Wonders of Technology- CAR Cell Therapy

The immune system is one of the most important systems in our bodies. Without it, our body can become highly susceptible to harmful substances, germs, and cell and tissue changes that can make us ill. Because of this, it is vital to remain healthy and maintain an equilibrium for optimal functioning of the immune system. When out of balance, not only does the immune system fail to protect the body, but it can also mistakenly attack itself, triggering autoimmune diseases such as Lupus or Inflammatory Bowel Disease (Embria Health Sciences). Realizing the importance of an efficient immune system for the overall health of an individual, scientists and researchers are actively finding new solutions to stimulate the immune system to effectively fight off various illnesses. One such example of an innovation helping in this regard would be Chimeric Antigen Receptor (CAR) cell therapy.

CAR T-cell therapy is a way to get T cells, specialized immune cells of our body, to find and destroy the cancer cells by genetically altering them in labs. In the process of fighting off disease or illness, the immune system recognizes foreign substances in the body by finding specific molecules called antigens on their surface. Antigens bind to various immune cells including T-cells and trigger an immune response, which tries to destroy these foreign substances. In a way, the immunoreceptor-antigen relationship can be seen as a lock and key. Similar to how every key has its own lock, each antigen has its own unique immunoreceptor. Cancer cells also have antigens, but if the immune system does not have the right immunoreceptors, they cannot attach to the antigen and destroy the cancer cells. When this happens, CAR T-cell therapy is a common solution. The T cells being used in this therapy are genetically engineered so that they express a man-made or artificial receptor such as the chimeric antigen receptor (CAR), which gives T cells the ability to target these cancer cells which were previously unrecognized and ultimately destroy them. The whole process of CAR T-cell therapy can take a few weeks to complete. To start the process, white blood cells which include the T cells, are taken out of the patient’s body through a procedure called leukapheresis. After the T cells are separated, they are sent to the lab where they are reprogrammed with CAR. The process of adding these cancer finding receptors itself may take a few weeks. Once CAR T cells have been made, they will be given to the patient via T-cell infusion. Normally, before the patient receives the T cells, they may undergo chemotherapy to lower the number of other immune cells which may interfere in the process (Dana-Farber Cancer Institute). The chemotherapy given is generally not as strong as those used directly to remove cancerous cells because T cells that are to be infused work best when there are cancer cells. Once the T cells start binding with the cancer antigen, they start to increase in number, thereby quickly destroying the cancer cells.

According to Michael Bishop, director of UChicago Medicine's cellular therapy program, there is about a 30-40% success rate with no additional treatment (Bartosch). However, some people who have received T-cell therapy have had major side effects. Many of the side effects happen as the T cells multiply in the body. Cytokines are a group of small proteins that are secreted by the immune system to aid in cell signaling. During this multiplication, large amounts of cytokines are released in the blood which may cause high fevers and dangerously low blood pressures (American Cancer Society). This triggers an inflammatory condition called cytokine release syndrome. As doctors have gained more experience in administering CAR T-cell therapy, they have also learned how to identify and treat these side effects at its early stages.

New technologies and research have made it possible to discover solutions for today’s healthcare problems. Specifically for CAR T-cell therapy, it makes it possible to stimulate the immune system to treat cancers in our bodies. With the evolving innovations in healthcare, there is no doubt that technology is influencing our thinking and innovating to create unanimous solutions to medical problems in society.

References:

American Cancer Society. (n.d.). CAR T-cell Therapy and Its Side Effects. Cancer.org. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/car-t-cell1.html#:~:text=Chimeric antigen receptor (CAR) T,find and destroy cancer cells.

Bartosch, J. (2019). Three years after CAR T-cell therapy for lymphoma, patient still cancer-free. UChicago Medicine. https://www.uchicagomedicine.org/forefront/cancer-articles/a-walking-miracle-car-t-cell-therapy

Dana-Farber Cancer Institute. (n.d.). Cellular Therapies Program. https://www.dana-farber.org/cellular-therapies-program/car-t-cell-therapy/faq-about-car-t-cell-therapy/#:~:text=CAR T-cell therapy is,(CARs) on their surface.

Embria Health Sciences. (n.d.). The Importance of a Balanced Immune Response. https://www.embriahealth.com/resources/healthlifestylereports

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C, S. (2020, January). CAR T-cell manufacturing: Challenges Remain [Digital image]. Retrieved from https://bioprocessintl.com/manufacturing/cell-therapies/challenges-and-opportunities-in-car-t-cell-manufacturing/