Translator: Robert Deliman Reviewer: Denise RQ
翻译人员：罗伯特·德里曼 审核人：丹尼斯·RQ
[music]
[音乐]
This is a talk about sugar,
这是一场关于糖的演讲
and it’s not the only one we’ve heard today.
它不是我们今天听到的唯一一场
But this is a talk about sugar and cancer,
但这是一场关于糖和癌症的演讲
and that might give it a twist that is a little more unfamiliar.
这可能会给糖带来一个更陌生的转变
And I start with this slide, because this is my equivalent of
我从这张幻灯片开始
when the teacher in high school says, “Sex,”
因为这就相当于高中老师说 “性”
and everybody pays attention.
全班同学都会集中注意力
So this is, “Do you have my attention?”
那么 你们注意我了吗？
I became interested in sugar, actually, when I was in college.
实际上我开始对糖感兴趣 是在上大学的时候
Not this kind of sugar though.
但不是这种糖
It was the sugar
而是我们的生物学教授
that our biology professors taught us about
在讲细胞涂层的时候
in the context of the coating of your cells.
教给我们的糖
And maybe you didn’t know that your cells are coated with sugar.
也许你不知道你的细胞被糖包裹着
And I didn’t know that either until I took these courses in college.
我也不知道 直到我在大学上了这些课程
But back then, and this was, let’s just call it the 1980s.
但那时 我们姑且称之为20世纪80年代
This was when people didn’t know much about
那时人们不太了解为什么
why our cells are coated with sugar.
我们的细胞被糖包裹
And I saved my old college notes.
我保存了我大学时的笔记
Do people save their notes from their college classes
有人会把大学课堂上的笔记保存下来
and dig through them once in a while?
偶尔翻一翻么？
And when I dug through my notes,
当我翻阅笔记时
what I noticed I had written down
我注意到我写下的是
is that the sugar coating on our cells
我们细胞上的糖衣就像
is like the sugar coating on a Peanut M&M.
M&M花生巧克力豆上的糖衣
And do you remember that commercial from the 1970s or ’80s which is
你还记得上世纪七八十年代的那则广告吗？
that M&M’s melt in your mouth
“M&M融化在你嘴里
but not in your hand?
而不是在你手里”
Right? And people thought the sugar coating on our cells
对吧？ 那时人们认为我们细胞上的糖衣
was like a protective coating
就像一层保护膜
that somehow made our cells stronger or tougher.
以某种方式令我们的细胞更强壮或更坚韧
But we now know, many decades later,
但几十年后的今天我们知道了
that it’s much more complicated than that,
实际情况要比那复杂得多
and that the sugars on our cells are actually very complex.
我们细胞上的糖实际上非常复杂
And if you could shrink yourself down to a little miniature airplane
如果你能把自己缩小成一架微型飞机
and fly right along the surface of your cells,
沿着细胞表面飞行
it might look something like this, with geographical features.
它可能看起来像这样 具有地理特征
And now the complex sugars are these trees, and bushes, weeping willows
复杂的糖就是这些树木 灌木和垂柳
swaying in the wind and moving with the waves.
在细胞中摇曳随波逐流
And when I started thinking about all these complex sugars
当我开始把这些复杂的糖
that are like this foliage on our cells,
当做我们细胞上的叶子来思考时
it became one of the most interesting problems that I encountered
它成了我作为生物学家和化学家
as a biologist and also as a chemist.
遇到的最有趣的问题之一
So now we tend to think about the sugars
所以现在我们倾向于
that are populating the surface of our cells
把聚居在我们细胞表面的糖
as a language.
看作一种语言
They have a lot of information stored in their complex structures,
它们复杂的结构贮藏了大量信息
but what are they trying to tell us?
但它们想告诉我们什么？
And this is a very exciting area of biology and medicine
这是一个非常令人兴奋的生物学和医学领域
that I’ve been working on now for almost
在我的职业生涯中
20 years in my own career.
我已经在这个领域工作了近20年
I can tell you
我可以告诉你
that we do know some information that comes from these sugars,
我们确实从这些糖中得知一些信息
and it’s turned out already to be incredibly important
事实证明这些信息
in the world of medicine.
在医学界已经非常重要
For example, one thing your sugars are telling us
例如 有件事你的糖会告诉我们
is your blood type.
那就是你的血型
So your blood cells, your red blood cells, are coated with sugars,
你的血细胞 也就是红细胞都被糖包裹
and the chemical structures of those sugars determine your blood type.
这些糖的化学结构决定了你的血型
So for example, I know that I am blood type O.
例如 我知道我是O型血
How many people are also blood type O?
有多少人也是O型血？
Get your hands up. It’s a pretty common one.
举起手来 这是一种很常见的血型
And so when so few hands go up,
所以 当举手的人这么少时
either you’re not paying attention
要么你没有注意听讲
or you don’t know your blood type,
要么你不知道自己的血型
and both of those are bad.
这两种情况都很糟糕
But for those of you who share the blood type O with me,
但对于那些和我一样都是O型血的人来说
what this means is that we have this chemical structure
这意味着我们的血细胞表面
on the surface of our blood cells——
有这种化学结构
three simple sugars linked together to make a more complex sugar,
即三种单糖连接在一起形成一种更复杂的糖
and that, by definition, is blood type O.
根据定义 这就是O型血
Now how many people are blood type A?
有多少人是A型血？
Right here,
在这儿
so that means you have an enzyme in your cells
这意味着你们的细胞中有一种酶
that adds one more building block, that red sugar,
它可以再添加一种基本元素 即红糖
to build a more complex structure.
来构建一个更复杂的结构
And how many people are blood type B?
有多少人是B型血？
Quite a few.
相当多
You have a slightly different enzyme than the A people,
你们的酶与A血型的人稍有不同
so you build a slightly different structure.
所以你们构建的结构也略有不同
And those of you that are AB
你们这些AB型血的人
have the enzyme from your mother the other enzyme from your father,
从父母双方各继承一种酶
and now you make both of these structures in roughly equal proportions.
并以大致相同的比例构建这两种结构
And when this was figured out,
当这个问题
which is now back in the previous century,
在上个世纪被解决后
this enabled one of the most important medical procedures in the world,
这使得世界上最重要的医疗程序之一成为可能
which of course, is the blood transfusion.
当然 就是输血
And by knowing what your blood type is,
通过了解你的血型
we can make sure, if you ever need a transfusion,
如果你需要输血 我们可以确保
that your donor has the same blood type
你的捐赠者有相同的血型
so that your body doesn’t see foreign sugars
这样你的身体就不会出现
which it wouldn’t like, and it would certainly reject.
不受欢迎的 肯定会遭排斥的外来糖
What else are the sugars on the surface of your cells trying to tell us?
细胞表面的糖还想告诉我们什么？
Well, those sugars might be telling us
那些糖可能是在告诉我们
that you have cancer.
你得了癌症
So a few decades ago,
所以几十年前
correlations began to emerge from
糖和癌症的相关性
the analysis of tumor tissue.
开始出现在对肿瘤组织的分析中
And the typical scenario
典型的情况
is a patient would have a tumor detected,
是患者会检测到肿瘤
-perhaps by one of the imaging methods
——可能通过亚当·德拉泽达
that Adam de la Zerda talked about earlier today,
在今天早些时候提到的一种成像方法
and the tissue would be removed in a biopsy procedure
肿瘤组织会在活检过程中被切除
and then sent down to a pathology lab where that tissue would be analyzed
然后被送到病理实验室进行分析
to look for chemical changes
并寻找其中的化学变化
that might inform the oncologist about the best course of treatment.
为肿瘤学家的最佳治疗方案提供信息
And what was discovered from studies like that
从这类研究中发现的是
is that the sugars have changed when the cell transforms
当细胞从健康状态转变为疾病状态
from being healthy to being sick.
糖已经发生了变化
And those correlations have come up again and again and again,
这些相关性一次又一次地出现
but a big question in the field has been why?
但该领域的一个大问题是 为什么？
Why do cancers have different sugars?
为什么癌症有不同的糖？
What’s the importance of that?
这有什么重要性？
Why does it happen?
为什么会发生这种情况？
What can we do about it if it does turn out to be
如果证明它确实与疾病过程有关
related to the disease process?
我们能做些什么？
So one of the changes that we study here at Stanford
我们在斯坦福大学研究的其中一个变化
is an increase in the density of a particular sugar
是一种特定糖的密度增加
that’s called sialic acid.
这种糖叫做唾液酸
And I think this is going to be
我认为这将是
one of the most important sugars of our time.
我们这个时代最重要的糖之一
So I would encourage everybody to get familiar with this word.
所以我鼓励大家熟悉这个词
Sialic acid is not the kind of sugar that we eat,
唾液酸不是我们吃的那种糖
those are different sugars.
这些是不同的糖
This is a kind of sugar that is actually found
实际上在你体内的所有细胞中
at certain levels on all of the cells in your body;
都有一定含量的这种糖
it’s actually quite common on your cells.
这种糖实际上在你的细胞中很常见
But for some reason, cancer cells,
但由于某些原因 癌细胞
at least in a successful progressive disease,
至少在有成效的渐进性疾病中
tend to have more sialic acid than a normal healthy cell would have.
往往比正常健康细胞含有更多的唾液酸
And why? What does that mean?
这是为什么？ 这意味着什么？
Well, what we’ve learned is that it has to do with your immune system.
我们发现这与你的免疫系统有关
So let me tell you a little bit
所以让我来告诉大家
about the importance of your immune system in cancer.
免疫系统在癌症中的重要性
And this is something that’s I think in the news a lot these days,
我认为这在最近新闻中很常见
you know, people are starting to become familiar with the term cancer immune therapy,
人们开始熟悉癌症免疫治疗这个术语
and some of you might even know people
你们中的一些人甚至可能认识
who are benefiting from these very new ways of treating cancer.
从这些非常新的癌症治疗方法中受益的人
What we now know is that your immune cells,
我们现在知道的是 你的免疫细胞
which are the white blood cells coursing through your bloodstream,
也就是在你血液中流动的白细胞
they protect you on a daily basis from things gone bad,
它们每天都在保护你远离疾病侵害
including cancer.
包括癌症在内
And so in this picture,
在这张照片中
those little green balls are your immune cells,
那些绿色的小球是你的免疫细胞
and that big pink cell is a cancer cell.
而那个粉红色的大细胞是癌细胞
And these immune cells, they go around,
这些免疫细胞四处游走
and they taste all the cells in your body.
它们品尝你体内的所有细胞
That’s their job.
那是它们的工作
And most of the time, the cells taste OK,
大多数时候 细胞尝起来不错
but once in a while, a cell might taste bad.
但偶尔 一个细胞尝起来不好
Hopefully, that’s the cancer cell.
那可能就是癌细胞
And when those immune cells get the bad taste,
当这些免疫细胞尝到不好的味道时
they launch an all-out strike and they kill those cells.
它们会发动一场全面的打击 杀死这些细胞
So we know that.
我们知道这一点
We also know that if you can potentiate that tasting,
我们还知道 如果你能增强这种不良的味道
if you can encourage those immune cells
如果你能够鼓励那些免疫细胞
to actually take a big, old bite out of a cancer cell,
真正从癌细胞身上咬下一大口
you get a better job protecting yourself from cancer every day
你就能更好地每天保护自己免受癌症的侵袭
and maybe even curing a cancer.
甚至可能治愈癌症
And there are now a couple of drugs out there in the market
现在市面上有几种用于治疗癌症患者的药物
that are used to treat cancer patients that act exactly by this process.
正是通过这一过程起作用的
They activate the immune system
这些药物激活免疫系统
so that the immune system can be more vigorous
使免疫系统能够更有力地
in protecting us from cancer.
保护我们免受癌症侵害
And in fact, one of those drugs
事实上 其中一种药物可能
may well have spared president Jimmy Carter’s life.
救了吉米·卡特总统的命
Do you remember president Carter had malignant melanoma
你还记得卡特总统的恶性黑色素瘤
that had metastasized to his brain?
已经转移到他的大脑吗？
And that diagnosis is one that is usually accompanied
而且这种诊断通常伴随着
by numbers like months to live.
诸如生命还剩几个月之类的数字
But he was treated with one of these new immune stimulating drugs,
但他接受了一种新的免疫刺激药物的治疗
and now his melanoma appears to be in remission,
现在他的黑色素瘤似乎正在缓解
which is remarkable,
考虑到几年前的情况
considering the situation only a few years ago.
这是值得注意的
In fact, so remarkable,
事实上 这是如此引人注目
that provocative statements like this one,
以至于人们在谈论这些新的免疫治疗药物时
“Cancer is having a penicillin moment”
会出现像这样的挑衅性声明
that people are saying with these new immune therapy drugs.
“癌症正在经历一个青霉素的时刻”
I mean, that’s an incredibly bold thing
我的意思是 对一种疾病而言
to say about a disease,
这是一个非常大胆的说法
which as Adam mentioned earlier,
正如亚当早些时候提到的
we’ve been fighting for a long time
我们已经与之斗争了很长时间
and mostly losing the battle with.
但大部分时间都失败了
So this is very exciting
所以这非常令人兴奋
Now, what does this have to do with sugars?
那这和糖有什么关系呢？
Well, I’ll tell you what we’ve learned:
好吧 我来告诉你们我们发现了什么：
when an immune cell
当一个免疫细胞
snuggles up against a cancer cell to take a taste
依偎在一个癌细胞上品尝它时
it’s looking for signs of disease,
它在寻找疾病的迹象
and if it finds those signs,
如果它发现了这些迹象
the cell gets activated,
免疫细胞就会被激活
and it launches a missile strike and kills the cell.
它会发射导弹攻击并杀死癌细胞
But if that cancer cell
但如果癌细胞
has a dense forest of that sugar sialic acid,
有一层浓密的唾液酸森林
well,starts to taste pretty good.
癌细胞的味道开始变得很好
And there’s a protein on immune cells
免疫细胞上还有一种蛋白质
that grabs the sialic acid,
可以抓住唾液酸
and if that protein gets held at that synapse
如果这种蛋白质被困在
between the immune cell and the cancer cell,
免疫细胞和癌细胞之间的突触上
it puts that immune cell to sleep.
就会使免疫细胞进入睡眠状态
The sialic acids are telling the immune cell,
唾液酸告诉免疫细胞
“Hey! This cell is alright. Nothing to see here.
“嘿 这个细胞没问题 这里没什么好看的
Move along. Look somewhere else.”
往前走 看看别的地方”
So, in other words,
所以 换句话说
as long as our cells
只要我们的细胞
are wearing a thick coat of sialic acid
披着一层厚厚的唾液酸外衣
they look fabulous.right?
它们看起来就棒极了 对吧？
It’s amazing.
这太神奇了
What if you could strip off that coat
如果你能脱掉那件外衣
and take that sugar away?
把糖拿走会怎么样？
Well, your immune system
这样你的免疫系统
might be able to see that cancer cell for what it really is,
也许能看到癌细胞的真实情况
something that needs to be destroyed.
和一些需要被摧毁的东西
And so this is what we’re doing in my lab,
这就是我们在实验室里做的
we’re developing new medicines
我们正在研发新的药物
that are basically cell-surface lawnmowers,
这些药物基本上是细胞表面的割草机
molecules that go down to the surface of these cancer cells
药物分子可以深入到这些癌细胞的表面
and just cut off those sialic acids
去切断这些唾液酸
so that the immune system can reach its full potential
这样免疫系统就可以充分发挥其潜能
in eliminating those cancer cells from our body.
从我们体内清除这些癌细胞
So in closing, let me just remind you again:
所以最后 让我再次提醒你：
your cells are coated with sugars,
你的细胞被糖包裹
the sugars are telling cells around that cell
糖会告诉细胞周围的免疫细胞
whether the cell is good or bad.
这个细胞是好还是坏
And that’s important
这很重要
because our immune system needs to leave the good cells alone;
因为我们的免疫系统需要远离好的细胞
otherwise, we’d have autoimmune diseases.
否则我们就会患上自身免疫性疾病
But once in a while,
但偶尔
cancers get the ability to express these new sugars,
癌症得到了表达这类新糖的能力
and now that we understand how those sugars
现在我们了解这类糖是如何
mesmerize the immune system,
迷惑免疫系统的
we can come up with new medicines
我们可以研制出新的药物
to wake up those immune cells,
来唤醒那些免疫细胞
tell them, “Ignore the sugars, eat the cell,
告诉它们 “忽略糖 吃掉细胞
and have a delicious snack on cancer.”
享受一顿美味的癌症点心”
Thank you.
谢谢
[Applause]
[掌声]