HARNESSING THE IMMUNE SYSTEM TO TREAT INFECTION, AUTOIMMUNE DISORDERS AND CANCER.
Our ability to harness the power of the immune system to treat a vast variety of diseases is rapidly advancing. On May 27, 2014 the Life Sciences Institute’s Infection, Inflammation & Immunity – I3 – research group presented short talks and hosted a discussion about the use of the immune system in treating infection, autoimmune disorders and cancer.
- Using the immune system to combat infection – Dr Georgia Perona-Wright
- Harnessing the immune system to fight cancer – Dr Ken Harder
- Immunotherapies in autoimmunity – Dr Marc Horwitz
- Moderator – Dr Ninan Abraham
A video of the talk can be viewed here.
Question & Answer period begins 1h 09m into the video
- What is a cytokine? How does it work and/or what is its purpose? (1h 09m)
- How accurately can a person’s immune system state be measured? (1h 11m)
- How do T cells differentiate tumour cells from other cells? (1h 15m)
- Have there been any long-term effects of treatments like B cell malignancy (CLL & ALL)? (1h 17m)
- What’s being done to catch autoimmune disorders early and prevent them all together? (1h 18m)
- What role do stress and diet play in autoimmune diseases? (1h 21m)
- Are exercise/lifestyle/food we eat immune system boosters? Could they be preventive medicine for cancer and many other diseases? (1h 22m)
- Have you heard of bacteriophage therapy and the Phage Therapy Centre in Tbilisi, Georgia? (1h 26m)
- Is it better to swallow our saliva than to spit it out? Does our saliva strengthen our immune system? What about our snot? (1h 27m)
- For solid tumours, how can we get the designer treatments into the tumour and not just on the surface of the tumour? (1h 29m)
- How do you work out which antigen is on the tumour cell but not on the other cells? Are there known antigens for particular cancers? Or are they specific to each patient? (1h 32m)
- What are your comments about the new era of anti-virals for Hepatitis C virus like Sofosbuvir and Simeprevir? (1h 34m)
- What do you think of Jonathan Schneck’s work at Johns Hopkins University on artificial antigen presenting cells? Is this a viable strategy for cancer or infectious disease therapy? (1h 37m)
- Is osteo-arthritis an autoimmune disease? What are the latest therapies?
- Do you consider hyper-electrosensitivity an immune system issue and what are your thoughts on possible treatments?
- Are immune boosters such as Andrographis effective in treating infection?
- What, if any, are the studies involving “cross-pollination” approach i.e. Western and alternative therapies?
- What are the ramifications of living without B-cells after undergoing a successful immunotherapy cancer treatment
- Why are there so many methods for expanding T cells and treating cancers?
The panel did not have time to answer all questions from the audience. They have provided answers to some of them here:
Q: Is osteo-arthritis an autoimmune disease? What are the latest therapies?
A: No, osteo-arthritis is not an autoimmune disease. Osteo-arthritis is the most common form of arthritis. It still involves loss of cartilage in joints, and it also causes impaired joint mobility and loss of function, but in osteo-arthritis this joint damage is not a direct result of an immune attack. In osteo-arthritis, damage often begins as wear and tear, or a physical or mechanical injury. In rheumatoid arthritis and psoriatic arthritis, both of which are autoimmune diseases, the primary cause of the arthritis is the immune system’s attack on different parts of the joint. One complication is that even in osteo-arthritis there can be some inflammation associated with the injury, but this inflammation comes after the injury rather than before it. It’s the same type of inflammation that you would experience if you tear a muscle: swelling, heat and pain which may necessitate an ice pack or more serious interventions. For this reason, some situations of osteo-arthritis may still be treated with non-steroidal anti-inflammatory drugs or corticosteroid injections. Consultation with your physician or rheumatologist is important for appropriate treatment.
Q: Do you consider hyper-electrosensitivity an immune system issue and what are your thoughts on possible treatments?
A: Also known as “electromagnetic hypersensitivity” (EHS), this syndrome manifests as medically unexplained symptoms that adversely affect certain people. We have no evidence the immune system is affected by non-visible radiation. There is strong evidence that immune cells exhibit circadian rhythms, express molecular “clocks” that are the basis for circadian rhythms and are sensitive to visible light/dark cycles.
Q: Are immune boosters such as Andrographis effective in treating infection?
A: Andrographis is an herb used in traditional medicine for several purposes. Based on a brief review of the literature, there are double-blinded studies supporting its effectiveness in treating uncomplicated, upper respiratory infections. The mechanism by which the extract works is unknown, and its use for other conditions has not been extensively tested.
Q: What, if any, are the studies involving “cross-pollination” approach i.e. Western and alternative therapies?
A: The two approaches are not always as far apart as you might at first think. Quinine, which was our first choice anti-malaria drug right up until 2006, is an extract from the bark of the Cinchona tree. Our increasing knowledge about the human gut microbiota (see Ken’s comments at 1h 22m in the video) is giving us greater understanding of ways in which the contents of our intestines can affect health and disease in even distant parts of our bodies, so our ability even in Western medicine to understand the body as a whole is rapidly advancing.
Q: What are the ramifications of living without B-cells after undergoing a successful immunotherapy cancer treatment?
A: Ken touches on this in his answer at 1h 17m in the video. B cells are useful for many things, particularly the production of antibodies and the defense against certain types of bacteria. Without them, the patient may be more susceptible to some infections and may need greater or more frequent use of medications such as antibiotics to help them stay healthy. How severe the problems are depends on the context of treatment: removing B cells from a young child may be more serious than removing them from an adult, for example, because the adult will have many antibodies already made and will suffer less from the inability to make any more.
Q: Why are there so many methods for expanding T cells and treating cancers?
A: There are a couple of ways to answer this question. Part of the reason there are multiple methods is that we haven’t yet found a perfect one, and many people are contributing many good ideas. We still need to try some of them out to decide which is most effective in what context. From a T cell perspective, T cells must be activated through a unique T cell receptor to expand each one. How they are activated shapes the specialized functions they acquire next. The effectiveness of T cells in specific situations, such as clearing a tumour, depends on the particular set of functions those T cells have, which is a consequence of how they were activated. That means identifying the best procedure to activate and expand T cells can make a big difference to clinical outcome.
The need for multiple approaches to treat cancer comes from the fact that cancer is not one disease – each type of cancer (such as breast, colon, pancreatic, leukemia) is a unique disease. In fact, we’re learning from tumour DNA sequence analysis that there are multiple sub-types of certain cancers. There is also considerable patient-to-patient variability. This is part of the reason that personalized approaches to diagnosis and treatment, based on an individual’s tumour type, genome information and perhaps even their microbiota, could be such an important advance in the clinic.
