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This is a painting from the 16th century from Lucas Cranach the Elder.
這是幅 16 世紀的畫作, 繪者是老盧卡斯·克拉納赫。
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It shows the famous Fountain of Youth.
畫的是有名的「青春之泉」。
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If you drink its water or you bathe in it, you will get health and youth.
如果喝了泉水或是沐浴其中, 就會變得健康、年輕。
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Every culture, every civilization has dreamed of finding eternal youth.
每種文化、每個文明, 都夢想能夠青春永駐。
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There are people like Alexander the Great or Ponce De León, the explorer,
亞歷山大大帝 或是探險家龐塞德萊昂,
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who spent much of their life chasing the Fountain of Youth.
終其一生追尋不老之泉。
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They didn't find it.
最後無疾而終。
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But what if there was something to it?
但它真的存在嗎?
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What if there was something to this Fountain of Youth?
青春之泉會不會是真的?
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I will share an absolutely amazing development in aging research
我要分享「老化研究」的驚人發展,
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that could revolutionize the way we think about aging
徹底顛覆我們對老化的了解,
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and how we may treat age-related diseases in the future.
以及未來老年疾病的治療。
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It started with experiments that showed,
首先是一些實驗顯示,
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in a recent number of studies about growing,
近期關於「成長」的研究指出,
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that animals -- old mice -- that share a blood supply with young mice
動物,比如年老的老鼠, 被供應年輕老鼠的血液,
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can get rejuvenated.
會變年輕。
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This is similar to what you might see in humans, in Siamese twins,
這個情況就像人類的連體嬰,
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and I know this sounds a bit creepy.
雖然聽起來有點詭異。
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But what Tom Rando, a stem-cell researcher, reported in 2007,
但根據幹細胞研究員 湯姆‧蘭朵 2007 年的報告,
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was that old muscle from a mouse can be rejuvenated
老鼠的老肌肉可以年輕化
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if it's exposed to young blood through common circulation.
藉由暴露在年輕的血液循環系統。
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This was reproduced by Amy Wagers at Harvard a few years later,
幾年後艾美‧維潔 在哈佛重做這個實驗,
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and others then showed that similar rejuvenating effects could be observed
結果發現類似的年輕化效果,
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in the pancreas, the liver and the heart.
也發生在胰臟、肝臟、心臟。
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But what I'm most excited about, and several other labs as well,
但最令我和其他同業興奮的是,
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is that this may even apply to the brain.
這也可能發生在大腦。
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So, what we found is that an old mouse exposed to a young environment
我們發現老老鼠 被暴露在年輕的環境中,
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in this model called parabiosis,
也就是模型中的「連體鼠」,
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shows a younger brain --
有更年輕的腦、
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and a brain that functions better.
運作得更好的腦。
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And I repeat:
再重說一次:
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an old mouse that gets young blood through shared circulation
藉由共享循環系統 獲得年輕血液的老老鼠,
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looks younger and functions younger in its brain.
腦部看起來、也運作得更年輕。
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So when we get older --
所以當我們老去,
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we can look at different aspects of human cognition,
用不同面向分析人類的知覺,
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and you can see on this slide here,
如這張投影片所示,
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we can look at reasoning, verbal ability and so forth.
比如推理、言語或其他能力。
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And up to around age 50 or 60, these functions are all intact,
到了 50 或 60 歲, 這些功能都還正常,
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and as I look at the young audience here in the room, we're all still fine.
告訴在座各位「年輕朋友」: 我們還算硬朗。
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(Laughter)
(笑聲)
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But it's scary to see how all these curves go south.
但可怕的是, 這些線會持續下滑。
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And as we get older,
隨著年紀漸長,
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diseases such as Alzheimer's and others may develop.
阿茲海默症之類的病就可能併發。
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We know that with age, the connections between neurons --
大家都知道隨著老化, 神經元之間的連結,
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the way neurons talk to each other, the synapses -- they start to deteriorate;
它們之間的溝通方式, 也就是「突觸」開始退化;
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neurons die, the brain starts to shrink,
神經元死亡、大腦開始萎縮,
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and there's an increased susceptibility for these neurodegenerative diseases.
增加罹患神經組織退化疾病的風險。
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One big problem we have -- to try to understand how this really works
這裡有個大問題, 當我們想了解大腦
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at a very molecular, mechanistic level --
分子、機轉層面的運作,
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is that we can't study the brains in detail, in living people.
沒辦法在活人身上研究。
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We can do cognitive tests, we can do imaging --
我們可以做知覺測試、掃描,
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all kinds of sophisticated testing.
各種精細的檢查。
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But we usually have to wait until the person dies
但通常要等到人死後,
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to get the brain and look at how it really changed through age or in a disease.
剖析腦的內部, 才知道老化或疾病造成的改變。
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This is what neuropathologists do, for example.
這是神經病理學家其中一項工作。
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So, how about we think of the brain as being part of the larger organism.
假設腦只是大型有機體的一部份。
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Could we potentially understand more
我們有沒有可能,
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about what happens in the brain at the molecular level
從分子的角度更了解大腦運作,
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if we see the brain as part of the entire body?
只把腦當作身體的某個部分?
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So if the body ages or gets sick, does that affect the brain?
如果身體老化或生病, 會影響到大腦嗎?
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And vice versa: as the brain gets older, does that influence the rest of the body?
或相反,當腦老化, 會不會影響身體其他部位?
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And what connects all the different tissues in the body
而連結身體各不同組織的
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is blood.
就是「血液」。
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Blood is the tissue that not only carries cells that transport oxygen, for example,
血液不只是夾帶輸氧細胞的組織,
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the red blood cells,
例如紅血球,
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or fights infectious diseases,
或是抵抗傳染病,
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but it also carries messenger molecules,
同時也夾帶了訊息因子,
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hormone-like factors that transport information
像賀爾蒙的因子,傳遞訊息,
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from one cell to another, from one tissue to another,
從一個細胞到另一個細胞, 一個組織到另一個組織,
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including the brain.
在大腦裡也一樣。
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So if we look at how the blood changes in disease or age,
所以我們看血液 因為疾病或老化產生的改變,
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can we learn something about the brain?
會不會更認識大腦?
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We know that as we get older, the blood changes as well,
我們知道隨著年紀漸長, 血液也會改變,
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so these hormone-like factors change as we get older.
這些像賀爾蒙的因子也會改變。
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And by and large, factors that we know are required
目前我們所知,
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for the development of tissues, for the maintenance of tissues --
發展或是維持組織 所需的因子或多或少,
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they start to decrease as we get older,
隨著年齡增長而減少,
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while factors involved in repair, in injury and in inflammation --
會造成破損、受傷、發炎的因子,
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they increase as we get older.
卻隨著年齡增長而增加。
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So there's this unbalance of good and bad factors, if you will.
所以說起來, 好因子和壞因子之間失衡了。
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And to illustrate what we can do potentially with that,
為了說明怎麼改善這個情況,
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I want to talk you through an experiment that we did.
我想解釋一下我們之前的實驗。
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We had almost 300 blood samples from healthy human beings
我們取了 300 份 健康人類的血液樣本,
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20 to 89 years of age,
從 20 歲到 89 歲都有,
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and we measured over 100 of these communication factors,
測試了超過 100 種這些溝通因子,
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these hormone-like proteins that transport information between tissues.
這些像賀爾蒙在組織間 傳遞訊息的蛋白質。
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And what we noticed first
我們首先發現
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is that between the youngest and the oldest group,
在最年輕和最年老的樣本間,
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about half the factors changed significantly.
有半數左右的因子有顯著改變。
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So our body lives in a very different environment as we get older,
所以我們的身體在老化以後, 對這些因子來說,
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when it comes to these factors.
是一個非常不一樣的環境。
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And using statistical or bioinformatics programs,
藉由這些統計、生物信息資料,
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we could try to discover those factors that best predict age --
我們可以試著去發現 最能預測年齡的因子,
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in a way, back-calculate the relative age of a person.
也就是反推某個人的相對年齡。
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And the way this looks is shown in this graph.
如同這張圖所顯示。
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So, on the one axis you see the actual age a person lived,
橫軸是人的實際年齡,
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the chronological age.
也就是年齡序列。
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So, how many years they lived.
看他們實際活了多久。
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And then we take these top factors that I showed you,
然後我們用剛剛的重要因子,
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and we calculate their relative age, their biological age.
去計算縱軸的相對、生理的年齡。
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And what you see is that there is a pretty good correlation,
你會發現兩者高度相關,
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so we can pretty well predict the relative age of a person.
所以能預測人的相對年齡。
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But what's really exciting are the outliers,
但偏離線外的點更值得注意,
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as they so often are in life.
他們不算少數。
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You can see here, the person I highlighted with the green dot
你看綠點標記的這個人,
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is about 70 years of age
將近 70 歲左右,
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but seems to have a biological age, if what we're doing here is really true,
但他的生理年齡, 如果我們的推論正確,
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of only about 45.
只有大概 45 歲。
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So is this a person that actually looks much younger than their age?
所以這個人是不是 實際看起來更年輕?
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But more importantly: Is this a person who is maybe at a reduced risk
更重要的是: 這個人是不是罹患
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to develop an age-related disease and will have a long life --
老化疾病的風險更小, 也會更長壽?
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will live to 100 or more?
甚至超過 100 歲?
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On the other hand, the person here, highlighted with the red dot,
另一方面, 紅點標記的這位,
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is not even 40, but has a biological age of 65.
還不到 40 歲, 但生理年齡已經 65 歲。
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Is this a person at an increased risk of developing an age-related disease?
罹患老化疾病的風險是不是更高?
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So in our lab, we're trying to understand these factors better,
所以我們實驗室 試著更了解這些因子,
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and many other groups are trying to understand,
其他團隊也在努力,
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what are the true aging factors,
關鍵的老化因子是什麼?
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and can we learn something about them to possibly predict age-related diseases?
我們找出來以後, 能不能有效預測老化疾病?
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So what I've shown you so far is simply correlational, right?
我剛剛說的 只是簡單的關聯性,
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You can just say, "Well, these factors change with age,"
你可能會說: 「這些因子會隨年齡改變嘛。」
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but you don't really know if they do something about aging.
但怎麼知道不是因子改變年齡?
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So what I'm going to show you now is very remarkable
所以我現在再說一個關鍵,
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and it suggests that these factors can actually modulate the age of a tissue.
說明這些因子會改變組織的年齡。
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And that's where we come back to this model called parabiosis.
回到剛剛的「連體鼠」實驗。
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So, parabiosis is done in mice
這是將兩隻老鼠,
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by surgically connecting the two mice together,
用手術連接在一起,
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and that leads then to a shared blood system,
共享同一個血液循環系統,
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where we can now ask, "How does the old brain get influenced
所以我們會問: 「比較老的腦接觸到年輕血液
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by exposure to the young blood?"
會有什麼影響?」
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And for this purpose, we use young mice
所以我們找了一隻小老鼠,
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that are an equivalency of 20-year-old people,
換算大約是人類的 20 歲,
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and old mice that are roughly 65 years old in human years.
和大約人類 65 歲的老老鼠。
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What we found is quite remarkable.
有個非常驚人的發現。
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We find there are more neural stem cells that make new neurons
我們發現產出更多神經幹細胞 製造新的神經元
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in these old brains.
在這些老的大腦裏面。
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There's an increased activity of the synapses,
突觸的活動變得更活躍,
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the connections between neurons.
突觸是神經元之間的連結。
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There are more genes expressed that are known to be involved
大家所知 更多的基因顯示涉及
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in the formation of new memories.
新記憶的資訊。
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And there's less of this bad inflammation.
導致發炎的壞因子減少。
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But we observed that there are no cells entering the brains of these animals.
我們也觀察到, 沒有新的細胞進入大腦。
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So when we connect them,
也就是說這個實驗中,
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there are actually no cells going into the old brain, in this model.
沒有任何細胞進入老腦。
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Instead, we've reasoned, then, that it must be the soluble factors,
所以可以推論, 這些因子一定溶於血,
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so we could collect simply the soluble fraction of blood which is called plasma,
所以我們只需要收集 血液裡的血漿,
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and inject either young plasma or old plasma into these mice,
然後把老血漿或年經血漿 注入老鼠體內,
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and we could reproduce these rejuvenating effects,
就可以重現年輕化的效果,
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but what we could also do now
但在此同時我們也可以,
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is we could do memory tests with mice.
幫老鼠做記憶測試。
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As mice get older, like us humans, they have memory problems.
老鼠老了就跟人一樣, 記憶力會衰退。
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It's just harder to detect them,
雖然不容易觀察,
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but I'll show you in a minute how we do that.
但我等一下會說我們怎麼做。
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But we wanted to take this one step further,
我們還想更進一步,
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one step closer to potentially being relevant to humans.
更近一步把結果和人類做連結。
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What I'm showing you now are unpublished studies,
接下來要說的實驗還沒發表,
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where we used human plasma, young human plasma,
我們用年輕人類的血漿,
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and as a control, saline,
和生理食鹽水做對照,
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and injected it into old mice,
注入到老老鼠體內,
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and asked, can we again rejuvenate these old mice?
想知道 能不能再次年輕化老老鼠?
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Can we make them smarter?
能讓牠們變聰明嗎?
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And to do this, we used a test. It's called a Barnes maze.
我們用「巴恩斯迷宮」來測試。
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This is a big table that has lots of holes in it,
這張大桌子有很多洞,
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and there are guide marks around it,
上面有一些指示標記,
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and there's a bright light, as on this stage here.
像這個講台一樣有打光。
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The mice hate this and they try to escape,
老鼠討厭光所以想逃跑,
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and find the single hole that you see pointed at with an arrow,
要找到箭頭指的這個洞,
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where a tube is mounted underneath
底下接了一根管子,
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where they can escape and feel comfortable in a dark hole.
牠們可以藉此重返舒適的黑洞。
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So we teach them, over several days,
所以我們教了牠們幾天,
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to find this space on these cues in the space,
怎樣透過標記找到小黑洞,
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and you can compare this for humans,
拿人類來說,
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to finding your car in a parking lot after a busy day of shopping.
就像逛了賣場一整天, 最後要在停車場找車。
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(Laughter)
(笑聲)
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Many of us have probably had some problems with that.
很多人都覺得那是大挑戰。
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So, let's look at an old mouse here.
回來看這隻老老鼠。
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This is an old mouse that has memory problems,
這是隻記憶力不好的老老鼠,
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as you'll notice in a moment.
你等一下就知道了。
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It just looks into every hole, but it didn't form this spacial map
牠每個洞都看, 但對空間毫無頭緒,
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that would remind it where it was in the previous trial or the last day.
對之前走過的路, 或昨天的事完全沒有印象。
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In stark contrast, this mouse here is a sibling of the same age,
這邊的對照組 是牠同齡的手足,
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but it was treated with young human plasma for three weeks,
但已經連續接受人類血漿 3 週,
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with small injections every three days.
每 3 天一次的少量施打。
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And as you noticed, it almost looks around, "Where am I?" --
你會發現牠環顧四周說: 「這是哪?」
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and then walks straight to that hole and escapes.
接著直直走到那個洞離開。
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So, it could remember where that hole was.
顯然牠記得洞的位置。
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So by all means, this old mouse seems to be rejuvenated --
看來這隻老老鼠年輕化了,
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it functions more like a younger mouse.
活得比較像一隻年輕老鼠。
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And it also suggests that there is something
代表不只是
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not only in young mouse plasma, but in young human plasma
年輕老鼠的血漿裡面, 年輕人類的血漿裡,
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that has the capacity to help this old brain.
也有能改善大腦能力的因子。
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So to summarize,
結論就是,
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we find the old mouse, and its brain in particular, are malleable.
我們發現老老鼠, 特別是大腦,是具可塑性的。
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They're not set in stone; we can actually change them.
決不是一成不變, 而是可以被我們改造。
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It can be rejuvenated.
可以被年輕化。
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Young blood factors can reverse aging,
年輕的血液因子讓你返老還童,
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and what I didn't show you --
但我沒說的是,
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in this model, the young mouse actually suffers from exposure to the old.
實驗裡的年輕老鼠, 卻因此被拖累。
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So there are old-blood factors that can accelerate aging.
所以年老血液的因子會加速老化。
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And most importantly, humans may have similar factors,
更重要的是, 人類也有類似的因子,
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because we can take young human blood and have a similar effect.
因為用年輕人血做實驗 也有類似效果。
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Old human blood, I didn't show you, does not have this effect;
但是老年人的血液 在實驗裡卻無效,
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it does not make the mice younger.
沒有讓老鼠變年輕。
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So, is this magic transferable to humans?
所以這能不能套用到人類呢?
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We're running a small clinical study at Stanford,
我們在史丹佛做小型的臨床實驗,
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where we treat Alzheimer's patients with mild disease
對輕度阿茲海默症患者,
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with a pint of plasma from young volunteers, 20-year-olds,
施打 1 品脫 20 歲志願者的血漿,
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and do this once a week for four weeks,
每週一次連續 4 週,
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and then we look at their brains with imaging.
然後再用儀器掃描他們的腦、
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We test them cognitively,
測試他們的知覺,
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and we ask their caregivers for daily activities of living.
透過照護員了解日常活動。
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What we hope is that there are some signs of improvement
我們希望透過這種治療,
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from this treatment.
看到一些好轉的跡象。
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And if that's the case, that could give us hope
如果成功,我們會希望
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that what I showed you works in mice
老鼠實驗展現的成果,
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might also work in humans.
也會在人類身上實現。
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Now, I don't think we will live forever.
我不認為人會長生不死。
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But maybe we discovered
但也許我們發現,
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that the Fountain of Youth is actually within us,
青春之泉就在我們身體裡,
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and it has just dried out.
只是逐漸乾涸。
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And if we can turn it back on a little bit,
如果能稍微活化它,
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maybe we can find the factors that are mediating these effects,
找到讓我們年輕化的因子,
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we can produce these factors synthetically
想辦法合成這些因子,
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and we can treat diseases of aging, such as Alzheimer's disease
就可以治療老化疾病,
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or other dementias.
例如阿茲海默或其他失智。
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Thank you very much.
非常感謝。
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(Applause)
(掌聲)