2020 THE YEAR OF MARVELOUS MEDICINE!

A vaccine to fight multiple cancers. ‘Smart’ insulin that senses blood sugar levels. A treatment for early dementia. Why a corona jab was far from the only breakthrough last year

A YEAR ago, the world was in the grip of a deadly and, seemingly, unstoppable virus and the UK went into its first lockdown. Since then, vaccines and life-saving drugs to counter Covid have been the focus of international attention. But the past year has also seen major developments in treatments for cancer, diabetes, multiple sclerosis and dementia — developments that have gone under the radar as a result of the pandemic. Here are some of the breakthroughs that could affect the lives of millions . . .

ONE INJECTION TO STOP MANY CANCERS

A VACCINE that could treat multiple types of tumours — and stop the cancer from returning — has been created in Australia.

It could be used against breast, lung, ovarian, kidney and pancreatic cancers, which together kill 65,000 people a year in the UK — 40 per cent of all cancer deaths — says researcher Dr Kristen Radford, of the University of Queensland, Brisbane.

Some blood cancers, including mul-tiple myeloma and myeloid leukaemia, are also expected to be within the grasp of the drug, the journal clinical & Translational immunology reported in June 2020.

Although we usually think of vaccines as preventing disease, the term can also be applied to drugs that harness the power of the immune system to treat disease. This vaccine consists of an anti-body that is fused to WT1 — a protein over-produced in the cells of many types of cancer.

Cancer cells can ‘hide’ from the immune system, which would otherwise destroy them.

The antibody helps ‘show’ the protein to the immune system, by ferrying it to white blood cells called dendritic cells which, in turn, tell the rest of the immune system to find and destroy cancer cells over-producing WT1.

The hope is that the immune response will not only eradicate the tumour but, by being on alert for WT1, stop the cancer from returning. in research on mice and on cells in a dish, part-funded by the charity Worldwide cancer Research, the vaccine produced a powerful immune response. Human trials are next — within the next few years.

Crucially, as the formula should work against multiple types of cancer, it will make it cheaper and easier to produce than other vaccines in development, which have to be tailored to individual patients.

Professor caetano Reis e Sousa, an immunologist work-ing on cancer vaccines at the Francis crick institute in Lon-don, says this builds on a large body of work showing delivering substances that provoke an immune response is a useful means of alerting immune cells to the presence of the tumour.

‘Teaching the immune system to recognise and fight tumours with a vaccine is an exciting prospect,’ he adds.

SMART INSULIN FOR DIABETES

A HIGH-TECH form of insulin that can sense blood sugar levels has ‘tremendous poten-tial to vastly improve the lives of people with type 1 diabetes’, predicts Knud Jensen, a professor of chemistry at the University of copenhagen.

In type 1 diabetes, which affects 400,000 Britons, a rogue immune response destroys the cells in the pancreas that make the insulin needed to turn the sugar in food into energy. Multiple blood sugar tests and insulin injections are needed each day to help control the condition.

But even with the blood tests and the jabs, hypoglycaemia — low blood sugar levels, which at their most severe can lead to a potentially fatal coma — is still common.

That is because many factors determine how much insulin you require — from what and when you eat, even outside temperature — which makes it tricky to calculate the exact dose required.

But the smart insulin is attached to a molecule designed to sense how much blood sugar is in the body. it then releases the hormone according to the patient’s need: the higher the blood sugar levels, the faster this occurs and the more insulin is released.

Injected just once a day, smart insulin would ease the onerous regimen of finger-prick tests and jabs, while better controlling blood sugar levels and so cutting the risk of hypoglycaemia.

Successful tests on animals were detailed in chemistry — A european Journal in December, and d while hil more research h i is needed, Professor Jenson told Good Health that people with type 2 diabetes could also benefit from their findings.

Type 2 diabetes is the most common and is linked to obesity. Although it is usually initially controlled with diet, exercise and blood sugar- lowering tablets, many patients eventu-ally need insulin injections.

The smart insulin, which was named as one of the global research highlights of 2020 by th the charity h it Di Diabetes b t UK UK, will ill now be refined and tested further on animals. Human trials are about five years away.

Naveed Sattar, a professor of metabolic medicine at the institute of cardiovascular & Medical Sciences at the University of Glasgow, says: ‘if a form of insulin can sense the body’s glucose levels and adjust its activity accordingly, this could be a great breakthrough as sugar control in people with

type 1 diabetes could then i improve meaningfully.’ i f ll ’

CURE FOR FAULTY HEARTBEAT

A hormone that helps keep our bones strong could be a powerful new treatment for atrial fibrillation ( AF), the UK’s most common heart rhythm disorder, researchers from the University of oxford said in november.

In the 1.4 million Britons with

AF, the electrical impulses impul in the th h heart’s t’ upper chambers h (atria) have gone haywire as a result of scarring to the heart tissue (typically due to ageing, high blood pressure or heart disease). This leads to an irregular or ‘fluttering’ heartbeat which increases the risk of a stroke five-fold, as it means blood can pool in the heart.

Current treatments work by restoring the natural rhythm by, for example, shocking it back into step; or by cutting the risk of a stroke with the use of blood-thinning drugs. But they do not work for everyone and none address the atrial scarring that is at the root of the condition.

A According to the national Ins Institute for he health and Ca Care excellence len (nICe), bet better treatment me could pre prevent 7,000 str strokes and sav save over 2,0 2,000 lives a yea year in england lan alone. now, experiment experiments on mice and cells from heart hear patients, reported in the journal nature, show that calcitonin, a bone hormone that was thought to be produced only by the thyroid gland, is also made by cells in the atria. And this research also found that higher levels reduced scarring and even prevented AF.

‘The most severe risk with AF is that it predisposes to blood clots forming in the heart that can dislodge to cause stroke, which often requires patients to take lifelong blood- thinning drugs that themselves can cause problems such as bleeding,’ says Tim Chico, a professor of cardiovascular medicine at the University of Sheffield.

‘Any treatment that could prevent or reverse someone’s tendency to have AF would be a major breakthrough.’

REVERSING SIGHT LOSS

DAmAge to the cells in the optic nerve — the vital link between the eye and the brain — has been repaired in the laboratory, providing real hope of restoring lost sight for the 500,000 Britons affected by glaucoma.

The condition, a leading cause of blindness, causes a build-up of fluid in the front part of the eye, which increases the pressure and kills some of the fibres sending information to the brain.

The damage cannot be reversed and 10-15 per cent of patients with glaucoma go blind in at least one eye, despite treatments to lower the pressure.

In research carried out on brain cells in a dish in a lab, scientists at the University of Cambridge increased levels of a protein called protrudin, which vastly improves the ability of injured brain cells to repair themselves.

Protrudin, which occurs naturally in nerve cells, helps kickstart regeneration by encouraging the movement of compounds vital for survival to the site of injury.

The work, which was published in the journal nature Communications in november, could also lead to new treatments for spinal cord damage. ‘This work is very exciting,’ says gus gazzard, a consultant ophthalmic surgeon at moorfields eye hospital in London. ‘The findings show that, in principle, powerful new routes to nerve protection are possible.’

CRACKING MALE BREAST CANCER

Three genes that raise the risk of male breast cancer — a little understood form of the disease — were uncovered in the world’s largest study of the condition’s genetic roots.

There are 370 cases a year in the UK, but the disease is becoming increasingly common, with numbers doubling in the past 20-30 years. Poor diet, lack of exercise, alcohol and obesity are thought to help explain the rise.

one in five men diagnosed with breast cancer in the UK each year dies from it.

The discovery, by scientists from the Institute of Cancer research in London in August, also showed genetic links between the male and female forms of the disease. (The ‘new’ genes are different from the faulty BrCA genes, which have long been known to raise women and men’s risk of breast cancer.)

having one of these three ‘new’ genes increases the risk of a man developing breast cancer by between 45 and 61 per cent. They have a smaller effect on women, raising the risk by 11 to 39 per cent.

The finding, which was reported in the Journal of the national Cancer Institute, could lead to new drugs to prevent the cancer. It could also mean that a man with a family history of the disease could be tested for these genetic changes to give a better picture of their risk.