Immune System Boosters for the Elderly, Newborns, and Cancer Patients

The quest to build better people.
May 16 2013 12:03 PM

How to Superpower the Immune System

New strategies for fighting disease in newborns, the elderly, and cancer patients.

Uma Thurman as Poison Ivy.
Uma Thurman played Poison Ivy in Batman & Robin.

Photo by Getty Images/Handout

For all their powers, superheroes aren’t necessarily the healthiest crew. Spider-Man is weakened by a nasty flu the night Green Goblin throws his girlfriend from a bridge. Superman is almost vanquished by a “meteor-borne Kryptonian fungus.” After Captain Marvel seals a tank of nerve gas with his bare hands, he eventually dies of cancer.

Amanda Schaffer Amanda Schaffer

Amanda Schaffer is a science and medical columnist for Slate.

An exception, however, is Batman’s nemesis Poison Ivy. In one version, after her botanical biochemistry professor experiments on her with poisons, she develops “immunity to all toxins, bacteria and viruses.” No rational person would want Poison Ivy’s life (her boyfriend dies in a car crash, she is locked in an insane asylum), but who wouldn’t covet that superpower? Who wouldn’t wish to grant it to others?

Imagine you could protect babies from whooping cough from the day they were born. You could shield the elderly from deadly infections like pneumonia. You could protect millions of people from the next outbreak of pandemic flu. You could even fight cancer. Such hopes animate vaccine researchers as they look for new ways to train the immune system, ramping it up for battle (while sparing us the near-death traumas of Poison Ivy). Recent work has explored immunity boosts for the very young and very old, shots to shield against unknown flu strains, and vaccines that might treat disease or prevent recurrences in patients with prostate cancer, melanoma, and breast cancer.  

Kids today, it turns out, already have superimmunity compared with their peers 100 years ago: Thanks to vaccines, their bodies learn to fight measles, mumps, rubella, whooping cough, tetanus, diphtheria, and other deadly diseases. With a few exceptions, though, this kick-ass training can’t begin at birth. That’s because newborns’ immune cells don’t respond vigorously enough to most vaccines to lock in later protection. Babies don’t receive their first whooping cough shot until they’re 2 months old, and they aren’t fully protected until after a third dose, at 6 months. For measles, they aren’t vaccinated until their first birthdays. These delays can have devastating consequences. In the 2010 outbreak of whooping cough in California, 10 babies died—almost all of them younger than 2 months.

But what if researchers could design immunizations for newborns? Scientists at Boston Children’s Hospital have identified several molecules that seem specifically able to stimulate immune cells isolated from umbilical cord blood, at least in Petri dishes. Now they’re testing whether newborn animals that receive vaccines combined with these molecules develop better protection against bacterial diseases like pneumonia than animals given nonboosted vaccines. (Of course, they’re also studying whether supercharging newborn immune systems is safe.) “We’re asking whether vaccines that are typically given at 2, 4, and 6 months could be done with a single shot at birth,” if given along with booster molecules, said Ofer Levy, a pediatric infectious diseases expert who is leading the work. Researchers are similarly bullish on immunity boosts for the elderly, who are at higher risk for pneumonia and other infectious diseases and seem not to respond as vigorously to standard vaccines. “I’m quite convinced that we will develop new vaccines for the aging population in the next decade,” Jan Poolman, the global head of bacterial vaccines for Janssen pharmaceutical companies, told me.

Another battlefront is against pandemic flu, which scientists fear could wreak havoc around the globe. Flu mutates like crazy, and from year to year different strains circulate in the population. Most years’ strains are different enough from the previous season’s that we need new flu shots, but they’re not so different that our immune systems have never seen anything like them. Periodically, though, come nasty surprises: Spanish flu in 1918, which killed about 40 million or 50 million people; the H5N1 avian flu, which is often deadly in those who catch it from birds, though for now it can’t spread easily from person to person. Researchers keep an anxious eye out, hoping for a jump-start on the scary strains.

But what if they could make shots to guard against the unpredictable? The idea is this: Flu virus has mushroom-shaped proteins on its surface called hemagglutinins that it uses to invade human cells. Today’s vaccines prep the immune system to attack the bulbous head of the protein. But this is precisely the part that changes most from strain to strain. So as an alternative, researchers are trying to train the body to attack the protein’s stem, which it usually ignores. Since the stem changes far less from strain to strain, antibodies mounted against it could potentially protect against a wide range of flu types, including pandemic strains. Shazam!

A few ingenious tricks are now in play. Researchers at Mount Sinai Hospital in New York have injected mice with three successive shots, each containing a different hemagglutinin head on the same stem. They have found that this causes the mice to make anti-stem antibodies (focusing on the common denominator of the three shots), and that when the mice were exposed to additional types of flu virus, they did not get sick. Scientists at the National Institutes of Health’s Vaccine Research Center, meanwhile, are testing a DNA-based vaccine, followed by a boost, that may have similar effects. In two small, phase-one clinical trials, some people who received these shots made antibodies against the hemagglutinin stem. The Vaccine Research Center has three more small trials under way, and if all goes well, it plans to launch a larger, phase-two study as early as next year. The process is slow-going, but “conceptually, I now feel we will get there,” Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told me.

And then there is cancer, the evil twin that threatens to destroy us. For as long as kids have played superheroes, researchers have dreamed of battling cancer by turning the body’s own powers against the disease. In 2010 the Food and Drug Administration approved the first therapeutic vaccine for cancer, called Provenge, for men with advanced prostate cancer. (Here’s how it works.) In clinical trials, when men were treated with Provenge, their tumors tended not to shrink. On average, though, they lived about four months longer than men who hadn’t gotten the vaccine. This isn’t revolutionary progress. Nor does it make you feel great about the $93,000 price tag.

But the effort has shown that cancer vaccines can make it to market. And maybe future versions will pack more of a punch. Scientists are now conducting a vast range of clinical trials, with phase-three trials under way for melanoma, lung cancer, and breast cancer, among others. Researchers at MD Anderson Cancer Center in Texas, for example, are testing several vaccines designed to prevent recurrences in women who’ve been treated for breast cancer. Their approach is simple: Focus on a major protein found on the surface of breast cancer cells, derive fragments from that protein, then inject them into women, along with an immunity-boosting molecule, in hopes of stimulating the women’s immune systems to attack rogue cancer cells. In research presented in 2012, women who received one such vaccine cut their chances of a cancer recurrence after 22 months pretty substantially: down from approximately 18 percent to 10 percent. The approach is cheap, too: “I could personally construct this vaccine for pennies,” said Elizabeth Mittendorf, a surgical oncologist at MD Anderson. She and her colleagues are now overseeing a phase-three trial to test another, similar vaccine, with recruitment under way at about 100 sites around the world.

Imagine: A few of Poison Ivy’s powers might someday reach the rest of us, and superimmunity might be achievable for all in Gotham.

Read more from Slate’s Superman package: Is human enhancement cheating? Everyday technologies that already give us superpowers. Would you use superpowers for good or evil? Manimal rights: human-animal hybrids and chimeras.

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