New Trachea, Fighting Prostate Cancer and Disease in a Dish:
Eric Topol, MD, Genomic Medicine, 09:59PM Jul 12, 2011
We're entering a new era in medicine in which an individual's cells can be sorted, manipulated, and de-differentiated into pluripotent stem cells. In 2011, this movement has really accelerated to not only understand diseases, but also to treat them.
Below is a transcript of Dr. Topol's post "New Trachea, Fighting Prostate Cancer, and Disease-in-a-Dish." We look forward to your feedback.
I know what you're thinking. What does a new trachea and finding prostate cancer have to do with disease-in-a-dish? What's going on here? Where's Topol going with this one?
Well, what I'm trying to get across is that there's a really exciting movement going on in medicine, which is capitalizing on the ability to harness individual cells and preserve their own genomic data and the integrity of their own genome. And so we’ve seen some great examples of this, both in treatment of patients as well as in research to understand diseases.
The recent exciting advance was announced by the Karolinska Institute in Sweden of a 36-year-old Icelandic individual who had cancer of the larynx and underwent a successful autologous trachea transplant. This was based on the synthetic mold of his trachea upon which were put the bone marrow transplant cells to essentially colonize this trachea and to be suitable to now function as a windpipe in this individual. A really exciting story not yet published in a medical journal, but published in the Wall Street "Medical" Journal that is linked to this post.
Now, sipuleucel, known as Provenge, is a therapy now being used in prostate cancer. It's very expensive, $93,000. It's an immunotherapy or a vaccine-like therapy which capitalizes on taking the blood samples from an individual with prostate cancer, sorting these cells through leukapheresis to get the T-cells and particularly the antigen presenting T-cells, then exposing these cells to prostatic acid phosphatase and GM-CSF, and then bringing these cells back in 3 separate treatments to rev up the immune system against prostate cancer.
This is a very interesting hyper-individualized therapy and very expensive. And it's shown to have some particular benefit certainly in individuals as seen in the trial, maybe not a large survival benefit, but some overall.
Now the third example I wanted to highlight is disease-in-a-dish. Here, we are taking, as researchers (and we just got a major grant for this), a skin punch biopsy. Those fibroblasts are morphed via 4 genes introduced to become pluripotent induced stem cells. And they can be coaxed to various cell lines, whether that's cardiomyocytes, liver cells, neural cells, etc. And these cells can be studied.
There are some caveats. They're not the same as embryonic stem cells. They have some somatic mutations. They have some epigenomic altered methylation and histone modifications. And beyond that, they are potentially immunogenic, as seen in experimental models.
I cannot figure out how to fix this URL so that it doesn't bring you to my page. On regular articles I can cut off my ID stuff but this is a blog/forum and seems like I can't do that. Maybe if you go to Medscape and search?