Could COVID-19 Help Fight Cancer? New Research Shows Promise

1. Cancer, often called the "emperor of all diseases," is a leading cause of death worldwide. Despite many advances in science, it is still hard to treat, especially when cancer spreads to other parts of the body (metastasis).
2. Recent Study Overview: A study published in The Journal of Clinical Investigation (November 2024) by researchers from Northwestern University, Chicago has brought new findings.
3. The research shows that white blood cells activated by severe COVID-19 could help fight cancer, especially in slowing its spread.

Key Findings from the Northwestern University Study

1. Research Focus: The study looked at how a type of white blood cell, induced non-classical monocytes (I-NCMs), activated by infections like COVID-19, can help stop cancer from spreading.
2. The research was done on laboratory mice, where they found that I-NCMs could slow cancer spread (metastasis).
3. These cells can be triggered by infections like COVID-19 or certain chemicals.
4. COVID-19 and Cancer Remission: Though COVID-19 usually worsens the condition of older people or those with other health problems (including cancer), there have been rare cases where cancer improved or went into remission after a person had COVID-19.
5. A 2023 study by De Nigris et al. reported 16 cases where cancers like leukemia, lymphoma, myeloma, and kidney cancer seemed to improve.
6. However, it’s unclear whether COVID-19 itself caused the remission or if it was part of the natural course of the disease.

I-NCMs: Key Players in Fighting Cancer

1. What Are I-NCMs?

   1. I-NCMs are a special type of monocyte (a kind of white blood cell) that travel through the bloodstream.
   2. These cells are involved in fighting infections, helping regulate the immune system, and repairing tissue damage.
   3. When the body faces infections or certain chemicals, some monocytes change into I-NCMs.
   4. I-NCMs are unique because they have a special receptor called CCR2, which helps them detect signals from cancer cells or inflamed areas, guiding them to tumours.

2. How I-NCMs Work at Tumour Sites:

   1. At infection sites, I-NCMs help the body get rid of harmful germs.
   2. At tumour sites, I-NCMs help bring in natural killer (NK) cells, another type of immune cell that can attack and destroy cancer cells.
   3. Natural Killer (NK) Cells:
      1. NK cells are an important part of the body's first line of defence against diseases.
      2. Unlike other immune cells like T cells, they can quickly attack and destroy abnormal cells, including cancer cells, without needing prior approval from the immune system.

How to Generate I-NCMs:

1. COVID-19 as a Trigger:
   1. The study showed that COVID-19, caused by the SARS-CoV-2 virus, can trigger the creation of I-NCMs.
   2. However, not every COVID-19 patient will experience this effect on cancer.
2. Other Chemical Triggers:
   1. Besides COVID-19, certain chemicals, such as bacterial products (peptidoglycans) and NOD2 agonists (like MDP analogues), can also trigger the formation of I-NCMs.
   2. This discovery could open up new possibilities for using these chemicals in cancer treatments to create I-NCMs that fight cancer.

Immunotherapy: A New Hope in Cancer Treatment

1. Immunotherapy is a type of cancer treatment that helps the immune system find and attack cancer cells.
2. Unlike traditional treatments like chemotherapy, which attack all fast-growing cells (including healthy ones), immunotherapy helps the immune system focus on cancer cells.
3. Cancer Cells’ Defence Mechanisms: Cancer cells often trick the immune system into thinking they are normal cells, allowing them to grow and spread.
4. Immunotherapy aims to stop this trickery by helping the immune system see cancer cells as enemies and attack them.

5. I-NCMs and Immunotherapy:

   1. The Northwestern University study suggests that I-NCMs could be used in a new form of immunotherapy to fight cancer spread, working in ways that don’t depend on T and B cells (the body’s adaptive immune system).
   2. If proven effective in humans, this could lead to new cancer treatments that use the body’s own defences to fight cancer more directly.

Historical Background and Immunotherapy Breakthroughs

1. William Coley’s Work (1890s):

   1. The idea of using infections to treat cancer dates back to the late 19th century.
   2. Dr. William Coley, a surgeon, noticed that some cancer patients who got bacterial infections after surgery showed better outcomes.
   3. He injected bacterial toxins into patients and found it helped prevent cancer from coming back.
   4. This method, called Coley’s toxins, was used until the 1950s and laid the foundation for modern immunotherapy.

2. Recent Immunotherapy Successes:

   1. 2022 Study on Immune Checkpoint Inhibitors:
      1. A study published in The New England Journal of Medicine (2022) showed that patients with rectal cancer (who had a certain genetic flaw called mismatch repair deficiency) could achieve complete remission using immune checkpoint inhibitors.
      2. These drugs remove the "brakes" on T cells, allowing them to recognize and destroy cancer cells.

3. CAR-T Therapy:

   1. Another type of immunotherapy is CAR-T (Chimeric Antigen Receptor T-cell) therapy.
   2. This involves taking a patient’s T cells, reprogramming them in a lab to attack cancer cells, and then putting them back into the patient.
   3. This treatment has been successful for certain blood cancers like leukemia and lymphoma.

Challenges in Immunotherapy

1. Not All Cancers Respond:

   1. Immunotherapy does not work for all cancers.
   2. Its effectiveness depends on factors like the tumour’s environment, the number of mutations in the cancer, and whether the cancer cells have certain proteins like PD-L1 that help them avoid being attacked by the immune system.
   3. Even when immunotherapy works at first, cancer cells can sometimes adapt and become resistant to treatment.

2. I-NCMs and Chemical Treatments:

   1. Efforts to use chemicals like MDP analogues to create I-NCMs in cancer patients have had limited success.
   2. Mifamurtide, a drug that activates monocytes, is approved for a rare type of bone cancer in children and young adults, but it has not worked for many other types of cancer.

Potential Impact and Future Directions

1. The Northwestern study presents a potential new way to treat cancer metastasis (spread of cancer) by using the body's own immune cells, particularly I-NCMs and NK cells.
2. If this approach works in humans, it could offer a new method to treat cancer using the body’s natural defences.
3. Long-Term Outlook:
   1. Although the research is promising, it is still in early stages. More studies are needed before I-NCM-based therapies can become a part of routine cancer treatment.
   2. But it could be a breakthrough in using the immune system more effectively to fight cancer.

Conclusion:

More research is needed to test how I-NCMs can be used in humans. If successful, this could represent a new chapter in cancer treatment, offering hope for better therapies, especially for cancers that spread to other parts of the body.

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