TEDxGlasgow
Richard Weller: Could the sun be good for your heart?
Richard Weller: Može li Sunce koristiti našem srcu?
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1,175,703 views
Naša tijela stvaraju vitamin D zahvaljujući Suncu, ali dermatolog Richard Weller upućuje na još jednu iznenađujuću blagodat Sunčeve svjetlosti. Novi nalazi njegova istraživačkog tima govore da dušikov oksid, kemijski prijenosnik u ogromnim količinama pohranjen u koži, može biti oslobođen ultraljubičastom svjetlošću i tako blagotvorno djelovati na krvni tlak i na krvožilni sustav. Što to znači? Ha, to bi mogao zametak objašnjenja zašto Škoti pobolijevaju više od Australaca...
Richard Weller - Dermatologist
Dermatologist Richard Weller wants to know: Why are Scots so sick? Full bio
Dermatologist Richard Weller wants to know: Why are Scots so sick? Full bio
Double-click the English transcript below to play the video.
00:16
So, before I became a dermatologist,
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Prije no što sam postao dermatolog,
00:18
I started in general medicine,
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započeo sam se baviti općom medicinom,
00:21
as most dermatologists do in Britain.
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poput većine dermatologa u Britaniji.
00:23
At the end of that time, I went off to Australia,
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Na kraju tog razdoblja,
otišao sam u Australiju.
otišao sam u Australiju.
00:25
about 20 years ago.
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Prije 20-ak godina.
00:27
What you learn when you go to Australia
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U Australiji naučite
00:29
is the Australians are very competitive.
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da su Australci vrlo kompetitivni.
00:32
And they are not magnanimous in victory.
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I nisu velikodušni u pobjedi.
00:34
And that happened a lot:
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Puno se puta to događalo...
00:36
"You pommies, you can't play cricket, rugby."
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"Vi, dotepenci britanski,
ne znate igrati kriket, ragbi..."
ne znate igrati kriket, ragbi..."
00:38
I could accept that.
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To sam mogao prihvatiti.
00:40
But moving into work --
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Ali... prijeđimo na posao...
00:43
and we have each week what's called a journal club,
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Svakog tjedna okupljamo se
u tzv. znanstvenom klubu,
u tzv. znanstvenom klubu,
00:45
when you'd sit down with the other doctors
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gdje mi, liječnici,
međusobno razgovaramo
međusobno razgovaramo
00:48
and you'd study a scientific paper
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i proučavamo znanstvene radove
00:50
in relation to medicine.
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iz medicinskog područja.
00:52
And after week one, it was about cardiovascular mortality,
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Drugog tjedna... Tema je bila
smrtnost od kardiovaskularnih bolesti.
smrtnost od kardiovaskularnih bolesti.
00:54
a dry subject -- how many people die of heart disease,
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Suhoparno područje!
Koliko ljudi umire od srčanih bolesti,
Koliko ljudi umire od srčanih bolesti,
00:58
what the rates are.
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kolike su stope smrtnosti...?
01:00
And they were competitive about this:
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I u tome su bili
natjecateljski raspoloženi...
natjecateljski raspoloženi...
01:01
"You pommies, your rates of heart disease are shocking."
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"Vi, dotepenci britanski,
vaše stope srčanih bolesti su šokantne!
vaše stope srčanih bolesti su šokantne!
01:05
And of course, they were right.
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I, naravno, bili su u pravu.
01:06
Australians have about a third less heart disease than we do --
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Australci imaju oko trećinu manje
srčanih bolesti od nas.
srčanih bolesti od nas.
01:10
less deaths from heart attacks, heart failure, less strokes --
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Manje smrtnih slučajeva od srčanog udara,
zatajenja srca, manje moždanih udara...
zatajenja srca, manje moždanih udara...
01:14
they're generally a healthier bunch.
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Općenito su zdravija družina.
01:16
And of course they said this was because of
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I, naravno, rekli su da je to zbog
01:18
their fine moral standing, their exercise,
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njihovih visokih moralnih gledišta,
njihovog vježbanja,
njihovog vježbanja,
01:20
because they're Australians and we're weedy pommies, and so on.
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jer oni su Australci,
a mi smo pripiti britanski dotepenci,...
a mi smo pripiti britanski dotepenci,...
01:24
But it's not just Australia that has better health than Britain.
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Ali, nije Australija jedina zemlja
u kojoj su ljudi boljeg zdravlja od Britanaca.
u kojoj su ljudi boljeg zdravlja od Britanaca.
01:29
Within Britain, there is a gradient of health --
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U Velikoj Britaniji,
koristimo se tzv. gradijentom zdravlja -
koristimo se tzv. gradijentom zdravlja -
01:33
and this is what's called standardized mortality,
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to je ono što se naziva
standardiziranom stopom smrtnosti -
standardiziranom stopom smrtnosti -
01:35
basically your chances of dying.
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u osnovi, vjerojatnost da ćete umrijeti.
01:37
This is looking at data from the paper about 20 years ago,
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Ovo su podaci iz istraživanja
od prije 20-ak godina,
od prije 20-ak godina,
01:40
but it's true today.
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ali vrijede i danas.
01:42
Comparing your rates of dying 50 degrees north --
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Uspoređujući stope umiranja na
50 stupnjeva sjeverne zemljopisne širine -
50 stupnjeva sjeverne zemljopisne širine -
01:45
that's the South, that's London and places --
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to je jug... London, i obližnja mjesta -
01:47
by latitude, and 55 degrees --
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s onima na 55 stupnjeva...
01:50
the bad news is that's here, Glasgow.
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Loša vijest je da je to ovdje - Glasgow.
01:53
I'm from Edinburgh. Worse news, that's even Edinburgh.
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Ja sam iz Edinburgha.
Još gora vijest - to je čak i Edinburgh.
Još gora vijest - to je čak i Edinburgh.
01:55
(Laughter)
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(Smijeh)
02:00
So what accounts for this horrible space here
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Kako objasniti ovu strašnu razliku
02:03
between us up here in southern Scotland
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između nas ovdje gore, na jugu Škotske,
02:05
and the South?
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i ljudi na jugu Engleske?
02:06
Now, we know about smoking,
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O pušenju sve znamo,
02:08
deep-fried Mars bars, chips -- the Glasgow diet.
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o prženim čokoladicama,
čipsu, prehrani u Glasgowu....
čipsu, prehrani u Glasgowu....
02:10
All of these things.
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O svim tim stvarima.
02:12
But this graph is after taking into account
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Ali, ovaj prikaz uzima u obzir
02:14
all of these known risk factors.
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sve te poznate rizične čimbenike:
02:16
This is after accounting for smoking, social class, diet,
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i pušenje, i društvenu klasu, prehranu,
02:20
all those other known risk factors.
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i sve ostale poznate rizične čimbenike.
02:22
We are left with this missing space
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No, nedostaje nam i dalje razlog
02:24
of increased deaths the further north you go.
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povećane smrtnosti
što dalje idemo prema sjeveru.
što dalje idemo prema sjeveru.
02:28
Now, sunlight, of course, comes into this.
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Naravno, ne zaboravimo na
Sunčevu svjetlost...
Sunčevu svjetlost...
02:31
And vitamin D has had a great deal of press,
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O vitaminu D je u tisku bilo puno govora,
02:33
and a lot of people get concerned about it.
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i zainteresirano je mnogo ljudi.
02:35
And we need vitamin D. It's now a requirement that children have a certain amount.
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Nama je vitamin D potreban! Danas ga
djeca moraju imati u određenoj količini.
djeca moraju imati u određenoj količini.
02:39
My grandmother grew up in Glasgow,
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Moja je baka odrasla u Glasgowu,
02:41
back in the 1920s and '30s when rickets was a real problem
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1920-ih i 30-ih kada je
rahitis bio istinski problem,
rahitis bio istinski problem,
02:45
and cod liver oil was brought in.
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i kad je u liječenje uvedeno
bakalarevo jetreno ulje.
bakalarevo jetreno ulje.
02:47
And that really prevented the rickets that used to be common in this city.
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To je doista zaustavilo rahitis,
dotad uobičajen u ovom gradu.
dotad uobičajen u ovom gradu.
02:51
And I as a child was fed cod liver oil by my grandmother.
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I mene je moja baka u djetinjstvu
hranila bakalarevim jetrenim uljem.
hranila bakalarevim jetrenim uljem.
02:55
I distinctly -- nobody forgets cod liver oil.
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Jako se dobro sjećam... nitko
ne zaboravlja bakalarevo jetreno ulje!
ne zaboravlja bakalarevo jetreno ulje!
02:58
But an association: The higher people's blood levels of vitamin D are,
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Jedna asocijacija:
što je viša razina vitamina D u krvi,
što je viša razina vitamina D u krvi,
03:03
the less heart disease they have, the less cancer.
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rjeđe su srčane bolesti,
rjeđi je rak.
rjeđi je rak.
03:06
There seems to be a lot of data suggesting that vitamin D is very good for you.
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Čini se da dosta podataka ukazuje
da je vitamin D vrlo dobar za sve nas.
da je vitamin D vrlo dobar za sve nas.
03:10
And it is, to prevent rickets and so on.
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I jest, za sprečavanje
rahitisa i sličnih bolesti...
rahitisa i sličnih bolesti...
03:12
But if you give people vitamin D supplements,
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No, prepisujete li ljudima
dodatke vitaminu D,
dodatke vitaminu D,
03:15
you don't change that high rate of heart disease.
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ne smanjujete tu visoku
stopu srčanih bolesti.
stopu srčanih bolesti.
03:18
And the evidence for it preventing cancers is not yet great.
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I dokazi da oni sprečavaju nastanak
raka još uvijek nisu uvjerljivi.
raka još uvijek nisu uvjerljivi.
03:22
So what I'm going to suggest is that vitamin D is not the only story in town.
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Zato bih naglasio da vitamin D
nije jedino o čemu vrijedi govoriti.
nije jedino o čemu vrijedi govoriti.
03:27
It's not the only reason preventing heart disease.
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On nije jedino što sprečava
pojavu srčanih bolesti.
pojavu srčanih bolesti.
03:30
High vitamin D levels, I think, are a marker for sunlight exposure,
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Smatram da je visoka razina vitamina D
pokazatelj izlaganja suncu,
pokazatelj izlaganja suncu,
03:35
and sunlight exposure, in methods I'm going to show,
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a izlaganje suncu,
u postupcima koje ću prikazati,
u postupcima koje ću prikazati,
03:38
is good for heart disease.
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blagotvorno je za srčane bolesti.
03:40
Anyway, I came back from Australia,
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Kako god, vrativši se iz Australije,
03:42
and despite the obvious risks to my health, I moved to Aberdeen.
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i unatoč očitim rizicima za moje zdravlje,
preselio sam se u Aberdeen.
preselio sam se u Aberdeen.
03:46
(Laughter)
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(Smijeh)
03:48
Now, in Aberdeen, I started my dermatology training.
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U Aberdeenu sam započeo
s dermatološkom izobrazbom.
s dermatološkom izobrazbom.
03:51
But I also became interested in research,
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Međutim, zainteresirao sam se i
za istraživanje,
za istraživanje,
03:53
and in particular I became interested in this substance, nitric oxide.
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i to osobito dušikovog oksida.
03:56
Now these three guys up here,
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Ova trojica ovdje,
03:58
Furchgott, Ignarro and Murad,
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Furchgott, Ignarro i Murad,
03:59
won the Nobel Prize for medicine back in 1998.
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osvojila su Nobelovu nagradu za medicinu 1998.
04:03
And they were the first people to describe
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Oni su bili prvi koji su opisali
04:05
this new chemical transmitter, nitric oxide.
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ovaj novi kemijski prijenosnik - dušikov oksid.
04:08
What nitric oxide does is it dilates blood vessels,
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Dušikov oksid proširuje krvne žile
04:11
so it lowers your blood pressure.
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snižavajući tako krvni tlak.
04:13
It also dilates the coronary arteries, so it stops angina.
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Proširuje i srčane arterije,
onemogućavajući tako anginu.
onemogućavajući tako anginu.
04:17
And what was remarkable about it
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S time u vezi,
04:19
was in the past when we think of chemical messengers within the body,
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značajno je da smo nekoć,
sjetimo li se kemijskih glasnika u tijelu,
sjetimo li se kemijskih glasnika u tijelu,
04:23
we thought of complicated things like estrogen and insulin,
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razmišljali o kompleksnim stvarima
poput estrogena i inzulina,
poput estrogena i inzulina,
04:26
or nerve transmission.
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ili o živčanom prijenosu.
04:27
Very complex processes with very complex chemicals
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Vrlo složeni procesi,
s vrlo složenim kemikalijama,
s vrlo složenim kemikalijama,
04:31
that fit into very complex receptors.
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što se uklapaju u vrlo složene receptore.
04:33
And here's this incredibly simple molecule,
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A ovdje je ta nevjerojatno
jednostavna molekula,
jednostavna molekula,
04:35
a nitrogen and an oxygen that are stuck together,
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spoj dušika i kisika,
04:39
and yet these are hugely important for [unclear] our low blood pressure,
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no iznimno važna za
snižavanje krvnog tlaka,
snižavanje krvnog tlaka,
04:43
for neurotransmission, for many, many things,
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za prijenos živčanih impulsa,
za mnogo toga...
za mnogo toga...
04:46
but particularly cardiovascular health.
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Naročito za zdravlje krvožilnog sustava!
04:49
And I started doing research, and we found, very excitingly,
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Započeo sam s istraživanjima,
i otkrili smo - vrlo uzbudljivo! -
i otkrili smo - vrlo uzbudljivo! -
04:53
that the skin produces nitric oxide.
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da koža proizvodi dušikov oksid.
04:55
So it's not just in the cardiovascular system it arises.
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Dakle, ne pojavljuje se on samo
u krvožilnom sustavu...
u krvožilnom sustavu...
04:58
It arises in the skin.
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Pojavljuje se u koži.
05:00
Well, having found that and published that,
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Pošto smo to otkrili i objavili otkriće,
05:02
I thought, well, what's it doing?
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pomislio sam: Dobro, a na što on utječe?
05:04
How do you have low blood pressure in your skin?
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Kako postići nizak krvni tlak u koži?
05:05
It's not the heart. What do you do?
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Ne radi se o srcu.
Što učiniti?
Što učiniti?
05:07
So I went off to the States, as many people do if they're going to do research,
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Otišao sam u SAD, kao i mnogi ljudi
koji se kane baviti istraživanjima,
koji se kane baviti istraživanjima,
05:11
and I spent a few years in Pittsburgh. This is Pittsburgh.
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i proveo sam nekoliko godina
u Pittsburghu. Ovo je Pittsburgh.
u Pittsburghu. Ovo je Pittsburgh.
05:15
And I was interested in these really complex systems.
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Zanimali su me ovi
doista složeni sustavi.
doista složeni sustavi.
05:18
We thought that maybe nitric oxide affected cell death,
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Pomislili smo da dušikov oksid možda
utječe na umiranje stanica,
utječe na umiranje stanica,
05:22
and how cells survive, and their resistance to other things.
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i na preživljavanje stanica,
i na njihovu otpornost na razne tvari.
i na njihovu otpornost na razne tvari.
05:24
And I first off started work in cell culture, growing cells,
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Započeo sam raditi na staničnoj
kulturi, na uzgoju stanica...
kulturi, na uzgoju stanica...
05:28
and then I was using knockout mouse models --
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Potom sam koristio mišje
"knockout" modele -
"knockout" modele -
05:30
mice that couldn't make the gene.
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miševe koji nisu mogli
stvoriti gen...
stvoriti gen...
05:32
We worked out a mechanism, which -- NO was helping cells survive.
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Otkrili smo mehanizam prema kojemu
dušikov oksid pomaže stanicama preživjeti.
dušikov oksid pomaže stanicama preživjeti.
05:36
And I then moved back to Edinburgh.
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Onda sam se vratio u Edinburgh...
05:40
And in Edinburgh, the experimental animal we use is the medical student.
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A u Edinburghu, kao "laboratorijskog miša"
koristimo - studenta medicine.
koristimo - studenta medicine.
05:43
It's a species close to human,
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To je vrsta bliska ljudskoj,
05:45
with several advantages over mice:
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s nekoliko prednosti
u odnosu na miševe:
u odnosu na miševe:
05:47
They're free, you don't shave them, they feed themselves,
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besplatni su, nije ih potrebno
brijati, sami se hrane,
brijati, sami se hrane,
05:50
and nobody pickets your office saying,
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i nitko ne upada u
vaš ured uz riječi:
vaš ured uz riječi:
05:52
"Save the lab medical student."
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"Zaštitimo laboratorijskog
studenta medicine!"
studenta medicine!"
05:55
So they're really an ideal model.
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Dakle, oni su stvarno idealni predlošci.
05:58
But what we found
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Međutim, otkrili smo da
06:00
was that we couldn't reproduce in man the data we had shown in mice.
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na čovjeku ne možemo ponoviti
nalaze koje smo dobili na miševima.
nalaze koje smo dobili na miševima.
06:04
It seemed we couldn't turn off the production
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Čini se da nismo mogli
isključiti proizvodnju
isključiti proizvodnju
06:08
of nitric oxide in the skin of humans.
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dušikovog oksida u koži ljudi.
06:11
We put on creams that blocked the enzyme that made it,
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Stavljali smo kreme koje
onemogućavaju enzim koji ga stvara,
onemogućavaju enzim koji ga stvara,
06:13
we injected things. We couldn't turn off the nitric oxide.
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ubrizgavali smo koješta.
Nismo mogli isključiti dušikov oksid.
Nismo mogli isključiti dušikov oksid.
06:18
And the reason for this, it turned out, after two or three years' work,
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Nakon dvije ili tri godine rada,
ispostavilo se
ispostavilo se
06:21
was that in the skin we have huge stores
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da u koži imamo ogromne zalihe -
06:25
not of nitric oxide, because nitric oxide is a gas,
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ne dušikovog oksida, jer on je plin,
06:28
and it's released -- (Poof!) -- and in a few seconds it's away,
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i pušten... puf!... nema ga za par sekundi,
06:31
but it can be turned into these forms of nitric oxide --
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ali može se pretvoriti u
oblike dušikovog oksida:
oblike dušikovog oksida:
06:35
nitrate, NO3; nitrite, NO2; nitrosothiols.
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nitrate (NO3), nitrite (NO2), nitrozotiole.
06:38
And these are more stable,
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Oni su stabilniji.
06:40
and your skin has got really large stores of NO.
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U našoj koži postoje uistinu
velike zalihe dušikovog oksida.
velike zalihe dušikovog oksida.
06:44
And we then thought to ourselves, with those big stores,
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Kad su već zalihe tolike,
pitali smo se
pitali smo se
06:47
I wonder if sunlight might activate those stores
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može li ih Sunčeva svjetlost aktivirati
06:50
and release them from the skin,
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i otpustiti ih iz kože
06:52
where the stores are about 10 times as big as what's in the circulation.
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u kojoj su one i 10-ak puta
veće od onih u krvotoku.
veće od onih u krvotoku.
06:55
Could the sun activate those stores into the circulation,
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Može li Sunce te zalihe
potaknuti ka krvotoku,
potaknuti ka krvotoku,
06:58
and there in the circulation do its good things for your cardiovascular system?
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i tako blagotvorno djelovati
na krvožilni sustav?
na krvožilni sustav?
07:03
Well, I'm an experimental dermatologist,
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Kako sam ja eksperimentalni dermatolog,
07:06
so what we did was we thought
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pomislili smo da ćemo
07:07
we'd have to expose our experimental animals to sunlight.
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morati naše "pokusne kuniće"
izlagati suncu.
izlagati suncu.
07:11
And so what we did was we took a bunch of volunteers
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Uzeli smo stoga hrpu dobrovoljaca
07:15
and we exposed them to ultraviolet light.
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i izlagali ih ultraljubičastom svjetlu.
07:17
So these are kind of sunlamps.
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To su, znači, svojevrsne
solarne svjetiljke.
solarne svjetiljke.
07:19
Now, what we were careful to do was,
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Pritom smo vodili računa o tome
07:22
vitamin D is made by ultraviolet B rays
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da ultraljubičaste B-zrake
potiču stvaranje vitamina D,
potiču stvaranje vitamina D,
07:25
and we wanted to separate our story from the vitamin D story.
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a ovaj smo svoj rad željeli
odvojiti od teme vitamina D.
odvojiti od teme vitamina D.
07:29
So we used ultraviolet A, which doesn't make vitamin D.
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Zato smo upotrebljavali ultraljubičaste
A-zrake koje ne stvaraju vitamin D.
A-zrake koje ne stvaraju vitamin D.
07:33
When we put people under a lamp
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Kad smo ljude izložili zrakama svjetiljke
07:35
for the equivalent of about 30 minutes of sunshine in summer in Edinburgh,
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onoliko koliko je istovjetno 30-minutnom
ljetnom sunčanju u Edinburghu,
ljetnom sunčanju u Edinburghu,
07:40
what we produced was, we produced a rise
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izazvali smo porast
07:42
in circulating nitric oxide.
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dušikovog oksida u krvi.
07:44
So we put patients with these subjects under the UV,
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Onda smo uključili i pacijente
i njih izlagali ultraljubičastim zrakama;
i njih izlagali ultraljubičastim zrakama;
07:47
and their NO levels do go up,
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količine dušikovog oksida su i kod njih rasle,
07:50
and their blood pressure goes down.
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a krvni tlak je padao.
07:52
Not by much, as an individual level,
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Na individualnoj razini ne suviše,
07:54
but enough at a population level
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ali na razini populacije dovoljno
07:57
to shift the rates of heart disease in a whole population.
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da utječe na učestalost
srčanih bolesti u cijeloj populaciji.
srčanih bolesti u cijeloj populaciji.
08:00
And when we shone UV at them,
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Kad smo ih obasjavali
ultraljubičastim zrakama,
ultraljubičastim zrakama,
08:03
or when we warmed them up to the same level as the lamps,
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ili kad smo ih zagrijavali
do temperature svjetiljki,
do temperature svjetiljki,
08:06
but didn't actually let the rays hit the skin, this didn't happen.
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ali smo onemogućili kontakt
zraka i kože, to se nije dogodilo.
zraka i kože, to se nije dogodilo.
08:10
So this seems to be a feature of ultraviolet rays hitting the skin.
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Dakle, čini se da samo sraz ultraljubičastih
zraka i kože dovodi do takvog učinka.
zraka i kože dovodi do takvog učinka.
08:14
Now, we're still collecting data.
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Naravno, još prikupljamo podatke.
08:15
A few good things here:
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Nekoliko je dobrih vijesti...
08:17
This appeared to be more marked in older people.
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Čini se da je to izraženije
kod starijih ljudi.
kod starijih ljudi.
08:20
I'm not sure exactly how much.
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Nisam siguran točno koliko.
08:22
One of the subjects here was my mother-in-law,
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Jedna od ispitanika bila je i moja punica,
08:23
and clearly I do not know her age.
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i, očito, ja ne znam koliko joj je godina.
08:26
But certainly in people older than my wife,
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Ali, sigurno kod osoba
starijih od moje supruge
starijih od moje supruge
08:30
this appears to be a more marked effect.
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učinak se čini izrazitijim.
08:33
And the other thing I should mention
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Moram napomenuti da
08:34
was there was no change in vitamin D.
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nije bilo promjene u razini vitamina D.
08:36
This is separate from vitamin D.
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Ovo nema veze s vitaminom D.
08:38
So vitamin D is good for you -- it stops rickets,
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Dakle, vitamin D je dobar za vas -
zaustavlja rahitis,
zaustavlja rahitis,
08:40
it prevents calcium metabolism, important stuff.
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sprečava razgradnju kalcija,
važnog elementa.
važnog elementa.
08:42
But this is a separate mechanism from vitamin D.
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No, ovdje se radi o procesu
različitom od onoga kod vitamina D.
različitom od onoga kod vitamina D.
08:45
Now, one of the problems with looking at blood pressure
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Jedan od problema s krvnim tlakom je
08:48
is your body does everything it can
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što tijelo čini sve što može
08:49
to keep your blood pressure at the same place.
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da bi ga održalo.
08:51
If your leg is chopped off and you lose blood,
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Ostanemo li bez noge i gubimo krv,
08:52
your body will clamp down, increase the heart rate,
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tijelo će pooštriti kontrolu,
ubrzati rad srca,
ubrzati rad srca,
08:55
do everything it can to keep your blood pressure up.
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učiniti sve što može kako bi
održalo naš krvni tlak.
održalo naš krvni tlak.
08:58
That is an absolutely fundamental physiological principle.
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To je apsolutno
temeljno fiziološko načelo.
temeljno fiziološko načelo.
09:01
So what we've next done
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Potom smo proučavali
09:02
is we've moved on to looking at blood vessel dilatation.
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širenje krvnih žila.
09:06
So we've measured -- this is again,
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Mjerili smo... ovo je ponovno...
09:08
notice no tail and hairless, this is a medical student.
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vidite ćelavoga i bez repa,
studenta medicine.
studenta medicine.
09:13
In the arm, you can measure blood flow in the arm
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Protok krvi u ruci moguće je izmjeriti
09:15
by how much it swells up as some blood flows into it.
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po tome koliko ruka
nabrekne uslijed dotoka krvi.
nabrekne uslijed dotoka krvi.
09:19
And what we've shown is that doing a sham irradiation --
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Pokazali smo da lažno ozračivanje -
09:22
this is the thick line here --
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to je ova debela crta ovdje -
09:24
this is shining UV on the arm so it warms up
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ovo je ultraljubičasto ozračivanje ruke,
kojime ju se zagrijava,
kojime ju se zagrijava,
09:26
but keeping it covered so the rays don't hit the skin.
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ali zrake ne dopiru do kože,
jer je pokrivena.
jer je pokrivena.
09:29
There is no change in blood flow, in dilatation of the blood vessels.
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Nema promjena u protoku krvi,
niti u širenju krvnih žila.
niti u širenju krvnih žila.
09:33
But the active irradiation,
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Međutim, pri aktivnom ozračivanju
09:35
during the UV and for an hour after it,
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ultraljubičastim zrakama i
sat vremena nakon njega,
sat vremena nakon njega,
09:38
there is dilation of the blood vessels.
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vidljivo je proširivanje krvnih žila.
09:40
This is the mechanism by which you lower blood pressure,
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Na ovaj se način
može sniziti krvni tlak,
može sniziti krvni tlak,
09:43
by which you dilate the coronary arteries also,
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čime se proširuju i srčane arterije,
09:45
to let the blood be supplied with the heart.
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što srcu olakšava
potiskivanje krvi u tijelo.
potiskivanje krvi u tijelo.
09:47
So here, further data that ultraviolet -- that's sunlight --
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Ovo je daljnja potvrda da
ultraljubičaste zrake, tj. Sunčeva svjetlost,
ultraljubičaste zrake, tj. Sunčeva svjetlost,
09:51
has benefits on the blood flow and the cardiovascular system.
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imaju blagotvoran učinak na
protok krvi i na krvožilni sustav.
protok krvi i na krvožilni sustav.
09:56
So we thought we'd just kind of model --
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Odlučili smo uobličiti u model
09:58
Different amounts of UV hit different parts of the Earth at different times of year,
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različite količine UV-zračenja, na različitim
dijelovima Zemlje, u različita doba godine.
dijelovima Zemlje, u različita doba godine.
10:05
so you can actually work out those stores of nitric oxide --
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Tako je moguće izračunati
zalihe dušikovog oksida -
zalihe dušikovog oksida -
10:09
the nitrates, nitrites, nitrosothiols in the skin --
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nitrate, nitrite, nitrozotiole u koži -
10:11
cleave to release NO.
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koji cijepanjem oslobađaju
dušikov oksid.
dušikov oksid.
10:14
Different wavelengths of light have different activities of doing that.
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Različite svjetlosne valne duljine
imaju pritom različite uloge.
imaju pritom različite uloge.
10:18
So you can look at the wavelengths of light that do that.
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Stoga možemo promatrati koje
svjetlosne valne duljine što čine.
svjetlosne valne duljine što čine.
10:20
And you can look -- So, if you live on the equator, the sun comes straight overhead,
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Dakle, ako živimo na ekvatoru,
Sunce je točno iznad naših glava;
Sunce je točno iznad naših glava;
10:24
it comes through a very thin bit of atmosphere.
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probija se kroz vrlo
tanak sloj atmosfere.
tanak sloj atmosfere.
10:25
In winter or summer, it's the same amount of light.
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I zimi i ljeti,
to je ista količina svjetla.
to je ista količina svjetla.
10:28
If you live up here, in summer
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Živimo li ovdje,
10:30
the sun is coming fairly directly down,
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ljeti sunce pada prilično izravno,
10:33
but in winter it's coming through a huge amount of atmosphere,
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ali zimi se probija kroz
ogromne slojeve atmosfere,
ogromne slojeve atmosfere,
10:36
and much of the ultraviolet is weeded out,
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i mnogo se ultraljubičastih zraka gubi,
10:40
and the range of wavelengths that hit the Earth
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a raspon valnih duljina
koje dolaze do Zemlje
koje dolaze do Zemlje
10:42
are different from summer to winter.
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se od ljeta do zime razlikuje.
10:44
So what you can do is you can multiply those data
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Dakle, možemo pomnožiti te podatke
10:46
by the NO that's released
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s oslobođenim dušikovim oksidom
10:48
and you can calculate how much nitric oxide
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i izračunati koliko će
dušikovog oksida
dušikovog oksida
10:51
would be released from the skin into the circulation.
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biti iz kože otpušteno u krvotok.
10:55
Now, if you're on the equator here --
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Nalazimo li se na ekvatoru -
10:57
that's these two lines here, the red line and the purple line --
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to su ove dvije crte ovdje,
crvena i ljubičasta -
crvena i ljubičasta -
11:00
the amount of nitric oxide that's released is the area under the curve,
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količina oslobođenog dušikovog oksida
odgovara površini ispod krivulje,
odgovara površini ispod krivulje,
11:04
it's the area in this space here.
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površini u ovom području ovdje.
11:06
So if you're on the equator, December or June,
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Dakle, nađemo li se na ekvatoru,
u prosincu ili u lipnju,
u prosincu ili u lipnju,
11:09
you've got masses of NO being released from the skin.
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koža će otpuštati
gomile dušikovog oksida.
gomile dušikovog oksida.
11:12
So Ventura is in southern California.
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Ventura se nalazi u južnoj Kaliforniji.
11:15
In summer, you might as well be at the equator.
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Ljeti bi nam jednako
bilo i na ekvatoru.
bilo i na ekvatoru.
11:17
It's great. Lots of NO is released.
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Sjajno je ondje! Oslobađaju se
ogromne količine dušikovog oksida.
ogromne količine dušikovog oksida.
11:19
Ventura mid-winter, well, there's still a decent amount.
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Ventura usred zime? Još je uvijek
zamjetna pristojna količina.
zamjetna pristojna količina.
11:23
Edinburgh in summer, the area beneath the curve is pretty good,
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Edinburgh ljeti? Površina
ispod krivulje je zadovoljavajuća.
ispod krivulje je zadovoljavajuća.
11:27
but Edinburgh in winter, the amount of NO that can be released
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Ali, Edinburgh zimi? Količina
oslobođenog dušikovog oksida
oslobođenog dušikovog oksida
11:31
is next to nothing, tiny amounts.
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gotovo je nikakva, neznatna.
11:35
So what do we think?
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Dakle, što mi mislimo?
11:37
We're still working at this story,
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Još uvijek na ovome radimo,
11:38
we're still developing it, we're still expanding it.
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još uvijek razvijamo model,
proširujemo ga.
proširujemo ga.
11:40
We think it's very important.
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Smatramo ovo vrlo važnim!
11:42
We think it probably accounts for a lot of the north-south health divide within Britain,
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Ovo vjerojatno uvelike objašnjava zdravstvene
razlike između britanskog sjevera i juga.
razlike između britanskog sjevera i juga.
11:46
It's of relevance to us.
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Ovo je i za nas važno!
11:47
We think that the skin --
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Mislimo da koža...
11:49
well, we know that the skin has got very large stores
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Dobro, znamo da koža
sadrži vrlo velike zalihe
sadrži vrlo velike zalihe
11:52
of nitric oxide as these various other forms.
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dušikovog oksida u svim tim
različitim drugim oblicima.
različitim drugim oblicima.
11:54
We suspect a lot of these come from diet,
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Pretpostavljamo da je za mnoge
zaslužna prehrana -
zaslužna prehrana -
11:56
green leafy vegetables, beetroot, lettuce
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zeleno lisnato povrće,
cikla ili zelena salata
cikla ili zelena salata
11:58
has a lot of these nitric oxides that we think go to the skin.
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bogati su dušikovim oksidima za
koje vjerujemo da odlaze u kožu.
koje vjerujemo da odlaze u kožu.
12:02
We think they're then stored in the skin,
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Potom se pohranjuju u koži,
12:04
and we think the sunlight releases this
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i mislimo da ih
Sunčeva svjetlost oslobađa
Sunčeva svjetlost oslobađa
12:06
where it has generally beneficial effects.
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što, općenito, ima korisne učinke.
12:09
And this is ongoing work, but dermatologists --
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Puno je još posla pred nama,
ali dermatolozi...
ali dermatolozi...
12:11
I mean, I'm a dermatologist.
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Želim reći, ja sam dermatolog.
12:13
My day job is saying to people, "You've got skin cancer,
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Moj svakodnevni posao je
govoriti ljudima: "Imate rak kože;
govoriti ljudima: "Imate rak kože;
12:15
it's caused by sunlight, don't go in the sun."
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uzrokovan je suncem;
ne izlazite na sunce..."
ne izlazite na sunce..."
12:17
I actually think a far more important message
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A mislim da je, zapravo,
daleko važnija poruka
daleko važnija poruka
12:20
is that there are benefits as well as risks to sunlight.
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da se u sunčevoj svjetlosti
kriju i blagodati, kao i opasnosti.
kriju i blagodati, kao i opasnosti.
12:23
Yes, sunlight is the major alterable risk factor for skin cancer,
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Da, Sunčeva svjetlost je glavni
promjenljiv rizični uzročnik raka kože,
promjenljiv rizični uzročnik raka kože,
12:29
but deaths from heart disease are a hundred times higher
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ali smrtnost oboljelih
od srčanih bolesti stoput je veća
od srčanih bolesti stoput je veća
12:32
than deaths from skin cancer.
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od smrtnosti uslijed raka kože.
12:34
And I think that we need to be more aware of,
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Mislim da moramo biti oprezniji,
12:37
and we need to find the risk-benefit ratio.
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i da trebamo naći pravu mjeru
opasnosti i blagodati.
opasnosti i blagodati.
12:39
How much sunlight is safe,
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Koliko se smijemo izlagati suncu,
12:40
and how can we finesse this best for our general health?
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i kako ga možemo najbolje
iskoristiti za svoje zdravlje?
iskoristiti za svoje zdravlje?
12:44
So, thank you very much indeed.
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Hvala vam najljepša, doista!
12:47
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Richard Weller - DermatologistDermatologist Richard Weller wants to know: Why are Scots so sick?
Why you should listen
Edinburgh-native Richard Weller was studying medicine in Australia when something suddenly struck him as odd: Why are the Scots so sick? Australians suffer from heart disease at one-third the rate that Britons do, with lower death rates from heart attacks and heart failure, and fewer strokes overall. When Weller looked into it, this wasn't unique to Australia and England: In fact, there are wide gaps in mortality even within the UK, a gradient which maps roughly ... geographically? A five-degree change in latitude -- between London and Edinburg, for example -- shows a nearly 20 percent higher rate of mortality. Weller and his team have been working ever since to crack this mysterious gap, and most recently their research shows it may be related to exposure to sunlight. Nitric oxide (NO), a chemical transmitter produced by the skin and stored in great reserves, is released by exposure to UV rays, and this in turn is very important to cardiovascular health.
Weller is a senior lecturer in Dermatology at the University of Edinburgh. His two areas of study are the role of NO in human skin physiology and the role of skin barrier function deficiencies in atopic disease.
Richard Weller | Speaker | TED.com