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Cell therapy: We will use cells to treat diseases in future
Cell therapy: We will use cells to treat diseases in future. Throughout the history of medical drugs, our concepts of disease and drug treatment are still stuck on a very simple model.
This model can be summarized in some words: Have Disease, Take Pill, Kill Something.
This simple model brought about by the antibiotic revolution once dominated until the advent of cell therapy.
In 2015, the famous cancer doctor and writer Siddhartha Mukherjee gave a wonderful speech on “Forget the Pill, Cell Therapy is Coming” in the TED speech program.
At that time, he made a point: There will be transformative treatments in the future. Personalized medicine needs to consider personalized cell therapy, then personalized tissue and organ therapy, and finally personalized immersion environmental therapy. Only 2 years later, the personalized cell therapy he proposed became a reality.
In 2017, the US FDA approved three cell and gene therapies one after another: Novartis’ breakthrough CAR-T therapy Kymriah was approved for the treatment of leukemia; Kite Pharma’s CAR-T therapy Yescarta was approved , The treatment of lymphoma; the gene therapy Luxturna brought by Spark Therapeutics was approved for the treatment of children and adult patients with specific hereditary eye diseases.
In 2017, human beings officially entered a new era of cell therapy, and research on the treatment of diseases with cell and gene therapy has also entered the fast lane.
Throughout the history of medical drugs, our concepts of disease and drug treatment are still stuck on a very simple model. This model can be summarized in six English words: Have Disease (sick), Take Pill (take medicine), Kill Something (kill something). This simple model brought about by the antibiotic revolution once dominated until the advent of cell therapy.
1. Drug therapy mode
Drug treatment has brought a huge change to people, turning incurable diseases such as pneumonia, syphilis, and tuberculosis into curable diseases. For example, if you are infected with pneumonia, you can take penicillin to kill microorganisms and cure the disease.
The chemical medicine you got. Whether it is a medicine extracted from nature or a medicine artificially synthesized from a laboratory, after taking it, it will spread all over your body, find its target, and then lock the target-a microorganism or a part of it-through a very delicate and Special means to turn off a certain function of the target. This is the model of drug treatment of disease.
In the past 100 years, scientists have been trying to replicate this model, trying to apply it to diseases that are not caused by infection, such as chronic diseases such as diabetes, high blood pressure, and heart disease.
However, some work, some don’t.
To give a simple example, we assume that there are 1 million possible chemical reactions in the human body. Among the medical chemical reactions of all drugs, only 250 are truly effective. In other words, only 0.025% of the chemical reactions in a person’s body are suitable for the current mechanism of drug treatment.
What should we do when medication is no longer as effective as we thought? Nature provides us with a completely different solution.
2. Cell therapy mode
In fact, we found that nature provides us with a completely different perspective on disease. It is different from the “disease, drug, target” model. The natural world develops from the bottom up, layer by layer, not from top to bottom, but from bottom to top. Life first begins in a cell. These cells combine to form an organ. These organs are organically aggregated to form the human body. Finally constructed this rich ecosystem.
Therefore, the treatment of disease may not be a functional problem, or a chemical problem, but a stem cell problem.
Take osteoarthritis as an example. From the perspective of skeletal stem cells, treat arthritis as a cellular disease, and everything will be solved. There are two such hypotheses: First, suppose that there are such skeletal stem cells that constitute the entire spine skeleton, bones, cartilage tissue, and support around the skeleton, just like hematopoietic stem cells in the blood, just like in the nervous system Neural stem cells. Hypothesis two, it may be due to the degeneration or disability of bone stem cells, which leads to the common disease of arthritis. The root of the problem may be that we have been looking for therapeutic drugs, but in fact we should be looking for such cells. Such cells exist inside the skeleton.
The picture shows the schematic and real bones. The white ones are bones, the red tubular ones you see, and the yellow cells are all grown from a single stem cell-cartilage and bone tissue all come from the same stem cell.
Compared with the current “killing something”, for a large number of chronic degenerative diseases-kidney failure, diabetes, high blood pressure, arthritis, perhaps what we have to do is “cultivating something”, that is, stem cells .
The reason why stem cell therapy is so amazing lies in their four characteristics.
First, the stem cells exist in the expected location. Whether it is under the surface of the bone or under the cartilage tissue. Biological location is very important. These stem cells can be moved to a suitable location to facilitate the production of bone, cartilage and other required tissues and organs.
Second, stem cells can be isolated. Even if placed in a petri dish in a laboratory, they will desperately construct cartilage tissue.
Third, stem cells are the fastest tinkerers. They are like some kind of cell glue, filled into the fractured place, repaired, and then finished.
Fourth, the number of stem cells will decrease. With age, the number of stem cells decreases at a rate of 10 times or 15 times.
At first, we worked hard to find drugs, but finally found new theories. From a certain perspective, we return to the original idea: cells, tissues, and environment. Now we start from the perspective of skeletal stem cells, and we begin to treat arthritis as a cellular disease.
3. Personalized “Cell Therapy”
Question 1: There are a lot of discussions in the field of science and technology that mention personalized medicine, saying that we collect all the data, and then future drugs will be tailored based on your genome and environment. This is the model you mentioned. Fit?
Speaker: This question is very interesting. We have been thinking about personalized medicine from a genetic point of view for some time. That’s because gene itself is a mainstream metaphor, and it is also this word. In today’s medical world, we believe that the genome will dominate the progress of personalized medicine. But obviously, the concept of genome is only the most basic part of this chain.
The first truly organized unit of this chain is the “cell”. So if we really want to start personalized medicine, what we need to consider is personalized “cell therapy”, then personalized tissue and organ therapy, and finally, personalized immersive environmental therapy.
Question 2: So when you say that the future drug is cells rather than drugs, are you talking about your own cells?
Question 3: Converted into stem cells, may be tested with various drugs or other things, and then ready.
Speaker: This is not possible. We are doing it now, this is what is happening. In fact, we are slowly making progress, not breaking away from the genome, but integrating with the genome. We call it a multi-level, semi-automatic, self-made system, such as cells, organs, and the environment.
Siddhartha Mukherjee is a cancer doctor and a writer. Author of “The Gene: An Intimate History” (The Gene: An Intimate History).
(source:internet, reference only)