1.媒体来源: The Verge
2.完整新闻标题:
An artificial womb successfully grew baby sheep — and humans could be next
人造子宫成功地使羔羊生长 — 人类可能是下一个
The lambs spent four weeks in the external wombs and seemed to develop
normally
羔羊在外部子宫待了四周且似乎发育正常
3.完整新闻内文:
by Rachel Becker Apr 25, 2017, 5:09pm EDT
https://www.facebook.com/verge/videos/1423052887731050/
Inside what look like oversized ziplock bags strewn with tubes of blood and
fluid, eight fetal lambs continued to develop — much like they would have
inside their mothers. Over four weeks, their lungs and brains grew, they
sprouted wool, opened their eyes, wriggled around, and learned to swallow,
according to a new study that takes the first step toward an artificial womb.
One day, this device could help to bring premature human babies to term
outside the uterus — but right now, it has only been tested on sheep.
看似超大的夹链袋，周围散布著各种充满血与液体的管子，八只羊胎儿在里面持续成长
— 就像牠们还在母亲的体内一样。经过四周，牠们长大了肺与脑，长出羊毛，睁开了眼
睛，扭动身体，并且学会吞咽。这个新研究踏出了人造子宫的第一步。终有一天，这个装
置将会帮助人类早产儿在子宫外存活 — 而现在，它只在绵羊上试验过。
It's appealing to imagine a world where artificial wombs grow babies,
eliminating the health risk of pregnancy. But it's important not to get ahead
of the data, says Alan Flake, fetal surgeon at the Children's Hospital of
Philadelphia and lead author of today's study. “It's complete science
fiction to think that you can take an embryo and get it through the early
developmental process and put it on our machine without the mother being the
critical element there,” he says.
这很吸引人去想像一个使用人造子宫培育胎儿的新世界，完全除去怀孕造成的健康风险。
“重要的并不是超越现有的研究”，该研究的第一作者，费城儿童医院的胎儿外科医师，
Alan Flake 表示。“别认为可以拿一个经过早期发育的胎儿放入我们的机器，使母亲不
再是这个过程的关键要素，这根本只是科幻小说的情节”。
Instead, the point of developing an external womb — which his team calls the
Biobag — is to give infants born months too early a more natural,
uterus-like environment to continue developing in, Flake says.
Flake 表示，正在开发的外部子宫，研究团队称之为 Biobag，目标并不是取代母亲，而
是让早产儿在更自然，更像子宫的环境继续发育。
Image: The Children’s Hospital of Philadelphia
http://i.imgur.com/tmsOVyI.png
图中文字
Extracorporeal System for Physiologic Fetal Support — Three components
1. Pumpless, low resistance, low surface area, heparin coated, oxygenator
circuit
2. Closed Biobag system, Continuous fluid exchange
3. Umbilical Artery (2)/Umbilical vein vascular interface
The Biobag may not look much like a womb, but it contains the same key parts:
a clear plastic bag that encloses the fetal lamb and protects it from the
outside world, like the uterus would; an electrolyte solution that bathes the
lamb similarly to the amniotic fluid in the uterus; and a way for the fetus
to circulate its blood and exchange carbon dioxide for oxygen. Flake and his
colleagues published their results today in the journal Nature Communications.
Biobag 看起来可能不像子宫，但它包含一样的关键部位: 与子宫相似，用来装入羊胎儿
并保护牠的干净塑胶袋; 与羊水相似，用来浸泡羔羊的电解液; 以及使胎儿的血液循环与
把二氧化碳交换成氧。Flake 和他的同事们已经在今天发表他们的成果在 Nature
Communications 期刊上。
Flake hopes the Biobag will improve the care options for extremely premature
infants, who have “well documented, dismal outcomes,” he says. Prematurity
is the leading cause of death for newborns. In the US, about 10 percent of
babies are born prematurely — which means they were born before they reach
37 weeks of pregnancy. About 6 percent, or 30,000 of those births, are
considered extremely premature, which means that they were born at or before
the 28th week of pregnancy.
Flake 表示，“大量文献记载着极早期早产儿的悲伤结果”，他希望 Biobag 能改善他们
的照护方案。早产是新生儿的主要死因。在美国，约有10％的婴儿过早出生 — 这意谓著
他们在怀孕未满37周就出生了。大约6％(三万名)的早产儿，是被认为是极早期早产儿，
这代表着他们在孕期28周或之前就出生了。
These infants require intensive support as they continue to develop outside
their mothers' bodies. The babies who survive delivery require mechanical
ventilation, medications, and IVs that provide nutrition and fluids. If they
make it out of the intensive care unit, many of these infants (between 20 to
50 percent of them) still suffer from a host of health conditions that arise
from the stunted development of their organ systems.
这些婴儿要在母体外发育需要密集的照护。活过分娩的婴儿需要呼吸器，投药，与用点滴
提供水和养分。如果他们从加护病房中解脱出来，许多这些婴儿(其中20％至50％)仍然受
到其器官系统发育迟缓的一系列健康状况的影响。
“So parents have to make critical decisions about whether to use aggressive
measures to keep these babies alive, or whether to allow for less painful,
comfort care,” says neonatologist Elizabeth Rogers, co-director for the
Intensive Care Nursery Follow-Up Program of UCSF Benioff Children's Hospital,
who was not involved in the study. “One of the unspoken things in extreme
preterm birth is that there are families who say, ‘If I had known the
outcome for my baby could be this bad, I wouldn’t have chosen to put her
through everything.’”
一位没有参予这项研究的新生儿学家，UCSF Benioff 儿童医院加护病房后续计画联合主
任，Elizabeth Rogers 表示，“因此，父母必须作出艰难的决定，是否采取积极措施以
保住婴儿的性命，或是允许用较少痛苦的安慰护理”。“极端早产的一个不言而喻的事情
是，有一些家庭说：‘如果我知道宝宝的结果可能会这么糟糕，我不会选择让她承受这一
切’。”
That's why for decades scientists have been trying to develop an artificial
womb that would re-create a more natural environment for a premature baby to
continue to develop in. One of the main challenges was re-creating the
intricate circulatory system that connects mom to fetus: the mom’s blood
flows to the baby and back, exchanging oxygen for carbon dioxide. The blood
needs to flow with just enough pressure, but an external pump can damage the
baby’s heart.
这就是为什么几十年来，科学家们不断地尝试发展人造子宫，为早产儿再造出更自然的环
境使其在里面发育。主要挑战之一是，重造出连接母亲与胎儿的复杂循环系统。血液流动
需要刚刚好足够的压力，但外部的泵会损害婴儿的心脏。
To solve this problem, Flake and his colleagues created a pumpless
circulatory system. They connected the fetus’s umbilical blood vessels to a
new kind of oxygenator, and the blood moved smoothly through the system.
Smoothly enough, in fact, that the baby’s heartbeat was sufficient to power
blood flow without another pump.
为了解决这个问题，Flake 与他的同事创造出一种无泵循环系统。他们把胎儿的脐带血管
连结到一种新型的氧合器，使血液在系统中顺畅流动。事实上，无须用泵，婴儿的心跳就
足以驱动血液流动。
The next problem to solve was the risk for infections, which premature
infants in open incubators face in the neonatal intensive care unit, or NICU.
That’s where the bag and the artificial amniotic fluid comes in. The fluid
flows in and out of the bag just like it would in a uterus, removing waste,
shielding the infant from infectious germs in the hospital, and keeping the
fetus’s developing lungs filled with fluid.
接下来要解决的问题是传染风险，也就是早产儿在新生儿加护病房(NICU)开放保温箱中所
面临的风险。这就是引入袋子和人造羊水的原由。液体就像在子宫里一样，借由流入和流
出袋子来移除代谢废物。液体也使婴儿免受医院空气中的感染性细菌侵扰，并保持胎儿发
育中的肺部充满液体。
Flake and his colleagues tested the setup for up to four weeks on eight fetal
lambs that were 105 to 120 days into pregnancy — about equivalent to human
infants at 22 to 24 weeks of gestation. After the four weeks were up, they
were switched onto a regular ventilator like a premature baby in a NICU.
Flake 与他的同事测试了八个羊胎儿长达四周的时间，这些羊胎儿105到120天大，相当于
22至24周大的人类婴儿。四个星期之后，他们换成一般的呼吸机，就像在NICU的早产儿一
样。
The lambs' health on the ventilator appeared nearly as good as a lamb the
same age that had just been delivered by cesarean section. Then, the lambs
were removed from the ventilator and all but one, which was developed enough
to breathe on its own, were euthanized so the researchers could examine their
organs. Their lungs and brains — the organ systems that are most vulnerable
to damage in premature infants — looked uninjured and as developed as they
should be in a lamb that grew in a mother.
呼吸机上的羔羊健康状况几乎与同样年龄通过剖腹产的羔羊一样好。之后，将羔羊从呼吸
机中取出，除了已发育到可自主呼吸的羔羊之外，其它的羔羊都被安乐死，让研究人员可
以检查牠们的器官。牠们的肺和大脑 — 早产儿最容易受到损伤的器官系统 — 看起来没
有受损，发育得与在母体内生长的羔羊一样。
Of course, lambs aren't humans — and their brains develop at a somewhat
different pace. The authors acknowledge that it's going to take more research
into the science and safety of this device before it can be used on human
babies. They've already started testing it on human-sized lambs that were put
in the Biobags earlier in pregnancy. And they are monitoring the few lambs
that survived after being taken off the ventilator to look for long-term
problems. So far, the lambs seem pretty healthy. “I think it's realistic to
think about three years for first-in-human trials,” Flake says.
当然，羔羊并不是人类 — 他们的大脑发育有些不同的步调。作者承认，在该设备用于人
类婴儿之前，会对它的科学和安全性进行更多的研究。他们已经开始试验人类大小的羔羊
，在怀孕天数更少时放入 Biobag。他们正持续观察少数取下呼吸机后幸存的羔羊，是否
有对其造成长期影响。到目前为止，羔羊似乎都很健康。Flake 表示，"“我认为在三年
后进行首次的人体试验是可行的”。
“It's so interesting, and it's really innovative,” Rogers says. “To be
able to continue to develop in an artificial environment can reduce the many
problems caused by simply being born too early.” Rogers adds that not every
facility has the resources or expertise to offer cutting-edge care to
expecting mothers — a problem that the Biobag won’t be able to solve. “We
know there are already disparities after preterm birth. If you have access to
high-level regionalized care your outcomes are often better than if you don't,
” she says.
“这非常有趣，也很创新”，Rogers 表示。"在人造环境持续发育可以减少许多因过早生
产造成的问题"。Rogers 补充，并不是每个设施都有资源与专门知识来提供最先进的孕妇
护理 — 这个问题是 Biobag 无法解决的。她表示，“我们知道早产之后已经存在差异。
如果你有机会获得高级的区域性护理，那么你的结果通常会比没有更好”。
And Rogers worries about how hype surrounding the Biobag could impact parents
coping with preterm infants. “I think many people have been affected by
preterm birth and they think this is going to be some magic bullet. And I
think that prematurity is just really complicated.” Preventing it in the
first place should be a top priority, she says, but the Biobag could help
drive that research forward.
而 Rogers 担心围绕着 Biobag 的炒作报导可能会影响父母如何应对早产儿。"我认为很
多人受到早产的影响，而他们认为这将是某种可以解决一切问题的魔法子弹。但我认为早
产是很复杂的"。她表示，预防早产应该是首要任务，但是Biobag可以帮助推动研究进展
。
For Flake, the research continues. “I'm still blown away, whenever I'm down
looking at our lambs,” he says. “I think it's just an amazing thing to sit
there and watch the fetus on this support acting like it normally acts in the
womb... It's a really awe-inspiring endeavor to be able to continue normal
gestation outside of the mom.”
对于 Flake，研究仍在继续。他说:“到现在我看到这些羔羊都会感到很惊讶”。“我认
为坐在那里看着胎儿是一件令人吃惊的事情，就像是牠还在正常的子宫里 ... 能够继续
在母体外正常地孕育非常地鼓舞人心。”
4.完整新闻连结 (或短网址):
https://goo.gl/63pgJ5
5.备注:
人造子宫这个标题很引人遐想，不过他的目标并不是我们想像中的有完整功能的子宫，而
是帮助改善极早期早产儿的发育环境。