6 ms·

James P Allison and Tasuku Honjo win Nobel prize for medicine

176 points by okket 8y ago

Insanity 8y ago
There's also a link to live-reporting: https://www.theguardian.com/science/live/2018/oct/01/the-nobel-prize-in-physiology-or-medicine-2018-live https://www.theguardian.com/science/live/2018/oct/01/the-nob...
- Brakenshire 8y ago
  James P Allison on the harmonica! https://www.youtube.com/watch?v=pPsjsdNsdgs https://www.youtube.com/watch?v=pPsjsdNsdgs
dm319 8y ago
That's great. They discovered the CTLA4 and PD-1 receptors - cell pathways that help protect against auto-immunity and allergy, but which can be hijacked by cancer to prevent cancer clearance. The realisation that our immune system is important in protection of cancer is only really just starting to blossom, and there is a lot that still isn't understood. We don't know how many cancers are routinely cleared by our immune system. Some researchers think it might be in the order of 10s a day.
- rqs 8y ago
  So if my understanding was correct, by applying the treatment (Immune Checkpoint Therapy I guess), immune system will clean cancer cells like they're doing a everyday task? Well, then I hope one day that treatment will become cheap enough so it can benefit everybody.
  - iskander 8y ago
    The immune system is thought to already clear mutated and defective cells as part of their everyday activity. Cancers which grow to a detectable/dangerous population have to find some way to evade this immune surveillance and hitting off switches like "immune checkpoints" is one way to accomplish this. So, blocking the off switches helps the immune system resume its everyday task of killing weird cells.
    - lmkg 8y ago
      Is this envisioned as a treatment for detected cancer, or a preventative measure, or is the discovery too recent to tell at this point?
      - jfarlow 8y ago
        This is already being deployed in therapies today - https://en.wikipedia.org/wiki/Checkpoint_inhibitor https://en.wikipedia.org/wiki/Checkpoint_inhibitor And it works well in conjunction with other therapies that guide or otherwise help the immune system find the cancer. In particular, a style of designer gene therapy just approved by the FDA, of which one is called a Chimeric Antigen Receptor - https://en.wikipedia.org/wiki/Chimeric_antigen_receptor https://en.wikipedia.org/wiki/Chimeric_antigen_receptor These are in patients now, and curing people today. If, for instance, the chimeric receptor (a designed synthetic cell-receptor) is able to enable immune cells to better sense the cancer, and that is coupled with the checkpoint inhibitors to prevent the cancer from disabling those immune cells, one's own immune cells will then be able to directly kill the cancer. The checkpoint inhibitors (associated with the Nobel here), take the brakes off of the immune system. This can of course be dangerous, but generally one of cancer's first tricks it learns is how to apply those brakes to hide from detection. So by tuning down the sensitivity to the immune system's 'brake pedal', one's own immune system becomes more capable in fighting cancer.
        iskander 8y ago
        Maybe helpful for the HN crowd: the adaptive immune response typically prioritizes a low false positive rate. A developing cancer sneaks by as a false negative. Checkpoint blockade moves the immune system to a regime of higher sensitivity, at the expense of potentially lower specificity.
        teekert 8y ago
        Yes, this. The side effects are not to be underestimated (they are similar to autoimmune disorders). Moreover, there are no good tests yet that can predict whether someone will respond. If someone does, it's sometimes spectacular but with all therapies from the field combined optimally, less than 40-50% responds (with single drugs it's around 10% I believe).
mxuribe 8y ago
Obvious cancer treatment aside, I'm amazed about the possibilities for treating allergies. Sure, allergies might not seem as big a deal, but with the last few American generations having to deal with - what seems like a crazy increase in manifestations - from mild nasal/environmental allergies all the way to severe, deadly anaphylaxis-type (such as vs. peanut and other food) allergies...I sure hope this area of research gets tons of money thrown in. Don't mean to get political, but when many U.S. administrations talk of throwing billions towards military weapons, but nowhere near as much towards positive research like this, it just gets me frustrated. (Caveat: I do understand and support some types of military research that lead to positive technologies such as GPS, etc. I'm referring to governments spending billions on stupid projects like the F-35 joint strike jet fighter.) Anyway, kudos and hearty congrats to the Nobel winners!
- thanatropism 8y ago
  It's not a 100% fit to your point, but there's that old bromide that half of $[stuff] is $[good in some way] and half is $[bad], but we don't know which is which.
- jbob2000 8y ago
  > Don't mean to get political, but when many U.S. administrations talk of throwing billions towards military weapons, but nowhere near as much towards positive research like this, it just gets me frustrated. I picked up an adage from an old engineer once: “It doesn’t matter how many men or how much money you have, it still takes 9 months to make a baby”. I do agree that science is underfunded, but sometimes money isn’t the problem, things just take time.
  - patall 8y ago
    It quite often is actually. Until today, about half of all human genes have never been described in any detail at all. We do not know what function they serve, only that they exist and that most of those are probably not that important. Therefore no early career scientist can really dare to investigate any of them, if they do not certainly want to endanger their future careers. If they would have not worry about that, a lot of bright minds that now only study those 5% of genes that promise the most interesting results could diverge and with a high probability discover a new PD-1 here and CTLA4 there. And thats not a question of time (besides the maybe 10 years to study a gene well), that is 100% a problem of funding.
MrEfficiency 8y ago
EDIT: Deleted my question to save HN karma
- psychometry 8y ago
  This is science, not peace. Not a difficult distinction.
  - MrEfficiency 8y ago
    Isnt it the same Academy? Why would science be assumed to be uncorrupted?
    - sorenjan 8y ago
      No. The peace prize isn't even awarded by the same country.
    - dctoedt 8y ago
      No, it's not the same academy. The peace prize is awarded by a Norwegian committee [0], the science prizes by Swedes. https://en.wikipedia.org/wiki/Nobel_Peace_Prize https://en.wikipedia.org/wiki/Nobel_Peace_Prize
vincnetas 8y ago
Why not link to the source of information (with summary, explanation and illustrations to for common people): https://www.nobelprize.org/prizes/medicine/2018/prize-announcement/ https://www.nobelprize.org/prizes/medicine/2018/prize-announ...
beautifulfreak 8y ago
I wonder how long it will take for CRISPR to be recognized.
- rflrob 8y ago
  Kary Mullis waited 9 years after PCR to win a Nobel, but the recognition (for both PCR and CRISPR) came much faster.
- oldgradstudent 8y ago
  Why should it be awarded the Nobel prize for medicine? Are there any medical applications in use today?
- sndean 8y ago
  Possibly soon. Some awards that Allison/Honjo and CRISPR researchers have both won recently: Warren Alpert Foundation Prize: Allison, Honjo et al. (2017). CRISPR researchers (2016). Tang Prize: Allison, Honjo et al. (2014); CRISPR researchers (2016). Albany Medical Center Prize: Allison et al. (2018); CRISPR researchers (2017). Gairdner Foundation International Award: Allison et al. (2014); CRISPR researchers (2016). Gabbay Award: Allison (2011); CRISPR researchers (2014). Breakthrough Prize in Life Sciences: Allison (2014); CRISPR researchers (2015). That doesn't mean they'll win the Nobel, but they're definitely in the same awards realm recently. It might be Emmanuelle Charpentier, Feng Zhang, and Jennifer Doudna.
- patall 8y ago
  CRISPR will mostly likely win the chemistry (same as PCR) prize at some point. Maybe Wednesday, maybe in 10 years when the committee can finally decide whether Doudna and Charpetier deserve it more, or Zhang or any of the other scientists involved. Anyways, CRISPR is recognized and will win a nobel, its only a question of time.
bawana 8y ago
I wonder what the effect on some psychiatric diseases will be? Recently it was reported that bone marrow transplant resolved schizophrenia in a cancer patient.
iskander 8y ago
Surreal to be at the CRI / cancer immunotherapy conference while this got announced.
- Gatsky 8y ago
  Yes, I’m there too, feels like we are participating in history.
vedtopkar 8y ago
Amazing and very well deserved! Checkpoint blockade drugs are in their nascency, and though they aren't a silver bullet, they can be incredibly effective nonetheless. A large number of people will be saved from cancer (and maybe some other ailments too) thanks to these scientists. As an aspiring medical researcher, stories like these are humbling and inspiring.
AtlasBarfed 8y ago
This certainly is promising, but I fear the drug companies will block the customized processes that would make this truly useful for mass produced pills of less efficacy. I think there are lots of medical treatments involving custom genetics that might not be as profitable as drug production but would rather involve a lot of lab work. Things that are initially not as easily automated and profitable (but certainly economically feasible given the prices of drugs imposed by patent monopolies). I don't think investment in these approaches will occur without government sponsorship and kickstarting.

176 points by okket 8y ago

There's also a link to live-reporting: https://www.theguardian.com/science/live/2018/oct/01/the-nobel-prize-in-physiology-or-medicine-2018-live https://www.theguardian.com/science/live/2018/oct/01/the-nob...

Brakenshire 8y ago
James P Allison on the harmonica! https://www.youtube.com/watch?v=pPsjsdNsdgs https://www.youtube.com/watch?v=pPsjsdNsdgs

dm319 8y ago

That's great. They discovered the CTLA4 and PD-1 receptors - cell pathways that help protect against auto-immunity and allergy, but which can be hijacked by cancer to prevent cancer clearance. The realisation that our immune system is important in protection of cancer is only really just starting to blossom, and there is a lot that still isn't understood. We don't know how many cancers are routinely cleared by our immune system. Some researchers think it might be in the order of 10s a day.

rqs 8y ago
So if my understanding was correct, by applying the treatment (Immune Checkpoint Therapy I guess), immune system will clean cancer cells like they're doing a everyday task? Well, then I hope one day that treatment will become cheap enough so it can benefit everybody.
- iskander 8y ago
  The immune system is thought to already clear mutated and defective cells as part of their everyday activity. Cancers which grow to a detectable/dangerous population have to find some way to evade this immune surveillance and hitting off switches like "immune checkpoints" is one way to accomplish this. So, blocking the off switches helps the immune system resume its everyday task of killing weird cells.
  - lmkg 8y ago
    Is this envisioned as a treatment for detected cancer, or a preventative measure, or is the discovery too recent to tell at this point?
    - jfarlow 8y ago
      This is already being deployed in therapies today - https://en.wikipedia.org/wiki/Checkpoint_inhibitor https://en.wikipedia.org/wiki/Checkpoint_inhibitor And it works well in conjunction with other therapies that guide or otherwise help the immune system find the cancer. In particular, a style of designer gene therapy just approved by the FDA, of which one is called a Chimeric Antigen Receptor - https://en.wikipedia.org/wiki/Chimeric_antigen_receptor https://en.wikipedia.org/wiki/Chimeric_antigen_receptor These are in patients now, and curing people today. If, for instance, the chimeric receptor (a designed synthetic cell-receptor) is able to enable immune cells to better sense the cancer, and that is coupled with the checkpoint inhibitors to prevent the cancer from disabling those immune cells, one's own immune cells will then be able to directly kill the cancer. The checkpoint inhibitors (associated with the Nobel here), take the brakes off of the immune system. This can of course be dangerous, but generally one of cancer's first tricks it learns is how to apply those brakes to hide from detection. So by tuning down the sensitivity to the immune system's 'brake pedal', one's own immune system becomes more capable in fighting cancer.
      - iskander 8y ago
        Maybe helpful for the HN crowd: the adaptive immune response typically prioritizes a low false positive rate. A developing cancer sneaks by as a false negative. Checkpoint blockade moves the immune system to a regime of higher sensitivity, at the expense of potentially lower specificity.
        teekert 8y ago
        Yes, this. The side effects are not to be underestimated (they are similar to autoimmune disorders). Moreover, there are no good tests yet that can predict whether someone will respond. If someone does, it's sometimes spectacular but with all therapies from the field combined optimally, less than 40-50% responds (with single drugs it's around 10% I believe).

mxuribe 8y ago

Obvious cancer treatment aside, I'm amazed about the possibilities for treating allergies. Sure, allergies might not seem as big a deal, but with the last few American generations having to deal with - what seems like a crazy increase in manifestations - from mild nasal/environmental allergies all the way to severe, deadly anaphylaxis-type (such as vs. peanut and other food) allergies...I sure hope this area of research gets tons of money thrown in. Don't mean to get political, but when many U.S. administrations talk of throwing billions towards military weapons, but nowhere near as much towards positive research like this, it just gets me frustrated. (Caveat: I do understand and support some types of military research that lead to positive technologies such as GPS, etc. I'm referring to governments spending billions on stupid projects like the F-35 joint strike jet fighter.) Anyway, kudos and hearty congrats to the Nobel winners!

thanatropism 8y ago
It's not a 100% fit to your point, but there's that old bromide that half of $[stuff] is $[good in some way] and half is $[bad], but we don't know which is which.
jbob2000 8y ago
> Don't mean to get political, but when many U.S. administrations talk of throwing billions towards military weapons, but nowhere near as much towards positive research like this, it just gets me frustrated. I picked up an adage from an old engineer once: “It doesn’t matter how many men or how much money you have, it still takes 9 months to make a baby”. I do agree that science is underfunded, but sometimes money isn’t the problem, things just take time.
- patall 8y ago
  It quite often is actually. Until today, about half of all human genes have never been described in any detail at all. We do not know what function they serve, only that they exist and that most of those are probably not that important. Therefore no early career scientist can really dare to investigate any of them, if they do not certainly want to endanger their future careers. If they would have not worry about that, a lot of bright minds that now only study those 5% of genes that promise the most interesting results could diverge and with a high probability discover a new PD-1 here and CTLA4 there. And thats not a question of time (besides the maybe 10 years to study a gene well), that is 100% a problem of funding.

MrEfficiency 8y ago

EDIT: Deleted my question to save HN karma

psychometry 8y ago
This is science, not peace. Not a difficult distinction.
- MrEfficiency 8y ago
  Isnt it the same Academy? Why would science be assumed to be uncorrupted?
  - sorenjan 8y ago
    No. The peace prize isn't even awarded by the same country.
  - dctoedt 8y ago
    No, it's not the same academy. The peace prize is awarded by a Norwegian committee [0], the science prizes by Swedes. https://en.wikipedia.org/wiki/Nobel_Peace_Prize https://en.wikipedia.org/wiki/Nobel_Peace_Prize

vincnetas 8y ago

Why not link to the source of information (with summary, explanation and illustrations to for common people): https://www.nobelprize.org/prizes/medicine/2018/prize-announcement/ https://www.nobelprize.org/prizes/medicine/2018/prize-announ...

beautifulfreak 8y ago

I wonder how long it will take for CRISPR to be recognized.

rflrob 8y ago
Kary Mullis waited 9 years after PCR to win a Nobel, but the recognition (for both PCR and CRISPR) came much faster.
oldgradstudent 8y ago
Why should it be awarded the Nobel prize for medicine? Are there any medical applications in use today?
sndean 8y ago
Possibly soon. Some awards that Allison/Honjo and CRISPR researchers have both won recently: Warren Alpert Foundation Prize: Allison, Honjo et al. (2017). CRISPR researchers (2016). Tang Prize: Allison, Honjo et al. (2014); CRISPR researchers (2016). Albany Medical Center Prize: Allison et al. (2018); CRISPR researchers (2017). Gairdner Foundation International Award: Allison et al. (2014); CRISPR researchers (2016). Gabbay Award: Allison (2011); CRISPR researchers (2014). Breakthrough Prize in Life Sciences: Allison (2014); CRISPR researchers (2015). That doesn't mean they'll win the Nobel, but they're definitely in the same awards realm recently. It might be Emmanuelle Charpentier, Feng Zhang, and Jennifer Doudna.
patall 8y ago
CRISPR will mostly likely win the chemistry (same as PCR) prize at some point. Maybe Wednesday, maybe in 10 years when the committee can finally decide whether Doudna and Charpetier deserve it more, or Zhang or any of the other scientists involved. Anyways, CRISPR is recognized and will win a nobel, its only a question of time.

bawana 8y ago

I wonder what the effect on some psychiatric diseases will be? Recently it was reported that bone marrow transplant resolved schizophrenia in a cancer patient.

iskander 8y ago

Surreal to be at the CRI / cancer immunotherapy conference while this got announced.

Gatsky 8y ago
Yes, I’m there too, feels like we are participating in history.

vedtopkar 8y ago

Amazing and very well deserved! Checkpoint blockade drugs are in their nascency, and though they aren't a silver bullet, they can be incredibly effective nonetheless. A large number of people will be saved from cancer (and maybe some other ailments too) thanks to these scientists. As an aspiring medical researcher, stories like these are humbling and inspiring.

AtlasBarfed 8y ago

This certainly is promising, but I fear the drug companies will block the customized processes that would make this truly useful for mass produced pills of less efficacy. I think there are lots of medical treatments involving custom genetics that might not be as profitable as drug production but would rather involve a lot of lab work. Things that are initially not as easily automated and profitable (but certainly economically feasible given the prices of drugs imposed by patent monopolies). I don't think investment in these approaches will occur without government sponsorship and kickstarting.