BODY, HEAL THYSELF

SCI­ENCE IS LOOK­ING IN­WARD FOR NEW FIXES TO WHAT AILS US

Popular Science - - BEST OF WHAT’S NEW 2017 - BY DANIEL ENGBER

EVER SINCE A SA­VANNA DWELLER FIRST SLAPPED MUD

on a wound to ward off flies—and in­fec­tion—our frail hu­man bod­ies have re­lied on cre­ative in­ter­ven­tion to sur­vive. Sci­ence has since come up with all man­ner of po­tions and pro­ce­dures (from as­pirin to or­gan trans­plants to bionic knees) to keep us from fall­ing to pieces. But it turns out the body might be its own best phar­macy; each one of us pos­sesses in­ter­nal stores of life-ex­tend­ing re­me­di­a­tion. Sci­en­tists are now learn­ing to ac­cess those once locked and guarded in­ner ware­houses to nudge us to­ward dura­bil­ity.

Wit­ness the fron­tier of us­ing the body to fix it­self. From su­per­charg­ing our im­mune sys­tems to bol­ster­ing pro­tec­tive mi­crobes in our guts to tweak­ing our genes, med­i­cal re­search is now en­hanc­ing our own de­fenses and sel­f­re­pair mech­a­nisms. And not just in terms of im­me­di­ate threats but fu­ture ones too—in some cases pro­tect­ing gen­er­a­tions down the line.

Nowhere is this more ev­i­dent than in the boom­ing im­munother­apy field for cancer treat­ment, in which ge­neti­cists soup up the body’s own de­fense sys­tem to fight off life-threat­en­ing ill­ness. In Au­gust, the FDA ap­proved one of the most ad­vanced tech­niques, Kym­riah, mak­ing it the first gene ther­apy to reach the mar­ket. With it, doc­tors can ex­tract T cells from a pa­tient, train the cells in a petri dish to fight cancer, then re-in­ject them into the body where they go to work as world-class tu­mor bul­lies. The newly armed im­mune sys­tem could re­main a life­long pow­er­house, pre­vent­ing that cancer from com­ing back.

But wield­ing im­munother­a­pies is still tricky. For now these tools can de­feat cer­tain can­cers but not oth­ers, cure some pa­tients but not all. This year alone, re­searchers un­der­took an as­ton­ish­ing 1,000 or so clin­i­cal tri­als to ad­dress these and other chal­lenges. “The rea­son a thou­sand tri­als are go­ing on is be­cause they’re mix­ing and match­ing ev­ery­thing they can get hold of,” says Jeff Blue­stone, an im­mu­nol­o­gist at the Univer­sity of Cal­i­for­nia at San Fran­cisco and head of the Parker In­sti­tute for Cancer Im­munother­apy. These tri­als will even­tu­ally iden­tify more-spe­cific tar­gets. “We’ll see a much more sci­en­tific ap­proach to learn­ing from peo­ple who failed treat­ment.”

This year also saw the cul­mi­na­tion of the Hu­man Mi­cro­biome Project, a decade-long ef­fort by 53 re­search groups to as­sem­ble some­thing like an Audubon guide of all the mi­crobes in­hab­it­ing our mu­cosa. This new­found knowl­edge about all the bac­te­ria, yeasts, par­a­sites, and viruses that live in our guts, on our skin, in our mouths and nasal pas­sages, and in our uro­gen­i­tal tracts is help­ing re­searchers de­vise fixes for things that once took years of med­i­ca­tion.

With that knowl­edge, sci­en­tists are try­ing to go one step fur­ther. They are at­tempt­ing to re­pro­gram micro­organ­isms to re­lease nat­u­ral an­tibi­otics, anti-in­flam­ma­tory mol­e­cules, and pro­tec­tive pro­teins. For ex­am­ple, lab re­searchers have en­gi­neered a be­nign E. coli strain to de­tect spe­cific lipids found in a form of bac­te­ria called P. aerug­i­nosa, a drug-re­sis­tant pathogen that can in­fect hu­mans and cause pneu­mo­nia. The harm­less E. coli finds and kills these in­vaders. In con­cept, such “smart bac­te­ria” could re­main in a per­son’s body for life, de­tect­ing and pre­vent­ing dis­ease.

As self-re­pair tech­niques im­prove, the de­vel­op­ment of pow­er­ful and pre­cise meth­ods for mod­i­fy­ing the hu­man genome is about to take bio­med­i­cine into its sec­ond gen­er­a­tion. A few weeks be­fore the FDA OK’d Kym­riah ther­apy, Ore­gon re­searchers re­vealed in the jour­nal Na­ture that they had used the gene-edit­ing prodigy CRISPR-Cas9 for the first time to edit out a heart-dis­ease gene in hu­man em­bryos (though its suc­cess is still be­ing de­bated). CRISPR and other gene-edit­ing tech­niques in­tro­duce a de­lib­er­ate break into a cell’s DNA, and then let the body’s own DNA self-re­pair mech­a­nism take over. Not only can these tech­niques help mend an in­her­ited de­fect in an in­di­vid­ual, but if ap­plied to so-called germ-line cells, the body can over­write the faulty code in suc­ces­sive gen­er­a­tions of off­spring. That means that by fix­ing a mu­ta­tion at in­cep­tion, genes can then pass on the fix—like a soft­ware patch—for ages.

What this all means is that the an­swer to cur­ing dis­ease might not lie in an op­er­at­ing room or a pill but within bod­ies. By tweak­ing them in the right fash­ion, we might be able to con­trol cancer, delete ge­netic dis­eases, and bet­ter treat chronic ill­nesses to live longer, higher-qual­ity lives.

In short, it’s a self-em­pow­er­ing time for ev­ery body.

THE AN­SWER TO CUR­ING DIS­EASE MIGHT NOT LIE IN A LAB OR IN A PILL— BUT WITHIN OUR­SELVES.”

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