ABOUT THE SPEAKER
Siddharthan Chandran - Regenerative neurologist
Siddharthan Chandran explores how to heal damage from degenerative disorders such as MS and motor neuron disease (ALS).

Why you should listen

Multiple sclerosis (MS) affects the nervous system by chewing up the axons that connect neurons to one another, which slows, stops or simply randomizes the transmission of nerve impulses. At the Centre for clinical brain sciences at the University of Edinburgh, Siddharthan Chandran works in the emerging discipline of regenerative neurology -- exploring how injured or damaged neurons in the brain might actually be repaired.
 
His research strategy uses MS and motor neuron disease (ALS, or Lou Gehrig's diesease) as primary disease models, combining laboratory and clinical activity to study  brain injury, neurodegeneration and repair, using stem cells to model and test. His work, he says, "reflects the complexity of the brain. You can replace a kidney, but not a brain. One must remain careful and humble in the face of current knowledge." He is also director of the Anne Rowling Regenerative Neurology Clinic.

More profile about the speaker
Siddharthan Chandran | Speaker | TED.com
TEDGlobal 2013

Siddharthan Chandran: Can the damaged brain repair itself?

西德森·查尔恩: 受损大脑是否能自我修复?

Filmed:
1,388,092 views

有时在遭受创伤之后,大脑能进行自我修复,生长出新的脑细胞来替代受损的细胞。但是由于修复缓慢,大脑不能从抑生长疾病——如神经元这样的疾病(格雷克氏症或者肌萎缩侧索硬化症)——中恢复过来。西德森·查尔恩借用新式的技术,利用特殊的干细胞来促进大脑更快的进行自我修复。
- Regenerative neurologist
Siddharthan Chandran explores how to heal damage from degenerative disorders such as MS and motor neuron disease (ALS). Full bio

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

00:12
I'm very pleased满意 to be here today今天
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今天很高兴能在此
00:14
to talk to you all about how we might威力 repair修理
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与你们探讨我们如何去修复
00:16
the damaged破损 brain,
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受损的大脑
00:18
and I'm particularly尤其 excited兴奋 by this field领域,
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研究这个领域使我倍感激动
00:21
because as a neurologist神经学家 myself,
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因为我本身就是一名神经学家
00:23
I believe that this offers报价 one of the great ways方法
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我坚信这项研究足以带来最好的治疗
00:25
that we might威力 be able能够 to offer提供 hope希望
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使我们可以将希望带给
00:27
for patients耐心 who today今天 live生活 with devastating破坏性的
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众多病入膏肓且回天乏术
00:30
and yet然而 untreatable不可治愈 diseases疾病 of the brain.
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大脑疾病的患者
00:33
So here's这里的 the problem问题.
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那么请看我们面临的问题。
00:36
You can see here the picture图片 of somebody's某人的 brain
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你们可以看到这是一张
00:38
with Alzheimer's老年痴呆症 disease疾病
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老年痴呆患者的大脑图
00:40
next下一个 to a healthy健康 brain,
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旁边是健康的大脑图
00:42
and what's obvious明显 is, in the Alzheimer's老年痴呆症 brain,
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明显可以看到 老年痴呆的患者的大脑
00:44
ringed环状的 red, there's obvious明显
damage损伤 -- atrophy, scarring疤痕.
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红色圈出来明显受损的区域——萎缩 有疤痕
00:49
And I could show显示 you equivalent当量 pictures图片
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我还可以向你们展示类似的
00:51
from other disease疾病: multiple sclerosis硬化,
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其他疾病的图片:多发性硬化
00:53
motor发动机 neuron神经元 disease疾病, Parkinson's帕金森氏 disease疾病,
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运动神经元疾病 帕金森症
00:56
even Huntington's亨廷顿 disease疾病,
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甚至是亨廷顿氏舞蹈病
00:58
and they would all tell a similar类似 story故事.
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这些图片大同小异
01:01
And collectively these brain disorders障碍 represent代表
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这些大脑疾病共同显示了
01:03
one of the major重大的 public上市 health健康 threats威胁 of our time.
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当今威胁我们公众健康的主要疾病之一
01:06
And the numbers数字 here are really rather staggering踉跄.
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现在患病人数令人乍舌
01:11
At any one time, there are 35 million百万 people today今天
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如今 共有三千五百万人
01:14
living活的 with one of these brain diseases疾病,
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患有某种脑部疾病
01:17
and the annual全年 cost成本 globally全球
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并且全球每年用于治疗这些疾病的花费
01:19
is 700 billion十亿 dollars美元.
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均高达到七千亿美元
01:21
I mean, just think about that.
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听听 仔细想想吧
01:23
That's greater更大 than one percent百分
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这一数字比全球GDP总额的百分之一
01:25
of the global全球 GDPGDP.
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还要多
01:27
And it gets得到 worse更差,
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情况正变得更糟
01:29
because all these numbers数字 are rising升起
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因为这一数字不断攀升
01:32
because these are by and large
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因为这类疾病总体上
01:33
age-related年龄相关 diseases疾病, and we're living活的 longer.
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与年龄相关 而我们的寿命在延长
01:36
So the question we really need to ask ourselves我们自己 is,
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所以我们真正要问自己的问题是
01:39
why, given特定 the devastating破坏性的 impact碰撞 of these diseases疾病
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这类疾病会对个人的造成如此毁灭性的影响
01:43
to the individual个人,
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这类疾病会对个人的造成如此毁灭性的影响
01:44
never mind心神 the scale规模 of the societal社会的 problem问题,
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为什么我们还对此社会问题置若罔闻
01:47
why are there no effective有效 treatments治疗?
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为什么没有有效地治疗?
01:50
Now in order订购 to consider考虑 this,
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为了思考这类问题
01:52
I first need to give you a crash紧急 course课程
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我现在必须上一堂让你们抓狂的课
01:55
in how the brain works作品.
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关于大脑如何运作的
01:57
So in other words, I need to tell you
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换而言之 我需要告诉你们
01:59
everything I learned学到了 at medical school学校.
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我在医学院学到的一切知识
02:01
(Laughter笑声)
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(笑)
02:03
But believe me, this isn't going to take very long.
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但是相信我 不会花很长时间的
02:05
Okay? (Laughter笑声)
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行吗?(笑)
02:08
So the brain is terribly可怕 simple简单:
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其实大脑很简单:
02:10
it's made制作 up of four cells细胞,
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它由四种细胞组成
02:13
and two of them are shown显示 here.
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两个已经展示在这儿 了
02:14
There's the nerve神经 cell细胞,
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这是神经细胞
02:16
and then there's the myelinating脱髓鞘 cell细胞,
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而这是髓鞘细胞
02:18
or the insulating绝缘 cell细胞.
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或者是绝缘细胞
02:19
It's called oligodendrocyte少突胶质细胞.
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这个被称为少突细胞
02:22
And when these four cells细胞 work together一起
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当这四种细胞健康和谐地
02:23
in health健康 and harmony和谐,
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共同工作时
02:25
they create创建 an extraordinary非凡
symphony交响乐 of electrical电动 activity活动,
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会产生一种特殊的电流活动
02:29
and it is this electrical电动 activity活动
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而正是这种电流活动
02:31
that underpins巩固 our ability能力 to think, to emote作表情,
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加强了我们的能力去思考 去表现自己
02:35
to remember记得, to learn学习, move移动, feel and so on.
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去记忆 学习 行动 感受等等
02:38
But equally一样, each of these individual个人 four cells细胞
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但同样的 每一种细胞
02:41
alone单独 or together一起, can go rogue流氓 or die,
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单独或者一起 都有可能会失常或死亡
02:47
and when that happens发生, you get damage损伤.
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如果发生这种情况 大脑便受损
02:49
You get damaged破损 wiring接线.
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大脑的线路会损坏
02:50
You get disrupted破坏 connections连接.
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大脑间的联系会被切断
02:53
And that's evident明显 here with the slower比较慢 conduction传导.
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这里的活动明显减速了
02:57
But ultimately最终, this damage损伤 will manifest表现
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但最终 这种损害将恶化为疾病
03:00
as disease疾病, clearly明确地.
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但最终 这种损害将恶化为疾病
03:02
And if the starting开始 dying垂死 nerve神经 cell细胞
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如果正走向于死亡的神经细胞
03:05
is a motor发动机 nerve神经, for example,
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是元神经的话
03:07
you'll你会 get motor发动机 neuron神经元 disease疾病.
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你就会患神经元疾病
03:09
So I'd like to give you a real-life现实生活 illustration插图
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我想给你们展示一个现实生活中的例子
03:12
of what happens发生 with motor发动机 neuron神经元 disease疾病.
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如果患了神经元疾病会怎么样
03:16
So this is a patient患者 of mine called John约翰.
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这是我的一个病人叫做约翰
03:18
John约翰 I saw just last week in the clinic诊所.
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我上周才在诊所看到约翰
03:21
And I've asked John约翰 to tell us something
about what were his problems问题
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我让约翰告诉我们是什么样的问题
03:25
that led to the initial初始 diagnosis诊断
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导致了他最初被诊断为
03:27
of motor发动机 neuron神经元 disease疾病.
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患有神经元疾病
03:28
John约翰: I was diagnosed确诊 in October十月 in 2011,
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约翰:我在2011年11月确诊
03:33
and the main主要 problem问题 was a breathing呼吸 problem问题,
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关键的问题出在呼吸上
03:37
difficulty困难 breathing呼吸.
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呼吸很困难
03:38
SiddharthanSiddharthan Chandran德兰: I don't know if you
caught抓住 all of that, but what John约翰 was telling告诉 us
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我不知道你们听懂了没 约翰刚说的是
03:41
was that difficulty困难 with breathing呼吸
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他呼吸困难
03:43
led eventually终于 to the diagnosis诊断
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最终确诊为
03:45
of motor发动机 neuron神经元 disease疾病.
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患有神经元疾病
03:48
So John's约翰 now 18 months个月
further进一步 down in that journey旅程,
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现在距离约翰患病过去了18个月
03:51
and I've now asked him to tell us something about
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我让他告诉你们
03:54
his current当前 predicament困境.
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他现在的困境
03:56
John约翰: What I've got now is
the breathing's呼吸的 gotten得到 worse更差.
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约翰:我现在的呼吸更加了困难了
03:59
I've got weakness弱点 in my hands,
my arms武器 and my legs.
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我的双手 胳膊和双脚没什么力气
04:05
So basically基本上 I'm in a wheelchair轮椅 most of the time.
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所以现在基本上我都坐在轮椅上
04:09
SCSC: John's约翰 just told us he's in a wheelchair轮椅
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约翰刚刚告诉我他大部分时间
04:12
most of the time.
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都坐在轮椅上
04:14
So what these two clips剪辑 show显示
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所以这两个影音片段不仅证明了
04:17
is not just the devastating破坏性的
consequence后果 of the disease疾病,
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疾病造成的后果是毁灭性的
04:19
but they also tell us something about
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并且疾病恶化的速度
04:21
the shocking触目惊心 pace步伐 of the disease疾病,
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也是十分惊人的
04:23
because in just 18 months个月,
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因为仅仅只过了18个月
04:26
a fit适合 adult成人 man has been rendered呈现
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一个健康的成年人就必须
04:29
wheelchair-轮椅- and respirator-dependent呼吸器依赖性.
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依靠轮椅和呼吸器度日
04:32
And let's face面对 it, John约翰 could be anybody's任何人的 father父亲,
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让我们正视这个事实吧 约翰可能是一位父亲
04:35
brother哥哥 or friend朋友.
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一位兄长或是朋友
04:37
So that's what happens发生 when the motor发动机 nerve神经 dies.
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所当神经元细胞死亡时就会出现这样的情况
04:39
But what happens发生 when that myelin髓鞘 cell细胞 dies?
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那么如果是髓鳞脂细胞死亡 情况又是怎样的呢?
04:44
You get multiple sclerosis硬化.
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那就会得多发性硬化症
04:46
So the scan扫描 on your left
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左边的这个扫描图
04:48
is an illustration插图 of the brain,
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显示的是大脑内部
04:51
and it's a map地图 of the connections连接 of the brain,
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里面的各种连接
04:53
and superimposed叠加 upon which哪一个
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而这块叠加的地方
04:55
are areas of damage损伤.
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这是受损区域
04:57
We call them lesions病变 of demyelination脱髓鞘.
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我们称之为髓鞘脱失
04:59
But they're damage损伤, and they're white白色.
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细胞受损后呈现白色
05:02
So I know what you're thinking思维 here.
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我知道你们在想什么
05:03
You're thinking思维, "My God, this bloke小子 came来了 up
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你们在想 “老天爷呀,这哥们儿跳出来
05:06
and said he's going to talk about hope希望,
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说是要谈谈希望
05:08
and all he's doneDONE is give a really rather bleak苍凉
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结果尽在这儿谈些惨淡压抑的事儿”
05:10
and depressing压抑 tale故事."
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结果尽在这儿谈些惨淡压抑的事儿”
05:12
I've told you these diseases疾病 are terrible可怕.
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我确实说过这些疾病很可怕
05:13
They're devastating破坏性的, numbers数字 are rising升起,
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又是毁灭性的 患病人数也在上升
05:16
the costs成本 are ridiculous荒谬, and worst最差 of all,
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花费惊人 最糟的是
05:18
we have no treatment治疗. Where's哪里 the hope希望?
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我们没法儿治愈 希望在哪儿呢?
05:20
Well, you know what? I think there is hope希望.
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但是你们知道吗?我认为希望就在这儿
05:23
And there's hope希望 in this next下一个 section部分,
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在某个多发性硬化症患者脑部的
05:25
of this brain section部分 of somebody else其他 with M.S.,
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另一个区域出现了希望
05:28
because what it illustrates说明
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因为它展示了
05:29
is, amazingly令人惊讶, the brain can repair修理 itself本身.
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大脑的惊人自愈能力
05:32
It just doesn't do it well enough足够.
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只是这种能力不是特别强而已
05:34
And so again, there are two
things I want to show显示 you.
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所以 我想再一次的向你展示两幅图
05:36
First of all is the damage损伤 of this patient患者 with M.S.
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首先是多发性硬化症的图
05:40
And again, it's another另一个 one of these white白色 masses群众.
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另外一张是有白色物质的图
05:43
But crucially关键, the area that's ringed环状的 red
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但重要的是 用红色圈出的区域
05:47
highlights强调 an area that is pale苍白 blue蓝色.
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有浅蓝色的物质
05:49
But that area that is pale苍白 blue蓝色 was once一旦 white白色.
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但是这片蓝色曾经也是白色的
05:52
So it was damaged破损. It's now repaired修复.
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它之前受损 但现在它自己修复了
05:55
Just to be clear明确: It's not because of doctors医生.
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要明白的是:这不是医生的功劳
05:58
It's in spite尽管 of doctors医生, not because of doctors医生.
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这与医生无关 并不是因为他们
06:01
This is spontaneous自发 repair修理.
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这是一种自发的修复
06:03
It's amazing惊人 and it's occurred发生
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令人称奇但确实发生了
06:04
because there are stem cells细胞 in the brain, even,
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因为大脑中的干细胞
06:07
which哪一个 can enable启用 new myelin髓鞘, new insulation绝缘,
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能够创造新的髓磷脂 新的绝缘细胞
06:11
to be laid铺设 down over the damaged破损 nerves神经.
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覆盖在受损的神经上
06:13
And this observation意见 is important重要 for two reasons原因.
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这一观察十分重要,有两个原因
06:17
The first is it challenges挑战 one of the orthodoxies正统
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一是它挑战了医学院所教授的
06:21
that we learnt学到了 at medical school学校,
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正统权威
06:22
or at least最小 I did, admittedly固然 last century世纪,
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至少是我上世纪念医学院的时候所接受的教育
06:26
which哪一个 is that the brain doesn't repair修理 itself本身,
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医学院的权威认为大脑不能自我修复
06:28
unlike不像, say, the bone or the liver.
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不像是骨头或者是肝脏
06:32
But actually其实 it does, but it
just doesn't do it well enough足够.
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但大脑确实有这能力只是不够强大而已
06:35
And the second第二 thing it does,
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二是我们知道大脑有这样的再生机制
06:37
and it gives us a very clear明确 direction方向
of travel旅行 for new therapies治疗 --
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这为我们提供了新式治疗的明确方向——
06:41
I mean, you don't need to be a rocket火箭 scientist科学家
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我是说 即使不是造火箭的专家
06:42
to know what to do here.
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也知道该怎么做
06:44
You simply只是 need to find ways方法 of promoting促进
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你只需找到方法来推动
06:47
the endogenous内源性, spontaneous自发
repair修理 that occurs发生 anyway无论如何.
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这一自发性治愈的进程
06:51
So the question is, why, if we've我们已经 known已知 that
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问题是 假使我们知道这一事实
06:54
for some time, as we have,
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我们现在就知道了
06:56
why do we not have those treatments治疗?
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为什么我们还没有治疗方案呢?
07:00
And that in part部分 reflects反映 the complexity复杂
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这至少从局部反映出
07:02
of drug药物 development发展.
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药品研发的复杂性
07:05
Now, drug药物 development发展 you might威力 think of
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你们可能认为制药虽然昂贵
07:07
as a rather expensive昂贵 but risky有风险 bet赌注,
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却值得一试
07:10
and the odds可能性 of this bet赌注 are roughly大致 this:
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这一尝试的概率大概是这样的:
07:12
they're 10,000 to one against反对,
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万分之一的机会
07:14
because you need to screen屏幕
about 10,000 compounds化合物
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因为我们需要从一万种化合物中
07:17
to find that one potential潜在 winner优胜者.
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找到可能有效的某一种
07:19
And then you need to spend 15 years年份
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这可能需要花上15年时间
07:21
and spend over a billion十亿 dollars美元,
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以及10亿不止
07:22
and even then, you may可能 not have a winner优胜者.
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即使如此 也可能徒劳无功
07:26
So the question for us is,
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所以现在的问题是
07:27
can you change更改 the rules规则 of the game游戏
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我们能否改变游戏规则
07:29
and can you shorten缩短 the odds可能性?
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或者我们能否加大胜算?
07:31
And in order订购 to do that, you have to think,
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为了达到这一目标 就必须思考
07:33
where is the bottleneck瓶颈 in this drug药物 discovery发现?
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药品研发的瓶颈在哪儿?
07:36
And one of the bottlenecks瓶颈 is
early in drug药物 discovery发现.
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瓶颈之一就是在制药发现的早期阶段
07:39
All that screening筛查 occurs发生 in animal动物 models楷模.
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所有的筛选都以动物为研究对象
07:43
But we know that the proper正确
study研究 of mankind人类 is man,
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但是我们知道研究人类才是合适的
07:47
to borrow from Alexander亚历山大 Pope教皇.
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这句话出自亚历山大蒲伯之口
07:49
So the question is, can we study研究 these diseases疾病
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问题是 我们能用人类的材料
07:51
using运用 human人的 material材料?
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来研究这些疾病吗?
07:54
And of course课程, absolutely绝对 we can.
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当然 我们绝对可以
07:56
We can use stem cells细胞,
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我们可以利用干细胞
07:57
and specifically特别 we can use human人的 stem cells细胞.
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具体就是说我们可以利用人类干细胞
08:00
And human人的 stem cells细胞 are these extraordinary非凡
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人类干细胞是十分特别
08:02
but simple简单 cells细胞 that can do two things:
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但也很简单的细胞 能做两件事情:
08:05
they can self-renew自我更新 or make more of themselves他们自己,
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干细胞能自我更新或者自我利用
08:07
but they can also become成为 specialized专门
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但是他们能变得更细化
08:09
to make bone, liver or, crucially关键, nerve神经 cells细胞,
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分裂出骨骼细胞 肝脏细胞 最重要的是神经细胞
08:12
maybe even the motor发动机 nerve神经 cell细胞
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甚至是神经元细胞
08:14
or the myelin髓鞘 cell细胞.
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或者是髓磷脂细胞
08:16
And the challenge挑战 has long been,
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长期以来的挑战都是
08:18
can we harness马具 the power功率,
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我们能否驾驭这种力量
08:20
the undoubted无疑的 power功率 of these stem cells细胞
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驾驭干细胞毋庸置疑的力量
08:22
in order订购 to realize实现 their promise诺言
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2018
去开发细胞的潜能
08:24
for regenerative再生 neurology神经内科?
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发展再生长神经学?
08:25
And I think we can now, and the reason原因 we can
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我认为我现在有能力了 原因就在于
08:28
is because there have been
several一些 major重大的 discoveries发现
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在过去的10年20年中有了
08:31
in the last 10, 20 years年份.
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些许重大的发现
08:33
One of them was here in Edinburgh爱丁堡,
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其中一个便是在这儿 爱丁堡出现的
08:35
and it must必须 be the only celebrity名人 sheep, Dolly玩具娃娃.
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这肯定是唯一的一只出名的绵羊了 多莉
08:39
So Dolly玩具娃娃 was made制作 in Edinburgh爱丁堡,
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多莉就是爱丁堡制造
08:40
and Dolly玩具娃娃 was an example
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它是第一个克隆的哺乳动物
08:42
of the first cloning克隆 of a mammal哺乳动物
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它是第一个克隆的哺乳动物
08:45
from an adult成人 cell细胞.
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来自于一个小小的成年细胞
08:47
But I think the even more significant重大 breakthrough突破
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但是我认为更加重要的一项突破
08:50
for the purposes目的 of our discussion讨论 today今天
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同时也是今天我们讨论的基础
08:53
was made制作 in 2006 by a Japanese日本 scientist科学家
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是2006年一位日本科学家
08:55
called Yamanaka山中.
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名为山中
08:57
And what Yamaka双论 did,
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他用了一种
08:58
in a fantastic奇妙 form形成 of scientific科学 cookery烹调术,
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令人称奇的科学方式将
09:01
was he showed显示 that four ingredients配料,
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四种成分如烹调般混在一起
09:03
just four ingredients配料,
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仅仅四种
09:05
could effectively有效 convert兑换 any cell细胞, adult成人 cell细胞,
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就能有效地转换任何一个细胞 任何成年细胞
09:08
into a master stem cell细胞.
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使之变成干细胞
09:10
And the significance意义 of this is difficult to exaggerate夸大,
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这项研究意义之重大难以言喻
09:13
because what it means手段 that
from anybody任何人 in this room房间,
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因为这就意味着在这间会议室的任何一个人
09:15
but particularly尤其 patients耐心,
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尤其是病人
09:17
you could now generate生成
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可以生长出
09:18
a bespoke定制, personalized个性化 tissue组织 repair修理 kit套件.
217
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一套私人定制 个性化的成套修复工具
09:21
Take a skin皮肤 cell细胞, make it a master pluripotent多能 cell细胞,
218
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2948
取一个皮肤细胞 将其培育成多功能细胞,
09:24
so you could then make those cells细胞
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1739
这样便能生长出许多
09:26
that are relevant相应 to their disease疾病,
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与疾病相关的细胞
09:28
both to study研究 but potentially可能 to treat对待.
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可以用于研究也能用于未来的治疗
09:31
Now, the idea理念 of that at medical school学校 --
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现在 医学院对此的看法
09:33
this is a recurring经常性 theme主题, isn't
it, me and medical school学校? —
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是觉得很荒谬
09:36
would have been ridiculous荒谬,
224
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1818
这是一个无限循环的主题 不是吗:我 医学院
09:37
but it's an absolute绝对 reality现实 today今天.
225
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但今时今日这是绝对的现实
09:40
And I see this as the cornerstone基石
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我认为这是一个
09:42
of regeneration再生, repair修理 and hope希望.
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再生长 修复以及希望的转折点
09:45
And whilst同时 we're on the theme主题 of hope希望,
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既然说到了希望的主题
09:47
for those of you who might威力 have failed失败 at school学校,
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那些在学校表现欠佳的人
09:49
there's hope希望 for you as well,
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你们也应心存希望
09:51
because this is the school学校 report报告 of John约翰 GerdonGerdon.
231
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2496
因为这是一篇约翰戈登的学校报告
09:54
["I believe he has ideas思路 about becoming变得 a scientist科学家;
on his present当下 showing展示 this is quite相当 ridiculous荒谬."]
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“我相信他有科学家的想法;但他呈现的东西很荒谬”
09:55
So they didn't think much of him then.
233
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所以他们当时不是很看好他
09:56
But what you may可能 not know is that he
got the Nobel诺贝尔 Prize for medicine医学
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但是你可能不知道的是他获得了诺贝尔医学奖
09:59
just three months个月 ago.
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就在三个月前
10:02
So to return返回 to the original原版的 problem问题,
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再回来说说最先前的问题
10:04
what is the opportunity机会 of these stem cells细胞,
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这些干细胞
10:06
or this disruptive破坏性 technology技术,
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或者是分裂技术能提出怎样的机遇
10:08
for repairing修复 the damaged破损 brain,
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帮助修复受损大脑
10:10
which哪一个 we call regenerative再生 neurology神经内科?
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发展再生长神经学?
10:12
I think there are two ways方法 you can think about this:
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我们可以从两个方面来看再生神经学:
10:14
as a fantastic奇妙 21st-centuryST-世纪 drug药物 discovery发现 tool工具,
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3448
它可以成为本世纪一个极佳的药品研发工具
10:18
and/or as a form形成 of therapy治疗.
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以及/或者作为治疗的手段
10:20
So I want to tell you a little bit about both of those
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2027
我想再花一点时间说说
10:22
in the next下一个 few少数 moments瞬间.
245
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这两方面
10:25
Drug药物 discovery发现 in a dish is how people often经常
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制药发现就是人们常常
10:27
talk about this.
247
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讨论的话题
10:28
It's very simple简单: You take a patient患者 with a disease疾病,
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很简单:有一个身患疾病的病人
10:31
let's say motor发动机 neuron神经元 disease疾病,
249
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比如说患了神经元疾病
10:33
you take a skin皮肤 sample样品,
250
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1757
我们取一点他皮肤样本
10:35
you do the pluripotent多能 reprogramming重新编程,
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然后进行多功能重组
10:38
as I've already已经 told you,
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就像我先前说的那样
10:40
and you generate生成 live生活 motor发动机 nerve神经 cells细胞.
253
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生长出新的神经元细胞
10:42
That's straightforward直截了当, because that's what
254
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1734
直观明了 因为这就是
10:44
pluripotent多能 cells细胞 can do.
255
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1737
多功能细胞的强大之处
10:46
But crucially关键, you can then compare比较 their behavior行为
256
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2956
但重要的是 我们能将病人的行为
10:49
to their equivalent当量 but healthy健康 counterparts同行,
257
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2423
与健康的人
10:51
ideally理想 from an unaffected未受影响 relative相对的.
258
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2030
最好是他们健康的亲人进行比较
10:53
That way, you're matching匹配 for genetic遗传 variation变异.
259
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这样 他们能为基因变体做配对
10:56
And that's exactly究竟 what we did here.
260
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这就是我们的研究
10:59
This was a collaboration合作 with colleagues同事:
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这是全体同事的共同努力:
11:01
in London伦敦, Chris克里斯 Shaw; in the U.S.,
Steve史蒂夫 Finkbeiner芬克拜纳 and Tom汤姆 Maniatis马尼亚蒂斯.
262
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3523
伦敦的肖克里斯 美国的芬克贝勒斯蒂夫和马力特斯汤姆
11:04
And what you're looking at, and this is amazing惊人,
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2522
你所看到的 是很了不起的
11:07
these are living活的, growing生长, motor发动机 nerve神经 cells细胞
264
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这些鲜活的 正在生长的运动神经元细胞
11:10
from a patient患者 with motor发动机 neuron神经元 disease疾病.
265
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是来自于一名身患运动神经元疾病的病人
11:12
It happens发生 to be an inherited遗传 form形成.
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细胞处在遗传阶段的状态
11:14
I mean, just imagine想像 that.
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仔细想想吧
11:15
This would have been unimaginable不可思议 10 years年份 ago.
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这在10年之前是想都没法儿想的
11:18
So apart距离 from seeing眼看 them
grow增长 and put out processes流程,
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3354
除了能够观察细胞的生长以及干预过程外
11:21
we can also engineer工程师 them so that they fluoresce发萤光,
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2442
我们还能设计细胞使其发出荧光
11:24
but crucially关键, we can then
track跟踪 their individual个人 health健康
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但是重要的是 我们能追踪单个细胞的健康情况
11:27
and compare比较 the diseased病态的 motor发动机 nerve神经 cells细胞
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并将患病的神经元细胞与健康细胞进行比较
11:29
to the healthy健康 ones那些.
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1872
并将患病的神经元细胞与健康细胞进行比较
11:31
And when you do all that and put it together一起,
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3487
当我们将这些细胞放在一起时
11:35
you realize实现 that the diseased病态的 ones那些,
275
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2099
我们发现患病细胞
11:37
which哪一个 is represented代表 in the red line线,
276
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1788
就是由红色线代表的
11:39
are two and a half times more likely容易 to die
277
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3621
相较健康细胞而言死亡的几率
11:42
than the healthy健康 counterpart副本.
278
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2705
高达2.5倍
11:45
And the crucial关键 point about this is that you then have
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2643
重要的一点是接下来我们
11:48
a fantastic奇妙 assay化验 to discover发现 drugs毒品,
280
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3589
能用神奇的试验来发现制药
11:51
because what would you ask of the drugs毒品,
281
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1909
因为我们对药物的要求
11:53
and you could do this through通过 a high-throughput高通量
282
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1761
只需要通过高流通量
11:55
automated自动化 screening筛查 system系统,
283
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2409
自动化的筛选系统完成
11:57
you'd ask the drugs毒品, give me one thing:
284
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2446
我们将要求制药者一件事
12:00
find me a drug药物 that will bring带来 the red line线
285
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2825
发明一种药能把这条红线更加
12:02
closer接近 to the blue蓝色 line线,
286
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1890
靠近这条蓝线
12:04
because that drug药物 will be a high-value高价值 candidate候选人
287
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3219
因为这样的药物是一种高价值的备份
12:08
that you could probably大概 take direct直接 to human人的 trial审讯
288
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2900
能直接用于人类实验
12:10
and almost几乎 bypass旁路 that bottleneck瓶颈
289
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2587
并且能绕过在制药发现中
12:13
that I've told you about in drug药物 discovery发现
290
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2401
以动物为模型的
12:15
with the animal动物 models楷模,
291
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1813
瓶颈问题
12:17
if that makes品牌 sense. It's fantastic奇妙.
292
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2653
如果可行 这将妙不可言
12:20
But I want to come back
293
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1564
但是我想再回头说说
12:22
to how you might威力 use stem cells细胞 directly
294
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2049
我们如何能直接利用干细胞
12:24
to repair修理 damage损伤.
295
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1775
来修复大脑损伤
12:25
And again there are two ways方法 to think about this,
296
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1825
同样要通过两方面来思考
12:27
and they're not mutually相互 exclusive独家.
297
735659
2015
这两方面可以相通
12:29
The first, and I think in the long run
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2290
第一 我觉得长远来说
12:31
the one that will give us the biggest最大 dividend股利,
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2229
能为我们带来巨大回报的
12:34
but it's not thought of that way just yet然而,
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2604
让我们以不同视角去看待问题的
12:36
is to think about those stem cells细胞 that are already已经
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是这些干细胞已经
12:40
in your brain, and I've told you that.
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存在于我们大脑中的事实 我已经说过了
12:41
All of us have stem cells细胞 in the brain,
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我们的大脑中都有干细胞
12:43
even the diseased病态的 brain,
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即使受损大脑中也有
12:45
and surely一定 the smart聪明 way forward前锋
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当然明智的方法是
12:47
is to find ways方法 that you can promote促进 and activate启用
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想办法去促进并且激活
12:49
those stem cells细胞 in your brain already已经
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这些已经存在于大脑中的干细胞
12:51
to react应对 and respond响应 appropriately适当 to damage损伤
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使之正确应对大脑损伤
12:54
to repair修理 it.
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将其修复
12:56
That will be the future未来.
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这是未来的远景
12:57
There will be drugs毒品 that will do that.
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未来会有具有这样疗效的药物
13:00
But the other way is to effectively有效 parachute降落伞 in cells细胞,
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另外一种办法是有效地
13:04
transplant移植 them in,
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移植这些细胞
13:06
to replace更换 dying垂死 or lost丢失 cells细胞, even in the brain.
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让其代替死亡或消逝的细胞
13:10
And I want to tell you now an experiment实验,
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我想跟你们说说一项实验
13:12
it's a clinical临床 trial审讯 that we did,
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这是我们做的一项临床试验
13:14
which哪一个 recently最近 completed完成,
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刚结束不久
13:16
which哪一个 is with colleagues同事 in UCLUCL,
318
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是和在伦敦大学学院的同事一起做的
13:19
David大卫 Miller磨坊主 in particular特定.
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尤其是米勒大卫
13:21
So this study研究 was very simple简单.
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这项研究其实很简单
13:23
We took patients耐心 with multiple sclerosis硬化
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我们选出患有多发性硬化症的患者
13:26
and asked a simple简单 question:
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问自己一个简单的问题:
13:28
Would stem cells细胞 from the bone marrow骨髓
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来自于骨髓的干细胞
13:30
be protective保护的 of their nerves神经?
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能保护他们的神经么?
13:31
So what we did was we took this bone marrow骨髓,
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所以我们选取了这一骨髓细胞
13:35
grew成长 up the stem cells细胞 in the lab实验室,
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在实验室培植出干细胞
13:37
and then injected注射 them back into the vein静脉.
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再将其注射进血管里
13:40
I'm making制造 this sound声音 really simple简单.
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我尽量将这一过程简化描述
13:42
It took five years年份 off a lot of people, okay?
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这花了我们整整五年时间
13:45
And it put gray灰色 hair头发 on me
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我头发都白了
13:46
and caused造成 all kinds of issues问题.
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期间尽是这样那样的问题
13:48
But conceptually概念, it's essentially实质上 simple简单.
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但这一概念本质上还是很简单的
13:52
So we've我们已经 given特定 them into the vein静脉, right?
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于是我们把干细胞注射进了血管
13:55
So in order订购 to measure测量 whether是否
this was successful成功 or not,
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为了测量我们成功与否
13:59
we measured测量 the optic视神经 nerve神经
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我们测量了视觉神经
14:01
as our outcome结果 measure测量.
336
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作为我们成果的测量
14:02
And that's a good thing to measure测量 in M.S.,
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这在多发性硬化症中很有效
14:04
because patients耐心 with M.S. sadly可悲的是 suffer遭受
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因为多发性硬化症的患者很不幸的
14:06
with problems问题 with vision视力 --
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会出现视力问题——
14:08
loss失利 of vision视力, unclear不明 vision视力.
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失明 视线模糊
14:10
And so we measured测量 the size尺寸 of the optic视神经 nerve神经
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所以我们测量了视觉神经
14:12
using运用 the scans扫描 with David大卫 Miller磨坊主
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通过对米勒大卫进行扫描
14:14
three times -- 12 months个月, six months个月,
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总共三次——12个月前一次 6个月前一次
14:16
and before the infusion注入 --
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以及注射前一次——
14:18
and you can see the gently平缓 declining下降 red line线.
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你们可以看到红线有轻微的下降
14:21
And that's telling告诉 you that
the optic视神经 nerve神经 is shrinking萎缩,
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这就是说视觉神经正在减少
14:23
which哪一个 makes品牌 sense, because their nerves神经 are dying垂死.
347
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确实说得通 因为这一神经细胞正在死亡
14:25
We then gave the stem cell细胞 infusion注入
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然后我们注射了干细胞
14:28
and repeated重复 the measurement测量 twice两次 --
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并且连续测量了两次——
14:30
three months个月 and six months个月 --
350
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三个月一次及六个月一次——
14:31
and to our surprise, almost几乎,
351
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1973
令我们吃惊的是
14:33
the line's线的 gone走了 up.
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这条线上升了
14:36
That suggests提示 that the intervention介入
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这意味着这一干预
14:38
has been protective保护的.
354
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奏效了
14:40
I don't think myself that what's happened发生
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我个人认为
14:42
is that those stem cells细胞 have made制作 new myelin髓鞘
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870356
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这些干细胞并没有生长出新的髓磷脂
14:44
or new nerves神经.
357
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或者新的神经
14:45
What I think they've他们已经 doneDONE is they've他们已经 promoted提拔
358
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我认为是促进了
14:48
the endogenous内源性 stem cells细胞, or precursor先导 cells细胞,
359
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内生的干细胞或者是前体细胞
14:50
to do their job工作, wake唤醒 up, lay铺设 down new myelin髓鞘.
360
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3451
唤醒了他们使之能覆盖新的髓磷脂
14:54
So this is a proof证明 of concept概念.
361
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研究证明了这一点
14:56
I'm very excited兴奋 about that.
362
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我对此十分激动
14:58
So I just want to end结束 with the theme主题 I began开始 on,
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最后结束时我想再提先前的主题
15:01
which哪一个 was regeneration再生 and hope希望.
364
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1990
即再生长以及希望
15:03
So here I've asked John约翰
365
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我又问了约翰
15:05
what his hopes希望 are for the future未来.
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2298
他未来的希望是什么
15:07
John约翰: I would hope希望 that
367
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约翰:我希望
15:09
sometime某时 in the future未来
368
897286
1800
未来的某一天
15:11
through通过 the research研究 that you people are doing,
369
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通过你们的研究
15:13
we can come up with a cure治愈
370
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2209
我们的疾病得以治愈
15:15
so that people like me can lead a normal正常 life.
371
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像我这样的病人就能过正常的生活了
15:19
SCSC: I mean, that speaks说话 volumes.
372
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这已经说的很明白了
15:22
But I'd like to close by first of all thanking表达感谢 John约翰 --
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在结束这次演讲时 我首先想先感谢约翰
15:24
thanking表达感谢 John约翰 for allowing允许 me to share分享
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使我能够与你们分享他的
15:26
his insights见解 and these clips剪辑 with you all.
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见解以及这些片段
15:29
But I'd also like to add to John约翰 and to others其他
376
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我想对约翰及其他人补充的是
15:32
that my own拥有 view视图 is, I'm hopeful有希望 for the future未来.
377
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我个人的想法是 我对未来充满希望
15:34
I do believe that the disruptive破坏性 technologies技术
378
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我相信这样的极具颠覆性的技术
15:37
like stem cells细胞 that I've tried试着 to explain说明 to you
379
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例如我前面解释的干细胞一样
15:39
do offer提供 very real真实 hope希望.
380
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确实给了我们希望
15:40
And I do think that the day that we might威力 be able能够
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我坚信我们能够
15:42
to repair修理 the damaged破损 brain
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修复受损大脑的那一天
15:44
is sooner than we think.
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一定会提早到来
15:45
Thank you.
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谢谢
15:47
(Applause掌声)
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(掌声)
Translated by Liu Xiying
Reviewed by Dong Mao

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ABOUT THE SPEAKER
Siddharthan Chandran - Regenerative neurologist
Siddharthan Chandran explores how to heal damage from degenerative disorders such as MS and motor neuron disease (ALS).

Why you should listen

Multiple sclerosis (MS) affects the nervous system by chewing up the axons that connect neurons to one another, which slows, stops or simply randomizes the transmission of nerve impulses. At the Centre for clinical brain sciences at the University of Edinburgh, Siddharthan Chandran works in the emerging discipline of regenerative neurology -- exploring how injured or damaged neurons in the brain might actually be repaired.
 
His research strategy uses MS and motor neuron disease (ALS, or Lou Gehrig's diesease) as primary disease models, combining laboratory and clinical activity to study  brain injury, neurodegeneration and repair, using stem cells to model and test. His work, he says, "reflects the complexity of the brain. You can replace a kidney, but not a brain. One must remain careful and humble in the face of current knowledge." He is also director of the Anne Rowling Regenerative Neurology Clinic.

More profile about the speaker
Siddharthan Chandran | Speaker | TED.com

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