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Training an Immune System To Kill Cancer
NotSanguine sends in a story about William Ludwig, a 65-year-old leukemia patient who underwent a new, experimental treatment that draws upon two decades of advances in molecular biology. Quoting:
"Doctors removed a billion of his T-cells — a type of white blood cell that fights viruses and tumors — and gave them new genes that would program the cells to attack his cancer. Then the altered cells were dripped back into Mr. Ludwig’s veins. At first, nothing happened. But after 10 days, hell broke loose in his hospital room. He began shaking with chills. His temperature shot up. His blood pressure shot down. He became so ill that doctors moved him into intensive care and warned that he might die. His family gathered at the hospital, fearing the worst. A few weeks later, the fevers were gone. And so was the leukemia. ... In essence, the team is using gene therapy to accomplish something that researchers have hoped to do for decades: train a person's own immune system to kill cancer cells."
Not yet, but if it's possible to reprogram white blood cells via retroviruses, then perhaps someday it will be as simple as doing a plasma collection and then a few days later having the cells re-infused.
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A killer T cell is an end product cell type. It does not divide. As such introduction of the cells shouldn't cause lasting immunological issues, unless the synthetically activated cells initiate a cascade autoimmune reaction.
(T cells destroy pathogens, but they also pass antigen information on to B cells, which "remember" previous infectious agents, and mass replicate antibodies in the hystamine cycle. This mechanism is how vaccination works. Deactivated virus is introduced, white cells engage, destroy, and then present the debris to B cells, which produce antibodies. When the real virus comes along, the immine system reacts with a flood of antibody production, which greatly inhibits proliferation of the pathogen. In this case, researchers would have to be VERY careful what cellular membrane cues they program their new mutant superhero T cells to go after, or else the body may become sensitized against its own cellular membranes, resulting in runaway autoimmune reactions.)
Assuming that everything goes well, then the modified T cell culture will natually self-terminate like normal T cells do, and then all traces of the manipulation would be gone from the host.
This means that there shouldn't be a need for long term antirejection meds, like with a bone marrow transplant.
I can't gauge the validity of this research without a mention of subluxations as a calibration reference for my stupidity detector.
Blank until
I am currently a candidate for an experimental treatment that does just that - plasma collection at start, then they convince the white blood cells to reproduce like mad, then put them back into me at weekly intervals.
Hopefully, my turn to play guinea pig for this one will come up this next month.
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Any chance of using this technique in a preventative way? I mean, could you give an inoculation to train your body to fight off the cancer when it first starts? Not an MD by any stretch.
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A killer T cell is an end product cell type. It does not divide.
T-cells are differentiated cells, but they most certainly do undergo clonal expansion.
(T cells destroy pathogens, but they also pass antigen information on to B cells, which "remember" previous infectious agents, and mass replicate antibodies in the hystamine cycle. This mechanism is how vaccination works.
Huh? "Histamine Cycle"?
Deactivated virus is introduced, white cells engage, destroy, and then present the debris to B cells, which produce antibodies. When the real virus comes along, the immine system reacts with a flood of antibody production, which greatly inhibits proliferation of the pathogen
This description relates to the humoral branch of the adaptive immune system, but is irrelevant here. The treatment in question primarily operates via a cell-mediated mechanism.
In this case, researchers would have to be VERY careful what cellular membrane cues they program their new mutant superhero T cells to go after, or else the body may become sensitized against its own cellular membranes, resulting in runaway autoimmune reactions.)
Target cue was CD19, a B-cell specific receptor (but not cancer-specific receptor). Hence the patient's ensuing state of hypo-gammaglobulinemia, due to indiscriminant destruction of antibody-producing cells.
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I did not know T cells underwent mitosis. I thought they were produced as needed by their progenitor cells in the bone marrow, similarly to red cells.
Yes, that's correct, there are T-cell progenitors in the bone marrow that generate new T-cells. However, experienced T-cells are maintained in a population of circulating "memory" cells that persist long-term, and undergo rapid expansion upon encountering their triggering antigen.
Indescriminate destruction of B cells is a very bad thing and would make the patient extremely immune suppressed following the initial "thermonuclear" immune response, as the patient's immune system would effectively be given a lobotomy and would forget every pathogen it had encountered, and would remain that way until new B cells are produced.
Yes, these patients are currently on IVIG (Intravenous Immunoglobulin - antibodies collected and pooled from donors), and will be for a long time, possibly for the rest of their lives. Very expensive.
This treatment could be adapted for other types of cancer besides this flavor of leukemia, just as long as there is a reasonably reliable target for the t cells to go after.
Yes, I believe one of the next targets they are going after with this technique will be mesothelin-expressing tumors (found in certain ovarian/mesothelioma/pancreatic tumors). Will probably be messy, as it is expressed in certain populations of normal mesothelial cells.
His fiancee has stage three breast cancer. I see it only as a way of coping with the pain and uncertainty that situation brings.