演講MP3+雙語文稿:一種能夠預(yù)防抑郁癥和PTSD的新型藥物

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【演講人及介紹】Rebecca Brachman 神經(jīng)科學(xué)家、作家、企業(yè)家

【演講主題】一種能夠預(yù)防抑郁癥和PTSD的新型藥物

【演講文稿-中英文】

翻譯 Hoi Fei Cheung 校對 Homer Li

00:13

So the first antidepressants were madefrom, of all things, rocket fuel, left over after World War II. Which isfitting, seeing as today, one in five soldiers develop depression, orpost-traumatic stress disorder or both. But it's not just soldiers that are athigh risk for these diseases. It's firefighters, ER doctors, cancer patients,aid workers, refugees -- anyone exposed to trauma or major life stress. Andyet, despite how commonplace these disorders are, our current treatments, ifthey work at all, only suppress symptoms.

治療抑郁癥和創(chuàng)傷后應(yīng)激障礙的藥物 是由第二次世界大戰(zhàn)后 剩下的火箭燃料制成 對于有五分之一士兵患上抑郁癥 或創(chuàng)傷后應(yīng)激障礙的現(xiàn)代社會 似乎是個合適的話題 事實上，士兵不是 唯一的高危族群 消防員，急診醫(yī)生，癌癥患者，援助者，難民 以及面對創(chuàng)傷或巨大壓力的人，都有患病的可能 盡管這些病癥很常見 現(xiàn)時的治療方法，假設(shè)有效 也只能到抑制癥狀的程度

00:53

In 1798, when Edward Jenner discovered thefirst vaccine -- it happened to be for smallpox -- he didn't just discover aprophylactic for a disease, but a whole new way of thinking: that medicinecould prevent disease. However, for over 200 years, this prevention was notbelieved to extend to psychiatric diseases. Until 2014, when my colleague and Iaccidentally discovered the first drugs that might prevent depression and PTSD.We discovered the drugs in mice, and we're currently studying whether they workin humans. And these preventative psychopharmaceuticals are notantidepressants. They are a whole new class of drug. And they work byincreasing stress resilience, so let's call them resilience enhancers.

1798年, 愛德華·詹納發(fā)明了第一支疫苗 用于預(yù)防天花 他不單發(fā)現(xiàn)了預(yù)防疾病的藥物 更開創(chuàng)了嶄新的思考方式： 藥物可以預(yù)防疾病 可是，在之后的二百多年里 民眾認(rèn)為預(yù)防式藥物 不能拓展治療到精神疾病 直到2014年，我和 同僚意外地發(fā)現(xiàn)了 首個或可預(yù)防抑郁癥和 創(chuàng)傷后應(yīng)激障礙的藥物 藥是從老鼠中發(fā)現(xiàn)的 我們正研究在人類身上的作用 這類預(yù)防性精神藥物 不等于抗抑郁藥 而是一種全新類別的藥 能增加壓力復(fù)原力 姑且將它命名為 復(fù)原力增強(qiáng)劑

01:40

So think back to a stressful time thatyou've since recovered from. Maybe a breakup or an exam, you missed a flight.Stress resilience is the active biological process that allows us to bounceback after stress. Similar to if you have a cold and your immune system fightsit off. And insufficient resilience in the face of a significant enoughstressor, can result in a psychiatric disorder, such as depression. In fact,most cases of major depressive disorder are initially triggered by stress. Andfrom what we've seen so far in mice, resilience enhancers can protect againstpurely biological stressors, like stress hormones, and social and psychologicalstressors, like bullying and isolation.

回想一下，你上次遇到壓力的時候——可能是經(jīng)歷了分手，考試，錯過了飛機(jī)壓力復(fù)原是一個有效的生理過程令人從壓力中恢復(fù)過來這過程類似感冒后免疫系統(tǒng)會進(jìn)行抵抗 當(dāng)抗復(fù)原力不足夠 來面對巨大壓力源時 就會導(dǎo)致精神疾病，例如抑郁癥 事實上，大部分嚴(yán)重抑郁癥的個案 都是由壓力引起的 我們從老鼠中看到 復(fù)原力增強(qiáng)劑可以 抵抗生理壓力源 例如壓力激素 以及社會及心里壓力源，例如被欺凌和孤立

02:24

So here is an example where we gave micethree weeks of high levels of stress hormones. So, in other words, a biologicalstressor without a psychological component. And this causes depressivebehavior. And if we give three weeks of antidepressant treatment beforehand, ithas no beneficial effects. But a single dose of a resilience enhancer given aweek before completely prevents the depressive behavior. Even after three weeksof stress. This is the first time a drug has ever been shown to prevent the negativeeffects of stress.

我們在老鼠上做了個測試?yán)鲜筮B續(xù)三周接受大量壓力激素 也就是說，純粹只有生理壓力源，沒有任何心理壓力源的成分、 結(jié)果是老鼠表現(xiàn)出抑郁癥狀 即使在事前已提供了 三星期的抗抑郁藥 也沒有任何作用 但在一周前注射一劑 復(fù)原力增強(qiáng)劑 就能完全預(yù)防抑郁 即使是壓力已經(jīng)持續(xù)三周 這是史上首次有藥物 能有效地預(yù)防壓力 所帶來的負(fù)面影響

03:02

Depression and PTSD are chronic, oftenlifelong, clinical diseases. They also increase the risk of substance abuse,homelessness, heart disease, Alzheimer's, suicide. The global cost ofdepression alone is over three trillion dollars per year. But now, imagine ascenario where we know someone is predictively at high risk for exposure toextreme stress. Say, a red cross volunteer going into an earthquake zone. Inaddition to the typhoid vaccine, we could give her a pill or an injection of aresilience enhancer before she leaves. So when she is held at gunpoint by lootersor worse, she would at least be protected against developing depression or PTSDafter the fact. It won't prevent her from experiencing the stress, but it willallow her to recover from it. And that's what's revolutionary here. Byincreasing resiliency, we can dramatically reduce her susceptibility todepression and PTSD, possibly saving her from losing her job, her home, herfamily or even her life.

抑郁癥和創(chuàng)傷后應(yīng)激障礙都屬于慢性，甚至是終身的臨床病患者會增加濫用藥物，無家可歸，心臟病，阿爾茨海默癥，自殺的幾率光是憂抑郁癥全球每年所產(chǎn)生的費(fèi)用就超過三兆美元。到了今天，假設(shè)有這么一個情況： 我們預(yù)先得知某人會 處于高壓力的環(huán)境。比如說，一位紅十字會志愿者 到地震災(zāi)區(qū)救援 除了為她提供傷寒疫苗，我們也可以在她出發(fā)前提供 復(fù)原力增強(qiáng)劑的藥丸或注射劑。這樣，即使她在槍口下遭到掠奪，甚至是遇到更嚴(yán)重的情況，至少，在事后可以防止患上抑郁癥和創(chuàng)傷后應(yīng)激障礙。雖然這藥不能讓患者避免經(jīng)歷受創(chuàng)，但可以使患者從創(chuàng)傷中復(fù)原。稱得上是個革命性的改變。只要增強(qiáng)復(fù)原力就能大幅地減少患上憂郁癥和創(chuàng)傷后應(yīng)激障礙的機(jī)率避免發(fā)生失去工作，家庭，親人，甚至性命的情況。

04:10

After Jenner discovered the smallpoxvaccine, a lot of other vaccines rapidly followed. But it was over 150 yearsbefore a tuberculosis vaccine was widely available. Why? In part becausesociety believed that tuberculosis made people more sensitive and creative andempathetic. And that it was caused by constitution and not biology. And similarthings are still said today about depression. And just as Jenner's discoveryopened the door for all of the vaccines that followed after, the drugs we'vediscovered open the possibility of a whole new field: preventativepsychopharmacology. But whether that's 15 years away, or 150 years away,depends not just on the science, but on what we as a society choose to do withit.

詹納發(fā)現(xiàn)首支天花疫苗后不同類型的疫苗如雨后春筍般出現(xiàn) 但過了150年 肺結(jié)核疫苗才能被廣泛使用 為什么？ 部分原因的是，人們相信肺結(jié)核 能讓患者變得更敏感，有創(chuàng)意，及富同情心，他們相信這是個人體質(zhì)造成的，和生物學(xué)沒有關(guān)系。對于抑郁癥，也有坊間相似的傳聞。正如詹納的發(fā)現(xiàn)為日后的疫苗發(fā)明，打開了一扇門，而新發(fā)明的藥物開創(chuàng)了領(lǐng)域的先河也就是預(yù)防性精神藥理學(xué)。至于結(jié)果是要等15年還是150年，不只是取決於科學(xué)還在於我們的社會如何看待處理。

05:04

Thank you.

謝謝。

05:05

(Applause)

(掌聲）