ja konkurisali za pomenuti program
16:55
and created a consortium
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i stvorili konzorcijum
16:57
at USC
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na Univerzitetu Južne Kalifornije
16:59
where we've got some of the best oncologists in the world
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gde smo okupili neke od najboljih onkologa sveta
17:02
and some of the best biologists in the world,
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i neke od najboljih biologa sveta
17:05
from Cold Spring Harbor,
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iz Kold Spring Harbora
17:07
Stanford, Austin --
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Stanforda, Ostina...
17:09
I won't even go through and name all the places --
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Ne mogu sada navesti imena svih instituticija -
17:12
to have a research project
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kako bismo odradili naučno-istraživački projekat
17:15
that will last for five years
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koji će trajati pet godina sa krajnjim
17:17
where we're really going to try to build a model of cancer like this.
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ciljem postavljanja modela kancera po opisanim principima.
17:20
We're doing it in mice first,
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Radićemo ova istraživanja prvo na miševima.
17:22
and we will kill a lot of mice
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Puno ce miševa stradati
17:24
in the process of doing this,
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u toku razvijanja ovih eksperimenata
17:26
but they will die for a good cause.
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ali će oni umreti za opšte dobro.
17:28
And we will actually try to get to the point
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Mi ćemo u principu pokušati da dođemo do momenta
17:31
where we have a predictive model
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kada imamo uspostavljeni uzročni model
17:33
where we can understand,
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na osnovu kog možemo da razumemo,
17:35
when cancer happens,
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kada se rak desi,
17:37
what's actually happening in there
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šta se u osnovi dešava u organizmu
17:39
and which treatment will treat that cancer.
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i koji specifičan tretman će biti efektan u lečenju.
17:42
So let me just end with giving you a little picture
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I za sam kraj bih vam pokazao mali shematski prikaz
17:45
of what I think cancer treatment will be like in the future.
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kako ja zamišljam da tretman protiv raka izgleda u budućnosti.
17:48
So I think eventually,
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Ja mislim da na kraju,
17:50
once we have one of these models for people,
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kada budemo imali ovakav model za ljude,
17:52
which we'll get eventually --
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koji ćemo svakako na kraju imati -
17:54
I mean, our group won't get all the way there --
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naša istraživačka grupa neće sama doći do cilja
17:56
but eventually we'll have a very good computer model --
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ali ćemo na kraju imati veoma dobar kompjuterski model -
17:59
sort of like a global climate model for weather.
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nešto kao globalni model vremenske prognoze.
18:02
It has lots of different information
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Model će imati puno različitih informacija o
18:05
about what's the process going on in this proteomic conversation
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procesima koji se dešavaju u toku komunikacije u
18:08
on many different scales.
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proteomu na različitim nivoima.
18:10
And so we will simulate
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Na taj način mi ćemo simulirati
18:12
in that model
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tim modelom specifičan rak
18:14
for your particular cancer --
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od kojeg osoba boluje i taj model
18:17
and this also will be for ALS,
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će imati primenu i za amiotrofičnu lateralnu sklerozu (ALS)
18:19
or any kind of system neurodegenerative diseases,
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ili bilo koju sistemsku neurodegenerativnu bolest,
18:22
things like that --
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bolesti kao te
18:24
we will simulate
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mi ćemo simulirati
18:26
specifically you,
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Vas posebno, ne neku
18:28
not just a generic person,
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generičku osobu, nego baš
18:30
but what's actually going on inside you.
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same procese koji se odvijaju unutar vašeg tela.
18:32
And in that simulation, what we could do
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I ono što možemo da uradimo u takvoj simulaciji
18:34
is design for you specifically
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jeste da specifično dizajniramo
18:36
a sequence of treatments,
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za Vas kombinaciju tretmana,
18:38
and it might be very gentle treatments, very small amounts of drugs.
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koji mogu biti veoma blagi, veoma male doze lekova.
18:41
It might be things like, don't eat that day,
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To mogu biti saveti tipa: nemojte jesti ovog dana,
18:44
or give them a little chemotherapy,
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ili primenićemo malu dozu hemoterapije,
18:46
maybe a little radiation.
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možda malo zračenja.
18:48
Of course, we'll do surgery sometimes and so on.
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Naravno, ponekad ćemo odraditi operativni zahvat.
18:51
But design a program of treatments specifically for you
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Ali ćemo dizajnirati poseban program tretmana samo za vas
18:54
and help your body
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i pomoći vašem telu
18:57
guide back to health --
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da se oporavi - tako ćemo
19:00
guide your body back to health.
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usmeravati vaše telo ka zdravom stanju.
19:02
Because your body will do most of the work of fixing it
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Jer će vaše telo odraditi najveći deo posla da reši problem
19:06
if we just sort of prop it up in the ways that are wrong.
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ukoliko mu mi samo pomognemo u tome.
19:09
We put it in the equivalent of splints.
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To bi bio ekvivalent metalnim udlagama.
19:11
And so your body basically has lots and lots of mechanisms
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Vaš organizam ima veoma puno mehanizama
19:13
for fixing cancer,
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koji se mogu uspešno boriti protiv raka
19:15
and we just have to prop those up in the right way
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i mi samo treba da stimulišemo te mehanizme na pravi način
19:18
and get them to do the job.
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i pokrenemo ih da ponovo počnu da rade svoj posao.
19:20
And so I believe that this will be the way
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Ja sam duboko ubeđen da će ovo biti način
19:22
that cancer will be treated in the future.
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na koji ćemo lečiti rak u budućnosti.
19:24
It's going to require a lot of work,
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To će zahtevati mnogo, mnogo rada,
19:26
a lot of research.
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mnogo istraživanja.
19:28
There will be many teams like our team
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Biće mnogo timova koji kao i naš tim
19:31
that work on this.
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pokušavaju da razumeju pomenuti fenomen.
19:33
But I think eventually,
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Ali ja mislim da ćemo u budućnosti
19:35
we will design for everybody
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biti u mogućnosti da dizajniramo
19:37
a custom treatment for cancer.
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specifičan tretman protiv raka za svaki pojedinačni slučaj.
19:41
So thank you very much.
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Na kraju, mnogo vam hvala.
19:43
(Applause)
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(Aplauz)
ABOUT THE SPEAKER
Danny Hillis - Computer theoristInventor, scientist, author, engineer -- over his broad career, Danny Hillis has turned his ever-searching brain on an array of subjects, with surprising results.
Why you should listen
Danny Hillis is an inventor, scientist, author and engineer. While completing his doctorate at MIT, he pioneered the concept of parallel computers that is now the basis for graphics processors and cloud computing. He holds more than 300 US patents, covering parallel computers, disk arrays, forgery prevention methods, various electronic and mechanical devices, and the pinch-to-zoom display interface. He has recently been working on problems in medicine as well. He is also the designer of a 10,000-year mechanical clock, and he gave a TED Talk in 1994 that is practically prophetic. Throughout his career, Hillis has worked at places like Disney, and now MIT and Applied Invention, always looking for the next fascinating problem.
Danny Hillis | Speaker | TED.com