Team:Tongji China/Integrated
Human Practice
Integrated Human Practice
In recent years, multiple ways of immunotherapy arise which leads to brand-new hope for patients with cancers and arouse our great interest to make further research. However, based on the clinical results of those like CAR-T, side effects happen with its unsteady curative effect. Improvement is needed and we are willing to take over this challenge.
Besides, this year unexpected scandals happened in Jilin-based Changsheng Biotechnology which has been ordered by the Chinese government to cease production of its fake rabies vaccine. It brings about great influence among society and gives rise to attention and debates of vaccine production. We are fully surprised by this scandal and reflect a lot. This issue about vaccine also plays a role in leading us to determine what we what to do to make a better world.
After plenty of research and design, we set up our project based on one specific system – Type III secretion system (T3SS) and developed our goal of design it as an antigen delivering agent for immunotherapy, which is promising in individualized treatment. Our primary thought is rough and is necessary to fill up the blank, therefore research from both professional and social field are required.
Though we could construct the major part of our project through self-searching on the internet and literature reading, there are some questions and negligible aspects when it comes to practical application and it is of great benefit if we could get advice from professional consultant. Therefore, we invited Professor Du Xin to assist us in aspect of bacterial immunity and possibility of bringing our project into practical medicine.
Professor Du
We concluded the conversation into several tips we got as inspiration and project promotion:
1) About oral administration:
Professor raised the questions like -- “Questions are that how to protect your medicine from digesting when being taken orally and how to achieve the antigen-presentation on target……” and instruct us to complete our projects based on those.
2) Advantages in bacterial immunity compared to antigen-immunity
Professor Du provided several advantages from bacterial immunity. Firstly, the immunoreaction could appear immediately, basically faster than antigen-immunity; secondly the antigens could be designed more specific to trigger the immunity; Thirdly, with the protection of the cell body the antigen is less likely to be degraded; Fourthly, research revealed that bacterial immunity shows evidence in on-target reaction, which is promising for cancer therapy. Therefore, Professor Du is optimistic to our idea.
3) Side effect in over-triggering the immunity?
Professor Du propose to take CAR-T as an example. To some extent, functions are confirmed only through detecting of those side effects, such as cytokine storm. However, there are co-medicine to reduce the bad influence from those side effects. Therefore, “Some of the risk are part of the response mechanism, but the thing we need to take care is, first, how to reduce it, second, if it happens, what medicine we could use to handle it”.
4) Clearage of exogenous bacterial after effect？
As is mentioned by Professor Du, there is natural mechanism of clearage in vivo, which plays a major rule in the clearage of exogenous bacterial. Besides, antibiotics are recommended in clinical therapy. With both protection methods, it is guaranteed that the engineered bacterial could be cleaned thoroughly after their effects.
5) Encouragement
“To be or not to be, that may not be your chief question; the key is to identify the problem and find pathway to solve it.”
Apart from those main points for the design, Professor Du also makes significant advice in experimental designing which is of great use.
We learned through researches that the P. aeruginosa has certain invasive ability, which means they will invade the cells, and eventually enter the blood after oral administration. We concerned about the safety issue about P. aeruginosa and its advantages over Salmonella and Yersinia, therefore, professional instruction of using P. aeruginosa orally is necessary.
Biography of Dr. Fang Bai
Fang Bai, Associate Professor, School of Pharmacy, Nankai University, focusing on microbial and biochemical drugs and making a great progress in utilizing P. aeruginosa Type III secretion system to deliver transcription factors to achieve the gene editing of PSCs and to trigger diferenciation of ESCs. Also professional at the threatment of P. aeruginosa.
We received professional instructions in the following aspects: The safety issue on P. aeruginosa
The advantages over Salmonella and Yersinia
The advantages of oral administration over intravenous injection
For the promising application of our project to people’s health condition, it is significant to consider the actual application and possible patient responses and promote our design specifically. Therefore, we made our visit to a doctor Likun Hou in lung cancer at Lung Hospital affiliated to Tongji University.
Here are points of view from the doctor:
1) Individualized Treatment of cancer would be promising in future. Current therapy shows different effects in different clinical cases, sometimes it is confused even to doctors that whether the common therapy could work to specific patient. With the development of NGS (next generation sequencing), it would be a trend to treat patients more individualized.
2) The main limitation in future Individualized Treatment is the common standard for selection of antigens. It has already been available for a great amount of companies to do the sequencing, what matters most would be the way to select target antigens, which a standard for selecting is required.
3) Possible patients’ attitude towards our products:
We are concerned that whether the patient would refuse to intake our products for it depends on live bacterial-delivery. However, doctor Hou claimed that what patients care most is the effect of your product. As long as it has effects in curing the illness, they’d love to have a try. Take PD-1 inhibitor as an example. Despite its high expense and relative low rate for curing (around 30%), there are still patients choose to take it. Therefore, there is no need to worry about refuses from patients’
4) Opinions to our projects:
The idea is quite interesting. First it would reduce the cost of immunotherapy, despite the fact that current research for completing this therapy would take great amount of money. Secondly, It seems more safe compared to current immunotherapy such as CAR-T, which may leads to less side effects. Therefore, I suppose your project has great potentials.
To guarantee that our project would eventually develop practical medicine product for cancer therapy, we visited local pharmaceutical factory – Shanghai Roche Ltd. for advice in medicine capsules. After the visit of workshops for capsule coating, we were suggested that the capsule coats were available to buy in several companies, which they offered us a list to choose. Besides, they recommended that since our final products are in small amount, it was possible to acquire capsules from their recommended companies and coat our products by ourselves in the lab. Besides, they offered to assist the design of the capsules, accessory compounds adding and operation procedures for coating if was needed.
