TEDGlobal 2012
Nina Tandon: Could tissue engineering mean personalized medicine?
Nina Tandon: Da li inžinjering tkiva znači personalizovanje medicine?
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Naša tijela su u potpunosti jedinstvena, što zaista jeste fantastično sve dok ne pomislimo na liječenje raznih bolesti - svaka jedinka reaguje drugačije na standardne tretmane i to često na način koji ne možemo da predvidimo. Nina Tendon, inžinjer tkiva, predstavlja moguće rješenje: korišćenje pluripotentnih matičnih ćelija za pravljenje ličnih modela organa, na kojima bi bilo moguće testirati nove ljekove i tretmane, pri čemu bi oni bili uskladišteni na kompjuterskom čipu. (Možemo to nazvati ekstremnom personalizovanom medicinom).
Nina Tandon - Tissue engineering researcher
Nina Tandon studies ways to use electrical signals to grow artificial tissues for transplants and other therapies. Full bio
Nina Tandon studies ways to use electrical signals to grow artificial tissues for transplants and other therapies. Full bio
Double-click the English transcript below to play the video.
00:16
I'd like to show you a video of some of the models
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Pokazaću vam video snimak pojedinih modela
00:18
I work with.
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na kojima radim.
00:20
They're all the perfect size, and they don't have an ounce of fat.
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Savršene su veličine i nemaju ni trunke sala.
00:23
Did I mention they're gorgeous?
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Da li sam već spomenula da su savršeni?
00:26
And they're scientific models? (Laughs)
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I da su to naučni modeli? (Smijeh)
00:29
As you might have guessed, I'm a tissue engineer,
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Vjerovatno ste već shvatili
da se bavim inžinjeringom tkiva,
da se bavim inžinjeringom tkiva,
00:31
and this is a video of some of the beating heart
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a ovo je video snimak srca koje kuca,
00:34
that I've engineered in the lab.
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proizvela sam ga u laboratoriji.
00:36
And one day we hope that these tissues
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Nadamo se da ćemo jednog dana ova tkiva
00:38
can serve as replacement parts for the human body.
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koristiti za zamjenu organa u ljudskom tijelu.
00:41
But what I'm going to tell you about today
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Danas ću vam objasniti zašto su ova tkiva
00:43
is how these tissues make awesome models.
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odlični laboratorijski modeli.
00:48
Well, let's think about the drug screening process for a moment.
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Hajde da porazmislimo o testiranju ljekova.
00:50
You go from drug formulation, lab testing, animal testing,
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Neophodno je da smislite lijek,
odradite testiranja u laboratoriji,
odradite testiranja u laboratoriji,
00:53
and then clinical trials, which you might call human testing,
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testiranja na životinjama i potom
kliničke studije, tj. testiranja na ljudima,
kliničke studije, tj. testiranja na ljudima,
00:56
before the drugs get to market.
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prije nego što lijek izađe na tržište.
00:58
It costs a lot of money, a lot of time,
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To zahtjeva mnogo novca i vremena
01:01
and sometimes, even when a drug hits the market,
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i ponekad, tek kada lijek izađe na tržište
01:04
it acts in an unpredictable way and actually hurts people.
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uočimo mehanizam djelovanja
koji nije očekivan i šteti ljudima.
koji nije očekivan i šteti ljudima.
01:08
And the later it fails, the worse the consequences.
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Što kasnije ustanovimo loše strane,
posljedice su gore.
posljedice su gore.
01:12
It all boils down to two issues. One, humans are not rats,
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Sve se svodi na dva problema.
Prvo, ljudi nijesu pacovi
Prvo, ljudi nijesu pacovi
01:16
and two, despite our incredible similarities to one another,
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i drugo, bez obzira na sve sličnosti među nama,
01:20
actually those tiny differences between you and I
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baš te male razlike između vas i mene
01:23
have huge impacts with how we metabolize drugs
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značajno utiču na način obrade lijeka
01:25
and how those drugs affect us.
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i na to kako ti ljekovi utiču na nas.
01:27
So what if we had better models in the lab
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A šta ako bismo imali bolje
modele u samoj laboratoriji
modele u samoj laboratoriji
01:30
that could not only mimic us better than rats
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koji bi nas predstavili bolje nego pacovi,
01:33
but also reflect our diversity?
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kao i našu raznolikost?
01:37
Let's see how we can do it with tissue engineering.
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Hajde da vidimo kako se to
može postići uz pomoć inžinjeringa tkiva.
može postići uz pomoć inžinjeringa tkiva.
01:41
One of the key technologies that's really important
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Jedna od ključnih tehnologija za to su
01:44
is what's called induced pluripotent stem cells.
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takozvane indukovane pluripotentne matične ćelije.
01:47
They were developed in Japan pretty recently.
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Nedavno su razvijene u Japanu.
01:49
Okay, induced pluripotent stem cells.
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Znači, indukovane pluripotentne matične ćelije.
01:52
They're a lot like embryonic stem cells
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U mnogome podsjećaju na
embrionalne matične ćelije,
embrionalne matične ćelije,
01:54
except without the controversy.
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ali ih ne prate kontroverze.
01:56
We induce cells, okay, say, skin cells,
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Indukujemo ćelije, na primjer ćelije kože,
01:59
by adding a few genes to them, culturing them,
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tako što im dodamo nekoliko gena,
gajimo ih
gajimo ih
02:02
and then harvesting them.
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i potom ih sakupimo.
02:03
So they're skin cells that can be tricked,
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Prosto možemo da prevarimo te ćelije kože
02:06
kind of like cellular amnesia, into an embryonic state.
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da se vrate u embrionalno stanje,
to je kao ćelijska amnezija.
to je kao ćelijska amnezija.
02:09
So without the controversy, that's cool thing number one.
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Dakle, ništa nije kontroverzno,
što je super stvar broj jedan.
što je super stvar broj jedan.
02:11
Cool thing number two, you can grow any type of tissue
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Super stvar broj dva,
možete od njih uzgajati bilo koji
možete od njih uzgajati bilo koji
02:14
out of them: brain, heart, liver, you get the picture,
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tip tkiva: mozak, srce, jetru,
shvatili ste već
shvatili ste već
02:16
but out of your cells.
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i to sa vašim ćelijama.
02:19
So we can make a model of your heart, your brain
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Tako da možemo da modelujemo
vaše srce, vaš mozak
vaše srce, vaš mozak
02:23
on a chip.
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na čipu.
02:25
Generating tissues of predictable density and behavior
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Pravljenje tkiva tačno određene gustine i ponašanja
02:28
is the second piece, and will be really key towards
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je drugi dio slagalice.
To će biti ključno za upotrebu
To će biti ključno za upotrebu
02:31
getting these models to be adopted for drug discovery.
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ovih modela u procesu otkrivanja ljekova.
02:34
And this is a schematic of a bioreactor we're developing in our lab
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Ovo je shematski prikaz bioreaktora
koji razvijamo u našoj laboratoriji,
koji razvijamo u našoj laboratoriji,
02:37
to help engineer tissues in a more modular, scalable way.
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koji nam pomaže u stvaranju
tkiva na modularan i mjerljiv način.
tkiva na modularan i mjerljiv način.
02:40
Going forward, imagine a massively parallel version of this
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Dalje, zamislite sada masivnu,
paralelnu verziju reaktora
paralelnu verziju reaktora
02:44
with thousands of pieces of human tissue.
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koji sadrži hiljade djelova ljudskog tkiva.
02:46
It would be like having a clinical trial on a chip.
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To bi bilo kliničko istraživanje na čipu.
02:50
But another thing about these induced pluripotent stem cells
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Druga prednost indukovanih
pluripotentnih matičnih ćelija
pluripotentnih matičnih ćelija
02:54
is that if we take some skin cells, let's say,
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je u tome što, ukoliko uzmemo
ćelije kože ljudi
ćelije kože ljudi
02:56
from people with a genetic disease
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koji boluju od određene genetičke bolesti
02:58
and we engineer tissues out of them,
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i napravimo tkiva od njih,
03:01
we can actually use tissue-engineering techniques
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onda možemo uz pomoć
tehnika inžinjeringa tkiva
tehnika inžinjeringa tkiva
03:03
to generate models of those diseases in the lab.
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napraviti modele tih bolesti u laboratoriji.
03:06
Here's an example from Kevin Eggan's lab at Harvard.
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Ovo je primjer koji je razvila
laboratorija Kevina Igana na Harvardu.
laboratorija Kevina Igana na Harvardu.
03:10
He generated neurons
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Oni su proizveli neurone
03:12
from these induced pluripotent stem cells
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od indukovanih pluripotentnih matičnih ćelija
03:15
from patients who have Lou Gehrig's Disease,
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od ćelija pacijenata koji pate
od Lu Gerigove bolesti.
od Lu Gerigove bolesti.
03:17
and he differentiated them into neurons, and what's amazing
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Dakle, ćelije su diferencirali
u neurone i fantastično je to
u neurone i fantastično je to
03:20
is that these neurons also show symptoms of the disease.
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što su ti neuroni takođe
pokazivali simptome bolesti.
pokazivali simptome bolesti.
03:23
So with disease models like these, we can fight back
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Dakle, uz pomoć takvih modela
možemo se efikasnije boriti
možemo se efikasnije boriti
03:25
faster than ever before and understand the disease better
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nego ikada prije,
možemo bolje razumjeti bolesti
možemo bolje razumjeti bolesti
03:28
than ever before, and maybe discover drugs even faster.
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nego ranije i možda možemo
otkriti brže i same ljekove.
otkriti brže i same ljekove.
03:32
This is another example of patient-specific stem cells
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Ovo je takođe primjer upotrebe
matičnih ćelija pacijenata,
matičnih ćelija pacijenata,
03:35
that were engineered from someone with retinitis pigmentosa.
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a ćelije su izolovane iz osobe
koja boluje od retinitis pigmentoze.
koja boluje od retinitis pigmentoze.
03:39
This is a degeneration of the retina.
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Ovdje se radi o propadanju retine.
03:41
It's a disease that runs in my family, and we really hope
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Članovi moje porodice pate od te bolesti
i zaista se nadamo
i zaista se nadamo
03:43
that cells like these will help us find a cure.
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da će nam ovakve ćelije pomoći
da nađemo lijek.
da nađemo lijek.
03:46
So some people think that these models sound well and good,
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Neki ljudi misle da sve to dobro zvuči
i da su modeli dobri,
i da su modeli dobri,
03:48
but ask, "Well, are these really as good as the rat?"
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ali se pitaju: "Da li su zaista dobri koliko i pacovi?"
03:52
The rat is an entire organism, after all,
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Pacov je organizam, na kraju,
03:55
with interacting networks of organs.
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tu postoji čitava mreža
međusobno povezanih organa.
međusobno povezanih organa.
03:57
A drug for the heart can get metabolized in the liver,
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U jetri se obrađuje lijek koji djeluje na srce
04:00
and some of the byproducts may be stored in the fat.
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i pojedini sporedni proizvodi mogu biti
uskladišteni u masnom tkivu.
uskladišteni u masnom tkivu.
04:03
Don't you miss all that with these tissue-engineered models?
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Zar u radu sa tim napravljenim modelima
ne propuštate te interakcije?
ne propuštate te interakcije?
04:08
Well, this is another trend in the field.
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To je drugi pravac razvoja ovog polja.
04:10
By combining tissue engineering techniques with microfluidics,
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Kombinujući tehniku inžinjeringa tkiva
sa sistemom mikrofluida,
sa sistemom mikrofluida,
04:13
the field is actually evolving towards just that,
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ova oblast napreduje upravo u tom pravcu,
04:15
a model of the entire ecosystem of the body,
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ka modelu cjelokupnog ekosistema tijela,
04:18
complete with multiple organ systems to be able to test
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povezanom sistemu brojnih
organskih sistema kako bismo
organskih sistema kako bismo
04:20
how a drug you might take for your blood pressure
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mogli da testiramo način
na koji lijek koji utiče na krvni pritisak,
na koji lijek koji utiče na krvni pritisak,
04:22
might affect your liver or an antidepressant might affect your heart.
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može da utiče na vašu jetru
ili kako antidepresivi utiču na vaše srce.
ili kako antidepresivi utiču na vaše srce.
04:25
These systems are really hard to build, but we're just starting to be able to get there,
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Nije lako uspostaviti te sisteme,
ali sada smo na dobrom putu
ali sada smo na dobrom putu
04:29
and so, watch out.
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da u tome uspijemo, zato pratite novosti.
04:32
But that's not even all of it, because once a drug is approved,
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To nije sve jer jednom
kada dođe do odobrenja lijeka,
kada dođe do odobrenja lijeka,
04:35
tissue engineering techniques can actually help us develop more personalized treatments.
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tehnike inženjeringa tkiva mogu nam pomoći
da razvijemo personalizovane tretmane.
da razvijemo personalizovane tretmane.
04:38
This is an example that you might care about someday,
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Možda ćete jednog dana
razmišljati o ovom primjeru,
razmišljati o ovom primjeru,
04:42
and I hope you never do,
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mada se nadam da se to neće desiti.
04:44
because imagine if you ever get that call
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Zamislite da vas neko pozove
04:47
that gives you that bad news that you might have cancer.
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i saopšti vam loše vijesti
da možda bolujete od raka.
da možda bolujete od raka.
04:50
Wouldn't you rather test to see if those cancer drugs
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Zar ne biste prije provjerili da li ljekovi protiv raka
04:53
you're going to take are going to work on your cancer?
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koji su vam prepisani zaista deluju efektivno na Vas?
04:55
This is an example from Karen Burg's lab, where they're
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Ovo je primjer rada iz laboratorije Karen Burg,
04:58
using inkjet technologies to print breast cancer cells
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oni se koriste tehnologijom
štampanja kako bi odštampali
štampanja kako bi odštampali
05:01
and study its progressions and treatments.
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ćelije raka dojke i tako izučavali
razvoj bolesti i njen tretman.
razvoj bolesti i njen tretman.
05:03
And some of our colleagues at Tufts are mixing models
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Naše kolege na Tufts univerzitetu kombinuju modele
05:06
like these with tissue-engineered bone to see how cancer
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kao što su modeli tkivnog inžinjeringa,
kako bi studirali
kako bi studirali
05:09
might spread from one part of the body to the next,
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na koji način se ćelije raka šire
od jednog organa u tijelu do drugog.
od jednog organa u tijelu do drugog.
05:12
and you can imagine those kinds of multi-tissue chips
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I možete zamisliti da će se
sljedeća generacija ovog tipa izučavanja
sljedeća generacija ovog tipa izučavanja
05:14
to be the next generation of these kinds of studies.
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zasnivati na čipovima koji oslikavaju
mnogobrojna tkiva.
mnogobrojna tkiva.
05:17
And so thinking about the models that we've just discussed,
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Razmišljajući o modelima o kojima smo upravo pričali
05:19
you can see, going forward, that tissue engineering
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možete uvidjeti da će u budućnosti
inžinjering tkiva
inžinjering tkiva
05:21
is actually poised to help revolutionize drug screening
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sigurno dovesti do revolucije
u procesu razvoja ljekova
u procesu razvoja ljekova
05:24
at every single step of the path:
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na svakom pojedinačnom koraku na tom putu:
05:26
disease models making for better drug formulations,
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modeli bolesti koji će omogućiti
sintezu boljih ljekova,
sintezu boljih ljekova,
05:29
massively parallel human tissue models helping to revolutionize lab testing,
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masivne, paralelne modele ljudskih tkiva
koji će u laboratorijskom testiranju
koji će u laboratorijskom testiranju
05:33
reduce animal testing and human testing in clinical trials,
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smanjiti broj testiranja na životinjama i ljudima
05:37
and individualized therapies that disrupt
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i razviće se terapije podešene
prema pojedincu, koje utiču
prema pojedincu, koje utiču
05:39
what we even consider to be a market at all.
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na ono što smatramo tržištem.
05:42
Essentially, we're dramatically speeding up that feedback
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U suštini, značajno ubrzavamo taj odnos
05:45
between developing a molecule and learning about
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između razvoja određenog molekula i saznanja
05:47
how it acts in the human body.
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kako to utiče na ljudsko tijelo.
05:50
Our process for doing this is essentially transforming
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Način na koji to činimo suštinski transformiše
05:52
biotechnology and pharmacology into an information technology,
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biotehnologiju i farmakologiju
u informacione tehnologije
u informacione tehnologije
05:57
helping us discover and evaluate drugs faster,
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i pomaže nam da brže, jeftinije i efektivnije
06:00
more cheaply and more effectively.
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otkrijemo i proučimo ljekove.
06:03
It gives new meaning to models against animal testing, doesn't it?
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Daje novo značanje modelima protiv testiranja
na životinjama, zar ne?
na životinjama, zar ne?
06:07
Thank you. (Applause)
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Hvala vam. (Aplauz)
ABOUT THE SPEAKER
Nina Tandon - Tissue engineering researcherNina Tandon studies ways to use electrical signals to grow artificial tissues for transplants and other therapies.
Why you should listen
Nina Tandon studies electrical signaling in the context of tissue engineering, with the goal of creating “spare parts” for human implantation and/or disease models. After receiving a bachelor’s degree in electrical engineering from Cooper Union, Nina worked on an electronic nose used to “smell” lung cancer as a Fulbright scholar in Rome. She studied electrical stimulation for cardiac tissue engineering at MIT and Columbia, and now continues her research on electrical stimulation for broader tissue-engineering applications. Tandon was a 2011 TED Fellow and a 2012 Senior Fellow. Nina was also honored as one of Foreign Policy's 2015 Global Thinkers.
Nina Tandon | Speaker | TED.com