[HN Gopher] World-first therapy using donor cells sends autoimmu...
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World-first therapy using donor cells sends autoimmune diseases
into remission
Author : Brajeshwar
Score : 80 points
Date : 2024-10-05 17:46 UTC (5 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| jajko wrote:
| That sounded almost too good to be true, especially with
| autoimmune stuff which seems even trickier to tackle than many
| cancers. One hell of achievement if it pans out long term.
| John_Cena wrote:
| I suffer from psoriasis. This seems like another 'solution'
| that really only addresses how the diseases manifest but not
| the root cause. I can go get a shot today that blunts my immune
| system, and my psoriasis will calm down for a year but I'll
| probably get a couple wicked chest colds.
|
| Autoimmune diseases in no small part ruined my life. Forgive me
| if I seem rude, but I don't trust pharma to solve jack or shit
| without the correct financial incentives, and those proper
| financial incentives just can't organically exist for chronic
| sufferers of any novel disease.
| fao_ wrote:
| > This seems like another 'solution' that really only
| addresses how the diseases manifest but not the root cause.
|
| If you read the article, you'd see that one of the features
| is that in the vast majority of cases, the B-cells return,
| but not the B-cells that were causing the immunodeficiency
|
| quote: "Once injected into the hosts, the CAR T cells got to
| work. They multiplied and targeted and destroyed all the B
| cells -- including pathogenic cells linked to the autoimmune
| conditions. The bioengineered T cells survived for weeks in
| the recipients before largely vanishing. Eventually, new
| healthy B cells returned, but no pathogenic ones did. A
| similar response has been observed in people with autoimmune
| conditions who received CAR T cells derived from their own
| cells."
|
| My point being that the immune system appears to remains
| functional with this treatment, differentiating it from the
| clinical therapies that are available to you currently.
|
| Speaking as someone who has also been let down by the medical
| system, but also who wouldn't be alive without it: I agree
| that Big Pharma is a problem (anyone disagreeing with that is
| arguing against the scientific evidence -- Ben Goldacre's
| book Bad Pharma is a good introduction to the problems with
| the industry), and that in the gross case they are lacking
| financial incentives. At the same time, this does not mean
| that the clinical therapies we have or are developing, are
| utterly ineffective.
| sosuke wrote:
| For the sake of my question let's assume this is legit and
| magically works for a wide range of autoimmune conditions. How
| many years away are we from being able to sign up for this
| treatment? 10 years? 20? 30?
|
| It would be nice to dream of it happening sometime soon.
| thebeardisred wrote:
| In the US, my "back of the napkin" estimate tends to be 8-15
| years, if it passes trials.
| kiba wrote:
| Is there a way to speed up trials without compromising
| quality?
| Retric wrote:
| Not really, the process gets shortcut when the benefits of
| moving fast are dramatic enough.
|
| So sure we could speed things up by killing more people
| undergoing medical experiments. But the current approach of
| validating safety in humans then efficacy in humans is
| inherently serial. Further a lot more stuff is going into
| the pipeline than actually ends up working.
| adamredwoods wrote:
| Possible to use surrogate endpoints, which is used for
| slower evolving diseases. But then the claims need to be
| associated with the new endpoints.
|
| FDA can fast track certain drugs, but it really needs to
| show amazing efficacy.
| throwup238 wrote:
| Only for orphan and ultra orphan diseases where there are
| so few patients that it's not economically viable to do
| full clinical trials.
|
| There is also a breakthrough therapy designation where the
| clinical evidence is solid enough to release the drug while
| they finish full trials but that's only in exceptional
| cases.
| hammock wrote:
| In Mexico, maybe a year?
|
| (Please don't downvote me because you don't like the tone of
| that. Europe banned artificial food colors and Japan is using
| self-replicating RNA vaccines. There is a wide spectrum of risk
| tolerance and healthcare does not revolve around the USA)
| dylan604 wrote:
| Depends. Do you want to be a patient, or a trial test subject?
| wpasc wrote:
| amen. I've tried 3 tnf inhibitors that have not worked (and had
| negative side effects). Cosentyx (il 17a inhibitor) kinda
| scares me. I always like to keep my hopes that some better
| autoimmune treatments could come soon
| mhuffman wrote:
| Maybe not long at all. Scroll down to the section that says
| "Our Approach : Building a Designer Immune System" on this
| site[0]
|
| [0]https://orcabio.com/what-we-do/
| wslh wrote:
| Does this new donor-cell therapy potentially include the top-10
| autoimmune diseases, such as rheumatoid arthritis, lupus
| (checked), and/or Hashimoto's thyroiditis?
| mrzimmerman wrote:
| Can I ask how "top 10" is defined? Is it the most common, or
| perhaps the most destructive to the individual?
| wslh wrote:
| I sorted by the most common, not the most destructive, but
| the key point is how 'easily' this could be extrapolated to
| other autoimmune diseases.
| m3kw9 wrote:
| In the future a pill with donor cells will be prescribed 1x a day
| for 3 days.
| dylan604 wrote:
| Depends. If it's up to bigPharma, it will be 1 pill 3x a day,
| forever. Chronic patients are the best to the bottom line
| adamredwoods wrote:
| Keep an eye on sickle cell anemia cure then.
| eth0up wrote:
| I thoroughly agree with your grayed comment. It doesn't
| necessarily imply that it's all greed and evil, but there's
| enough of it to dignify your statement, without applying my
| own experience.
| amluto wrote:
| Derek Lowe on this use of CAR-T:
| https://www.science.org/content/blog-post/car-t-autoimmune-d...
|
| And on the apparent long term risks of CAR-T:
| https://www.science.org/content/blog-post/downside-car-t-the...
| noobermin wrote:
| While the promise is great, let's be real. All of these
| personalised therapies get loads of funding because they almost
| inherently will be very expensive since they cannot scale,
| meaning drug manufactures supplying these can make a killing even
| compared to already expensive but more commonly used therapies. I
| guess this is more a comment on car-t usage in oncology and if
| this leads to seriously improved health outxomes, then of course,
| all the power to them.
|
| Edit: i was mistaken, see below.
| dyauspitr wrote:
| That's the whole point here, it's not personalized. It comes
| from a donor so it's somewhat standardized.
| danielfoster wrote:
| I understand this therapy is inherently more complex, but there
| are plenty of medical treatments that have helped millions of
| people without scaling like a drug: IVF, cognitive behavior
| therapy, casts for broken bones, etc.
|
| Maybe I'm too optimistic but I'm sure the overall cost can be
| reduced dramatically over time even with individualization.
| GeekyBear wrote:
| > very expensive since they cannot scale
|
| This approach does scale, but has new safety risks.
|
| They aren't genetically modifying each patient's own cells, one
| patient at a time, but are trying to create a line of generic
| T-cells that will attack only the B-cells of any patient.
|
| The risk is that genetically modified T-cells that are not
| derived from your own cells might attack all the cells of your
| body, and not just your misbehaving B-cells.
|
| They have made additional modifications to the CAR-T T-cells
| that they believe will prevent them from going rogue, but more
| safely testing is needed.
|
| From what I've read, this same more generic approach is being
| attempted with CAR-T cancer treatment as well.
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