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  • Hi everyone.

    譯者: Lilian Chiu 審譯者: Yanyan Hong

  • I would like to introduce you to Laika.

    嗨,大家好。

  • To most of us, Laika is simply a very cute pig.

    讓我向各位介紹萊卡。

  • However, to hundreds of thousands of patients in need of a lifesaving organ

    對大部分的人來說, 萊卡只是一隻非常可愛的豬。

  • Laika is a symbol of hope.

    然而,

  • You see, ever since the 1970s,

    對於數十萬名需要器官 來救命的病人來說,

  • when organ transplants became a real option

    萊卡是希望的象徵。

  • for patients with kidney failure and other organ diseases,

    在七十年代,

  • organ supply has been an issue.

    器官移植這個選項成真了,

  • Over the last few decades,

    腎臟衰竭和其他器官疾病的 病人都可以選擇它,

  • the issue only worsened as organ demand has exponentially increased.

    此後,器官供應便成了一個議題。

  • Currently in the US,

    在過去幾十年間,

  • there are close to 115,000 patients

    器官需求以指數增加, 使這個議題變得更糟。

  • in need of a lifesaving organ transplant.

    目前,在美國,

  • By the end of my talk,

    有接近 11 萬 5 千名病人

  • one more patient will be added to this list.

    需要組織移植來拯救他們的性命。

  • Today, about 100 people will get a new organ,

    在我的演說結束時,

  • a chance to start their life anew,

    就會再有一位病人加入名單中。

  • and yet by the end of today,

    今天,大約有 100 人 可以得到一個新器官,

  • 20 others will die waiting.

    一個重新開始新生活的機會,

  • The situation is heartbreaking

    但,在今天結束時,

  • for patients, for their families

    會有另外 20 個人 等不到器官而死。

  • and for the doctors who want to do more.

    這個情況讓人心碎,

  • In some parts of the world,

    對病人、對他們的家人,

  • the situation also becomes a disturbing social issue.

    及對想要做更多的醫生 來說都是如此。

  • In Asia, for example,

    在世界上的某些地方,

  • media outlets reported that desperate patients

    這個情況也變成了 令人不安的社會議題。

  • are obtaining organs from the cruel black market.

    比如,在亞洲,

  • It is clear that a solution is needed to this crisis.

    媒體管道報導指出, 走投無路的病人

  • Human lives are at stake.

    會從殘酷的黑市取得器官。

  • As a biologist and a geneticist,

    很明顯,這個危機 需要一個解決方案。

  • it has become my mission to help solve this problem.

    人命關天。

  • Today, I am optimistic to say that we are on our way there,

    身為生物學家和遺傳學家,

  • thanks to Laika.

    協助解決這個問題成了我的使命。

  • Using gene editing technology,

    今天,我能很樂觀地說, 我們正在朝那個目標邁進,

  • it's now possible to exquisitely create a human-transplantable organ

    這要感謝萊卡。

  • that can be safely grown in pigs.

    用基因編輯技術,

  • Before we jump into the incredible science that makes it happen,

    現在已經有可能精緻地創造出 可以移植給人類的器官,

  • let's have a better understanding what xenotransplantation is.

    並讓它在安全地長在豬身上。

  • It's a process of transplanting animal organs into humans.

    在我們跳進去談 讓它成真的偉大科學之前,

  • You may want to ask, why pig organs?

    咱們先多了解一下 「異種器官移植」是什麼。

  • Because some pigs carry organs with similar size and physiology

    它是把動物組織移植到 人類身上的過程。

  • to human organs.

    你們可能會想問, 為什麼用豬的器官?

  • Over the last half a century,

    因為有些豬本身的器官

  • pioneers of transplantation have tried hard to make it happen,

    和人類器官的大小 及生理機能都很類似。

  • but with limited to no success.

    在過去半個世紀,

  • Why is that?

    移植領域的先鋒 非常努力地實現這個想法,

  • Two fundamental hurdles stood in the way.

    但成功有限,或甚至根本沒能成功。

  • First is a problem of rejection.

    為什麼會這樣?

  • When our immune system sees a new organ as foreign,

    有兩個基本的阻礙。

  • it will reject it.

    第一,是排斥的問題。

  • Second, and this one is specific to the organs from the pig,

    當我們的免疫系統 把新器官視為是外來物,

  • every pig carries a virus that is benign to the pig,

    就會排斥它。

  • but can be transmitted into humans.

    第二,這是只有豬的器官 才會遇到的狀況,

  • It is called the porcine endogenous retrovirus (PERV),

    每隻豬都帶有一種病毒, 這病毒對牠的健康有益,

  • and this virus has the potential to cause a viral epidemic similar to HIV.

    但可能會被傳給人類。

  • Without an effective way to address these issues,

    這種病毒叫豬內源性 反轉錄病毒(PERV),

  • the field of xenotransplantation has been on hold for more than one decade.

    這種病毒有可能會造成 類似愛滋病的病毒大流行。

  • Little progress has been made, until now.

    因為沒有有效的方式 來處理這些議題,

  • Let me share with you how I got here today with Laika.

    異種器官移植的領域 停滯了超過十年的時間。

  • My journey started from Emei Mountain in China.

    到目前為止,進展都相當少。

  • That is the place well described in a lot of legendary stories,

    讓我分享一下,我和萊卡的故事 是怎麼今天來到這裡的。

  • like the "Crouching Tiger, Hidden Dragon."

    我的旅程始於中國的峨眉山。

  • That is the place I call home.

    許多傳奇故事都對這座山 做了很好的描述,

  • Growing up in the mountain,

    比如《臥虎藏龍》。

  • I started to have a strong connection with nature.

    那是我稱為家的地方。

  • This is me when I was seven years old

    我在山中長大,

  • standing in front of an ancient Buddhist temple

    我開始和大自然有強烈的連結。

  • with a monkey on my shoulder.

    這是我七歲的時候,

  • I still vividly remember how my friends and I

    站在一座古老的佛教寺廟前,

  • would toss peanuts around to distract the monkeys

    肩上有一隻猴子。

  • so that we could cross to hike through the valley.

    我仍然能很鮮明地記得 我和我的朋友

  • I love nature.

    如何向周圍丟花生, 來引開猴子的注意力,

  • When it was time to choose a field of study,

    這樣我們才能通過,去山谷中健行。

  • I chose to study biology at Peking University in Beijing.

    我愛大自然。

  • However, the more I learned,

    在要選擇研讀領域的時候,

  • the more questions I had.

    我選擇在北京大學研讀生物。

  • How could our genetic makeup be so similar to animals

    然而我學得越多,就有越多的問題。

  • and yet we look so different?

    怎麼可能我們的基因構造 和動物如此相似,

  • How is our immune system capable of fighting off so many pathogens

    外表上卻差這麼多?

  • but smart enough not to attack ourselves.

    為什麼我們的免疫系統 能夠抵抗這麼多病原體,

  • Questions like this tormented me.

    卻聰明到不會攻擊我們自身?

  • I know it sounds nerdy, but you know I'm a scientist.

    像這樣的問題讓我很煩擾。

  • After college, I decided I didn't want to just ask the questions,

    我知道這樣聽起來很宅, 但你們知道我是個科學家。

  • I wanted to answer them, so I did.

    大學之後,我決定 我不想要只是問問題,

  • In 2008, I was lucky enough to be accepted

    我想要回答問題, 我也的確就這麼做了。

  • into the PhD program at Harvard University

    2008 年,我很幸運,

  • and worked with Dr. George Church.

    被哈佛大學的博士班接受,

  • While working in Church's lab,

    跟著喬治丘奇博士研究。

  • I started to learn and experiment with the genetic makeup of mammals.

    在丘奇的實驗室中工作時,

  • Among all the experiments,

    我開始學習和實驗 哺乳動物的基因構造。

  • one particular one took me closer to Laika.

    在所有的實驗中,

  • In 2013, my colleagues and I made changes in a human cell

    有一項實驗特別讓我更靠近萊卡。

  • using a tool you may have heard about

    2013 年,我和同事 改造了人類的細胞,

  • called CRISPR.

    我們用的工具各位可能有聽過,

  • We were one of the first two groups

    叫 CRISPR。

  • to report the successful use of such a tool in changing our DNA.

    最早提出成功使用這種工具

  • It was an exciting moment in scientific discovery.

    改變人類 DNA 的兩個團隊, 其中一個就是我們。

  • The gene-editing tool CRISPR has two components.

    那是科學發現的一個興奮時刻。

  • It has a scissor called the enzyme CRISPR

    CRISPR 是種基因編輯工具, 它有兩個元件。

  • and what is called a guide RNA.

    它有一把剪刀, 叫做酵素 CRISPR,

  • Think about it as genetic scissors with a microscope.

    還有所謂的嚮導 RNA。

  • The microscope is a guide RNA,

    把它想成是有顯微鏡的基因剪刀。

  • which brings the scissors to the place we want to cut

    顯微鏡是一個嚮導 RNA,

  • and says, "Here it is,"

    能把剪刀帶到我們想要剪的地方,

  • and the enzyme CRISPR just cuts and repairs the DNA in the way we want.

    然後說「就是這裡」,

  • Shortly after we reported our study,

    接著酵素 CRISPR 就會剪下去,

  • physicians at Mass General Hospital were intrigued by the medical applications

    並以我們希望的方式 來修復該 DNA。

  • of our research.

    在我們提出了我們的 研究之後沒多久,

  • They reached out to us,

    麻省總醫院的醫師對於我們的研究

  • and together, we began to see the potential to use CRISPR

    在醫療上的應用很感興趣。

  • to solve the organ shortage crisis.

    他們跟我們聯絡,

  • How do we do it?

    我們合作之後,開始發現 是有可能使用 CRISPR

  • It is simple, yet very complex.

    來解決器官短缺的危機。

  • We started by making changes in a pig's cell to make it virus-free

    我們要如何做到?

  • and human-immune-compatible.

    很簡單,卻也很複雜。

  • The nucleus of that cell is then implanted into a pig egg

    我們開始改變豬的細胞,

  • and allowed to divide into an embryo.

    讓它變成沒有病毒, 且和人類免疫系統能夠相容。

  • The resulting embryo is then placed into the uterus of a surrogate mother

    接著,把那細胞核 植入豬的卵細胞中,

  • and allowed to divide into a pig.

    讓它分裂成胚胎。

  • Basically, it's a process of cloning.

    接著把產生出的胚胎 放到代理孕母的子宮中,

  • The piglet then carries organs whose genetic makeup

    讓它分裂成一隻豬。

  • hopefully wouldn't be rejected by the human immune system.

    基本上,它是一個複製的過程。

  • In 2015, our team decided to tackle the viral transmission problem first.

    這些器官接著就會生長在小豬身上,

  • We wanted to take out all 62 copies of the PERV virus

    希望它們的基因構造不會 被人類免疫系統給排斥。

  • from the pig genome,

    2015 年,我們的團隊決定

  • but at the time, it was nearly mission impossible.

    先處理病毒傳播的問題。

  • Even with CRISPR,

    我們想要從豬的基因組當中取出

  • we could only do one or two modifications within a cell.

    所有 62 個 PERV 病毒的複製品,

  • The record for number of modifications we can do in a particular cell was five.

    但在當時,那幾乎是不可能的任務。

  • We had to increase the throughput by more than tenfold to achieve that.

    即使有 CRISPR,

  • With very careful design and hundreds of trials,

    我們也只能在一個細胞中 做一或兩種修改。

  • we successfully took out all the virus,

    在一個細胞中,我們所能達到的

  • broke the record.

    最高修改數量記錄是五。

  • More importantly, our studies showed

    我們得要將總處理能力 增加十倍以上才能達成目標。

  • that we could eliminate the possibility of this dangerous virus

    經過非常小心的設計 和數百次的試驗,

  • being transmitted into humans.

    我們成功取出了全部病毒,

  • Last year, with a modified cell and cloning technology,

    打破了記錄。

  • our startup, eGenesis, produced Laika,

    更重要的是,我們的研究顯示,

  • the first pig of its kind born without PERV.

    我們可以消除這種危險病毒

  • (Applause)

    傳給人類的可能性。

  • Laika represents the first critical step

    去年,用修改過的細胞 以及複製技術,

  • in establishing safe xenotransplantation.

    我們的新創公司 eGenesis 產出了萊卡,

  • It is also a platform

    牠是第一隻生出來 就沒有 PERV 的豬。

  • that we can do further genetic modification on

    (掌聲)

  • to solve the immunology problem.

    萊卡代表的是關鍵的第一步,

  • Since then, we have created more than 30 pigs without PERV,

    朝向建立安全異種器官移植邁進。

  • and they may be the most advanced geno-modified animal living on earth.

    牠也是個平台,

  • We named Laika after the Soviet dog

    我們可以在上面 做進一步的基因修改,

  • who was the first animal to orbit the earth.

    來解決免疫學問題。

  • We hope Laika and her siblings

    從那之後,我們已經創造出了 超過 30 隻沒有 PERV 的豬,

  • can lead us into a new frontier of science and medicine.

    牠們可能是地球上 最先進的基因改造動物。

  • Imagine a world where patients who suffer from liver failure

    萊卡這個名字是取自第一隻

  • can be saved with a new liver

    進入環繞地球軌道的蘇聯太空犬。

  • without having to wait for a donation

    我們希望萊卡和牠的手足們

  • or another human to die.

    能領導我們進入 科學和醫學的新領域。

  • Imagine a world where people with diabetes

    想像一個世界, 在那裡,肝衰竭的病人

  • do not have to rely on insulin after every meal

    可以得到新的肝,因而得救,

  • because we can provide them with good pancreatic cells

    不需要等待捐贈, 也不用等待另一個人死亡。

  • that can produce insulin on their own.

    想像一個世界, 在那裡,有糖尿病的人

  • And imagine a world where patients with kidney failure

    不需要仰賴每餐後的胰島素,

  • do not have to face the burden of dialysis.

    因為我們能夠提供他們 好的胰臟細胞,

  • We are striving to create that world,

    那些細胞自己就可以產生胰島素。

  • a world without organ shortage.

    想像一個世界, 在那裡,腎臟衰竭的病人,

  • We finally have the tool to tackle the problem

    不需要面臨洗腎的沉重負擔。

  • we could never tackle before,

    我們在努力創造那樣的世界,

  • and Laika is just the beginning of our journey.

    沒有器官短缺的世界。

  • We have to be very humble in front of nature,

    我們終於有了一項工具 可以處理這個問題,

  • because there are more issues to be addressed,

    這是以前完全辦不到的,

  • including immunology

    萊卡只是我們旅程的開端。

  • and things we couldn't even anticipate at this point.

    在大自然面前,我們得要非常謙虛,

  • However, it is our responsibility to translate the cutting-edge science

    因為還有更多議題 需要處理,包括免疫學,

  • into medicine to save the lives of all the patients who are waiting.

    以及我們在這個時點, 我們甚至還無法預期的議題。

  • Thank you very much.

    然而,我們有責任

  • (Applause)

    要將這尖端科學轉變為醫學,

  • Chris Anderson: I mean, Luhan, this is extraordinary work here.

    來拯救所有在等待的病人的性命。

  • Come forward.

    非常謝謝。

  • So what's the next steps here? You've got rid of the virus.

    (掌聲)

  • The next steps involve trying to get to the point

    克里斯安德森:璐菡, 這是非常了不起的研究。

  • where a human body won't reject a transplant.

    請上前來。

  • What's involved in solving that?

    接下來要做的是什麼? 你已經解決了病毒問題。

  • Luhan Yang: It's a very complicated process.

    接下來要做的是

  • So we need to take out the antigen of the pigs.

    要試著讓人體不排斥移植。

  • In addition, we can learn a lot from cancer.

    要解決這問題,會牽涉到什麼?

  • How can cancer invade or circumvent our immune system

    楊:這是個非常複雜的過程。

  • so that we can utilize the trick of cancer

    所以我們得要從豬身上取出抗原。

  • and implement that on the pig organ

    此外,我們也從癌症學到很多。

  • to fool our immune system to not attack the organ.

    癌症如何能侵入或規避 我們的免疫系統?

  • CA: When would you estimate, when do you hope

    我們可能學癌症的技巧,

  • that the first successful transplant would happen?

    把它用在豬的器官上,

  • LY: It would be irresponsible for me to give you any number.

    來愚弄我們的免疫系統, 讓它不去攻擊移植的器官。

  • CA: We're at TED. We're always irresponsible.

    克:依你估計,你希望

  • LY: But we are working day and night

    第一次成功移值會在何時發生?

  • trying to make this happen for the patients.

    楊:我無法給你任何數字, 那是不負責任的行為。

  • CA: So not even, you won't say that you think it could happen

    克:我們在 TED。 我們總是不負責任。

  • within a decade or within five years or something?

    楊:但我們日以繼夜地在努力, 試著為病人實現這個夢。

  • LY: For sure we hope it happens within one decade.

    克:所以,你甚至 不能說你認為可能會在

  • (Laughter)

    十年或是五年之類的期間發生嗎?

  • CA: So there's a lot of people here who would be very, very excited at that,

    楊:當然我們會希望 能在十年內實現。

  • the potential is extraordinary.

    (笑聲)

  • There will be some other people here who are going,

    克:這裡有很多人 對此會感到非常興奮,

  • "That pig is too cute.

    這潛力是非常不凡的。

  • Humans shouldn't be exploiting something so cute for our benefit."

    這裡也會有一些其他的人說: 「那隻豬太可愛了。

  • Do you have any response to that?

    人類不應該利用那麼可愛的生物 來謀求自己的利益。」

  • LY: Yeah, sure.

    你對這個問題有什麼要回應的嗎?

  • So imagine one pig can save eight people's lives.

    楊:有,當然。

  • In addition, similar to human donation,

    想像一下,一隻豬能夠 拯救八個人的性命。

  • if we only harvest one kidney from the pig,

    此外,和人類捐贈很類似,

  • the pig can still be alive,

    如果我們只從豬身上 取得一個腎臟,

  • so we are very mindful about the issues,

    牠仍然能存活,

  • but I think our goal is just to address the unmet medical need

    我們對於這些議題非常小心謹慎,

  • for those patients and their families.

    但我認為我們的目標只是 要處理尚未滿足的醫療需求,

  • CA: Plus, no one can say that to you if they eat bacon, right?

    為了那些病人和他們的家人。

  • LY: That's a good point.

    克:此外,吃培根的人 也不能對你說那種話,對吧?

  • (Laughter)

    楊:說得有理。

  • CA: Luhan, thank you so much. LY: Thank you so much.

    (笑聲)

  • (Applause)

    克:璐菡,非常感謝。 楊:非常感謝。

Hi everyone.

譯者: Lilian Chiu 審譯者: Yanyan Hong

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B1 US TED 病毒 移植 基因 細胞 人類

【TED】楊璐菡:如何創造一個沒有人因等待移植而死亡的世界(如何創造一個沒有人因等待移植而死亡的世界|楊璐菡)。 (【TED】Luhan Yang: How to create a world where no one dies waiting for a transplant (How to create a world where no one dies waiting for a transplant | Luhan Yang))

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    林宜悉 posted on 2021/01/14
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