TEDGlobal 2013
Molly Stevens: A new way to grow bone
茉莉．史蒂文斯（Molly Stevens）: 讓骨骼重生的新方法
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要如何才能讓骨骼大量重生呢？一般的骨骼再生--把骨骼從病人的髖部取出並移植到其它部位的受損骨骼--是有條件限制的，也會在術後數年內讓病人疼痛不堪。茉莉．史蒂文斯介紹了幹細胞的一種新應用，它駕馭了骨骼先天的再生能力使其大量再生--而且不會痛。
Molly Stevens - Biomaterials researcher
Molly Stevens studies and creates new biomaterials that could be used to detect disease and repair bones and human tissue. Full bio
Molly Stevens studies and creates new biomaterials that could be used to detect disease and repair bones and human tissue. Full bio
Double-click the English transcript below to play the video.
00:12
As humans, it's in our nature
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身為人，想要增進健康以及
00:14
to want to improve our health
and minimize our suffering.
and minimize our suffering.
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減少痛苦是我們的天性。
00:17
Whatever life throws at us,
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不論我們在生命中得到了什麼，
00:19
whether it's cancer, diabetes, heart disease,
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不管是癌症、糖尿病、心臟病，
00:21
or even broken bones, we want to try and get better.
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或甚至是骨折，我們都想要試著好起來。
00:24
Now I'm head of a biomaterials lab,
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我現在是一間
生物材料實驗室的主持人，
生物材料實驗室的主持人，
00:27
and I'm really fascinated by the way that humans
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我對於人類自古以來，
00:30
have used materials in really creative ways
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在體內所使用的材料方面的創意
00:32
in the body over time.
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感到相當驚訝。
00:35
Take, for example, this beautiful blue nacre shell.
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例如這個珍珠貝漂亮的殼，
00:38
This was actually used by the Mayans
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它曾經被馬雅人
00:40
as an artificial tooth replacement.
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用來當做人工的牙齒替代品。
00:44
We're not quite sure why they did it.
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我們並不清楚他們為什麼這麼做，
00:45
It's hard. It's durable.
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它很硬，也很耐用，
00:48
But it also had other very nice properties.
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但是它也有其它很棒的特性。
00:52
In fact, when they put it into the jawbone,
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事實上，當它們被放到頜骨裡面，
00:54
it could integrate into the jaw,
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可能會和骨頭合而為一。
00:57
and we know now with very sophisticated
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先進的影像技術顯示，
00:59
imaging technologies
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兩者相融的一部分原因
01:01
that part of that integration comes from the fact
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來自於這種材料的
01:03
that this material is designed
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特殊之處。
01:05
in a very specific way, has a beautiful chemistry,
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不論在結構上
01:08
has a beautiful architecture.
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或是化學上都是如此。
01:10
And I think in many ways we can sort of think
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我認為在某些程度上，
01:12
of the use of the blue nacre shell and the Mayans
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用了藍珍珠貝的馬雅人
01:15
as the first real application
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是藍牙技術的
01:16
of the bluetooth technology.
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先驅。
01:19
(Laughter)
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（笑聲）
01:20
But if we move on and think throughout history
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如果我們觀察歷史上
01:25
how people have used different
materials in the body,
materials in the body,
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人類是如何將不同的材料運用在身體上，
01:28
very often it's been physicians
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就會發現這些傑作常常
01:29
that have been quite creative.
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來自富有創意的醫師。
01:31
They've taken things off the shelf.
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他們時常創新。
01:33
One of my favorite examples
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我最喜歡的一個例子
01:35
is that of Sir Harold Ridley,
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是關於 Harold Ridley 爵士。
01:38
who was a famous ophthalmologist,
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他是一位有名的眼科醫師，
01:40
or at least became a famous ophthalmologist.
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或至少成為了一位有名的眼科醫師。
01:42
And during World War II, what he would see
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二次大戰期間，
01:44
would be pilots coming back from their missions,
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他見到從任務結束后歸來的飛行員。
01:47
and he noticed that within their eyes
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他注意到這些飛行員的眼睛裡
01:49
they had shards of small bits of material
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卡了碎片，或是
01:52
lodged within the eye,
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其它的小東西。
01:53
but the very interesting thing about it
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但是有趣的是
01:55
was that material, actually, wasn't causing
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這些東西並沒有
01:57
any inflammatory response.
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引起任何的發炎反應。
01:59
So he looked into this, and he figured out
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因此他仔細的調查了這件事，
02:02
that actually that material was little shards of plastic
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他發現這些塑膠碎片
02:04
that were coming from the canopy of the Spitfires.
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其實是來自噴火式戰機的座艙蓋。
02:07
And this led him to propose that material
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這讓他提出使用這種物質
02:10
as a new material for intraocular lenses.
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來製作新型人工水晶體。
02:12
It's called PMMA, and it's now used
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這種物質叫做 PMMA，它現在每年
02:14
in millions of people every year
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幫助數百萬人
02:16
and helps in preventing cataracts.
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免於罹患白內障。
02:19
And that example, I think, is a really nice one,
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我認為這個例子非常非常棒，
02:21
because it helps remind us that in the early days,
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因為它提醒了我們，
02:24
people often chose materials
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從前的人們總是根據生物惰性
02:26
because they were bioinert.
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來選擇材料，
02:28
Their very purpose was to
perform a mechanical function.
perform a mechanical function.
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它們的唯一目的
就是進行機械的功能；
就是進行機械的功能；
02:31
You'd put them in the body
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你會把它們放進身體裡，
02:33
and you wouldn't get an adverse response.
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而且不希望身體產生不良反應。
02:35
And what I want to show you is that
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我想要展示給你們看的是
02:36
in regenerative medicine,
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在再生醫學中，
02:38
we've really shifted away from that idea
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我們並非一如往常地
02:40
of taking a bioinert material.
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選擇生物惰性材料。
02:41
We're actually actively looking for materials
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事實上我們積極地尋找
02:44
that will be bioactive, that will interact with the body,
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會和身體產生反應的生物活性材料，
02:47
and that furthermore we can put in the body,
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而且當我們把它們放到身體裡。
02:49
they'll have their function,
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它們會執行功能，
02:51
and then they'll dissolve away over time.
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然後會隨著時間被分解掉，
02:55
If we look at this schematic,
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當我們仔細思考這個概念，
02:57
this is showing you what we think of
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這是在告訴你們，
02:59
as the typical tissue-engineering approach.
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我們心目中典型的生物工程技術。
03:01
We have cells there, typically from the patient.
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我們有些細胞基本上是來自病人，
03:04
We can put those onto a material,
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我們能夠把這些細胞放到材料上，
03:05
and we can make that material
very complex if we want to,
very complex if we want to,
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如果想要的話，我們也
可以把這些材料做得很複雜，
可以把這些材料做得很複雜，
03:08
and we can then grow that up in the lab
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然後我們在實驗室裡培養這些細胞，
03:10
or we can put it straight back into the patient.
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或者直接放回病患體內。
03:13
And this is an approach that's
used all over the world,
used all over the world,
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這項技術在全世界被使用，
03:15
including in our lab.
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包括我們的實驗室。
03:19
But one of the things that's really important
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但是最重要的一件事情是：
03:21
when we're thinking about stem cells
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當我們講到幹細胞時，
03:23
is that obviously stem cells
can be many different things,
can be many different things,
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顯然它們能夠做到很多事，
03:26
and they want to be many different things,
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它們也想做很多事，
03:28
and so we want to make sure that the environment
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所以要確保我們讓它們生長的環境
03:29
we put them into has enough information
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擁有足夠的訊息。
03:32
so that they can become the right sort
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使幹細胞特化成為
03:34
of specialist tissue.
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正確的組織。
03:36
And if we think about the different types of tissues
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人們在世界各地的實驗室裡尋找
03:40
that people are looking at regenerating
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各式各樣
擁有再生能力的組織，
03:42
all over the world, in all the
different labs in the world,
different labs in the world,
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03:44
there's pretty much every tissue you can think of.
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你所能想的到的各種組織都有，
03:47
And actually, the structure of those tissues
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而且事實上這些組織之間
03:48
is quite different, and it's going to really depend
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有很大的差異，
也基於病人是否擁有相關疾病，
03:51
on whether your patient has any underlying disease,
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03:53
other conditions, in terms of how
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或是其它的條件來決定。
03:56
you're going to regenerate your tissue,
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要如何讓組織再生，
03:58
and you're going to need to think about the materials
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也要謹慎選擇材料
04:00
you're going to use really carefully,
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和使用材料；
04:02
their biochemistry, their mechanics,
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要考慮到這些材料的生化、機械
04:04
and many other properties as well.
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以及其它的特性。
04:08
Our tissues all have very
different abilities to regenerate,
different abilities to regenerate,
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我們所有的組織再生的能力迥異，
04:11
and here we see poor Prometheus,
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就像是可憐的普羅米修斯，
04:13
who made a rather tricky career choice
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因為他一個狡猾的生涯決定
04:16
and was punished by the Greek gods.
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而被希臘諸神所懲罰。
04:19
He was tied to a rock, and an eagle would come
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他被綁在一塊石頭上，每天都會有一隻老鷹
04:21
every day to eat his liver.
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來啄食他的肝臟。
04:23
But of course his liver would regenerate every day,
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當然他的肝臟每天都會長回來，
04:25
and so day after day he was punished
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所以諸神的懲罰日復一日
04:27
for eternity by the gods.
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直到永遠。
04:33
And liver will regenerate in this very nice way,
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肝臟有很強的再生能力，
04:37
but actually if we think of other tissues,
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但是其它的組織就不一樣了，
04:39
like cartilage, for example,
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以軟骨來說，
04:40
even the simplest nick and you're going to find it
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即使是一個小缺損
04:42
really difficult to regenerate your cartilage.
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也很難長回來。
04:45
So it's going to be very different from tissue to tissue.
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所以組織之間有很大的差異。
04:48
Now, bone is somewhere in between,
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好，骨骼介於兩者之間，
04:51
and this is one of the tissues
that we work on a lot in our lab.
that we work on a lot in our lab.
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也是我們實驗室努力研究的對象。
04:54
And bone is actually quite good at repairing.
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其實骨骼也很善於修補。
04:56
It has to be. We've probably all had fractures
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它必須如此。我們可能
04:58
at some point or other.
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都曾經經歷過骨折，
04:59
And one of the ways that you can think
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有一種你可能想像得到的
修補骨折的方法，
05:02
about repairing your fracture
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05:03
is this procedure here, called
an iliac crest harvest.
an iliac crest harvest.
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叫做髂嵴修補法。
05:06
And what the surgeon might do
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外科醫師會做的
05:08
is take some bone from your iliac crest,
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是取出髂嵴的部分骨骼，
05:11
which is just here,
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就像這樣，
05:12
and then transplant that
somewhere else in the body.
somewhere else in the body.
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然後移植到身體的其它部位。
05:15
And it actually works really well,
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這真的相當有效，
05:16
because it's your own bone,
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因為它是你自己的骨頭，
05:18
and it's well vascularized,
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同時也具有完整的血管系統，
05:19
which means it's got a really good blood supply.
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也就是說它能得到充足的血液供應。
05:22
But the problem is, there's
only so much you can take,
only so much you can take,
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但是問題在於
你能取出的骨骼很有限，
你能取出的骨骼很有限，
05:24
and also when you do that operation,
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而且在你進行手術之後兩年內，
05:27
your patients might actually have significant pain
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手術部位可能
05:30
in that defect site even two
years after the operation.
years after the operation.
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會讓病人感到相當痛苦。
05:33
So what we were thinking is,
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所以我們在思考的是，
05:35
there's a tremendous need
for bone repair, of course,
for bone repair, of course,
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當然，骨骼的修復是很重要的，
05:38
but this iliac crest-type approach
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但是這種髂嵴修補法
05:41
really has a lot of limitations to it,
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有很多限制，
05:43
and could we perhaps recreate
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我們能夠想出一種方法
05:45
the generation of bone within the body
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讓骨頭在身體裡面再生
05:47
on demand and then be able to transplant it
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並且能夠移植它
05:51
without these very, very painful aftereffects
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同時避免像是髂嵴修補法產生的
05:56
that you would have with the iliac crest harvest?
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劇烈疼痛等後遺症嗎？
05:59
And so this is what we did, and the way we did it
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我們做到了，我們用的方法又回到
典型的組織工程法
典型的組織工程法
06:02
was by coming back to this typical tissue-engineering approach
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我們做到了，我們用的方法
又回到典型的組織工程法，
又回到典型的組織工程法，
06:05
but actually thinking about it rather differently.
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但是卻有不同的思路。
06:08
And we simplified it a lot,
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我們也把它簡化了很多，
06:10
so we got rid of a lot of these steps.
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所以可以省略很多步驟。
06:12
We got rid of the need to
harvest cells from the patient,
harvest cells from the patient,
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我們省略了從病人體內取出細胞的步驟，
06:14
we got rid of the need to put
in really fancy chemistries,
in really fancy chemistries,
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省略了把細胞放進
令人眼花繚亂的化學物質
令人眼花繚亂的化學物質
06:17
and we got rid of the need
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也省略了
06:19
to culture these scaffolds in the lab.
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在實驗室裡培養這些組織的架構。
06:21
And what we really focused on
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我們著重在於
06:24
was our material system and making it quite simple,
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簡化材料系統，
06:27
but because we used it in a really clever way,
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這樣的巧思，
06:30
we were able to generate enormous amounts of bone
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讓我們能夠通過這種方法
06:32
using this approach.
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作出大量的骨骼。
06:34
So we were using the body
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我們把身體
06:36
as really the catalyst to help us
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當做催化劑，
06:38
to make lots of new bone.
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幫我們做出很多的新骨骼。
06:40
And it's an approach that we call
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我們把這樣的方法
06:42
the in vivo bioreactor, and we were able to make
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叫做體內生物反應器，利用這樣的方法
06:45
enormous amounts of bone using this approach.
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我們能作出大量的骨骼。
06:47
And I'll talk you through this.
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我現在詳細說明給你們聽。
06:49
So what we do is,
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我們是這樣做的，
06:51
in humans, we all have a layer of stem cells
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在人類的長骨外面
06:53
on the outside of our long bones.
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有一層幹細胞。
06:55
That layer is called the periosteum.
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叫做骨膜。
06:57
And that layer is actually normally
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這層細胞通常會
非常非常緊密的和
非常非常緊密的和
06:59
very, very tightly bound to the underlying bone,
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下面的骨頭結合，
07:02
and it's got stem cells in it.
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幹細胞就位在其中
07:03
Those stem cells are really important
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這些幹細胞
07:05
in the embryo when it develops,
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對胚胎發育很重要，
07:07
and they also sort of wake up if you have a fracture
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而它們在你骨折的時候就像被喚醒了一樣
07:09
to help you with repairing the bone.
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幫助你修補骨頭。
07:12
So we take that periosteum layer
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我們發展出了一種注射法，
07:14
and we developed a way to inject underneath it
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在鼓膜底下
07:17
a liquid that then, within 30 seconds,
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注射一種液體，
07:20
would turn into quite a rigid gel
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30 秒之內液體就會硬化成膠狀
07:21
and can actually lift the
periosteum away from the bone.
periosteum away from the bone.
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會把骨膜剝離骨骼
07:25
So it creates, in essence, an artificial cavity
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實際上，它在骨頭
跟帶有很多幹細胞的這層膜之間
跟帶有很多幹細胞的這層膜之間
07:28
that is right next to both the bone
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製造了一個人工腔室，
07:32
but also this really rich layer of stem cells.
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但同時含有豐富的幹細胞。
07:36
And we go in through a pinhole incision
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然後我們會從一個
針孔般的切口進入，
針孔般的切口進入，
07:37
so that no other cells from the body can get in,
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所以身體的其它細胞不會跑進去，
07:40
and what happens is that that
artificial in vivo bioreactor cavity
artificial in vivo bioreactor cavity
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這個人工體內生物反應器
07:45
can then lead to the proliferation of these stem cells,
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能夠讓這些幹細胞增殖，
07:48
and they can form lots of new tissue,
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然後它們就可以變成很多新組織，
07:50
and then over time, you can harvest that tissue
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一段時間過後你就能收集這些細胞
07:52
and use it elsewhere in the body.
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並用在身體的其他部位。
07:55
This is a histology slide
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這是我們做這件事當時的
07:57
of what we see when we do that,
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組織切片，
07:59
and essentially what we see
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我們所看到的基本上
08:02
is very large amounts of bone.
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就是很多的骨骼。
08:03
So in this picture, you can see the middle of the leg,
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在這張圖片裡面，你能看到腿的中段，
08:06
so the bone marrow,
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這是骨髓，
08:07
then you can see the original bone,
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1804
然後你可以看到原來的骨頭，
08:09
and you can see where that original bone finishes,
198
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原本的骨頭到這裡為止，
08:12
and just to the left of that is the new bone
199
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2511
左邊的是在這個
08:15
that's grown within that bioreactor cavity,
200
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2037
是在生物反應器裡面長出的新骨頭
08:17
and you can actually make it even larger.
201
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你也可以讓它長得更大
08:19
And that demarcation that you can see
202
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在原來的和新的骨頭之間
08:22
between the original bone and the new bone
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2351
的界線
08:24
acts as a very slight point of weakness,
204
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2013
有著非常微小的脆弱點，
08:26
so actually now the surgeon can come along,
205
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2134
外科醫師現在就可以過來
08:28
can harvest away that new bone,
206
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2024
將新的骨骼取走，
08:30
and the periosteum can grow back,
207
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2203
然後骨膜會長回去，
08:32
so you're left with the leg
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你的腿
在這樣的情況下
08:34
in the same sort of state
209
502696
1550
08:36
as if you hadn't operated on it in the first place.
210
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2002
就像沒做過任何事一樣。
08:38
So it's very, very low in terms of after-pain
211
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3849
所以和髂嵴修補法相比之下，
08:42
compared to an iliac crest harvest.
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術後幾乎可以說是完全沒有疼痛感。
08:45
And you can grow different amounts of bone
213
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2104
你可以借由調整注射膠的量來
08:48
depending on how much gel you put in there,
214
516056
2019
製造出不同量的骨頭，
08:50
so it really is an on demand sort of procedure.
215
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3202
所以這個技術確實可以量身訂做。
08:53
Now, at the time that we did this,
216
521277
2202
好，我們做這個計劃時
08:55
this received a lot of attention in the press,
217
523479
3337
這項技術受到了媒體的大量關注，
08:58
because it was a really nice way
218
526816
2431
因為這是
製造新骨骼很棒的方法，
09:01
of generating new bone,
219
529247
1466
09:02
and we got many, many contacts
220
530713
1995
也有很多人跟我們聯絡，
09:04
from different people that
were interested in using this.
were interested in using this.
221
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2618
他們對這種方法非常有興趣。
09:07
And I'm just going to tell you,
222
535326
1789
我要讓你們知道的是，
09:09
sometimes those contacts are very strange,
223
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2953
有時候這些和我們聯絡的人很奇怪，
09:12
slightly unexpected,
224
540068
1860
甚至有點出乎意料，
09:13
and the very most interesting,
225
541928
3062
我所遇過的
09:16
let me put it that way, contact that I had,
226
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2285
最有趣的的聯絡人
09:19
was actually from a team of American footballers
227
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3211
是美式足球隊員。
09:22
that all wanted to have double-thickness skulls
228
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3380
他們想要有
09:25
made on their head.
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兩倍厚的頭骨。
09:30
And so you do get these kinds of contacts,
230
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2724
就是這樣的一些人
09:32
and of course, being British
231
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2617
當然囉，身為一個英國人
09:35
and also growing up in France,
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1754
並且在法國長大，
09:37
I tend to be very blunt,
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2142
我必須試著很客氣
09:39
and so I had to explain to them very nicely
234
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2041
向他們解釋
09:41
that in their particular case,
235
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1475
這裡實在是沒有太多東西需要被保護，
09:42
there probably wasn't that much in there
236
570909
2014
因為
09:44
to protect in the first place.
237
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2988
首先沒有足夠的材料去保護他們。
09:47
(Laughter)
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（笑聲）
09:49
(Applause)
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1253
（掌聲）
09:50
So this was our approach,
240
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1855
這就是我們所用的方法，
09:52
and it was simple materials,
241
580589
1644
材料非常簡單，
09:54
but we thought about it carefully.
242
582233
1987
但是我們深思熟慮。
09:56
And actually we know that those cells
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584220
1620
我們也確實知道這些
在身體裡、在胚胎裡的細胞
在身體裡、在胚胎裡的細胞
09:57
in the body, in the embryo, as they develop
244
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2138
當它們發育之後
09:59
can form a different kind of tissue, cartilage,
245
587978
3229
能變成不同的組織，像是軟骨，
10:03
and so we developed a gel that was slightly different
246
591207
2555
因此我們法展出了一種膠，
10:05
in nature and slightly different chemistry,
247
593762
2419
這種膠和自然存在的不太一樣，
化學性質也不甚相同，
化學性質也不甚相同，
10:08
put it in there, and we were able to get
248
596181
2147
注射進去之後，
10:10
100 percent cartilage instead.
249
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2178
我們反而會得到百分之百的軟骨。
10:12
And this approach works really well, I think,
250
600506
2008
我認為這項技術
10:14
for pre-planned procedures,
251
602514
2482
對於有事先規劃的療程非常實用，
10:16
but it's something you do have to pre-plan.
252
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2872
但是你必須要事先規劃好。
10:19
So for other kinds of operations,
253
607868
2268
因此，對於其他手術來說
10:22
there's definitely a need for other
254
610136
1697
有架構的方法
10:23
scaffold-based approaches.
255
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2503
是絕對必須的。
10:26
And when you think about designing
256
614336
2369
當你想要設計
10:28
those other scaffolds, actually,
257
616705
1638
其他的架構時，實際上，
10:30
you need a really multi-disciplinary team.
258
618343
1971
你需要有一個全方位的團隊。
10:32
And so our team has chemists,
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2065
所以我們的團隊有化學家
10:34
it has cell biologists, surgeons, physicists even,
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3377
細胞生物學家、外科醫師，甚至是物理學家
10:37
and those people all come together
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2030
這些人聚在一起，
10:39
and we think really hard about
designing the materials.
designing the materials.
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2411
絞盡腦汁才設計出這些材料。
10:42
But we want to make them have enough information
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2966
我們希望讓他們獲得充足的資訊，
10:45
that we can get the cells to do what we want,
264
633163
2154
讓細胞做到我們期望的，
10:47
but not be so complex as to make it difficult
265
635317
2377
但是不能過於複雜而難以
10:49
to get to clinic.
266
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1743
應用在臨床上。
10:51
And so one of the things we think about a lot
267
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2751
因此我們想到了
10:54
is really trying to understand
268
642188
1795
要了解人
10:55
the structure of the tissues in the body.
269
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2377
人體內組織的結構，
10:58
And so if we think of bone,
270
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1660
當我們想到骨骼
11:00
obviously my own favorite tissue,
271
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2624
顯然是我最喜歡的組織，
11:02
we zoom in, we can see,
272
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1557
放大來看，
11:04
even if you don't know anything
about bone structure,
about bone structure,
273
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1882
既使你對它一無所知，
11:06
it's beautifully organized,
really beautifully organized.
really beautifully organized.
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2545
也會看到它是有組織的，非常有組織。
11:08
We've lots of blood vessels in there.
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1887
裡面有非常多的血管，
11:10
And if we zoom in again, we see that the cells
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2339
如果再放大來看，會看到細胞是被
11:12
are actually surrounded by a 3D matrix
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2972
奈米等級的纖維形成的 3D 結構包圍，
11:15
of nano-scale fibers, and they give a lot
278
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2171
這些纖維會
11:17
of information to the cells.
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2182
提供細胞很多訊息。
11:20
And if we zoom in again,
280
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1614
再放大，在骨頭的例子中
11:21
actually in the case of bone, the matrix
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2201
包圍細胞的胞外物質，
11:23
around the cells is beautifully organized
282
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2151
形成了非常有組織
11:26
at the nano scale, and it's a hybrid material
283
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2467
的奈米結構，
11:28
that's part organic, part inorganic.
284
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2584
同時也是兼具有機與無機的結構。
11:31
And that's led to a whole field, really,
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2072
那是這個領域的根本，
11:33
that has looked at developing materials
286
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2391
也讓我們想到要發展
11:35
that have this hybrid kind of structure.
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2748
兼具有機與無機的材料。
11:38
And so I'm showing here just two examples
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3278
我現在要講的兩個例子
11:41
where we've made some materials
that have that sort of structure,
that have that sort of structure,
289
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3120
是我們所製造出並具有相似結構的材料
11:44
and you can really tailor it.
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1438
而且可以客製化。
11:46
You can see here a very squishy one
291
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2064
這個材料質地像糊
11:48
and now a material that's also
this hybrid sort of material
this hybrid sort of material
292
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4099
但是與這種材料混合的另一種材料
11:52
but actually has remarkable toughness,
293
700406
1947
卻具有非同尋常的堅硬度，
11:54
and it's no longer brittle.
294
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1460
也不易碎。
11:55
And an inorganic material
would normally be really brittle,
would normally be really brittle,
295
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2456
一般無機材料是易碎的，
11:58
and you wouldn't be able to have
296
706285
1440
也無法擁有
11:59
that sort of strength and toughness in it.
297
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2188
如此的力量與韌性。
12:01
One other thing I want to quickly mention is that
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2489
我想快速帶過另外一件事情，
12:04
many of the scaffolds we make
are porous, and they have to be,
are porous, and they have to be,
299
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2715
很多我們做出的架構是有孔的，
它們也必須如此，
它們也必須如此，
12:07
because you want blood vessels to grow in there.
300
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2103
因為我們希望血管能在其中生長，
12:09
But the pores are actually oftentimes
301
717220
1877
但是這些孔洞常常
12:11
much bigger than the cells,
302
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1293
比細胞大上許多，
12:12
and so even though it's 3D,
303
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1711
所以即使它是 3D 的，
12:14
the cell might see it more
as a slightly curved surface,
as a slightly curved surface,
304
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3355
在細胞看來也是個曲面，
12:17
and that's a little bit unnatural.
305
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1676
這件事情不太自然。
12:19
And so one of the things you can think about doing
306
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2248
其中一個解決辦法就是，
12:21
is actually making scaffolds
with slightly different dimensions
with slightly different dimensions
307
729380
3148
讓架構在度量上有點不同，
12:24
that might be able to surround your cells in 3D
308
732528
2793
讓它能夠以 3D 的形式包住細胞
12:27
and give them a little bit more information.
309
735321
2569
然後給它們更多的訊息。
12:29
And there's a lot of work going
on in both of these areas.
on in both of these areas.
310
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3567
在這些領域，許多研究正在進行
12:33
Now finally, I just want to talk a little bit about
311
741471
3969
最後，我想說說把這些東西在
12:37
applying this sort of thing to cardiovascular disease,
312
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2708
心血管疾病上的應用，
12:40
because this is a really big clinical problem.
313
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3263
因為這些疾病在臨床上相當重要。
12:43
And one of the things that we know is that,
314
751411
3585
我們知道的一件事情是，很不幸的
12:46
unfortunately, if you have a heart attack,
315
754996
2239
如果你有了心肌梗塞，
12:49
then that tissue can start to die,
316
757235
2902
那裡的組織就會開始壞死，
12:52
and your outcome may not be very good over time.
317
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3751
長期下來的後果不會太好。
12:55
And it would be really great, actually,
318
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1710
如果我們能
12:57
if we could stop that dead tissue
319
765598
1919
阻止組織壞死那就太棒了
12:59
either from dying or help it to regenerate.
320
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3985
不論是從阻止壞死或是幫助它再生。
13:03
And there's lots and lots of stem
cell trials going on worldwide,
cell trials going on worldwide,
321
771502
3248
現在全世界進行著
非常多的幹細胞試驗，
非常多的幹細胞試驗，
13:06
and they use many different types of cells,
322
774750
2072
他們用了很多種不同的細胞，
13:08
but one common theme that seems to be coming out
323
776822
2352
但是有一件事情常常發生，
13:11
is that actually, very often, those cells will die
324
779174
2999
那就是這些細胞在被植入
13:14
once you've implanted them.
325
782173
1795
之後就會死亡。
13:15
And you can either put them into the heart
326
783968
1875
你可以把它們放進心臟
13:17
or into the blood system,
327
785843
2020
或是血液系統裡頭，
13:19
but either way, we don't seem to be able
328
787863
2362
但無論是哪種方法，我們似乎都不能
13:22
to get quite the right number of cells
329
790225
1867
讓細胞
13:24
getting to the location we want them to
330
792092
2242
到達我們希望它們去的部位，
13:26
and being able to deliver the sort of beautiful
331
794334
4494
然後進行美妙的
13:30
cell regeneration that we would like to have
332
798828
2740
細胞再生，
13:33
to get good clinical outcomes.
333
801568
3417
得到良好的療效。
13:36
And so some of the things that we're thinking of,
334
804985
1983
因此，我們以及在這個領域的很多人
13:38
and many other people in the field are thinking of,
335
806968
3121
在思考的事情是，
13:42
are actually developing materials for that.
336
810089
3006
發展出能夠做到這些事情的材料。
13:45
But there's a difference here.
337
813095
1619
但是不同的是，
13:46
We still need chemistry, we still need mechanics,
338
814714
2210
我們仍然需要化學、力學，
13:48
we still need really interesting topography,
339
816924
2671
需要很有趣的拓樸學，
13:51
and we still need really interesting
ways to surround the cells.
ways to surround the cells.
340
819595
2648
也需要能夠研究
這些細胞的有趣方法。
這些細胞的有趣方法。
13:54
But now, the cells also
341
822243
2511
目前，這些細胞
13:56
would probably quite like a material
342
824754
2025
比較像是
13:58
that's going to be able to be conductive,
343
826779
2018
能夠傳導的材料，
14:00
because the cells themselves will respond very well
344
828797
4209
因為這些細胞
會對訊號做出很好的回應，
會對訊號做出很好的回應，
14:05
and will actually conduct signals
between themselves.
between themselves.
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並在彼此之間傳遞這些訊號。
14:08
You can see them now
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你可以看到這些細胞在材料上
14:10
beating synchronously on these materials,
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同步跳動，
14:12
and that's a very, very exciting development
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這真的是
14:15
that's going on.
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令人相當興奮的進展。
14:17
So just to wrap up, I'd like to actually say that
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總而言之，我想說的是
14:22
being able to work in this sort of field,
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能在這個領域工作，
14:24
all of us that work in this field
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對在這個領域的所有人來說，
14:26
that's not only super-exciting science,
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這不只是令人超級興奮的科學，
14:28
but also has the potential
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也對病人
14:30
to impact on patients,
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有潛在影響力，
14:32
however big or small they are,
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不論這些影響是大是小，
14:35
is really a great privilege.
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都是很好的恩典。
14:36
And so for that, I'd like to thank all of you as well.
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在此我也想要感謝你們所有人。
14:39
Thank you.
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謝謝。
14:41
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Molly Stevens - Biomaterials researcherMolly Stevens studies and creates new biomaterials that could be used to detect disease and repair bones and human tissue.
Why you should listen
At Imperial College London, Molly Stevens heads a highly multidisciplinary research group that designs bioactive materials for regenerative medicine and biosensing. It's fundamental science with an eye to practical applications as healthcare products.
Among the products from her lab: an engineered bone, cardiac tissue suitable for use in transplants, and disease-sensing nanoparticle aggregates that change color in the presence of even tiny quantities of cancer-related enzymes, making early sensing possible. As Stevens told The Lancet: "It's right down at the nanoscience level. It's really exciting stuff, but it actually results in something very tangibly useful."
Molly Stevens | Speaker | TED.com