TEDxJacksonville
Joy Wolfram: How nanoparticles could change the way we treat cancer
乔伊·沃尔夫拉姆: 纳米粒子如何改变治疗癌症的方式
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百分之九十的癌症药物都不会到达肿瘤。在药物生效之前，它们就会被身体排出。我们该如何改善这些救命药呢？癌症研究人员乔伊·沃尔夫拉姆（乔伊·沃尔夫拉姆）分享了纳米粒子的前沿研究——纳米粒子是能够被用来准确运输癌症药物的微小粒子。乔伊还解释了纳米粒子是如何给药物更多时间发挥功效的。
Joy Wolfram - Nanotechnologist
Joy Wolfram leads a nanomedicine research lab with the goal of developing innovative nanoparticles that bring the next generation of treatments directly to the clinic. Full bio
Joy Wolfram leads a nanomedicine research lab with the goal of developing innovative nanoparticles that bring the next generation of treatments directly to the clinic. Full bio
Double-click the English transcript below to play the video.
00:13
It was a Sunday afternoon
back in April of this year.
back in April of this year.
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去年四月一个周日的下午，
00:17
My phone was ringing,
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我收到了一个电话。
00:19
I picked it up.
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我接了起来，
00:21
The voice said, "It's Rebecca.
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“我是丽贝卡，
00:24
I'm just calling to invite you
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我给你打电话，
00:27
to my funeral."
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是为了邀请你来我的葬礼。”
00:30
I said, "Rebecca,
what are you talking about?"
what are you talking about?"
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我说，“丽贝卡，你在说什么？”
00:33
She said, "Joy, as my friend,
you have to let me go.
you have to let me go.
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她说，“乔伊，
作为我的朋友，你需要放手，
作为我的朋友，你需要放手，
是时候让我离开了。”
00:39
It's my time."
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00:41
The next day, she was dead.
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第二天，她去世了。
00:46
Rebecca was 31 years old when she died.
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丽贝卡去世时才31岁。
00:49
She had an eight-year struggle
with breast cancer.
with breast cancer.
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她和乳腺癌斗争了八年。
00:53
It came back three times.
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癌症复发了三次。
00:55
I failed her.
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我让她失望了。
00:58
The scientific community failed her.
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科学界让她失望了。
01:01
And the medical community failed her.
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医疗界也让她失望了。
01:05
And she's not the only one.
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而且她不是唯一一个。
01:07
Every five seconds,
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每五秒钟，
01:09
someone dies of cancer.
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就有一个人死于癌症。
01:13
Today, we medical
researchers are committed
researchers are committed
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当下，我们医疗研究者
下决心不让像丽贝卡和
01:17
to having Rebecca and people like her
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01:20
be one of the last patients that we fail.
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像她这样的人再失望。
01:24
The US government alone has spent
over 100 billion on cancer research
over 100 billion on cancer research
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自二十世纪七十年代，美国政府
已经花了将近一千亿美元
已经花了将近一千亿美元
来研究癌症。
01:30
since the 1970s,
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01:32
with limited progress
in regards to patient survival,
in regards to patient survival,
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可是病人的存活率
却没有很大的改善，
却没有很大的改善，
01:36
especially for certain types
of very aggressive cancers.
of very aggressive cancers.
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特别是某些非常有侵略性的癌症。
01:40
So we need a change because, clearly,
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所以我们需要改变，
01:43
what we've been doing so far
has not been working.
has not been working.
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我们所做的并没有很突出的成效。
01:48
And what we do in medicine
is to send out firefighters,
is to send out firefighters,
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我们就像是派出消防员，
01:51
because cancer is like a big fire.
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来消灭烈火燎原一般的癌症。
01:54
And these firefighters
are the cancer drugs.
are the cancer drugs.
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这些消防员就是治疗癌症的药物。
01:58
But we're sending them out
without a fire truck --
without a fire truck --
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但是我们没有给它们消防车，
02:02
so without transportation, without ladders
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没有运输工具，没有云梯，
02:05
and without emergency equipment.
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没有应急设备。
02:08
And over 99 percent of these firefighters
never make it to the fire.
never make it to the fire.
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所以超过99%的
消防员都到达不了火场。
消防员都到达不了火场。
02:15
Over 99 percent of cancer drugs
never make it to the tumor
never make it to the tumor
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超过99%的癌症药物
都到达不了肿瘤，
都到达不了肿瘤，
02:20
because they lack transportation and tools
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因为它们缺少运输方式和工具
02:24
to take them to the location
they're aiming for.
they're aiming for.
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让它们到达目的地。
02:29
Turns out, it really is all about
location, location, location.
location, location, location.
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而这就跟房地产一样，
地点非常非常重要。
地点非常非常重要。
02:33
(Laughter)
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（笑声）
02:35
So we need a fire truck
to get to the right location.
to get to the right location.
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所以我们需要
让癌症药物到达准确的地点。
让癌症药物到达准确的地点。
02:40
And I'm here to tell you
that nanoparticles are the fire trucks.
that nanoparticles are the fire trucks.
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我认为纳米粒子就是
我们所需要的工具。
我们所需要的工具。
02:45
We can load cancer drugs
inside nanoparticles,
inside nanoparticles,
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我们可以把癌症药物
放在纳米粒子里面，
放在纳米粒子里面，
02:49
and nanoparticles
can function as the carrier
can function as the carrier
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这些粒子就是能够
让药物到达肿瘤中心
02:53
and necessary equipment
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的载体和必要工具。
02:55
to bring the cancer drugs
to the heart of the tumor.
to the heart of the tumor.
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03:00
So what are nanoparticles,
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什么是纳米粒子，
03:01
and what does it really mean
to be nano-sized?
to be nano-sized?
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纳米到底是多大？
03:05
Well, there are many different
types of nanoparticles
types of nanoparticles
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纳米粒子有很多种，
03:09
made out of various materials,
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由不同的材料组成，
03:10
such as metal-based nanoparticles
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比如金属基纳米粒子，
03:14
or fat-based nanoparticles.
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或者脂肪基纳米粒子。
03:17
But to really illustrate
what it means to be nano-sized,
what it means to be nano-sized,
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但是为了展示纳米材料的大小，
03:20
I took one of my hair strands
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我拿了我的一根头发
03:23
and placed it under the microscope.
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放在显微镜下。
03:26
Now, I have very thin hair,
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我的头发很细，
03:27
so my hair is approximately
40,000 nanometers in diameter.
40,000 nanometers in diameter.
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它的直径差不多是四万纳米。
03:33
So this means, if we take
400 of our nanoparticles
400 of our nanoparticles
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这意味着四百个纳米粒子
03:36
and we stack them on top of each other,
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一个一个叠在一起，
03:39
we get the thickness
of a single hair strand.
of a single hair strand.
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就是一根头发的厚度。
03:43
I lead a nanoparticle laboratory
to fight cancer and other diseases
to fight cancer and other diseases
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我在杰克逊维尔当地的
梅奥诊所领导着一个用纳米粒子
梅奥诊所领导着一个用纳米粒子
03:49
at Mayo Clinic here in Jacksonville.
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治疗癌症和其它疾病的实验室。
03:52
And at Mayo Clinic,
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在梅奥诊所，
03:53
we really have the tools
to make a difference for patients,
to make a difference for patients,
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我们拥有能够改变病人生活的工具，
03:57
thanks to the generous donations
and grants to fund our research.
and grants to fund our research.
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这要归功于
赠予实验室的大量捐款。
赠予实验室的大量捐款。
04:03
And so, how do these nanoparticles
manage to transport cancer drugs
manage to transport cancer drugs
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这些纳米粒子又是怎么
把癌症药物运送到肿瘤的呢？
04:08
to the tumor?
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04:09
Well, they have an extensive toolbox.
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它们的方法和工具有很多。
04:13
Cancer drugs without nanoparticles
are quickly washed out of the body
are quickly washed out of the body
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没有纳米粒子的
癌症药物会被肾脏
癌症药物会被肾脏
04:18
through the kidneys
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快速的排出，
04:19
because they're so small.
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因为它们太小了。
04:21
So it's like water going through a sieve.
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就像是水流过漏斗一样。
04:24
And so they don't really have time
to reach the tumor.
to reach the tumor.
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所以它们没有时间到达肿瘤。
04:27
Here we see an illustration of this.
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这是一个过程的演示。
04:30
We have the firefighters,
the cancer drugs.
the cancer drugs.
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癌症药物，就是消防员，
04:32
They're circulating in the blood,
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它们在血液里循环，
04:34
but they're quickly
washed out of the body
washed out of the body
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但是它们很快被身体排出，
04:36
and they don't really end up
inside the tumor.
inside the tumor.
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而根本不会到达肿瘤。
04:40
But if we put these cancer drugs
inside nanoparticles,
inside nanoparticles,
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但是如果把它们放在纳米粒子里，
04:45
they will not get washed out by the body
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它们就不会被身体排出，
04:47
because the nanoparticles are too big.
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因为纳米粒子太大了。
04:49
And they will continue
to circulate in the blood,
to circulate in the blood,
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所以它们会继续在血液里循环，
04:52
giving them more time to find the tumor.
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就有更多的时间找到肿瘤。
04:56
And here we see the cancer drug,
the firefighters,
the firefighters,
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这里我们可以看到
癌症药物，就是消防员，
癌症药物，就是消防员，
04:58
inside the fire truck, the nanoparticles.
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在纳米粒子“消防车”里。
05:02
They're circulating in the blood,
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它们在血液里循环，
05:04
they don't get washed out
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不会被排出，
05:05
and they actually end up
reaching the tumor.
reaching the tumor.
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它们最后到达了肿瘤。
05:11
And so what other tools
do nanoparticles have?
do nanoparticles have?
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纳米粒子还有什么功能？
05:14
Well, they can protect cancer drugs
from getting destroyed inside the body.
from getting destroyed inside the body.
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它们可以保护药物不被损坏。
05:20
There are certain very important
but sensitive drugs
but sensitive drugs
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有些非常重要但很脆弱的药物
05:24
that are easily degraded
by enzymes in the blood.
by enzymes in the blood.
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很容易会被血液里的酶给分解。
05:27
So unless they have
this nanoparticle protection,
this nanoparticle protection,
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所以除非它们有
这些纳米粒子的保护，
这些纳米粒子的保护，
05:30
they will not be able to function.
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它们就不会发挥功效。
05:34
Another nanoparticle tool
are these surface extensions
are these surface extensions
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纳米粒子的另一个作用是
这些表面上的触角，
这些表面上的触角，
05:37
that are like tiny hands with fingers
that grab on to the tumor
that grab on to the tumor
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它们像小手一样能够抓住肿瘤，
05:42
and fit exactly onto it,
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丝毫不松手。
05:44
so that when the nanoparticles
are circulating,
are circulating,
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所以当纳米粒子在血液里循环，
05:46
they can attach onto the cancer cells,
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它们会粘附在癌症细胞上，
05:49
buying the cancer drugs
more time to do their job.
more time to do their job.
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让癌症药物有更多的时间发挥功效。
05:53
And these are just some of the many tools
that nanoparticles can have.
that nanoparticles can have.
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这些还不是纳米粒子的全部作用。
05:58
And today,
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现在，
05:59
we have more than 10 clinically approved
nanoparticles for cancer
nanoparticles for cancer
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我们给了世界各地的病人
超过10种临床批准的
癌症治疗纳米粒子。
癌症治疗纳米粒子。
06:03
that are given to patients
all over the world.
all over the world.
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06:08
Yet, we have patients,
like Rebecca, who die.
like Rebecca, who die.
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当然，还是有病人
像丽贝卡这样，没能幸存。
像丽贝卡这样，没能幸存。
06:13
So what are the major
challenges and limitations
challenges and limitations
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现有的纳米粒子技术
06:17
with currently approved nanoparticles?
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有什么主要的挑战和缺陷呢？
06:21
Well, a major challenge is the liver,
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一个主要的挑战是肝，
06:24
because the liver is the body's
filtration system,
filtration system,
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肝是人体的过滤系统，
06:28
and the liver recognizes
and destroys foreign objects,
and destroys foreign objects,
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可以识别并销毁外来物体，
06:31
such as viruses, bacteria
and also nanoparticles.
and also nanoparticles.
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比如病毒、细菌和纳米粒子。
06:36
And the immune cells in the liver
eat the nanoparticles,
eat the nanoparticles,
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肝里的免疫细胞会吞噬纳米粒子，
06:39
preventing them from reaching the tumor.
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让它们到不了肿瘤。
06:45
And here we see an illustration
where the kidney is no longer a problem,
where the kidney is no longer a problem,
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这个演示表明
通过肾脏已经不是问题，
通过肾脏已经不是问题，
06:49
but these fire trucks, the nanoparticles,
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但是这些纳米粒子，
06:51
get stuck in the liver
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会被卡在肝里，
06:53
and, actually, less of them
end up reaching the tumor.
end up reaching the tumor.
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很少会到达肿瘤。
06:59
So a future strategy
to improve nanoparticles
to improve nanoparticles
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改善纳米粒子的可行方案
07:02
is to temporarily disarm
the immune cells in the liver.
the immune cells in the liver.
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是暂时性地关闭
肝脏中的免疫细胞。
肝脏中的免疫细胞。
07:07
So how do we disarm these cells?
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我们怎么做到呢？
07:09
Well, we looked at drugs
that were already clinically approved
that were already clinically approved
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我们查看了其他
有临床批准的药物，
07:13
for other indications
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07:15
to see if any of them
could stop the immune cells
could stop the immune cells
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看它们能不能让免疫细胞
07:18
from eating the nanoparticles.
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不吞噬纳米粒子。
07:21
And unexpectedly,
in one of our preclinical studies,
in one of our preclinical studies,
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出乎意料，在之前的研究里，
07:25
we found that a 70-year-old malaria drug
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我们找到了一个70年前的疟疾药物。
07:30
was able to stop the immune cells
from internalizing the nanoparticles
from internalizing the nanoparticles
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它能够让免疫细胞不吞噬纳米粒子，
07:34
so that they could escape the liver
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这样纳米粒子就能够通过肝
07:37
and continue their journey
to their goal, the tumor.
to their goal, the tumor.
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并继续循环到肿瘤。
07:42
And here we see the illustration
of blocking the liver.
of blocking the liver.
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从这张图可以看到肝被关闭。
07:45
The nanoparticles don't go there,
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纳米粒子不会到达肝，
07:47
and they instead end up in the tumor.
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而会最后到达肿瘤。
07:51
So, sometimes, unexpected connections
are made in science
are made in science
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有的时候，科学中
一些意想不到的联系
一些意想不到的联系
07:55
that lead to new solutions.
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能够带领我们找到新的解决方法。
07:59
Another strategy
for preventing nanoparticles
for preventing nanoparticles
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另外一个不让纳米粒子
被肝过滤的方法，
08:03
from getting stuck in the liver
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08:06
is to use the body's own nanoparticles.
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是用我们身体自带的纳米粒子。
08:09
Yes -- surprise, surprise.
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没有错，想不到吧？
08:10
You, and you and you, and all of us
have a lot of nanoparticles
have a lot of nanoparticles
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我们所有人体内都有很多纳米粒子
08:16
circulating in our bodies.
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在我们的血液里循环。
08:18
And because they're part of our bodies,
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因为它们是我们身体的一部分，
08:21
the liver is less likely
to label them as foreign.
to label them as foreign.
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肝就更不可能会
把它们当成外来物。
把它们当成外来物。
08:26
And these biological nanoparticles
can be found in the saliva,
can be found in the saliva,
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这些人体的纳米粒子可以在唾液、
08:30
in the blood, in the urine,
in pancreatic juice.
in pancreatic juice.
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血液、尿液和胰液里找到。
08:33
And we can collect them from the body
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我们可以从身体里提取这些液体，
08:35
and use them as fire trucks
for cancer drugs.
for cancer drugs.
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并把它们当成癌症药物的消防车。
08:40
And in this case,
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这样，
08:42
the immune cells in the liver
are less likely to eat
are less likely to eat
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肝里面的免疫细胞就更不会
08:45
the biological nanoparticles.
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吞噬这些纳米粒子。
08:47
So we're using
a Trojan-horse-based concept
a Trojan-horse-based concept
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这个方式很像特洛伊木马，
08:50
to fool the liver.
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来欺骗肝。
08:52
And here we see
the biological nanoparticles
the biological nanoparticles
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这里我们看到纳米粒子
08:55
circulating in the blood.
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在血液里循环。
08:56
They don't get recognized by the liver,
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它们不会被肝识别，
08:59
and they end up in the tumor.
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并最后到达肿瘤。
09:02
And in the future,
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在未来，
09:03
we want to exploit
nature's own nanoparticles
nature's own nanoparticles
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我们想用非人造的纳米粒子
09:07
for cancer drug delivery,
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来当癌症药物的运载工具，
09:10
to reduce side effects and save lives
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并减少副作用和保护肝，
09:13
by preventing the cancer drugs
from being in the wrong location.
from being in the wrong location.
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让癌症药物直达肿瘤。
09:19
However, a major problem has been:
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但是，一个很重要的问题是
09:21
How do we isolate these biological
nanoparticles in large quantities
nanoparticles in large quantities
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我们如何大量抽取这些纳米粒子
09:27
without damaging them?
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而不损坏它们？
09:30
My lab has developed
an efficient method for doing this.
an efficient method for doing this.
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我的实验室研究出了
一种有效的方法。
一种有效的方法。
09:33
We can process large quantities
of liquids from the body
of liquids from the body
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我们可以用大量体液
09:38
to produce a highly concentrated,
high-quality formulation
high-quality formulation
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来产出高浓度高质量的
09:43
of biological nanoparticles.
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纳米粒子。
09:46
And these nanoparticles
are not yet in clinical use,
are not yet in clinical use,
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这些纳米粒子还没有被投入使用，
09:50
because it takes an average of 12 years
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因为把实验室的研究
09:53
to get something from the lab
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放到你的药箱里，
09:55
to your medicine cabinet.
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一般需要12年。
10:00
And this is the type of challenge
that requires teamwork
that requires teamwork
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面对这样的挑战，
需要投身于这场战斗的
10:04
from scientists and physicians,
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科学家和医师团队协作。
10:07
who dedicate their lives to this battle.
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10:12
And we keep going,
thanks to inspiration from patients.
thanks to inspiration from patients.
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为了病人们，·我们要坚持不懈。
10:17
And I believe that if we keep working
on these nanomedicines,
on these nanomedicines,
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我相信如果我们继续研发
这些纳米药物，
这些纳米药物，
10:21
we will be able to reduce harm
to healthy organs,
to healthy organs,
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就能够减少对器官的损伤，
10:25
improve quality of life
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提高病人的生活质量，
10:27
and save future patients.
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并挽救他们的生命。
10:32
I like to imagine
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我喜欢想象
10:34
that if these treatments
had been available for Rebecca,
had been available for Rebecca,
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如果有人提供给丽贝卡
这些治疗方案，
这些治疗方案，
10:39
that call from her
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她的那个电话，
10:41
could have been an invitation
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就可能会是邀请我
10:44
not to her funeral,
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去她的婚礼，
10:46
but her wedding.
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而不是葬礼。
10:47
Thank you.
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谢谢。
10:48
(Applause)
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（鼓掌）
Translated by Conway Ye
ABOUT THE SPEAKER
Joy Wolfram - NanotechnologistJoy Wolfram leads a nanomedicine research lab with the goal of developing innovative nanoparticles that bring the next generation of treatments directly to the clinic.
Why you should listen
Dr. Joy Wolfram has designed many preclinical nanoparticles for treating cancer and other life-threatening diseases, and has authored more than 50 publications in the past five years. She is the director of the Nanomedicine and Extracellular Vesicles Laboratory at Mayo Clinic in Jacksonville, Florida, and holds affiliate faculty positions at the Houston Methodist Hospital, the University of North Florida and the Chinese Academy of Sciences. She is a board member and scientific advisor of several companies around the world with a cumulative customer base of more than 18 million.
Wolfram's mission is to inspire and support underrepresented minorities in science. She is actively involved in community outreach and scientific education, including serving as the chair of an education and outreach working group of the National Cancer Institute in the United States. She was included in the Amgen Scholars "ten to watch" list, which highlights the best and brightest up-and-comers in science and medicine across 42 countries.
A native of Finland, Wolfram was selected as one of 12 internationally accomplished Finns, alongside Nobel laureates. She was also listed on the Forbes "30 under 30" in healthcare in 2019. Additionally, she is part of the Global Young Academy, which represents 83 countries and is limited to 200 members who are selected based on scientific excellence and commitment to service.
Joy Wolfram | Speaker | TED.com