TEDGlobal 2012
Nina Tandon: Could tissue engineering mean personalized medicine?
Nina Tandon: Može li tkivni Inženjering značiti personaliziranu medicina?
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Sva tijela su krajnje jedinstvena, što je lijepa misao dok ne dođemo do liječenja bolesti -- gdje svako tijelo reagira dugačije, često nepredvidljivo, na standardnu terapiju. Tkivni inžinjer Nina Tandon govori o mogućem rješenju: koristeći se pluripotentnim matičnim stanicama kako bi se stvorili personalizirani modeli organa na kojima se mogu testirati novi lijekovi i terapije, te njihovo pohranjivanje na čipove. (Nazovimo to ekstremno personalizirana medicina.)
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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Voljela bih vam pokazati
snimku nekih od modela
snimku nekih od modela
00:18
I work with.
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s kojima radim.
00:20
They're all the perfect size, and they don't have an ounce of fat.
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Svi su savršene veličine i
nemaju ni trunke masti.
nemaju ni trunke masti.
00:23
Did I mention they're gorgeous?
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Jesam li spomenula da su prekrasni?
00:26
And they're scientific models? (Laughs)
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I da su znanstveni modeli? (Smijeh)
00:29
As you might have guessed, I'm a tissue engineer,
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Kao što ste mogli pretpostaviti,
ja sam tkivni inženjer,
ja sam tkivni inženjer,
00:31
and this is a video of some of the beating heart
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a ovo je snimka kucajućeg srca
00:34
that I've engineered in the lab.
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koje sam projektirala u labosu.
00:36
And one day we hope that these tissues
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Nadamo se da će jednog dana ova tkiva
00:38
can serve as replacement parts for the human body.
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služiti kao zamjena za
dijelove ljudskog tijela.
dijelove ljudskog tijela.
00:41
But what I'm going to tell you about today
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Ono o čemu ću danas pričati
00:43
is how these tissues make awesome models.
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je kako ova tkiva čine odlične modele.
00:48
Well, let's think about the drug screening process for a moment.
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Dobro, razmislimo na
trenutak o testiranju lijekova.
trenutak o testiranju lijekova.
00:50
You go from drug formulation, lab testing, animal testing,
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Krećemo od stvaranja lijeka, testiranja
u labosu, testiranja na životinjama
u labosu, testiranja na životinjama
00:53
and then clinical trials, which you might call human testing,
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zatim klinička testiranja, koja možemo
zvati testiranjem na ljudima,
zvati testiranjem na ljudima,
00:56
before the drugs get to market.
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prije nego što se lijek pusti u prodaju.
00:58
It costs a lot of money, a lot of time,
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Sve to zahtijeva puno novaca i vremena,
01:01
and sometimes, even when a drug hits the market,
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a ponekad, čak i kad lijek dođe na tržište,
01:04
it acts in an unpredictable way and actually hurts people.
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ponaša se nepredvidivo i našteti ljudima.
01:08
And the later it fails, the worse the consequences.
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Što kasnije zakaže, to su gore posljedice.
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 nisu štakori,
Prvo, ljudi nisu štakori,
01:16
and two, despite our incredible similarities to one another,
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i drugo, unatoč našim nevjerojatnim
međusobnim sličnostima,
međusobnim sličnostima,
01:20
actually those tiny differences between you and I
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zapravo one sitne razlike između vas i mene
01:23
have huge impacts with how we metabolize drugs
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imaju ogroman utjecaj na način na koji
metaboliziramo lijekove
metaboliziramo lijekove
01:25
and how those drugs affect us.
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i kako ti lijekovi utječu na nas.
01:27
So what if we had better models in the lab
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Stoga, što bi bilo kada bi
imali bolje modele u labosu,
imali bolje modele u labosu,
01:30
that could not only mimic us better than rats
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koji ne samo da će nas
bolje oponašati od štakora
bolje oponašati od štakora
01:33
but also reflect our diversity?
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već odražavati naše različitosti.
01:37
Let's see how we can do it with tissue engineering.
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Pogledajmo kako to možemo
postići s tkivnim inženjerstvom.
postići s tkivnim inženjerstvom.
01:41
One of the key technologies that's really important
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Jedna od ključnih tehnologija
koja je uistinu važna
koja je uistinu važna
01:44
is what's called induced pluripotent stem cells.
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je nešto što se naziva inducirane
pluripotentne matične stanice.
pluripotentne matične stanice.
01:47
They were developed in Japan pretty recently.
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Razvijene su u Japanu, prilično nedavno.
01:49
Okay, induced pluripotent stem cells.
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U redu, inducirane pluripotentne
matične stanice.
matične stanice.
01:52
They're a lot like embryonic stem cells
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Vrlo su slične embrionalnim
matičnim stanicama
matičnim stanicama
01:54
except without the controversy.
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osim što oko njih nema polemike.
01:56
We induce cells, okay, say, skin cells,
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Induciramo stanice, u redu,
recimo, stanice kože,
recimo, stanice kože,
01:59
by adding a few genes to them, culturing them,
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dodajući im par gena, uzgajamo ih,
02:02
and then harvesting them.
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i onda ih pobiremo.
02:03
So they're skin cells that can be tricked,
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Dakle, one su kožne stanice
koje možemo prevariti
koje možemo prevariti
02:06
kind of like cellular amnesia, into an embryonic state.
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u nešto poput stanične amnezije,
u embrionalnom stanju.
u embrionalnom stanju.
02:09
So without the controversy, that's cool thing number one.
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Stoga, bez diskusije, to je najzanimljivija
stvar u vezi toga.
stvar u vezi toga.
02:11
Cool thing number two, you can grow any type of tissue
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Druga zanimljivost je ta da se iz njih mogu
uzgajati sve vrste tkiva:
uzgajati sve vrste tkiva:
02:14
out of them: brain, heart, liver, you get the picture,
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mozak, srce, jetra, razumijete,
02:16
but out of your cells.
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ali od vaših stanica.
02:19
So we can make a model of your heart, your brain
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Stoga, možemo napraviti
model vašeg srca, mozga
model vašeg srca, mozga
02:23
on a chip.
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na čipu.
02:25
Generating tissues of predictable density and behavior
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Proizvodnja tkiva čija su gustoća
i ponašanje predvidljivi
i ponašanje predvidljivi
02:28
is the second piece, and will be really key towards
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je drugi dio, i bit će zaista ključno za to
02:31
getting these models to be adopted for drug discovery.
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da se usvoji korištenje ovih
modela u otkrivanju lijekova.
modela u otkrivanju lijekova.
02:34
And this is a schematic of a bioreactor we're developing in our lab
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Ovo je shema bioreaktora
kojeg smo razvili u labosu
kojeg smo razvili u labosu
02:37
to help engineer tissues in a more modular, scalable way.
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kako bi pomogao u izradi tkiva
na modularnije, skalarnije načine.
na modularnije, skalarnije načine.
02:40
Going forward, imagine a massively parallel version of this
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Zamislite, u budućnosti, masivnu
paralelnu verziju ovoga
paralelnu verziju ovoga
02:44
with thousands of pieces of human tissue.
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s tisućama ljudskih tkiva.
02:46
It would be like having a clinical trial on a chip.
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To bi bilo kao da imate
klinička ispitivanja na čipu.
klinička ispitivanja na čipu.
02:50
But another thing about these induced pluripotent stem cells
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Druga stvar u vezi tih inducirnih
pluripotentnih matičnih stanica
pluripotentnih matičnih stanica
02:54
is that if we take some skin cells, let's say,
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je ukoliko uzmemo neke
kožne stanice, recimo,
kožne stanice, recimo,
02:56
from people with a genetic disease
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od ljudi s genetskom 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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možemo koristiti tkivne inženjerske tehnike
03:03
to generate models of those diseases in the lab.
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kako bi napravili modele
tih bolesti u labosu.
tih bolesti u labosu.
03:06
Here's an example from Kevin Eggan's lab at Harvard.
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Ovdje imamo primjer iz
labosa Kevina Eggana na Harvardu.
labosa Kevina Eggana na Harvardu.
03:10
He generated neurons
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On je proizveo neurone
03:12
from these induced pluripotent stem cells
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od tih induciranih pluripotentnih
matičnih stanica
matičnih stanica
03:15
from patients who have Lou Gehrig's Disease,
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pacijenata koji imaju Lou Gehrigovu bolest,
03:17
and he differentiated them into neurons, and what's amazing
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te ih je diferencirao u neurone,
i ono što je zapanjujuće
i ono što je zapanjujuće
03:20
is that these neurons also show symptoms of the disease.
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je to da su ti neuroni pokazivali
znakove te bolesti.
znakove te bolesti.
03:23
So with disease models like these, we can fight back
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Dakle s modelima bolesti kao što
su ove, možemo uzvratiti udarac
su ove, možemo uzvratiti udarac
03:25
faster than ever before and understand the disease better
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brže nego što smo to ikad prije mogli
i možemo bolje razumjeti bolest
i možemo bolje razumjeti bolest
03:28
than ever before, and maybe discover drugs even faster.
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nego ikad prije, i možda
otkriti lijek još brže.
otkriti lijek još brže.
03:32
This is another example of patient-specific stem cells
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Ovo je još jedan primjer
matičnih stanica specifčnog pacijenta
matičnih stanica specifčnog pacijenta
03:35
that were engineered from someone with retinitis pigmentosa.
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koje su stvorene od nekoga
tko boluje od retinitis pigmentoze.
tko boluje od retinitis pigmentoze.
To je degenerativna bolest retine.
03:39
This is a degeneration of the retina.
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03:41
It's a disease that runs in my family, and we really hope
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To je bolest koja se javlja
u mojoj obitelji, i stvaro se nadam
u mojoj obitelji, i stvaro se nadam
03:43
that cells like these will help us find a cure.
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da će stanice poput
ovih pomoći u pronalasku lijeka.
ovih pomoći u pronalasku lijeka.
03:46
So some people think that these models sound well and good,
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Neki ljudi misle da su
ovi modeli odlična zamisao
ovi modeli odlična zamisao
03:48
but ask, "Well, are these really as good as the rat?"
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ali pitaju: "Jesu li stvarno
dobri poput štakora?"
dobri poput štakora?"
03:52
The rat is an entire organism, after all,
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Štakor je ipak cijeli organizam
03:55
with interacting networks of organs.
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sa svim interakcijama organa.
03:57
A drug for the heart can get metabolized in the liver,
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Lijek za srce se može
metabolizirati u jetri,
metabolizirati u jetri,
04:00
and some of the byproducts may be stored in the fat.
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i neki od nusprodukata se
mogu pohraniti u masti.
mogu pohraniti u masti.
04:03
Don't you miss all that with these tissue-engineered models?
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Zar se sve to ne gubi s
ovim modelom stvaranja tkiva?
ovim modelom stvaranja tkiva?
04:08
Well, this is another trend in the field.
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Ovo je drugi trend u ovom polju.
04:10
By combining tissue engineering techniques with microfluidics,
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Kombiniranjem tehnike
stvaranja tkiva s mikrofluidima,
stvaranja tkiva s mikrofluidima,
04:13
the field is actually evolving towards just that,
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polje zapravo napreduje upravo prema tome,
04:15
a model of the entire ecosystem of the body,
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modelu cijelog ekosustava tijela,
04:18
complete with multiple organ systems to be able to test
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potpunog sa raznim organskim
sustavima da bi se testiralo
sustavima da bi se testiralo
04:20
how a drug you might take for your blood pressure
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kako lijekovi koje uzimate za krvni tlak
04:22
might affect your liver or an antidepressant might affect your heart.
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možda utječu na vašu jetru
ili antidepresivi na vaše srce.
ili antidepresivi 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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Takve sustave je teško izgraditi,
i tek krećemo prema tome,
i tek krećemo prema tome,
04:29
and so, watch out.
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zato, pazite se.
04:32
But that's not even all of it, because once a drug is approved,
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Ali to nije sve, jer
jednom kada je lijek odobren,
jednom kada je lijek odobren,
04:35
tissue engineering techniques can actually help us develop more personalized treatments.
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tehnika razvoja tkiva može zapravo
pomoći razviti osobniji tretman.
pomoći razviti osobniji tretman.
04:38
This is an example that you might care about someday,
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Ovo je primjer onoga
što bi vas zanimalo jednog dana,
što bi vas zanimalo jednog dana,
04:42
and I hope you never do,
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ali nadam se da neće,
04:44
because imagine if you ever get that call
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jer zamislite ako dobijete taj poziv
04:47
that gives you that bad news that you might have cancer.
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koji donosi lošu vijest da možda imate rak.
04:50
Wouldn't you rather test to see if those cancer drugs
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Zar se ne bi ste radije testirali i
vidjeli djeluju li ti lijekovi za rak
vidjeli djeluju li ti lijekovi za rak
04:53
you're going to take are going to work on your cancer?
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koje će te uzimati na vaš rak?
04:55
This is an example from Karen Burg's lab, where they're
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Ovo je primjer iz labosa
Karen Burg, gdje oni
Karen Burg, gdje oni
04:58
using inkjet technologies to print breast cancer cells
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koristeći se tehnologijom printanja
printaju stanice raka dojke
printaju stanice raka dojke
05:01
and study its progressions and treatments.
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i proučavaju njegov napredak i tretman.
05:03
And some of our colleagues at Tufts are mixing models
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A neke od naših kolega na
Turfu miješaju modele
Turfu miješaju modele
05:06
like these with tissue-engineered bone to see how cancer
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poput ovih sa stvorenim
tkivom kosti i gledaju kako se rak
tkivom kosti i gledaju kako se rak
05:09
might spread from one part of the body to the next,
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širi s jednog dijela tijela na drugi,
05:12
and you can imagine those kinds of multi-tissue chips
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možete zamisliti čipove s različitim tkivima
05:14
to be the next generation of these kinds of studies.
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kao sljedeću generaciju ovakvih studija.
05:17
And so thinking about the models that we've just discussed,
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Razmislite o modelima
koje smo upravo spomenuli,
koje smo upravo spomenuli,
05:19
you can see, going forward, that tissue engineering
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vidite, napredujući, tkivni inženjirign
05:21
is actually poised to help revolutionize drug screening
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bi mogao zapravo revolucionizirati
razvoj lijekova
razvoj lijekova
05:24
at every single step of the path:
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u svakome koraku svoga puta:
05:26
disease models making for better drug formulations,
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modeli bolesti pomažu u
boljoj formulaciji lijekova,
boljoj formulaciji lijekova,
05:29
massively parallel human tissue models helping to revolutionize lab testing,
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masivni paralelni modeli ljudskih tkiva
revolucionariziraju testiranje u labosima,
revolucionariziraju testiranje u labosima,
05:33
reduce animal testing and human testing in clinical trials,
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smanjeno je testiranje na životinjama
i kliničko testiranje na ljudima,
i kliničko testiranje na ljudima,
05:37
and individualized therapies that disrupt
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i individualizirane terapije koje poništavaju
05:39
what we even consider to be a market at all.
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ono što smo smatrali tržištem.
05:42
Essentially, we're dramatically speeding up that feedback
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Zapravo, dramatično
ubrzavamo povratnu informaciju
ubrzavamo povratnu informaciju
05:45
between developing a molecule and learning about
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između razvoja molekule i proučavanja
05:47
how it acts in the human body.
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kako djeluje na ljudsko tijelo.
05:50
Our process for doing this is essentially transforming
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Napredak u tome je zapravo pretvorba
05:52
biotechnology and pharmacology into an information technology,
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biotehnike i farmakologije
u jednu informacijsku tehnologiju,
u jednu informacijsku tehnologiju,
05:57
helping us discover and evaluate drugs faster,
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pomažući nam razviti i
procijeniti lijekove brže,
procijeniti lijekove brže,
06:00
more cheaply and more effectively.
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jeftinije i efikasnije.
06:03
It gives new meaning to models against animal testing, doesn't it?
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dajući novo značenje modelima protiv
testiranja na životinjama, zar ne?
testiranja na životinjama, zar ne?
06:07
Thank you. (Applause)
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Hvala vam. (Pljesak)
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