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心脏之伤不可逆?

作者;louie    文章点击:122

摘自2013年5月20日BBC  翻译:沈静

1. Scientists hope they can repair the harm caused by a heart attack without having to replace the organ. 
科学家们希望不必更换器官就能修复心脏病带来的损伤。
2. But it’s proving to be a frustrating task.
但很难。

3. The problem with broken hearts is that they just keep breaking. 
有损伤的心脏最大的问题是它们会一直处于损伤状态。
4. While organs like your liver or skin excel at regenerating themselves after injuries the heart is the class dunce. 
肝脏或皮肤等器官在受伤后可以再生,但心脏却做不到。
5. If its muscle cells or cardiomyocytes die during a heart attack they are replaced by scar tissue rather than fresh muscle. 
如果它的肌肉细胞,或者说是心肌细胞在心脏损伤之后死亡,疤痕组织会代替长出新的肌肉。
6. This temporarily supports the damaged tissue but in the long term it weakens the heart and increases the risk of more heart attacks. 
这样的方式只能暂时地应对受伤组织,从长远来看,它使心脏功能弱化并增加了更多的心脏病风险。
7. It’s no wonder that heart disease is the leading cause of death worldwide. 
难怪心脏病是世界上致人死亡的一大杀手。
8. By 2030 it’s estimated that failing hearts will kill more than 23 million people every year.
据估计,到2030年为止,每年心脏衰竭将使两千三百万人失去生命。

9.For now the only way to stop the downward spiral of a damaged heart is to replace it.
当前唯一阻止受损心脏愈发糟糕的办法就是更换。
10. But donor hearts are so rare that only a few thousand transplants are carried out every year and the lucky recipients still face a reduced life expectancy full of toxic drugs that suppress their immune systems.
但捐赠心脏的数量极为有限,以至于每年只有几千例移植,而且受捐赠者仍然面临生命缩短和严重的排异反应。

11. Since the early 2000s scientists have been trying to use stem cells from a person’s own body to persuade their hearts to grow new muscle. 
从二十一世纪初,科学家们就致力于从人体中取出干细胞去引导心脏长出新的肌肉。
12. Stem cells can produce all of the various types of cell in the body and the hope was that they’d generate new cardiomyocytes if injected into an ailing heart.
干细胞能制造出身体中的多种细胞。人们希望如果将这些干细胞注入受损的心脏中,能生成新的心肌细胞。

13. That optimism was fuelled by a study published in Nature in 2001 which showed that stem cells from the bone marrow of mice could efficiently produce new muscle when injected into the rodents’ damaged hearts. 

这一乐观的态度来源于2001年《自然》上发表的一项实验。该实验表明:老鼠骨髓中的干细胞在被注入这种啮齿类动物的受损的心脏中,能有效地制造新的肌肉。

14. Those results were refuted three years later but by then many clinical trials were already underway. 
那些实验结果虽然在三年以后遭到驳斥,但到那时候许多临床试验已经开展起来。
15. Dozens have since been done using stem cells taken mostly from bone marrow but also skeletal muscles and other sources.
已经做了几十个实验,使用的绝大多数干细胞来自于骨髓,也有来自骨骼肌和其它的干细胞。

16. In 2012 the Cochrane Collaboration – an organisation that specialises in assessing medical evidence – analysed the outcomes of 33 of these trials that between them included 1765 patients. 
考科蓝合作组织,是一个评估医疗证据的机构。它们在2012年分析了33项该种实验(涉及1756名患者)的结果。
17. Their results were underwhelming. 
他们的结论并未激起人们的热情。

18. On average injected stem cells improved the heart’s pumping ability by just 3-4% and they didn’t prevent further heart attacks produce new blood vessels or actually save lives.
平均来看,注入的干细胞提升了心脏的动力达3%-4%,但它们没有阻止心脏的进一步损害,生出新的血管或实质性地挽救生命。

19. That said it’s a big ask for these cells to do what we expect. 
那就是说,这些细胞能否达成我们的预期还是个疑问。

20. Once inside a patient they have to survive home in to the right parts of the heart and produce new muscle that beats in time with existing cells. 
一旦进入患者体内,它们必须存活下来,然后跑到心脏合适的部位,最后创造出与原有的细胞同一节拍跳动的新肌肉。
21. There’s little evidence that they do any of that.
没有证据显示它们真的做到了以上几点。
22. Even if you inject millions of cells the vast majority of them die and disappear within a few weeks.
即便你注入了几百万个细胞,大多数在几个星期之内就死掉或消失不见。
23. If they have any beneficial effect it’s probably because they send signals to existing cells that encourage them to carry out their own repairs.
如果说它们有任何有益的作用,可能就是它们发送信号给原有的细胞去促进其自身的修复。

24. These treatments might improve if say the cells are injected as soon as possible after a heart attack. 
比方说,如果在病人心脏病发作后立刻注入干细胞,治疗效果或许会提高。
25. But Paul Riley from Oxford University says “We probably parked the cart before the horse.” 
但牛津大学的保罗·莱利说:”我们可能本末倒置了。“
26. Driven by the dire need for better treatments for heart disease “the field ended up pushing clinical trials more rapidly than it ought to have done” he says.
在急于找到更好的心脏病治疗方法的驱使下,这个领域在推动临床试验上过快,远未达到本应需要的研究深度。
27. Stem cells from bone marrow may not work but there are more promising sources.
也许取自骨髓的干细胞不能奏效,但还有其它来源。
28. Unexpectedly the heart itself is one of them.
令人大为惊讶的是,心脏本身就是一种有希望的来源。
29. Recent studies have overturned the popular idea that the adult heart doesn’t make new cells. 
最近的研究推翻了这一流行的说法,即成人的心脏不能制造新的细胞。
30. Instead it has its own population of stem cells that replace between 0.5-1% of cardiomyocytes every year. 
心脏却有着自己的干细胞群,每年更替0.5%到1%的心肌细胞。
31. Perhaps the heart contains the secrets to its own salvation after all.
也许心脏自身藏有拯救自己的秘密。

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