Episode 27: 用自己身体的力量治癌症
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Hi, everyone. Welcome to today's High Handed Foods. I'm Liu Jia. I'm Zhu Yi. Today, we have another guest, Wang Jun. He is an assistant professor in the Department of Physiology at New York University. His research direction is immunology. Immunology and tumor. What does it mean? Is it used to treat tumors?

Eh?

So the end result is that he is repeatedly re-applying, re-applying, re-applying, right? You can understand it that way. When is it good? When is it bad? Because humans are multicellular creatures. So multicellular creatures, if they want to maintain a certain order, they must keep life and death. When it should be born, it will be born. When it should die, it will die.

Once the limit is eliminated, it can produce a tumor in some way. It can be repeated constantly and grow faster than other places. The positive and negative side is that the positive side is actually a little bit similar to the surrounding organs or surrounding tissues. But it hasn't been eliminated yet. It hasn't been completely eliminated yet.

Oh, so you can't control it and then you get cancer? It's supposed to be in this place.

I remember I heard that everyone has cancer cells in their body, but only a few. Is that right? You can understand it that way. Think about it. Because there are many human cells,

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This is a pity. Because now, in the field of immunology, there is more evidence than ever. Another example is that now we have found that immune cells monitor these mutated cells every day. If we remove the immune cells, for example, a certain type of immune cell called CD8 immune cells, at this time, the rate of tumor occurrence will increase. And at some point, we can still see how immune cells monitor tumor cells.

这是有准确的,有一些数据来支持的。 所以我们一般来讲还是认为, 人体里面正常人每天都有不停的有病变的细胞, 有肿瘤发生潜力的细胞, 只是这个细胞被免疫系统所监视。 所以说正常人不会得癌症, 或者正常人得癌症的几率相对比较低。 就是这个社区里面警力管理的比较严格, 所以就没有坏人, 但是其实每个人心中也都有犯罪思想。

这个意思吗? 可以这么理解,对。 就是说肿瘤细胞无处不在, 只是说正常情况下可以得到清除。

我知道你今天要告诉我们一个新的治疗癌症的方法就是用免疫学,但是在你讲之前可不可以告诉一下我们旧的方法都有哪几种呀? 肿瘤现在其实基本上有三种主要的方法,第一种呢是手术,这个大家都容易想到了,你如果看到肿瘤细胞,肿瘤这个组织,你可以用手术刀把它切掉,但是因为很多肿瘤是恶性的,因为扩展到了全身,所以这个时候就很难切掉。

而且也切不干净。 所以现在其实主要的就是化疗和放疗。 化疗呢是用化学的方法去干预细胞增殖的那些途径, 去用一些化学小分子去干预这样的一些蛋白。 是吃药吗,还是注射?

吃药,一般是吃药,一般是口服,然后吃下去过后就可以阻断细胞生长的那些蛋白之间的作用,所以使细胞生长得到阻碍。 化疗也是这样的,化疗可以打断 DNA,也是对于 DNA 的复制受到影响,是用一个放射的一些方法。

其实最终现在还有一种方法叫 target therapy, 这个是什么意思呢? 这个是后来的发展,就是说就肿瘤上面有一些... 中文是叫靶向药吗? 靶向药物,对,靶向药物就是针对肿瘤上面的某个特点, 比如说某个细胞或者某个分子或者某个途径, 然后用化学的方法, 现在一般来讲也是用化学药物或者是一些蛋白类的药物, 去把肿瘤上面这个特点把它阻断掉或者把它杀掉, 所以肿瘤细胞就受到了一些影响。 那和化疗有什么区别啊?

花疗放疗它都是针对 DNA 的,但我后来讲的那种方法呢是针对肿瘤上面其他的特点,比如肿瘤上面有个 marker,就是把这个肿瘤细胞全部去除掉。 就是你找肿瘤的方法不一样。 对,因为刚才谈到肿瘤两种方法嘛,第一点就是它长得很快,所以都是跟细胞复制相关的,第二种呢是肿瘤上面可能有些标记物,你通过这个肿瘤标记物把这个肿瘤清除掉。

诶?

Then I have a question. If we can easily know which cell is a tumor and which is not, can humans kill them? Or is the biggest problem that we don't know how to distinguish them? You are very right. If we can see clearly what is a tumor and what is not, we can cut it off. But if we can't cut it off, it will be very troublesome. But if you can see some markers with the method of division, you can kill it.

But the problem is that it's hard to find. The tumor is relatively abundant in cells. If you remove the cells that are relatively abundant, it will also produce a lot of toxicity. So this toxicity is very big. People have hair loss, including intestinal problems. Because the cells in the small intestine grow very fast every day. Including the immune cells are also growing. So this way is very difficult to solve this matter clearly. The tumor cells grow faster, but they don't grow every day. So there will always be some tumor cells that can't kill it. And I remember I talked to you at that time. You said that

Because of the characteristics of chemotherapy, children and pregnant women cannot be treated with chemotherapy because their newborn cells grow faster. No, I just want to mention one thing here. Especially for women, especially unmarried women, because everyone wants to have children. But if you use chemotherapy or chemotherapy, especially some chemotherapy, because chemotherapy just breaks down the DNA, so there may be a lot of bad mutations.

Oh.

总流治疗最大的特点就是说,只要能找到什么肿瘤特异的东西,把肿瘤清除掉就行了。 但实际上找不到,很难找到。 我们一直知道做放疗,化疗可能也是吧,头发会掉。 对。 是因为头发也长得很快吗? 头发天天在长啊。 可是指甲为什么不掉,指甲也长很快啊。

口水不是细胞啊

The hair follicles are very sensitive to radiation and chemicals. But nails may be affected, but it doesn't affect your hair that much. I just talked about the biggest problem with hair follicles treatment. We can take two points. The first point is to interfere with DNA reproduction. But because normal cells also have DNA reproduction problems. So the side effects are very big. And you can't remove all the follicles. The second point is that there may be some markup on the follicle.

Then you have a marker, find a poison to poison the cells or find a way to remove all the cells with markers

That would solve the problem. But in fact, there is no such mark. Even if there is, not all tumor has it. Because the tumor has another characteristic. Tumor is a variety of cells that are produced by various reasons. So the tumor is actually diverse. Its mark is not that everyone is the same. All tumor cells are the same. It's not like that. In fact, the tumor cells in people's bodies are very different. These characteristics lead to most of the treatment methods now. It's hard to succeed. Yes. Then what method? What is an ideal disease treatment? Especially what kind of tumor therapy is? There should be a

Plasticity.

这个疗法最好不是一个固定的东西,因为肿瘤在变嘛,一个在变一个里不变就很难 catch up,然后最终你还需要一个记忆性,因为肿瘤在变嘛,你需要长期的去控制这个肿瘤,所以你需要有一个有记忆性的东西,这是最理想的情况。

嗯。

因为免疫系统它生下来就是为了去区分什么是好的什么是坏的 免疫系统也天天在变 免疫系统有各种各样的 coverage 最终免疫系统它也有记忆性 因为比如像我们小时候的打疫苗 打了过就终身免疫 所以实际上免疫系统是真正能够做到这一点的 就是很少的手段之一 所以很早包括 100 年前 大家在想免疫系统肯定能治疗肿瘤 但是为什么

怎么去做到这一点,其实花了很长很长的时间。 在你继续讲下去之前,可以讲一下免疫系统究竟是怎么回事,我们都知道就是打预防针嘛之类的,但是人类怎么知道就是有免疫系统这个东西啊? 这是非常有意思的问题,因为其实免疫这个东西呢,

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就是让你自己的身体一点一点的,就是在安全的环境下学习这个东西吗?

最后达到很坚强的抵抗能力。 这个原理其实现在很清楚了, 其实这点除了中国, 中国很早就开始用这件事情, 只是不知道什么原因, 但是后来在英国的时候, 有些他们发现挤牛奶的女工, 很难得流痘, 那个时候才开始觉得, 是不是有些相关性在里面, 所以就开始接种牛豆, 然后发现可以预防很多疾病, 所以后来就开始把这些,

病毒上面的抗原把它提出来,提出来过后做成疫苗,特别是灭活的病毒。 灭活? 灭活就是说本来它有感染性的,就把它弄成没有感染性,因为要不然的话你不能让一个正常人去感染一个病毒,太危险了。 通过这个过程大家发现什么呢?免疫系统很有意思,免疫系统就是会区分什么是好的什么是坏的,如果是坏了的话它都要去不停地去攻击或者不停地去识别这些坏的东西。

and then there are many ways to target it. In general, vaccines produce antibodies. Antibiotics neutralize the antibodies on these viruses and remove these viruses or bacteria. And after the immune system detects it, it has a memory. What does that mean? For example, the first time it produces a certain degree of reaction, but when it detects it for the second time, it may produce a thousand or ten thousand times the reaction. So this is a very powerful place for the immune system. And this kind of memory is likely to last forever.

但是你说的这种先给它一点点小剂量的有害的不致死的,然后再给它一点点再就是多次的这种,这个也不是一个放之四海皆准的,不是说所有的病毒都可以这样,是的吧? 没错。 有些就死了。

So in fact, there is a very core problem involved in this. That is, if a virus is very immune, or this virus belongs to a virus like DNA or some virus, it is not easy to mutate. So in this case, the vaccine is very effective. It is a liver or a biscuit. Recently, biscuits are not very effective, mainly liver. Liver is very effective.

为什么呢?是因为乙肝病毒它的不大容易变化,它不大容易变异,所以你只要把它的某个抗原拿出来做成疫苗效果非常好,所以现在乙肝疫苗全中国基本上非常成功,但是为什么艾滋病这样的病毒也是病毒,为什么它很难做成艾滋病的治疗性的疫苗,或者说预防性的疫苗,就是因为艾滋病病毒也是这样的病,包括流感病毒也是这样的。 对,所以每年都要逼我们去打一次流感。 而且每次打的还不一样。

本季新款流感疫苗。 所以说白了就是, 免疫学最核心的原理就是区分, 什么是好的,什么是坏的, 什么是变的,什么是不变的。 如果是不变的东西, 你一次一次地反复刺激, 它就会产生很大的反应。 你说疫苗有记忆,记在哪里啊? 是这样的,其实免疫系统很复杂了。 最有意思的免疫系统, 就是有记忆性的免疫系统, 主要是有 T 细胞和 B 细胞。 B 细胞就是产生抗体, 来综合这个抗原。 比如说一个病毒来了, 或者是一个细菌来了, 然后,

If the immune cells detect it, it will generate a resistance to the brain and neutralize it. If it is a T-cell, it will also generate memory and eventually kill this thing. So what is memory? Memory detects the bad thing. The so-called protein sequence on the label is a certain feature that has been detected by the immune system. It starts to react. It's a key and lock relationship, to be honest.

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很多时候掉到免疫系统发生呢 免疫系统会导致自身免疫病 这是一个很大的问题 啥 你再说一遍 导致自身免疫病 会导致啥 自身免疫病 Autoimmunity 自身免疫病 是什么 刚才不是讲免疫系统它可以区分什么是好的什么是坏的嘛 对不对 所以说除了它区分坏的东西之外 你还要知道哪些东西是好的 那免疫系统针对好的东西就不能反应

就是开始攻击好的细胞

嗯。

So then we thought, can we adjust the immune system on purpose? So we started to study how to specifically activate the immune system. It turned out to be very difficult. I remember that more than 20 years ago, there was a clinical experiment that found a key cell on how T cells activate.

So I did a clinical trial at that time. Everyone thought it was amazing. Because that thing is too important. As long as antibodies are injected, the immune cells will be revived. T cells will be revived. Because T cells are the most powerful cells that kill the virus. So that clinical trial was done on a normal person. It's an antibody test every half hour. Because this antibody test is effective in rats and monkeys. It's okay to destroy the immune system. But in rats and monkeys, the toxicity is not as big as we thought. So on normal people, it's an antibody test every 30 minutes.

Wow.

So at that time, the whole field felt that how to distinguish between the self-sufficient immune disease and the individual immune system to treat the tumor. This is very difficult. Of course, I think this field is not very possible. We also have no way to train the immune system. So now there is one of the biggest breakthroughs. What is the reason for this breakthrough that was also mentioned by Robert last time? That is, we are also thinking that since we can't distinguish which is good and which is bad, then let's start from the general point of view.

嗯。

无药这个想法就产生了两种治疗方式,叫 checkpoint,说白了就是一个免疫抑制的机制,主要就是肿瘤怎么去抑制免疫细胞的这样一个机制,就在这两个药之前都是提高免疫反应的,而后面呢就是说去针对免疫抑制的机制来产生的疗法,有两个药,但第一个药呢是效果一般,

I

这个蛋白呢,它就跟 T 细胞上面的一个蛋白结合, 可以把 T 细胞抑制住。 所以这个叫 checkpoint,所谓的 checkpoint。 我们认为就是说是一个肿瘤和免疫间的一个调节机制。

And then you're studying this? What is the problem you need to solve now?

还有什么没有解决,感觉已经很 perfectly 解决了这个问题。 是这样的,因为癌症真的是太难了,在几年前大家都知道,只要是恶性肿瘤,只要一旦转移,就是病人的存活率大概几个月或者几年之内,存活率非常低。 但是呢,现在这个疗法呢,也只是说绝大部分肿瘤有效果,但是呢,不同的肿瘤效果也是不一样的,比如说有些肿瘤 80%的病人都有效果,那有些肿瘤只有 10%的病人有效果,有些有 20%的效果。

其实这个效果也只是说有反应。 那最终只是说提高这个存活率几个月的时间, 已经算在现在这个程度来讲, 你能够提高一个肿瘤病人存活期, 让他多活几个月, 已经是非常厉害的药物了。 的确有些病人效果非常非常好, 最有名的例子就是美国前总统 Jimmy Carter, 卡特总统,老总统 90 多岁了, 他当时得了黑色塑料转移到脑部, 他就很紧张,那个老头很紧张, 就用了第一代的药物, 这是 BMS 做的一个抗体,

Oh

Interesting.

第二呢,现在有这个问题是因为我们刚开始打开这三门,研究肿瘤跟免疫之间的关系,所以产生了一个新的学科叫肿瘤免疫学,不是简单的肿瘤学,也不是简单的免疫学,所以说我做介绍不应该说我只是一个免疫学家,也不是说我是个肿瘤学家,而是说我是做肿瘤免疫的人,研究肿瘤跟免疫关系的这样一个,这是一个新的学科。

So the new studies are about the relationship between tumor and immune system, including how the tumor affects the immune system, how the immune system affects the tumor, including how to design some new drugs to treat the tumor, how to specifically regulate the immune system in a certain environment, in a certain time, more specifically and more effectively. This is a very new study.

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除了肿瘤之外呢,其实很多人还会遇到一些更普遍的和免疫系统有关的经历。 比方说我们每个人都打过预防针,然后每个人也都活了那么大,可能会经过一两次至少大的流行病。 比如说我们小时候都有 SARS 啊,什么什么禽流感啦。

还有就是大家都会过敏,尤其是来美国之后我就发现大家有很深的两个感触,一个是美国人怎么那么多过敏,感觉在中国好像没什么过敏的嘛,还有一个是就是大家来美国几年之后都会开始过敏,这个是怎么回事啊,我们先从这个开始聊吧。

I think it's a very interesting topic. I also encountered this. I'm not allergic to anything in China. I went to Beijing and saw the current floating around. I'm not allergic to anything.

到了美国过后,自从第四年第五年就开始每年对花粉过敏。 我也是,为什么是一定过了一段时间才过敏? 其实这跟我们刚才讲的就是有关系的,因为就是免疫系统嘛, 免疫系统它怎么产生记忆性,怎么反应,大概是这样的。 一般来讲,因为我们是亚洲人,所以我们的免疫系统包括祖祖代代, 所以我们感受的是亚洲这个环境或者你周围的那些环境。

那我们没有见过美国的花粉或者某些地方是不一样的,所以我们的免疫系统可能会认为里面的某些东西是异元的,是坏的。 正常来讲,其实免疫系统不应该对花粉有反应,所以它就开始起反应,而这个反应是一点一点增加的,因为我刚才也谈到有个记忆性嘛,所以第一点可能只有从 0 变到 0.1,那第二点可能从 0.1 变到 1,对吧?

但是这个累加的效果。 这个累加指的是这个物质在我的身体里积累到多一个点还是? 物质都是一样,但是免疫系统对它反应的程度是不一样的。 那它不会说训练了之后一开始有很大的反应,渐渐就习惯了吗? 这是两个办事,这个非常有意思的问题,这个呢其实再讲上就很学术了。 大概是什么呢?就是免疫系统这个东西呢也是有时候量太大呢,它就不反应了。 在某种程度上讲如果量太大它就不反应了。

Sometimes if the amount is too small, it may increase the reaction. This is not a completely linear relationship. What if I put a lot of pollen on your face? It may collapse and then it will cure your pollen disease. It's possible. There is such a possibility. But the problem is that it is very likely that you will die first.

所以是不知道的。 这里面不是不知道,这里面有一些比较复杂的问题,现在还没有彻底解决。 所以过敏说实话,听起来很简单,但是到现在其实没有一个彻底的解决方案,所以导致大家都过敏,而且各种原因过敏,但是现在没有特别好的药物。

但是美国人比中国人给我们的印象过敏更多,就是事儿更多。 我觉得我在生活的时候没有听说今天这个人乳糖不耐,那个人什么吃花生会肿。

这个很夸张,有一次我甚至跟一个同事去中国餐厅吃饭,然后他说我不能吃 nuts,然后他点了几个菜,他说我里面没有 nuts 吧,然后中餐馆说没有,吃完以后他在里面发现一颗,然后他就疯掉了,然后就嗓子开始有痒,然后他还要带那个什么。 我觉得非常好,非常好。 什么非常好? 就是我这个问题提的非常好。

Okay.

哦 我在想 还有一个原因会不会是因为 因为大家都说 就感觉美国怎么残疾人那么多 那是因为他们的设施比较好 所以残疾人都能上街 中国的残疾人就根本就出不了门嘛 所以是不是说 因为大家

因为大家有一个印象就觉得说 美国人很会来事儿 就是稍微有一点点需求都要满足那样 日本不是一个移民国家 但是他们也全国都在对花粉过敏呀 这里提到第二个问题 第二个问题就是说 你想想从这个原理 原理学的角度上讲 理论上来讲 你在小时候如果去接触

更多的东西,那个时候去训练免疫系统,因为很小了,免疫系统还没健全的时候去训练,免疫系统很有可能把它认真是一个自我的东西,是一个好的东西。 所以说到现在的话,特别是在一些发达国家,他因为这些小孩可能他也不大出去有些户外活动,像我是在农村长大,我天天在外面跑来跑去接受各种各样的,做各种各样乱七八糟的事情,去山上,去地里面,各种,接触了各种各样的抗原,所以...

I think my immune system actually trains a lot of things. The diversity may be relatively large. So I think in fact, for me, the possibility of being allergic is slightly lower than the general. If you are in a very clean environment, you stay at home all day long, you don't touch anything, this kind of person will also have a higher chance of getting allergic when he grows up. This is a hypothesis. This is a scientific hypothesis called hygiene hypothesis. That is, is it too healthy? Is the environment not good for the immune system? In fact, there is a lot of evidence to prove that.

这个其实也是很多家长觉得很困惑的地方。 在从小孩子长大的时候, 你到底是给他一个非常干净的环境, 空气非常清新, 然后他长大以后身体会锻炼得比较好, 还是说你从小把他放在污染的环境里, 然后他身体以后就是更强壮? 我觉得我自己,因为我是去免疫学的, 我是觉得早期的时候, 你接触一个稍微脏一点的环境, 当然不要太脏,不要天天接触这些病毒,

其实对孩子是有好处的。 包括很容易在比较是 剖腹产和自然的生产 对于小孩的影响。 其实有一些证据好像证明是 剖腹产的过敏的概率要大一些。 因为你想小孩, 因为小孩他在母亲体内的话,

It's actually separated from the mother. It must be separated. Because the child's genes are different from the mother's. So during the production period, that very short time, there was actually some contact. Contact with blood, etc. And at that time, the immune system had not fully developed. So through this, it will contact a lot of mother's antibodies. It will bring a lot of good things to the mother. At the same time, it also contributes to a change in the environment. So this process is actually good for the child's later immune system growth.

但是...

你不是说没有接触母亲的血吗? 那你就人为的去撒? 不仅只是血啊,不仅只是血啊,因为这里还有很多,因为出来过后,你马上都把那个, 脐带,脐带剪掉,因为它还要爬的那个过程,因为那里面很多微生物,很多微生物种群的问题, 就那么一瞬间就已经有, 那个产道,母亲的产道里面有微生物群, 母亲产道,母亲产道微生物群,还包括血液,反正就这里面,其实不完全血液,主要是微生物这个群体,那爬到这个过程中,我觉得是一个很好的一个训练,对,

you can't just feed those children who are pregnant and then pack a trash bag and then throw it away. But it's not the same. The biological group in the trash bag is different from the mother's delivery. But we can't, we're already so developed, we can't simulate a trash bag that looks like a delivery. This is reasonable. Maybe someone will do this in the future. But I don't think it's just giving some trash to children. Because there are some virus bacteria in it. You don't know if trash is good. I think this is a business opportunity. You can feed the pregnant women.

这个现在还没有啊,你可以去试一下,对。 但是我觉得这里面有一定的危险性,但是有一定的可能性,对。

诶,我们刚才是在聊什么呀? 怎么会聊到这个? 聊到过敏了。 诶,对,那照你这么说, 就是原来在这里土生土长的人, 他会对当地的水土更加适应, 那岂不是印第安人就不会过敏吗? 好问题哦。 也不是不会过敏的, 比方像印第安人在这个地方生长了成千上万年, 他可能对这个环境的过敏的概率,

和他跑到另外一个新的环境中是不大一样的。 但是会导致另外一个问题。 你知道当年的印第安人他死亡很多原因, 不是因为过敏的原因, 而是因为一些病毒的原因。 从欧洲来的一些病毒。 对对对。 这个是很有意思的问题。 他对这个环境已经很耐受了, 这个环境已经驯服得很好了, 但是对于新的细菌,新的病毒。 对,就是欧洲人来美洲大陆之后带过来的一些细菌。 他没有遇到过。 哦。

So it's very resistant. What kind of virus is it? Is it a natural disaster? Natural disaster. There are many more. You remind me of something very interesting. I remember when I was traveling, there were two places. One was Australia and the other was Hawaii. Because when you go to a new country, they would tell you not to bring fruits or anything when you go to the border.

But in fact, for example, when you go to the US, people are very loose in China. Just say it. Just bring an egg in. No one will really check you. But when you go to Hawaii and Australia, it's really very strict. Because they said it's on a small island, so they have a very independent ecological environment. So you bring an alien plant, it's very likely to have a very fatal effect on them. This has something to do with immunity. It doesn't matter. Because it's actually worried about a few things. The first thing is species.

The transmission between species Because some species, for example, go to China China has never seen this species This species may be very aggressive The second one may bring in some bacteria or viruses that you don't know That virus makes Indians very afraid of certain viruses But it's okay for Europeans This may lead to some racial problems Racial extinction, including some Not only for the human body, but also for some other bacteria Other plants and other animals This causes great harm, it is possible

For the international community, it's very careful. But what's better now? Because there's a lot of traffic now. Over the past 100 years, there's been a lot of traffic. But for places we haven't been to for thousands of years, I recommend that if you go on a trip,

盡量的不要去那些深山老林裡面 所謂的探險太要小心 因為你不知道有些細菌 你可能你足足不必都沒見過 可能對你不顯然 感覺像個恐怖片的開頭 這是要小心的事情 就是 be cautious 假設說一個中國的人 和一個美國的人結婚了生個小孩 那這個小孩他是會對 中國和美國這兩片土地上的都

- Not so much cautious, yeah?

也不是空话吧,我觉得小时候的这个训练很重要,对于这个环境的训练很重要。 回到我们很久很久之前说,你说癌症也在植物之间存在,那免疫系统植物也有吗? 这是个太好的问题了。

So proud of myself. No, that's really a good one. I don't know what to answer. Because T-cells and B-cells are not all living things. They are relatively high-level animals. Especially those with a spine. They have a higher system. As for some plants, they have a so-called immune system. But they are not as strong as humans. Right.

所以说它的治疗手段可能就不能像我们现在用的免疫系统来治疗肿瘤,可能通过一些其他的,比如说你的割掉。 不是,它好像更厉害,我之前看就是切尔诺贝利,不是遗弃了很久吗? 然后大家就去那边看到底怎么样了,然后就发现动物很多是有问题的,但是植物它反而会长得很茂盛,就是它虽然也会感染癌症,但是好像是,

它有细胞壁还是怎么样? 我也具体记不清是什么原因, 但是它的适应性其实更强。 是这样的,植物有个问题是什么呢? 只要它细胞生长旺盛, 都可以长成一个肿瘤, 但是呢,植物一般很少有恶性肿瘤, 就是说植物的细胞很难说会跑来跑去的, 会转移,这种情况相对比较少一些。 为什么? 可能有细胞壁啊。

还真被我说中了一个歌嘛,随口说了一句。 你如果注意看一下,植物它有时候会有个包,那个包长了个包过后,那植物就崴一下往另外一个方向长了。

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

你怎么知道他是疯狗啊? 因为一般的狗跑的时候, 它是好像是尾巴是翘着的, something like that. 是吗? 狂犬好像是尾巴夹着跑的。 而且那个狗一看就不对,它就是... 一看就很狂。 一看就是绕着圈跑的一种。

foreign

So I was very scared because for the general public, the vaccine should be given within 24 hours or else it won't work. So did you go and get it? Did you get it afterwards? Because our place is a small place. It seems to be the only place where the vaccine has expired.

能不能先给我打 20 小时之内打了一针

什么样的人会像买一支酒藏在餐厅一样,买一支狂犬疫苗他不用放哪? 因为疫苗是要放在室度的,你要连续每几周打一次,要打几针,所以他买了过后就放在冰箱里面放着。

但是别人已经买了,那医生就说能不能先给我用一下。 哦,救命恩人呢。 救命恩人,所以我当时就对这个事情很感兴趣,然后后来上了大学,然后因为中国的教育也并不是说你想学什么都已经学得到。 是的,是的。 所以后来大学学完过后,我觉得我一定要回归做生物学,然后就… 你大学学的是什么,是学医学吗? 我当时不是学医学,我是当时对生物学感兴趣,结果学了个生物工程,就是这些药怎么去放大,怎么去发酵这种,怎么去生产这些。

嗯。

正在就是 骄阳产业 那你干嘛去学肿瘤免疫 不学狂犬病免疫啊 因为当时我不说了 我想学这很基础嘛 当时其实我也是鬼死神差的 因为那个时候 我都不知道免疫是什么东西 那个时候 最好碰到这个学科 是吗 而且那个时候都没人相信 免疫能够治疗肿瘤的

这个领域能得诺贝尔奖 谁都没有想到 这是一个鬼使神才的一个原因 进到这个领域 然后在最冷的时候进来 现在变得最热 大概是这样的

幸好当时打到的那针狂犬疫苗不是后来,不是前两年出事情说那个是假的吗? 有很多国内的狂犬疫苗是假的。 反正狂犬疫苗其实潜伏期很长,我也不知道是否会假的。 但是至少是这么多年,我觉得没有太大问题,应该是没什么问题的。

So I'm very concerned about what I have to do for the next generation. Don't let these children be affected by these problems, including these liver diseases. Because in a developed country like China, not only in China, but also in Africa and many other places, sometimes a small illness really affects this person's life.

What do you mean? So it's...

看到了狂犬病以为自己看到的是吸血鬼 人得了狂犬病过后呢 他精神造狂 他就嗜水 然后有时候嗜血 就想喝 也不是想喝血 就是对这种东西有点 attraction 所以给人造成了很恐怖的印象 所以欧洲人呢 传来传去就变成了这样的一个 一个吓唬人的一个东西 但实际上 所以那些吸血鬼就是得了狂犬病的人 绝大部分是因为这个原因

哎 那可是 吸血鬼长生不老这件事又怎么来的 那是风传的呀

因为他们觉得... 那可能是艺术化处理吧? 因为当时他们是... 这里很有意思,因为在大家都不知道免疫系统的时候, 大家都不知道血是干嘛的, 大家都觉得血里面很神奇,你知道吗? 早年研究血的人都觉得血好像是跟精神有关系, 其实现在研究免疫过后, 大家都知道血里面大部分都是免疫细胞嘛, 还包括一些营养物质, 那还包括一些运送氧气啊,这些物质, 所以早年的时候,特别在欧洲, 他们不知道什么原因, 他们对血有一种很...

Right.

动物的血,比如说苏绵样的血。 这是真的是一个临床实验。 还有几个人好像觉得有点效果, 结果后来很快真的是, 你知道吗,打鸡血就是这个意思嘛。 打鸡血,它不会排异马上死掉吗? 这个血可以打多少量啊? 因为这一元的血一来, 棉性嘛,开始反应, 所以可能会凝血, 可能会成成很多很多乱七八糟的事情。 人很有可能死掉的。 那打鸡血真的会让你亢奋吗? 因为棉细胞被活化了呀。

马上就开始反应了。 有道理。 你睡不着觉了,我还在前层发烧了。 其实正是因为这些原因,因为大家开始试嘛, 才发现哇,血液里面很有意思, 开始找血里面怎么回事,才发现了免疫系统。 而且发现免疫系统其实识别各种各样的乱七八糟, 而且就是通过输血发现有些人的血可以输, 有些人的血还不能输, 有些人会凝血,有些还会抗, 所以通过这样发现了血型, 然后才发现了免疫细胞怎么回事, 发现了什么样的免疫细胞, 所以免疫才这样过来的。

哇,就是感觉看历史就像看一个小宝宝在那边学走路,然后今天这个人已经长大成人了,但是你看他以前那个过程就觉得好着急哦。 就是很多时候也是试错,对。 我觉得很多时候试错和试对,因为没有人知道是对的。 其实两种方法其实对于科学的进展,在一定程度上讲都是有一定的意义的。 但是不能够说你在知道错的时候还要去错,那个时候就是问题了。

取决于目标是什么? 因为我现在是更靠近于转化型的研究。 什么叫转化型研究? 就是说我更想去解决一些

能够帮助病人的这样一些问题 比如说病人为什么治不好 为什么病人现在的这个药 只能够使病人存活那么几个月 能不能提高 或者能不能找到更好的治疗手段 所以我现在其实 处在一个转化型的研究 和基础性研究这样的一个桥梁 所以我需要去做基础研究 基础的免疫学研究 去找这样的一些新的机制 然后还需要去跟医生在一块 去看病人里面有没有这样的机制

肿瘤里面有没有这样的肌疹。 然后呢,还跟很多公司合作。 那能不能去找一些药物, 设计一些药物来针对这些东西。 不仅是药公司, 是一些生物技术公司。 所以最终可能还要做设计一些临床 CN。 其实我想做的事情就是把这几方连在一起, 然后去对病人设计一些更好的药物。

嗯。

What is external research? External research means that you take tissue cells out

然后去研究它的细胞之间的一些东西, 基因这样的作用。 但是最终呢,特别是尝试一些药物的治疗方案, 或者药物的效果还是在动物身上, 或者猴子身上,或者在真正在人身上有效果。 那你一开始说政策是什么意思呢? 政策是什么意思呢? 就是说你必须得知道,比如说这种肿瘤, 你要知道现在已知的方案是什么。 因为你要做个药,假如做出来的效果比已知的还差, 那就没用了。

-

因為利潤那麼大,就是醫藥公司會給很多錢。 這也是變化的,真的也是變化。 比如像過敏,並不是說美式美帝,你能拿到很多錢來做研究。 對,那我就想問像這種新藥的研究, 你們的資金是更多來自於企業還是來自於政府啊? 基礎研究主要還是來自於政府。

Because it's been too long? Why do I say that policy is here? Sometimes you think it's important, others don't think it's important. Because every researcher thinks that what they do is the most important. But in fact, in the overall environment, everyone may think that research is meaningless. Unless you do it and find something very meaningful, then someone will come in. But in the early days, from zero to one, there was no way.

嗯,然后这个时候就是靠国家的基金。 这个时候一般来讲是靠国家的基金,或者是靠你自己的坚持。 那你也是需要去说服国家给你这个基金嘛,因为大家也在抢了吧。 这是个相互的,相互的。 嗯。 除非是大家都知道你这个领域特别重要,那容易拿钱。 嗯。

But sometimes, like I said, no one believed in this 15 years ago. Isn't that a vicious cycle? The less you develop, the less you have. So you know, it's very interesting. Very important researches are all suddenly emerging when it's very cold. At that time, it's very easy to die. It's very likely that it died before it made a very important contribution. Yes, yes, yes.

如果说这个领域能够经过这个煎熬,然后起来,然后长起来,那个时候就好。 那很多时候没人知道这个。 而且你现在回头看,就是说那个是他青黄不接的时候,但是你在当时你不知道说这个会不会再起来,可能他就是一个死胡同。 所以这里面就是其中最重要的,作为研究人员一定要坚信,首先你要看准这条路。

-

对。 所以你那个时候是很相信你这个能做出来吗? 我说实话,我刚进这个领域的时候,15 年前刚读研究生,那个时候我还真不知道这个领域能做到什么程度。 那你为什么要选这个? 我就觉得有意思,我不懂啊,明明觉得有意思,我觉得很有意思,但是我不懂,我要学一下。

But I didn't know what he could do. No one thought that he could do this. We all proposed to do this. But we didn't expect it to work on the patient. So I entered this field early. I didn't say I didn't believe it. I said I didn't know how powerful it was.

现在这个领域打开了过后,哇,这个真的很重要。 所以这个时候很多人就进来了,这个时候其实进来是很容易的。 我有个问题就是,你觉得你这个领域,飞跃性的进展一般是怎样产生的? 是因为一些

观察到的东西吗 还是说某一个很聪明的人 有一个新的想法 然后让这个理论去测试 有几点 因为几点很重要 就是如果我真的回顾这条路的话 也是我们这个科学这个领域 对于这个疾病的认识越来越深了 最早就很简单 就说只要让细胞不长就行了 让细胞长慢一点 或者化疗化疗就行了 结果发现还有一些免疫细胞也在长 副作用很大 头发也掉 然后肿瘤也治不好 所以才觉得光针对肿瘤可能不行

Maybe there is only one way to get rid of it. The way to get rid of it is to destroy the immune cells. In the end, the side effect is also very large and the effect is also bad. So we have to think about whether there is a more accurate way. So at this time, in the process, immune studies developed. In the same process, because there are many technologies that have begun to develop, including the Human Genetic Program. The Human Genetic Program is known to all genes.

So once the gene is released, the immune system will think whether there are genes to regulate the immune system. So we found that many people's genes are working in the immune system. At the same time, we also know that some genes can be specially regulated. Just like what I said, the genes of the tumor and the immune system were discovered at that time. So in general, it is also a process made by the angels and the earth and the human race at this time. So now the big data generation feels very important to you. So now I think there is still a little paradigm shift.

Why can we get the Nobel Prize? It means that before, everyone was going to live with immune cells. Now, they are going to stop a new type of immune system called checkpoint inhibitor. This is a new idea. After opening a door, there will be more things coming out. This is why I think there will be many things to do in the future.

-

China has opened hundreds of such companies in the past few years.

PD-1 is a drug that has been approved in the United States. China hasn't approved it yet. China has approved it in the past two years. In the past two years, they have approved the drug in the United States, the drug in the American company, in China. But China knew very early on that we should make our own drug, so the price is a little lower. So you know, at that time, there were 100 companies in China doing PD-1. They were all in competition.

But the market won't have 100 of them. So in the end, there may be three to four approved in China now. There are five or six approved drugs in China now. So what I want to say is that this is a field of development in the field of biotechnology. Every company has a lot of money. Then they will also want to dig people. Especially if you want to dig in from college. So many people who are now studying medicine can go to the company.

最大的 BioTech 就是

which is a huge biotech company. They usually develop some drugs. How to make the drug? The university usually finds the key mechanism or the key molecule to study why it plays a role, whether it has potential. After making it, these patents are licensed to some small biotech companies. Small biotech companies may focus on one or two such projects and push them forward to the top of the scale.

Where will the biggest cost be?

很多啊,研发需要很多钱啊,时间,还包括人上做实验啊,这是很贵的,人里面做实验是非常贵的。 这个钱是花在给那些被实验的人吗? 还有你研究要花钱,研究花很多钱,时间加钱,还要 test 这个 ID 花钱。

然后还有很多钱就是说你要去做这个药 还有因为这里面尝试很多很多东西 所以这里面其实很少钱的 比如说像 PD-1 这个药物 这个药物大概每年现在在美国的价格是十几万美金一年 其实很贵了对不对 但并不是说照这个药油花这个钱

而是说整体这个领域其实花了很多钱在研发方面然后去 debate 这个药 所以其实这个钱所以如果说一个公司看到现在的数据然后重新做这个药其实它的消费没有那么多的 但是你要知道这里面 ip 这里面后面的看不见的一些东西是花了很多钱 也就是为什么之前那个电影我不是药神他在印度买那个药会很便宜对呀因为他们

其实制造的费用是很低,但是研发的费用很高。 没错,因为还有时间的原因,你必须把这个考虑,要不然如果大家都去这样做的话, 那我们没必要做研究了,那我们都去,这是最赚钱嘛, 那我也应该去赚这个钱,对不对? 但是问题是,真的做成这样的事情, 花了无数人,无数人力,无数研究,无数公司, 这才是把这个领域...

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So these are two difficult two-way, but I think a healthy society should balance the two angles. I want to ask you, if your research direction is going very smoothly, what do you think will happen in the ultimate situation? Will we eliminate cancer? Can cancer become a chronic disease? That is to say, if you completely eliminate the tumor, there is no possibility at all. But it is very possible that the tumor or cancer will not affect life in such a critical way.

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But it has some complications, but in general, the impact is not so big. Once you get a tumor, everyone will think that I am going to die. Generally, it won't be like this. So this is the first point. The second point is that the immune system is not only for tumors. Because the tumor is just one of the indications. I think many other diseases can be controlled by the principle of the immune system. Including autoimmune diseases, including allergies, including nerve-reducing diseases, including Alzheimer's disease, including Parkinson's disease. These are all very possible.

你是说超级病毒吗?

这里面什么病毒病毒? 对,就好像以前也没有艾滋病,那以前也没有,可能有癌症吧,但是我们不知道,但是... 癌症是都是有的,艾滋病的产生呢,也是因为人在开拓新的疆土嘛,所以这个到非洲某个地方,然后感染上了本来不是属于人身上的一个病毒感染,所以这是因为人在开拓自己疆土的原因。 还有很多疾病是因为人的生活方式改变的原因,包括

including obesity, right? This is getting more and more common. Including cardiovascular diseases, these are related to people's lifestyle, and also related to people's pressure. So these are some modernized diseases. In general, new diseases will continue to occur. This is for sure.

但是问题是我们有没有什么办法去针对这样的疾病。 你刚才说到就是有一些病是人类在开拓疆土的时候得到的, 你刚才在说我们有一天可以把癌症变成慢性病嘛, 然后想说哎呀就是所有的致死的病如果都变成这样, 那人类就死不掉了呀, 因为

因为人所谓的老死也就是器官老化,得了各种致死的病才死的嘛,然后你刚才说开拓新的疆土得新的病,然后我想说那科技如果差不多同步到,人可以长生不老,但同时人又去火星啊,去开拓新的疆土,那又会得了新的病,就是那个病在那个时候就是又新的致死的病。 没有可能啊,因为医生是永远有事情可以做的。

Oh.

哦,对,我觉得有一点我要澄清的,就是说很多人在问我这个问题,说这个保健品提高免疫力,那个保健品提高免疫力,我是不是应该去买啊? 对对对,应不应该? 对,这一点我真的是觉得非常想和大家阐明我的一个观点,首先是我的观点,不要认为这是科学界供人,这是至少我的看法。

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It's all nonsense. It sounds good, but it's not that simple. So I don't agree with the health care products to increase immunity as a bait to call everyone to give me money to buy this product. If you look at it from an internal perspective, what kind of language will make you feel that this is reliable? I think the immune system is very difficult to adjust. Basically, it's hard to do now. So I spent so many years to know that PD-1 has something to do with the tumor. So I used it to treat the tumor.

但是有一个我常常感觉是睡觉好像可以提高免疫力是真的吗? 我觉得应该是说睡觉可以让你的精神得到很好的恢复 免疫系统也有一定的节律性 就是叫 Security and Reason 保持这个节律性对于发挥一个正常免疫系统是有一定的好处的

Generally speaking, I hope that because of the high rate of cancer, many relatives and friends... Why do you think it's getting higher and higher in China in the past few years? Because in China, it's mostly due to the environment. The environment is also genetic, including lifestyle. The pressure is also very high. It also includes Chinese food. There are many diseases that are not common. Generally speaking, I think the rate of disease is getting higher and higher. It's getting younger and younger. There's a trend like this.

Wow, that's amazing. On the one hand, technology is getting better and better. In fact, living conditions are getting better. On the other hand, diseases... It's not that the more you eat, the more money you have, the higher the computer CPU, the less disease you have. There is no such thing. I think it's still a healthy way of life. Including the reduction of pressure, and the healthy way of life. Because now, in most cities, there is less and less contact with nature. It's not a good thing for the immune system, to be honest.

So first, don't be afraid. Because I think so many people who do immunology, people who do general medicine, are working on this project. And everyone thinks this field is very likely to have some breakthroughs in the next 10 years, 20 years. A huge breakthrough. So I think everyone should not be afraid. First, everyone persists. If you are an unaccustomed cancer patient, persistence is very likely to be able to follow up soon. Hope so. Everyone works hard. The second point is to try to maintain some healthy lifestyle. I personally don't particularly agree with the treatment of health products.

肯定保养品有一定的用处,在某种程度上讲。 但是某些地方不能够太大噱头。 然后呢,就是在吃药方面呢, 我是赞同在不是特别必要的时候, 不要吃太多的药。 特别是包括抗生素,中国抗生素滥用太多了。 所以就是说,让人自己的免疫系统来对付这些。 尽量的,但如果真的很严重, 你还是需要去控制,但是不要滥用。 我妈就非常同意你,我妈就很不爱吃药。 对,我觉得老一辈的人都觉得是药三分毒。 对。

Thank you. What were you going to say? Thank you. I think the last time we had a mental illness, plus the mask system, we feel like our show is becoming a medical show. Because I think for me, it's my goal to share these basic knowledge with everyone. And I also hope that my mother can understand

完全不懂什么什么科学的人, 都要听明白,对他们有点帮助, 这是我觉得一个目标。 而且我们现在边坐着, 坐着突然想起了好多, 比如什么,你对中医怎么看? 不要讲,不要回答我,不要回答我。

I

人就是这样的性格,对,人的特性。 那好,今天就先这样吧。 好,谢谢刘佳,谢谢朱一。 谢谢王俊。 学到了很多。 对,学到了很多。

这次我学到的东西。

嗯,那就先这样吧。 好,谢谢。