Posts tagged white blood cells

Phase 1 trial safely resets patients’ immune systems, reduces attack on myelin protein

A phase 1 clinical trial for the first treatment to reset the immune system of multiple sclerosis (MS) patients showed the therapy was safe and dramatically reduced patients’ immune systems’ reactivity to myelin by 50 to 75 percent, according to new Northwestern Medicine research.

In MS, the immune system attacks and destroys myelin, the insulating layer that forms around nerves in the spinal cord, brain and optic nerve. When the insulation is destroyed, electrical signals can’t be effectively conducted, resulting in symptoms that range from mild limb numbness to paralysis or blindness.

“The therapy stops autoimmune responses that are already activated and prevents the activation of new autoimmune cells,” said Stephen Miller, the Judy Gugenheim Research Professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine. “Our approach leaves the function of the normal immune system intact. That’s the holy grail.”

Miller is the co-senior author of a paper on the study, which was published June 5 in the journal Science Translational Medicine. The study is a collaboration between Northwestern’s Feinberg School, University Hospital Zurich in Switzerland and University Medical Center Hamburg-Eppendorf in Germany. 

The human trial is the translation of more than 30 years of preclinical research in Miller’s lab.   

In the trial, the MS patients’ own specially processed white blood cells were used to stealthily deliver billions of myelin antigens into their bodies so their immune systems would recognize them as harmless and develop tolerance to them.    

Current therapies for MS suppress the entire immune system, making patients more susceptible to everyday infections and higher rates of cancer.

While the trial’s nine patients — who were treated in Hamburg, Germany — were too few to statistically determine the treatment’s ability to prevent the progression of MS, the study did show patients who received the highest dose of white blood cells had the greatest reduction in myelin reactivity. 

The primary aim of the study was to demonstrate the treatment’s safety and tolerability. It showed the intravenous injection of up to 3 billion white blood cells with myelin antigens caused no adverse affects in MS patients. Most importantly, it did not reactivate the patients’ disease and did not affect their healthy immunity to real pathogens.

As part of the study, researchers tested patients’ immunity to tetanus because all had received tetanus shots in their lifetime. One month after the treatment, their immune responses to tetanus remained strong, showing the treatment’s immune effect was specific only to myelin.   

The human safety study sets the stage for a phase 2 trial to see if the new treatment can prevent the progression of MS in humans. Scientists are currently trying to raise $1.5 million to launch the trial, which has already been approved in Switzerland. Miller’s preclinical research demonstrated the treatment stopped the progression of relapsing-remitting MS in mice.

“In the phase 2 trial we want to treat patients as early as possible in the disease before they have paralysis due to myelin damage.” Miller said. “Once the myelin is destroyed, it’s hard to repair that.”

In the trial, patients’ white blood cells were filtered out, specially processed and coupled with myelin antigens by a complex GMP manufacturing process developed by the study co-senior authors, Roland Martin, Mireia Sospedra, and Andreas Lutterotti and their team at the University Medical Center Hamburg-Eppendorf. Then billions of these dead cells secretly carrying the myelin antigens were injected intravenously into the patients. The cells entered the spleen, which filters the blood and helps the body dispose of aging and dying blood cells. During this process, the immune cells start to recognize myelin as a harmless and immune tolerance quickly develops. This was confirmed in the patients by immune assays developed and carried out by the research team in Hamburg.  

This therapy, with further testing, may be useful for treating not only MS but also a host of other autoimmune and allergic diseases simply by switching the antigens attached to the cells. Previously published preclinical research by Miller showed the therapy’s effectiveness for type 1 diabetes and airway allergy (asthma) and peanut allergy.

The MS human trial relates directly to Miller’s recently published research in mice in which he used nanoparticles — rather than a patient’s white blood cells — to deliver the myelin antigen. Using a patient’s white blood cells is a costly and labor-intensive procedure. Miller’s study showed the nanoparticles, which are potentially cheaper and more accessible to a general population, could be as effective as the white blood cells as delivery vehicles. This nanoparticle technology has been licensed to Cour Pharmaceutical Development Company and is in preclinical development.

Miller’s research represents several pillars of Northwestern’s Strategic Plan by discovering new ways to treat disease in the biomedical sciences and translating those discoveries into ideas and products that make the world a better place for everyone.

(Source: northwestern.edu)

How can the immune system be reprogrammed once it goes on the attack against its own body? EPFL scientists retrained T-cells involved in type I diabetes, a common autoimmune disease. Using a modified protein, they precisely targeted the white blood cells (T-lymphocytes, or T-cells) that were attacking pancreatic cells and causing the disease. When tested on laboratory mice, the therapy eliminated all signs of the pathology. This same method could be a very promising avenue for treating multiple sclerosis as well. The scientists have just launched a start-up company, Anokion SA, on the Lausanne campus, and are planning to conduct clinical trials within the next two years. Their discovery has been published in the journal PNAS (Proceedings of the National Academy of Science).

To retrain the rebellious white blood cells, the researchers began with a relatively simple observation: every day, thousands of our cells die. Each time a cell bites the dust, it sends out a message to the immune system. If the death is caused by trauma, such as an inflammation, the message tends to stimulate white blood cells to become aggressive. But if the cell dies a programmed death at the end of its natural life cycle, it sends out a soothing signal.

In the human body there is a type of cell that dies off en masse, on the order of 200 billion per day – red blood cells. Each of these programmed deaths sends a soothing message to the immune system. The scientists took advantage of this situation, and attached the pancreatic protein targeted by T-cells in type I diabetes to red blood cells.

"Our idea was that by associating the protein under attack to a soothing event, like the programmed death of red blood cells, we would reduce the intensity of the immune response," explains Jeffrey Hubbell, co-author of the study. To do this, the researchers had to do some clever bioengineering and equip the protein with a tiny, molecular scale hook, that is able to attach itself to a red blood cell. Billions of these were manufactured and then simply injected into the body.

Complete eradication of diabetes symptoms

As these billions of red blood cells died their programmed death, they released two signals: the artificially attached pancreatic protein, and the soothing signal. The association of these two elements, like Pavlov’s dog, who associates the ringing of a bell with a good or bad outcome, essentially retrained the T lymphocytes to stop attacking the pancreatic cells. “It was a total success. We were able to eliminate the immune response in type I diabetes in mice,” explains Hubbell.

Minimizing risks and side effects

Co-author Stephan Kontos adds that the great advantage of this approach is its extreme precision. “Our method carries very little risk and shouldn’t introduce significant side effects, in the sense that we are not targeting the entire immune system, but just the specific kind of T-cells involved in the disease.”

The scientists are planning to conduct clinical trials in 2014, at the earliest. To demonstrate the potential of their method, they plan to first test applications that would counteract the immune response to a drug known for its effectiveness against gout. “We chose to begin with this application before we tackled diabetes or multiple sclerosis, since we knew and were in control of all the parameters,” explains Hubbell.

Currently, the researchers are also testing the potential of this method in treating multiple sclerosis. In this disease, T-cells destroy myelin cells, which form a protective sheath around nerve fibers. They are also studying the potential of their method with another kind of white blood cell, B-lymphocytes, that are involved in many other autoimmune diseases.

(Source: eurekalert.org)

A small molecule known to regulate white blood cells has a surprising second role in protecting brain cells from the deleterious effects of stroke, Johns Hopkins researchers report. The molecule, microRNA-223, affects how cells respond to the temporary loss of blood supply brought on by stroke — and thus the cells’ likelihood of suffering permanent damage.

“We set out to find a small molecule with very specific effects in the brain, one that could be the target of a future stroke treatment,” says Valina Dawson, Ph.D., a professor in the Johns Hopkins University School of Medicine’s Institute for Cell Engineering. “What we found is this molecule involved in immune response, which also acts in complex ways on the brain. This opens up a suite of interesting questions about what microRNA-223 is doing and how, but it also presents a challenge to any therapeutic application.” A report on the discovery is published in the Nov. 13 issue of the Proceedings of the National Academy of Sciences.

RNA is best known as a go-between that shuttles genetic information from DNA and then helps produce proteins based on that information. But, Dawson explains, a decade ago researchers unearthed a completely different class of RNA: small, nimble fragments that regulate protein production. In the case of microRNA, one member of this class, that control comes from the ability to bind to RNA messenger molecules carrying genetic information, and thus prevent them from delivering their messages. “Compared with most ways of shutting genes off, this one is very quick,” Dawson notes.

Reasoning that this quick action, along with other properties, could make microRNAs a good target for therapy development, Dawson and her team searched for microRNAs that regulate brain cells’ response to oxygen deprivation.

To do that, they looked for proteins that increased in number in cells subjected to stress, and then examined how production of these proteins was regulated. For many of them, microRNA-223 played a role, Dawson says.

In most cases, the proteins regulated by microRNA-223 turned out to be involved in detecting and responding to glutamate, a common chemical signal brain cells use to communicate with each other. A stroke or other injury can lead to a dangerous excess of glutamate in the brain, as can a range of diseases, including autism and Alzheimer’s.

Because microRNA-223 is involved in regulating so many different proteins, and because it affects glutamate receptors, which themselves are involved in many different processes, the molecule’s reach turned out to be much broader than expected, says Maged M. Harraz, Ph.D., a research associate at Hopkins who led the study. “Before this experiment, we didn’t appreciate that a single microRNA could regulate so many proteins,” he explains.

This finding suggests that microRNA-223 is unlikely to become a therapeutic target in the near future unless researchers figure out how to avoid unwanted side effects, Dawson says.

(Source: hopkinsmedicine.org)