字幕列表 影片播放 列印英文字幕 Behind every disease statistic there is a person Lucy suffers from a disorder affecting a part of her brain that controls movement before her operation she was confined to a chair and had difficulty eating and breathing without surgery that could only have been developed through animal research Lucy could have died she now has a new lease of life the brain is the most complex organ in our body it is not just a sum of all its component pieces it is much more than that indeed, it is one of the most complex organ we have ever tried to understand and how it does what it does, is still largely a mystery this means that research techniques focusing on a small part of the brain or single pathway cannot tell the whole story to get to grips with its complexity we need to look at living brain the entire brain and how it interacts with other organs the brain controls every aspect of our lives from regulating our heartbeat and emotions to movement and speech however, unlike a heart or any other organ it can't be replaced when things go wrong and at the moment, there are no cures for diseases of the brain some disorders affecting the central nervous system are genetically driven as a child you have no influence on your genetic makeup which could predispose you to disorders like Schizophrenia Parkinson's disease or Alzheimers in addition anyone of us could have an accident and be left paralyzed well the common causes of spinal cord injury are things that could happen in everyday life, so they are things like automobile accidents and also for example, a lot of sporting injuries can cause spinal cord injury and if we take the famous case of Christopher Reeve, he actually fell off his horse and then develped paraplegia but at the moment there are a number of experimental techniques which are being developed which may potentially be the treatments of tomorrow for treating spinal cord injury so at the moment the majority of research looking at spinal cord injury, involves looking at rodents, in particular rats and what we do is, we look at the ability of a chemical, an enzyme called Chondroitinase, which has being shown to allow regeneration of nerve fibres in the spinal cord, to quite considerable distances. When the spinal cord is injured scar tissue forms, it is partly comprised of the cell type called ghlea this acts as a physical barrier to nerve regrowth. Chondroitinase may help it's thought to break down the constituents of the gleaus scar and therefore reduce the inhibitory environment that the injured nerve fibre faces after injury. You couldn't do this on humans for a number of reasons, the first major reason is because Chondroitinase is actually toxic to humans, so the doses that you would require to get functional recovery are just too great but using our animal models we can look at this drug and we can look at the active sites and how it could actually exert its action and divise an analogue pharmaceutically which could then be used in humans the second reason is obviously that you can't look at histology you can't look at post mortem of patients because you have to wait a very long time for them to actually expire and then to remove the spinal cord, whereas with rats it allows us to do this over a relatively short period of time. The same problems hold true when using post-mortem brains to study mental illness the drawback of studying things in post mortem brain is of course people have typically died of old age, often in an institution and they have been exposed to 30, 40 years of drug treatment and a very isolated kind of existence, so it's diffcult to find controlled people where all of that is matched you can't match the effects of the drug and you can't match the effect of lifestyle in that situation The difficulties in using human tissues are partly overcome by using animals, whose environment we can control in the case of an introduced spinal cord injury the animal still has normal function in one side of the body this means that the recovery following treatment in the injured side can be compared with the normal in a series of behavioral tests. There is something called the sticky tape test and essentially what this involves is a piece of sticky tape attached to the rodent's paw and it has to sense that this sticky tape is there and because it's not very comfortable for the animal it will then rip off the sticky tape and therefore you can assess 2 things you can assess the sensory benefits and regained after application of Chondroitinase because it can feel the sticky tape to pull it off and also the motor responses because in order to pull it off it needs some sort of motor ability the staircase test also measures mice are placed inside a small chamber where they have to walk along the stationary platform to retrieve the series of tiny sugar treats they can only use the right port to reach the right stair case and the left port to reach the left animals with the spinal lesion on one side finds this difficult to do on the side that is injured. Then there is a water maze task commonly used to assess memory impairment following stroke animals have to find a submerged platform hidden in a murky pool of water they use visual cues from around the room the position of the door or window for example to remember where the platform is once they find it they are taken out of the pool, towel dried and back to cage those that struggle with the task are fished out after a couple of minutes. In spinal cord injury, the challenge is to regenerate the damaged nerve cells for stroke patients it is the opposite here the difficulty lies in preventing cell death. Strokes are very big problem in the world, it is the second biggest killer globally and in Britain that translates to 1 in person in every 5 minutes having a stroke it is a massive problem and one of the worst things about stroke is that even if you survive a lot of people who do survive are left with other kinds of disability such as paralysis, impairment, their vision, their memory can be effected so it's a very debilitating disease a stroke is caused when the blood supply to the brain is stopped quickly and dramatically. What happens when you get the stroke is that region of the brain that stops receiving this blood supply, stops getting oxygen, stops getting glucose and the cells in the immediate area start to die and there is nothing we can do about that but what also happens is that subsequently there is a period of hours which can extend to days of what we call the delayed cell death Barry studies basic biology of stroke many different molecules are involved understanding what they do and how they interact may help researchers devise new anti stroke therapies We couldn't do what we are doing without using animals. The brain is such a complex organ, the most complex in the human body you can't simply take it apart and look at individual cells, every single one of the cells in the brain, in a living brain has thousands of other connections with lots of other cells and you need to keep that integrity you need to keep those cells in contact. In the UK, there is some work going on with a naturally produced chemical in our body called Interleukin-1 what they found in tissue culture was that appeared interleukin-1 was actually protective to the cells and it reduced damage to those cells. However, when they went on to actually look at this chemical in animal models, they found it was actually quite damaging and had this chemical gone on to be used in humans, it could have actually been fatal. So now thanks to this work in Manchester using animals they have been able to develop certain types of drugs to block the action of Interleukin-1 and those are now in clinical trials. This is the new treatment in the evaluation stages another treatment for stroke used worldwide is constraint induced therapy. It basically involves restricting the movement of the side of the body that is unaffected by stroke forcing the damaged side to perform the tasks it sounds obvious but the simple treatment is a direct result of studies in monkeys that showed the brain could undergo massive physical reorganization in response to damage that means over time, the nerve cells actually grow and make new connections. Stroke is a serious problem, about 10% of those that suffer a stroke are children but in terms of the effect it has on people's lives mental health problems exert a wider influence. At some point in our lives, 1 in 4 of us will develop a mental health problem so how do we study mental illness in animals? It's very difficult to model a mental illness in animals How do you model a hallucinations or a delusion? How do you model depression? and feeling unhappy and suicidal and so forth but it can be done, the 2 main approaches are first of all to observe the effects of drugs that we know cause these disorders so there are certain drugs that cause hallucinations and delusions in humans like LSD for example. Well, PCP has been taken as recreational drug and had been taken quite widely in like the 70's so it was observed that individuals exhibited physcotic response, very similar to that of Schizophrenics and that Is why we knew that we could use these drugs in rats to model the disorder the rat model of Schizophrenia that I was using was focused primarily on the attentional deficits that are exhibited in psychotic patients they find it very well in a lot of cases, they find it very difficult to concentrate on something so I could be talking to someone and they can be distracted by the noise of something coming through the window or the light or something else that is being said to them so that's the part that I primarily focused on but there are lots of other models of schizophrenia focusing on the other symptoms. Using drugs to induced symptoms is one approach Bill describes another which is used in studies of depression when someone is depressed things like having dinner with your family or a drink with friends holds no pleasure so we can model in animals a loss of pleasure one way of doing that is to see whether animals prefer sucrose to water normal rats prefer that, if they have been stressed in some gentle way then they lose that preference and that is a model for what we call Anhedonia, the loss of reward and then we can try and reverse that with drugs that may be effective in depression and all the ones that are affective in depression have that ability. The kind of thing that is done these days is to use mild stress upon it, mild stress model of depression for example where it's where you sort of mess about with the daily routine of a mouse so that the litter that the animal lives in is not cleaned out on time the water doesn't arrive on time, the light bulb cycle is messed about with and they are isolated for a bit there are many ways of trying to induce a state of Anhedonia using rather mild amd ethical kinds of stress I think for all mental illnesses actually the outlook has changed dramatically in the last 25 years mainly due to improvement in how anti-depressant drugs work, the development of new anti-depressant drugs, and the developmnet of new anti-psychotic drugs. To see somebody just get better from a simple depressive illness, to see somebody who is floridly psychotic recover and acheive a normal life again and to see somebody who is a manic-depressive whose mood is either up or down and has been like that for years and just to get the medication right is one of the most satisfying aspects of my job the improvements we have seen are just remarkable As we age, we are more likely to succumb to Parkinson's disease, Alzheimer's disease or suffer a stroke There are treatments but there are very few cures at the Charing Cross hospital, Tipu is a surgeon who treats patients with Parkinson's disease the therapy that he carries out 3 days a week was developed in animals Recently really in the last 10 years the use of primate models of Parkinson's disease has allowed us to find the central targets in the brain that drive the symptoms and surgery which involves implanting electrodes into this target, the subthalamic nucleus can dramatically alleviate Parkinson's and virtually restore you to normality. This therapy was demonstrated in monkeys before moving to patients 1 of every 1000 procedures using animals involves non-human primates these are some of the reasons why they are used. We walk on 2 legs they do they use their hands, we do their brains are wired identically, and given time they even develop listening conditions, people say and monkeys do not develop Alzheimer's they do it's just they don't live long enough in freedom. it is in captivity it has become apparent. Untreated Parkinson's, the 3 major signs are severe tremor very stiff limbs rigidity and a slowness of movement they move as if they are walking in treacle if they take drugs for a few years they can be restored virtually to a normal state, but within 5 years, 80% of Parkinsonian patients will develop severe uncontrollable thrashing so they either thrash about or they shake and are unable to move the technique is called deep brain stimulation it gave Lucy a new lease of life Mike Robbins is another one of more than 200 of Tipu's patients who has had the operation. I first noticed that I had a tick in my right shoulder about 8 to 10 years ago rather like the type of tick that you, that most of us have at sometime or another found in their eye but this did not go away it got slowly worse so that down the right side, the first real sign that I noticed that there was something quite wrong with me was when my fingers wouldn't work I'm a smoker and I could not knock the ash of a cigarette this index finger of my right hand just wouldn't do as it was told and slowly it got worse so that I then had a tremor start in my right side and after about 18 months my whole right side was quite a severe tremor I was diagnosed in Shanghai and then when I got back to the UK a neurologist put me on a variety of drugs none had any effect at all on my tremor but all gave me terrible side effects, some of the side effects were quite horrendous that I though that I was living inside a balloon, that people couldn't hear me in the room and so I was taken off those drugs and I had heard that there was surgery. For this procedure patients must be awake prior to surgery the patient's head is screwed into a frame and they have a CT scan the use of a reference grid helps the surgeon to know where to drill the hole. We drill a a tiny hole on the side opposite to which we want to improve, the brain controls the other side we past the electrode down to the target, and when we pass a current the patient being wide awake can immediately show us that the tremor has stopped the movement has improved and there are no side effects like uncontrollable tingling or speech affectation. The electrode is then fixed to the skull with a screw and then we do the same for the other side so both sides of the brain are brought under control following that the electrodes are connected to wires which are tunnelled under the skin and attached to what is a pacemaker which lies under the skin and you can communicate with it with an external programer to tell it exactly which electrodes to activate and how to stimulate and give the patient the best possible reversal. diseases such as Parkinson's and Alzheimers generally affect older people the distinguishing features are the loss of nerve cells in specific parts of the brain Huntington's disease although not as common belongs to the same class of disorders it is caused by a faulty gene and runs in families the gene mutation was discovered in 1993 but as of yet there is no cure. Sarah works at the national hospital she researches the disease and treats patients Huntington's disease is a particularly devastating neuro degenerative disease it affects young people but it has a slow inexorable progression over 15 to 20 years to death for example, if someone develop symptoms in their late 20's they develop acquiring difficulties with speech, swallowing, their bodily functions such as going to the toilet, they find it increasingly difficult to walk they are unable to think properly, they are unable to communicate properly and their thinking becomes affected and they are difficult to communicate with their loved ones so over that time their life becomes really intolerable Mendala's son and husband are both affected by the disease she describes how it makes her feel. Very painful and very very angry, my husband has got it and now he has got it as well there is no cure at the moment it's really hard to talk Huntingdon's disease usually only shows itself in adulthood by which time many couples will have had children and possibly grandchildren they have a 50% chance of inheriting the faulty gene and developing the disease and there is nothing that can be done I think that we owe it to our patients to be able to tell them about the research that Is going on in the fact that we are able to offer them some sort of hope for a therapy. I would find it very difficult to practice and to see patients every week without being able to tell them this. Neuro-degenerative disorders per se are going to be a significant public health problem, it is something we have to take very seriously. Statistical predictions have estimated that by 2025 there will be over a billion people in the world aged over 65 age-related diseases such as Parkinson's disease and Alzheimer's disease are going to be a significant public health problem and we are going to have an aging population many affected by this disorder who are going to be a great burden on the younger society and on their families, it is vitally important that we find some sort of therapy for these disorders now before that time comes. When you model diseases in mice you make the mouse and put the gene that causes the mutation in humans into the mouse, so you make a transgenic mouse it is a simplified way of explaining this there are a number of very good transgenic mouse researchers throughout the world and they have made models of neuro-degenerative diseases that closely mimicks the patients' symptoms that we see in clinic. For example, in Huntington's disease researchers have make a nice model of Huntington's that mimics many of the symptoms I see in patients, for example the mouse is shaky, it gets stiff it has behavourial problems it also in the brains of the mice has the changes that are seen in many of the patient's brains. Animal models of disease help us ease out what is happening in the brain when things go wrong. They do have limitations, any disease is complicated and has many different symptoms. Most animal models focus on just one symptom or molecular change. It may take years to understand the basis of a small parth of a diease pathway modelled in an animal but this takes us one step closer to better patient treatments In 2002 around 2.5 million procedures were carried out on animals most were on rodents but rats and mice are very different to humans so why not test new medicines on human volunteers or patients without doing animal testing? I certainly would not want to give any normal volunteer even a single dose of drug unless we knew that it was really safe and that has to be established by all sorts of procedures some of which has to involve animal testing and we can observe very marked behavioural affects of those drugs in animals, experimental animals and then we can use that to understand the brain mechanisms involved and to find drugs that reverse the behavioural abnormalities in animals. It is not ethical to take people off their anti psychotic medication and to start testing on them drugs that might not work, the same way as theirs does, it may worsen the symptoms working with animals is something scientists have to ethically justify to themselves It's a very difficult process to decide to conduct experiments on animals and because the bulk of our work is to do with that it's obviously it is a decision that you have to think about quite considerably really what I thought about was whether it would benefit the patient and whether I could do it in any other way so we did think about whether we could do it say in a dish or on some other way like modeling or using electronic software but it just doesn't fit to any of these, so you can't do this sort of research in that way. The first time I had to do an experiment involving rats was very difficult because to get used to using animals we had spent several weeks playing with the rats handling them and stroking them and when you are petting an animal twice a day, everyday for several weeks it becomes very difficult to go in there and do an experiment and it must have taken me 2 months to go from having never handled a rat to actually injecting and carrying out experiments my family have always been very supportive about me doing research involving animals but my friends were less so I had people telling, asking how I could do this and how could end the life of innocent creatures and all that it is something I chose to do and I believe that it is for the greater good I've always had mixed feelings about using animals in research but it comes down to simple decision of whether or not you are prepared to do that in order to try and help save people's lives some of the diseases that we are talking about are so serious that there is no other way to make progress in trying to find treatments Some would argue that animal research is not necessary and everything can be done with computer modeling and in cell culture even human cells are very different from the whole human being For example, drugs in mice that have been show to be of great benefit in slowing the disease down for example in Huntington's disease do very little in cell models but when you give it to mice it can extend life by 20, 40% and that's very exciting in that if we can try and extrapolate to humans, it could make a significant difference You can't walk into a hospital or even a general practitioner's clinic without being cognizant of the fact that virtually everything that has been offered you has been tried in animals If animal experimentation were banned I don't think we would discover any new drugs we might be able to carry on refining the drugs that we have but we would not be able to safely administer drugs and unless we could checked for safety, so it is a safety issue. Normal volunteers are not going to volunteer for a drug which might kill them. In the meantime procedures already developed are improving people's lives. Tipu's deep brain surgery is helping patients with movement disorders and Parkinson's disease mike recalls Tipu inserting the electrode into his brain. At one occasion during the process he said to me I'm just passing an area of the brain that controls sight and I saw the most magnificent colours that you have ever seen in your life at another occasion he said I'm just about to pass area that affects your speech, will you talk to me? So I said 1, 2, 3, 4 and I heard this reassuring voice off my shoulder saying not to worry, not to worry he withdrew it and tried again and eventually passed this area and then the next significant time point was I've got a few millimeters to go, Mike, and my right arm and my right leg were shaking quite dramatically and the moment that he touched the spot which I'm told is about the size of a grapefruit pip the shaking stopped immediately I laughed I gigled I couldn't believe my luck my right arm and right leg had been heavy for 18 months and they felt as light as if they were going to lift into the air Animal research is not an indulgence in the areas that we have covered today it is a necessary part of the advances we are having to make in understanding and treating a range of illnesses for which there is as yet no cure the probe that is placed into the brain, I understand comes level with the top of the nose and the ear and it is connected to a battery in my chest and underneath the skin in my chest here and this is controlled I can control the amount of the voltage going in I can control the length of time that the pulse is and I can identify the number of times per second that it goes in and I'll turn my self off now one of the problems, not only as you can appreciate is that you cannot do very much for your self, or your personal hygiene has to be done by somebody else but because my concentration is up to 90% of my tremor, I'm trying to control it and I am thinking the word Parkinsons all the time. I'm not terribly I'm not concentrating on my conversation with you at all
B1 中級 動物研究對大腦有什麼作用? (What has animal research done for the brain?) 222 13 稲葉白兎 發佈於 2021 年 01 月 14 日 更多分享 分享 收藏 回報 影片單字