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It was a Sunday afternoon back in April of this year. My phone was ringing, I picked it up.
去年四月一个周日的下午，我收到了一个电话。我接了起来。
The voice said, "It's Rebecca. I'm just calling to invite you to my funeral."
“我是丽贝卡，我给你打电话，是为了邀请你来我的葬礼。”
I said, "Rebecca, what are you talking about?"
我说，“丽贝卡，你在说什么？”
She said, "Joy, as my friend, you have to let me go. It's my time." The next day, she was dead.
她说，“乔伊，作为我的朋友，你需要放手，是时候让我离开了。”第二天，她去世了。
Rebecca was 31 years old when she died. She had an eight-year struggle with breast cancer.
丽贝卡去世时才31岁。她和乳腺癌斗争了八年。
It came back three times. I failed her. The scientific community failed her.
癌症复发了三次。我让她失望了。科学界让她失望了。
And the medical community failed her. And she's not the only one.
医疗界也让她失望了。而且她不是唯一一个。
Every five seconds, someone dies of cancer.
每五秒钟，就有一个人死于癌症。
Today, we medical researchers are committed to having Rebecca and people like her be one of the last patients that we fail.
当下，我们医疗研究者下决心不让像丽贝卡和像她这样的人再失望。
The US government alone has spent over 100 billion on cancer research since the 1970s,
自二十世纪七十年代，美国政府已经花了将近一千亿美元来研究癌症。
with limited progress in regards to patient survival, especially for certain types of very aggressive cancers.
可是病人的存活率却没有很大的改善，特别是某些非常有侵略性的癌症。
So we need a change because, clearly, what we've been doing so far has not been working.
所以我们需要改变，我们所做的并没有很突出的成效。
And what we do in medicine is to send out firefighters, because cancer is like a big fire.
我们就像是派出消防员，来消灭烈火燎原一般的癌症。
And these firefighters are the cancer drugs. But we're sending them out without a fire truck
这些消防员就是治疗癌症的药物。但是我们没有给它们消防车，
so without transportation, without ladders and without emergency equipment.
没有运输工具，没有云梯，没有应急设备。
And over 99 percent of these firefighters never make it to the fire.
所以超过99%的消防员都到达不了火场。
Over 99 percent of cancer drugs never make it to the tumor
超过99%的癌症药物都到达不了肿瘤，
because they lack transportation and tools to take them to the location they're aiming for.
因为它们缺少运输方式和工具让它们到达目的地。
Turns out, it really is all about location, location, location.
而这就跟房地产一样，地点非常非常重要。
So we need a fire truck to get to the right location.
所以我们需要让癌症药物到达准确的地点。
And I'm here to tell you that nanoparticles are the fire trucks.
我认为纳米粒子就是我们所需要的工具。
We can load cancer drugs inside nanoparticles,
我们可以把癌症药物放在纳米粒子里面，
and nanoparticles can function as the carrier and necessary equipment to bring the cancer drugs to the heart of the tumor.
这些粒子就是能够让药物到达肿瘤中心的载体和必要工具。
So what are nanoparticles, and what does it really mean to be nano-sized?
什么是纳米粒子，纳米到底是多大？
Well, there are many different types of nanoparticles made out of various materials
纳米粒子有很多种，由不同的材料组成，
such as metal-based nanoparticles or fat-based nanoparticles.
比如金属基纳米粒子，或者脂肪基纳米粒子。
But to really illustrate what it means to be nano-sized, I took one of my hair strands and placed it under the microscope.
但是为了展示纳米材料的大小，我拿了我的一根头发放在显微镜下。
Now, I have very thin hair, so my hair is approximately 40,000 nanometers in diameter.
我的头发很细，它的直径差不多是四万纳米。
So this means, if we take 400 of our nanoparticles and we stack them on top of each other,
这意味着四百个纳米粒子一个一个叠在一起，
we get the thickness of a single hair strand.
就是一根头发的厚度。
I lead a nanoparticle laboratory to fight cancer and other diseases at Mayo Clinic here in Jacksonville.
我在杰克逊维尔当地的梅奥诊所领导着一个用纳米粒子治疗癌症和其它疾病的实验室。
And at Mayo Clinic, we really have the tools to make a difference for patients,
在梅奥诊所，我们拥有能够改变病人生活的工具，
thanks to the generous donations and grants to fund our research.
这要归功于赠予实验室的大量捐款。
And so, how do these nanoparticles manage to transport cancer drugs to the tumor?
这些纳米粒子又是怎么把癌症药物运送到肿瘤的呢？
Well, they have an extensive toolbox.
它们的方法和工具有很多。
Cancer drugs without nanoparticles are quickly washed out of the body through the kidneys because they're so small.
没有纳米粒子的癌症药物会被肾脏快速的排出，因为它们太小了。
So it's like water going through a sieve. And so they don't really have time to reach the tumor.
就像是水流过漏斗一样。所以它们没有时间到达肿瘤。
Here we see an illustration of this. We have the firefighters, the cancer drugs.
这是一个过程的演示。癌症药物，就是消防员。
They're circulating in the blood, but they're quickly washed out of the body
它们在血液里循环，但是它们很快被身体排出，
and they don't really end up inside the tumor.
而根本不会到达肿瘤。
But if we put these cancer drugs inside nanoparticles,
但是如果把它们放在纳米粒子里，
they will not get washed out by the body because the nanoparticles are too big.
它们就不会被身体排出，因为纳米粒子太大了。
And they will continue to circulate in the blood, giving them more time to find the tumor.
所以它们会继续在血液里循环，就有更多的时间找到肿瘤。
And here we see the cancer drug, the firefighters, inside the fire truck, the nanoparticles.
这里我们可以看到癌症药物，就是消防员，在纳米粒子“消防车”里。
They're circulating in the blood, they don't get washed out and they actually end up reaching the tumor.
它们在血液里循环，不会被排出，它们最后到达了肿瘤。
And so what other tools do nanoparticles have?
纳米粒子还有什么功能？
Well, they can protect cancer drugs from getting destroyed inside the body.
它们可以保护药物不被损坏。
There are certain very important but sensitive drugs that are easily degraded by enzymes in the blood.
有些非常重要但很脆弱的药物很容易会被血液里的酶给分解。
So unless they have this nanoparticle protection, they will not be able to function.
所以除非它们有这些纳米粒子的保护，它们就不会发挥功效。
Another nanoparticle tool are these surface extensions
纳米粒子的另一个作用是这些表面上的触角，
that are like tiny hands with fingers that grab on to the tumor and fit exactly onto it,
它们像小手一样能够抓住肿瘤，丝毫不松手。
so that when the nanoparticles are circulating,
所以当纳米粒子在血液里循环，
they can attach onto the cancer cells, buying the cancer drugs more time to do their job.
它们会粘附在癌症细胞上，让癌症药物有更多的时间发挥功效。
And these are just some of the many tools that nanoparticles can have.
这些还不是纳米粒子的全部作用。
And today, we have more than 10 clinically approved nanoparticles for cancer that are given to patients all over the world.
现在，我们给了世界各地的病人超过10种临床批准的癌症治疗纳米粒子。
Yet, we have patients, like Rebecca, who die.
当然，还是有病人像丽贝卡这样，没能幸存。
So what are the major challenges and limitations with currently approved nanoparticles?
现有的纳米粒子技术有什么主要的挑战和缺陷呢？
Well, a major challenge is the liver, because the liver is the body's filtration system,
一个主要的挑战是肝，肝是人体的过滤系统，
and the liver recognizes and destroys foreign objects, such as viruses, bacteria and also nanoparticles.
可以识别并销毁外来物体，比如病毒、细菌和纳米粒子。
And the immune cells in the liver eat the nanoparticles, preventing them from reaching the tumor.
肝里的免疫细胞会吞噬纳米粒子，让它们到不了肿瘤。
And here we see an illustration where the kidney is no longer a problem,
这个演示表明通过肾脏已经不是问题，
but these fire trucks, the nanoparticles, get stuck in the liver and, actually, less of them end up reaching the tumor.
但是这些纳米粒子，会被卡在肝里，很少会到达肿瘤。
So a future strategy to improve nanoparticles is to temporarily disarm the immune cells in the liver.
改善纳米粒子的可行方案是暂时性地关闭肝脏中的免疫细胞。
So how do we disarm these cells?
我们怎么做到呢？
Well, we looked at drugs that were already clinically approved for other indications
我们查看了其他有临床批准的药物，
to see if any of them could stop the immune cells from eating the nanoparticles.
看它们能不能让免疫细胞不吞噬纳米粒子。
And unexpectedly, in one of our preclinical studies,
出乎意料，在之前的研究里，
we found that a 70-year-old malaria drug was able to stop the immune cells from internalizing the nanoparticles
我们找到了一个70年前的疟疾药物。它能够让免疫细胞不吞噬纳米粒子，
so that they could escape the liver and continue their journey to their goal, the tumor.
这样纳米粒子就能够通过肝并继续循环到肿瘤。
And here we see the illustration of blocking the liver.
从这张图可以看到肝被关闭。
The nanoparticles don't go there, and they instead end up in the tumor.
纳米粒子不会到达肝，而会最后到达肿瘤。
So, sometimes, unexpected connections are made in science that lead to new solutions.
有的时候，科学中一些意想不到的联系能够带领我们找到新的解决方法。
Another strategy for preventing nanoparticles from getting stuck in the liver is to use the body's own nanoparticles.
另外一个不让纳米粒子被肝过滤的方法，是用我们身体自带的纳米粒子。
Yes -- surprise, surprise. You, and you and you, and all of us have a lot of nanoparticles circulating in our bodies.
没有错，想不到吧？我们所有人体内都有很多纳米粒子在我们的血液里循环。
And because they're part of our bodies, the liver is less likely to label them as foreign.
因为它们是我们身体的一部分，肝就更不可能会把它们当成外来物。
And these biological nanoparticles can be found in the saliva, in the blood, in the urine, in pancreatic juice.
这些人体的纳米粒子可以在唾液、血液、尿液和胰液里找到。
And we can collect them from the body and use them as fire trucks for cancer drugs.
我们可以从身体里提取这些液体，并把它们当成癌症药物的消防车。
And in this case, the immune cells in the liver are less likely to eat the biological nanoparticles.
这样，肝里面的免疫细胞就更不会吞噬这些纳米粒子。
So we're using a Trojan-horse-based concept to fool the liver.
这个方式很像特洛伊木马，来欺骗肝。
And here we see the biological nanoparticles circulating in the blood.
这里我们看到纳米粒子在血液里循环。
They don't get recognized by the liver, and they end up in the tumor.
它们不会被肝识别，并最后到达肿瘤。
And in the future, we want to exploit nature's own nanoparticles for cancer drug delivery,
在未来，我们想用非人造的纳米粒子来当癌症药物的运载工具，
to reduce side effects and save lives by preventing the cancer drugs from being in the wrong location.
并减少副作用和保护肝，让癌症药物直达肿瘤。
However, a major problem has been:
但是，一个很重要的问题是，
How do we isolate these biological nanoparticles in large quantities without damaging them?
我们如何大量抽取这些纳米粒子而不损坏它们？
My lab has developed an efficient method for doing this.
我的实验室研究出了一种有效的方法。
We can process large quantities of liquids from the body
我们可以用大量体液
to produce a highly concentrated, high-quality formulation of biological nanoparticles.
来产出高浓度高质量的纳米粒子。
And these nanoparticles are not yet in clinical use,
这些纳米粒子还没有被投入使用，
because it takes an average of 12 years to get something from the lab to your medicine cabinet.
因为把实验室的研究放到你的药箱里，一般需要12年。
And this is the type of challenge that requires teamwork from scientists and physicians, who dedicate their lives to this battle.
面对这样的挑战，需要投身于这场战斗的科学家和医师团队协作。
And we keep going, thanks to inspiration from patients.
为了病人们，我们要坚持不懈。
And I believe that if we keep working on these nanomedicines,
我相信如果我们继续研发这些纳米药物，
we will be able to reduce harm to healthy organs, improve quality of life and save future patients.
就能够减少对器官的损伤，提高病人的生活质量，并挽救他们的生命。
I like to imagine that if these treatments had been available for Rebecca,
我喜欢想象如果有人提供给丽贝卡这些治疗方案，
that call from her could have been an invitation not to her funeral, but her wedding. Thank you.
她的那个电话，就可能会是邀请我去她的婚礼，而不是葬礼。谢谢。
