Most common childhood cancer 'partly caused by lack of infection'
最常見的兒童癌症“部分是由於缺乏感染引起的”
Childhood acute leukaemia is caused by genetic mutations and a lack of childhood infection, scientists say
科學家說，兒童急性白血病是由基因突變和缺乏感染引起的
Part of the solution to childhood acute leukaemia could be to ensure children under the age of one have social contact with others, possibly at daycare centres. Photograph: Alamy Stock Photo
兒童急性白血病的部分解決方案可能是確保一歲以下的兒童儘可能在日託中心與其他人有社交接觸。 照片：Alamy照片
Clean modern homes, antiseptic wipes and the understandable desire to protect small babies against any infection are all part of the cause of the most common form of childhood cancer, a leading expert has concluded after more than 30 years of research.
一位權威的專家經過30多年的研究得出結論，打掃家裡、消毒溼巾以及任何可以理解的保護小嬰兒不受感染的願望都是導致最常見兒童癌症的部分原因。
Childhood acute leukaemia, says the highly respected Prof Mel Greaves, is nothing to do with power lines or nuclear fuel reprocessing stations. Nor is it to do with hot dogs and hamburgers or the Vatican radio mast, as have also been suggested.
這位備受尊敬的梅爾格里夫斯教授說，兒童急性白血病與電力線或核燃料處理站無關。也與所謂的熱狗，漢堡包或梵蒂岡無線電桅杆無關。 經過一個世紀的推測，其中一些基本上沒有什麼科學依據。
After the best part of a century of speculation, some of it with little basis in science, Greaves – who recently won the Royal Society’s prestigious Royal Medal – says the cancer is caused by a combination of genetic mutations and a lack of childhood infection.
最近贏得皇家學會著名的皇家獎章的格里夫斯說，這種癌症是由基因突變和缺乏感染引起的。
The best news, says Greaves, is that the cancer is likely to be preventable. And part of the answer could be to ensure children under the age of one have social contact with others, possibly at daycare centres.
格里夫斯說，好消息就是癌症很可能被預防。部分預防措施可能包括確保一歲以下的兒童在日託中心與他人進行社交。
Greaves, from the Institute of CancerResearch in London, has compiled evidence from decades of work on acute lymphoblastic leukaemia (ALL), which affects one in 2,000 children. In the 1950s and 1960s, it was lethal. Today, 90% of children are cured, although the treatment is lengthy and toxic and can have long-term consequences.
Greaves describes a “triple whammy” that he believes is the cause of ALL. One in 20 children, he says, are born with a genetic mutation that puts them potentially at risk. But they will be fine if their immune system is properly set up. For that to happen, they must encounter benign bacteria or viruses in their first year of life.
格里夫斯提出導致白血病的“三個階段”。他說，每出生的20個孩子中就有一個基因突變，這可能使他們處於危險之中。但是如果它們的免疫系統健康的建立起來，它們將不會受影響。要做到這一點，他們必須在生命的第一年遇到良性細菌或病毒。
Those whose immune systems are not fully functioning because they have not had an early challenge to deal with – and who then later encounter an infection such as a cold or flu – may develop a second genetic mutation that will make them susceptible to the cancer.
那些免疫系統不能完全發揮作用的人，因為他們早期沒有應對挑戰，之後會遇到諸如感冒或流感之類的感染，這可能會導致第二次基因突變，使他們易患癌症。
ALL, he says, is increasing globally at the rate of about 1% a year. Unlike most diseases, it is increasing in more affluent populations. Something about our modern lifestyles has to be involved, Greaves reasoned. “Infectious disease tracks with poverty,” he said. “The problem is not infection. The problem is lack of infection.”
他說，白血病患病率每年都以大約1%的速度在全球增長。與大多數疾病不同的是，它在富裕人群中不斷增加，這與我們現代生活方式有關，梅爾格里夫斯解釋道。他說：“貧窮的人易感染疾病。”“但問題不是感染。問題是缺乏感染。”
There is a similar story at work in type 1 diabetes, Hodgkin’s lymphoma, multiple sclerosis and allergies, he says.
他說，在1型糖尿病、霍奇金淋巴瘤、多發性硬化和過敏方面也有類似的報道。
ALL rates are low or non-existent in the poorest countries, where families have lots of children and cross-infection is common. One exception is Costa Rica, which has invested heavily in medical schools and its health system, and brought down family sizes from 7.2 children on average to 2.3. They now have significant levels of Hodgkin’s lymphoma, type 1 diabetes and ALL.
在最貧困的國家裡，白血病患病率很低或者根本不存在，這些家庭有很多孩子，交叉感染很普遍。哥斯達黎加是一個例外，它在醫療學校和醫療體系上投入巨資，將家庭規模從平均7.2個孩子降到了2.3個。他們現在有最高的霍奇金淋巴瘤，1型糖尿病以及白血病患病率。
In a paper in the journal Nature Reviews Cancer, Greaves has assembled the evidence from his own work and that of colleagues around the world into the genetics, cell biology, immunology, epidemiology and animal modelling of childhood leukaemia.
在《自然評論癌症雜誌》的一篇論文中，梅爾格里夫斯收集了源於他自身工作和世界各地同事的資料，並將其用於研究兒童白血病的遺傳學、細胞生物學、免疫學、流行病學和動物模型。
That includes experiments in mice that have been modified to have the first gene mutation. Those that were kept in clean and sterile conditions and then later transferred into a dirty environment developed the cancer.
這包括在老鼠身上進行的實驗，這些老鼠已經成為第一個基因突變體。那些被保存在清潔和無菌條件下的老鼠，轉移到骯髒的環境後患了癌症。
Greaves and other scientists are anxious that no parents should feel in any way responsible for their child’s cancer, pointing out that keeping babies away from any source of infection is very normal behaviour – and that there is still an element of chance in developing the two genetic mutations.
梅爾格里夫斯和其他科學家擔心，沒有任何父母意識到他們應該對他們孩子癌症負責，並指出，讓嬰兒遠離任何感染源是非常正常的行為，而且形成兩種基因突變仍然存在著一定的可能性。
The factors that may decrease a baby’s risk, says the paper, are going to a day care centre as a small baby, having older siblings who are likely to bring infections into the home, breastfeeding and probably being born via a vaginal delivery rather than a more sterile caesarean.
這篇文章表示，可能降低嬰兒患病風險的因素包括，將小寶寶帶到日託中心、它的哥哥姐姐可能把感染帶到家裡、母乳餵養以及自然分娩而不是更無菌的剖腹產。
Greaves says he hopes the work may lead to some sort of vaccine or drug to prevent childhood leukaemia.
格里夫斯說，他希望這項工作能夠研製某種疫苗或藥物來預防兒童白血病。
Chris Bunce, professor of translational cancer biology at the University of Birmingham, called Greaves “one of the superstars amongst modern cancer biologists” who had demonstrated that the early mutation putting a child at risk occurred in a cell before birth and now presented “a compelling model” of the way the cancer arises.
伯明翰大學癌症轉化生物學教授Chris Bunce稱梅爾格里夫斯是“現代癌症生物學家中的巨星之一”，他已經證明，出生前在細胞中發生早期突變使小孩處於危險之中，並且提出了癌症出現方式的“引人注目的模式”。
Prof Charles Swanton, Cancer Research UK’s chief clinician, said: “This research sheds light on how a form of childhood blood cancer might develop, implicating a complex combination of genetics and early exposure to germs, dirt, and illness.”
But he added: “We want to assure any parents of a child who has or has had leukaemia that there’s nothing that we know of that could have been done to prevent their illness.”
但他補充說：“我們想向任何患有或曾患有白血病的兒童的父母保證，我們所知道的一切都是為了預防他們的疾病。”
中英雙語呈現，還可以加強英語學習哦！
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