Neuroscience Trials Australia CEO Dr Tina Soulis has traversed the globe attending conferences over the past several months, connecting with established and emerging leaders from the sector. From large-scale international industry events, such as BIO, to more niche and specialised meetings, including the Neurotech Investing and Partnering Conference, Tina has heard about and discussed the latest health innovations and most exciting investment opportunities in neuroscience research. Throughout this patchwork of different conferences around the world and across several axes of the drug and medtech development timeline, a string of recurring topics has revealed itself- a strong pattern of trends. Here, we briefly unpack what Tina sees as the three hottest trends in neuroscience research. This is Part III of a three-part series.
Inflammation and immunotherapy
Harnessing the power of the body’s own defence force – the immune system – and redirecting it where it’s gone off course is proving to be a hugely effective treatment approach and the focus of intensive research. Therapeutic interventions include immune suppression, often used to dampen inflammatory responses, and immunotherapy, which is used to enhance the immune system’s disease fighting capabilities.
Targeting the immune system has revolutionised cancer treatment. Malignant cells are able to evade the immune system by suppressing the immune response against them. Antibody-based immunotherapies neutralise these blockages and cell-based immunotherapies activate cancer-killing immune cells, allowing the immune system to mount an effective anti-tumour response. Immunotherapy is an approved treatment in a multitude of cancers and is being tested in many more.
While it is in the field of cancer where immunotherapy began its journey, it is now being investigated for other disease modalities. Great strides have been made in immunotherapy for neurological diseases, with a major focus on immunisation against the hallmark misfolded proteins of neurodegenerative diseases, amyloid-β (Aβ), tau and a-synuclein.
These immunisation-based immunotherapies started with the Aβ protein, with the first clinical trial in Alzheimer’s Disease nearly two decades ago. The field is making great progress despite a shaky beginning when trials were terminated due to adverse events or no therapeutic benefit was shown. Active and passive immunisation strategies against Aβ, tau and a-synuclein slow disease progression and even improve symptoms in animal models, and large numbers of ongoing clinical trials are very encouraging.
“When you use immunotherapy to activate the immune system, there is the risk that you increase inflammation, which we saw in the early clinical trials of amyloid-β immunisation. This is a huge problem in diseases like Alzheimer’s Disease where inflammation is part of the pathology,” says Neuroscience Trials Australia CEO, Dr Tina Soulis. “Researchers are working hard in the lab and the clinic to understand exactly when and how immune-activating immunotherapies should be used. It looks like they will be safest and most effective when used in the very early stages of disease.”
Only now are we beginning to explore the great opportunities for cell-based immunotherapies in neurodegenerative diseases. A recent trial in progressive Multiple Sclerosis (MS) involved taking T (immune) cells from patients, training them in the laboratory to kill Epstein Barr virus (EBV)-infected cells, then putting them back in the patients, where disease symptoms improved.
On the flipside, MS can also be treated by dampening down the pro-inflammatory immune response. Immune suppressing drugs and anti-inflammatory mediators can be used to keep inflammation at bay, and a recent trial showed that haematopoietic (blood) stem cell transplantation may be even more effective and just as safe. In the laboratory, researchers are also looking at how neurons respond to inflammation with a view to targeting nerve cells directly to protect neuronal function and the myelin sheath from damage.
The immune system has the potential to be an extremely powerful disease-fighting force. In neurodegenerative diseases where nothing close to a cure exists, the exciting landscape of immunotherapy research may enable the development of truly life-changing new therapies.