For years, immunology, or the study of the immune system, was a sleepy little corner in the otherwise fast-moving world of clinical research. Today, it is one of the hottest fields in medicine and a source for some of the most exciting new therapies in cancer and autoimmune disease.
Research hospitals around the world are working furiously to bring this budding science quickly into the clinic, but some are farther along. “We’ve been far ahead of the crowd in pursuing the translational aspect in ways that benefit patients,” says Tim Billar, Professor and Chair of the Department of Surgery at the University of Pittsburgh School of Medicine, UPMC’s academic partner. Billiar traces UPMC’s involvement in the field to the 1960s, when surgeons opened the field of organ transplantation with a number of firsts. Next came the introduction of effective immune suppression that transformed organ transplants from high-risk experiments to routine procedures. “Now with 20,000 organ transplants and many cancer breakthroughs,” Billiar says,
“we’ve been able to move seamlessly to clinical leadership in cancer immunotherapies like CAR T-cell therapy.”
Also in UPMC’s sights are treatments for a growing list of chronic inflammatory disorders. “Chronic inflammatory conditions affect nearly everyone at some point in their lives, are a major productivity drain, and contribute to accelerated aging,” Billiar says.
To consolidate their diverse capabilities in immunotherapy, UPMC and the University of Pittsburgh launched the Immune Transplant and Therapy Center (ITTC) in February 2018. The center’s goal is to advance the science of immunology to create innovations in four areas: cancer, chronic disease, aging, and transplant.
Ongoing projects include a clinical trial to infuse regulatory dendritic cells in liver transplant patients prior to surgery, with the hope of putting an end to toxic immunosuppression regimens. Another is a prospective trial using the diabetes drug metformin to see if it improves outcomes following high-risk surgery. Work is also progressing to explore bone marrow transplants as a novel pathway to treating debilitating conditions like refractory inflammatory bowel disease (IBD). The ITTC currently has five trials in motion.
Billiar, who serves as the center’s co-director and scientific lead, contends that the ITTC can help what ails the health research enterprise. “ITTC can rely on its position as part of UPMC’s own in-house business incubator, UPMC Enterprises, which commercializes what comes out of our labs,” Billar says. “Together, we’ve already had a hand in funding 30 projects and creating five start-up companies. Seeing our science come to life gives me a reason to think differently about the future of health care. From our perspective, the view looks promising.”
Scientific American asked four UPMC leaders about how technology, science, and adjusted incentives are transforming the patient experience, and the future of medicine. This article is one of four interviews.