T Cells - new breakthrough

[Caro12line]

Hi... I have been watching with interest and limited understanding the news about the new breakthroughs in engineering T Cells. I am right in thinking this could be used in autoimmune diseases? In the same way as treatments for cancer they could be modified to target particular forms of Vasculitus?

[PMRpro Ambassador]

I imagine it could in some way - but they might to need to know a lot more about the mechanism first. As I understand it, in this they identify the cancer cells and "train" cells with special proteins on their surface to recognise and destroy all similar cells in the body. There isn't a supply of "tumour" cells in many autoimmune diseases to use as a focus.

[Caro12line in reply to PMRpro]

Thanks PMRpro..... It is very early stages and complex ... But I suppose there could be a glimmer of hope that with further research they could find some breakthrough with autoimmune. Sort of the opposite of what they do now? As they train T cells to destroy maybe they could train T Cells to ignore our healthy arteries and stop destroying them.... I am sure autoimmune researchers are watching this closely

[PMRpro Ambassador in reply to Caro12line]

That is basically what the -mabs do - monoclonal antibodies. They are increasing in number almost monthly it feels sometimes. They were often aimed a lot at RA as they already have an idea what is going on though there are lots of others - and strangely some work and some don't depending on the patient so there are obviously loads of different mechanisms. They can have some fairly hefty side effects too though - when they work they can be very very good, but when they aren't- they're horrid.

This is good:

theconversation.com/four-ch...

and it mentions the why they work for some and not for others. I assume this new stuff has found some way of individualising it - as mentioned at the end of the article.

[Ida-June128]

When I was living in France in the 1990's my godfather who had cancer was going up to Paris every week where they were taking his blood, doing something to it, and then giving it back to him. He was almost 90 and in excellent health to have even been taken on to the research programme (as a biochemist he was well aware of the figures) and I believe it prolonged his life by some years. I am sure this is the same treatment now being hailed as 'new'.

[PMRpro Ambassador in reply to Ida-June128]

I suspect not quite - that was a sort of general approach and your godfather probably was one of the lucky x% for whom it worked (see the article I linked above) and this new work is a more designer, individualised approach that works on your own DNA. But the theory is much the same.

[piglette]

I was listening to some radio programme yesterday and apparently in the trial they found some really serious side effects which put a very small number of people in intensive care, I think two died. I am not sure if they would have died anyway. They did say what the side effect was but it was a lot of Latin I have forgotten. On the other hand it seemed to work well for the others.

[PMRpro Ambassador in reply to piglette]

There was a stop put on one of the trials 2 years ago because 2 people died and they changed the protocol as a precaution (Memorial Sloane-Kettering Cancer Centre). Their statement said "we are halting recruitment for a small study using T cells reengineered with chimeric antigen receptors (CARs) against CD19-positive B cells for aggressive non-Hodgkin lymphoma". But the patients were all very very ill anyway and I think one death was shortly after a bone marrow transplant. A patient death stopped another trial last summer.

The Guardian said about this trial:

"T-cell therapy is often considered an option of last resort because reprogramming the immune system can come with dangerous side-effects, including cytokine release syndrome (sCRS) – and overload defense cells. Twenty patients suffered symptoms of fever, hypotension and neurotoxicity due to sCRS, and two died, but the researchers noted that chemotherapy had failed in all the patients who participated in the new trials."

There have been several similar trials using engineered T-cells for several forms of cancer over recent years. This one reported the other week was for acute lymphoblastic leukaemia but the others cover cervical cancer, lung cancer, skin cancer as well as others. Unfortunately, the media reports made it sound as if it is about to leap onto the scene - and the commentators on the papers review on Sky News said they thought this should be rushed through as if the safety aspect was totally outweighed by 34 out of 35 patients having a (so far) good short term result.

The Guardian report is quite good I think - the only place I've seen some reticence in reporting!

theguardian.com/science/201...

[piglette in reply to PMRpro]

I do agree the media made it look like you had a few T- cells and then you leapt back into action, as if nothing had happened. They do that so often, I get so annoyed. On the recent blood cancer one I did not hear anything negative apart from this doctor on the radio.

[PMRpro Ambassador in reply to piglette]

It is there in the Guardian article - but how many read that to the end? And the major headlines were in that renowned medical journal the DM!

I get really p*$$"& off about medical reporting and medical stories in the media/on TV. It all gives people who aren't sceptical or with some medical background totally the wrong idea. Like CPR having the patient sitting up having breakfast half an hour later - no it doesn't! My daughter was at a cardiac arrest a few weeks ago - very frail man in his 80s, family standing over her shouting to save him like in Casualty. Really he was already gone when she got there and arrived at hospital with multiple broken ribs - and an output. The doctors called it - she isn't allowed to if there is anything there.

[piglette in reply to PMRpro]

Ah I should be reading the Guardian not that top medical journal, the DM, in fact I think the Express is good competition, we should all be cured of arthritis, heart disease and cancer by now, not to mention the blizzards, hurricanes and earthquakes that are on the way to destroy life as we know it.

[PMRpro Ambassador in reply to piglette]

Every so often on Sky News they mention a "good" story that is is in the Express and I think I really ought to have a look. The cursor hovers over the logo on dailynewspapers.uk and I have to steel myself to click

[piglette in reply to PMRpro]

You may as well read fairy stories they are just as believable! I have noticed even the Telegraph is starting to talk rubbish.

[PMRpro Ambassador in reply to piglette]

Don't read that - I'd have to pay for it! The Thunderer too. There are days when it takes me full 10 minutes to read all 3 of the rags I do look at. It is totally depressing...

[piglette in reply to PMRpro]

I get most of my news from Sky's what the papers say. Someone else reads it out for me!

[PMRpro Ambassador in reply to piglette]

The evening serious one? So does David. It's after my bedtime though since we're an hour ahead here!

[piglette in reply to PMRpro]

I am a night bird, you don't see me in the mornings!

[PMRpro Ambassador in reply to piglette]

I'm in bed at 10pm and rarely out of bed before 9am! In the early days of PMR bed at 8.30pm wasn't out of the question.