Making the immune system work for you: The story of CAMPATH-1H

A long story, short.

Harnessing the human immune system, for our own ends, has been a goal of medics and researchers for decades. The immune system is one of evolutions most impressive creations. Given limited genetic resources it’s capable of producing billions of unique antibodies and receptors to recognise pathogens.

Given this diversity, this power for recognising many different proteins, there is a problem: stopping the immune system from attacking its own body. Fortunately a system exists. Immune cells are tested on their ability to react to the various bumps, crannies, and crevices of proteins from the body’s own cells. If they react, they are ordered to commit suicide, and the threat of an immune system attacking its own body is thwarted.

Obviously, it’s not a perfect system. Sometimes things go wrong and people get autoimmune diseases, with varying degrees of severity. But on the whole, it’s pretty good.

But this pruning of self-reactive immune cells can itself be a problem. There are occasions where it might make sense for the body to recognise some marker it normally finds in the body, for example, a protein marker on a cancer cell—something I’ll be writing more about here shortly.

For a long time we sought to harness the power of the immune system, to create man-made antibodies, serving as ‘magic bullets’*. Once injected into a patient they seek out their target, flagging it for attack and elimination by other parts of the immune system.

There are a number of such drugs on the market now. These ‘therapeutic antibodies’ are being used for a wide range of diseases from rheumatoid arthritis to Multiple Sclerosis (MS).Antibody.svg

It is MS that I wanted to highlight here. In its early stages MS is an autoimmune disease. The body, for some reason, begins to recognise and attack a type of cell called a Schwann cell. Schwann cells wrap themselves around the axons of neurons, the part which carries a neurons electrical impulse communications from place to place in the body, forming the ‘myelin sheath’. The myelin sheath both protects axons, and speeds up the transmission of nerve impulses.

Immune system damage to the myelin sheath disrupts how the nerve impulses are transmitted from place to place, causing a variety of debilitating and unpleasant symptoms for sufferers as the disease progresses.

Recently, in the EU, a therapeutic antibody—originally called CAMPATH-1H, also known as Lemtrada or Alemtuzumab—has been approved for treating some forms of MS. This is one of the very first therapeutic antibodies ever developed. It’s been a painstaking process, of over 40 years of research and development, starting in the laboratories of the Pathology department at Cambridge University.

Over the years, it’s been something of a rollercoaster ride getting CAMPAPTH-1H out there; leaving academia, being bought up by various biotech and pharmaceutical companies who dropped it or sold it on again. In the end it was the work of a team of academics who, recognising its potential, that brought it back into favour where others would have dropped it.

Cambridge University have just released a film  (below) detailing the story of CAMPATH-1H, and I’d say it’s really worth a watch to get the story of how this drug came about. My old boss, Prof Geoff Hale, is one of the figure heads of the story, and in my past I spent some of my time in the lab working on a variety of CAMPATH-1H projects.

The only thing the story doesn’t give you an idea of is the literally hundreds, possibly thousands, of scientists and researchers who have worked on CAMPATH-1H; of which I was on occasion a very small cog in a much, much bigger machine. Or the huge bravery of those who put their bodies and lives on the line in clinical trials, bringing this drug to where it is today.

Irrespective of your feelings (that they’re good or they’re evil) about pharmaceutical companies, know that there are thousands of people—just like you, but who happen to be scientists, medics, or other forms of researcher—out there, genuinely doing their best to find, create, and test new treatments for all kinds of illnesses. And this is the story of just one of those treatments.

Here’s Cambridge’s write up of the story:

And here’s the video

*Though I’m not as fond of that expression as others.