Michael Valentinovich, you are not just an immunologist, you oncoimmunology. That is a specialist who not only explores, but also developing and implementing methods of immunotherapy in practice…
Michael kisielewski: every man should be reliable protection, which is determined by the state of its immunity. Protection from many diseases, including cancer. What affects the immune system? From many factors. But above all from genetics.
And so, if I’m lucky and I gave birth to with good genetics, I have a reliable immune system?
Michael kisielewski: Exactly. But if your body is not subjected to serious negative influences that can weaken innate immune defenses.
Such people, probably, does not happen. In varying degrees, someone once something negative is exposed.
Michael kisielewski: Wrong! If a person monitors their body, prevents chronic diseases, is not subject to injury, the other critical stress, the immune system needs to function normally.
it is written beautifully. Can bring the percent of such lucky?
Michael kisielewski: Alas! To this question the answer is no, and probably not just me. And genetics gives each person the so-called killer cells that are able not only to recognize and kill transformed, including tumor cells.
So, the main challenge for immunologists to not only find those cells, but to force them to become killers.
Michael kisielewski: You are absolutely right. This is the main problem we have, immunologists and geneticists. And our main difficulty lies in the fact that the tumor cells more cunning than us and is able to elude immune surveillance. Because the effectiveness of the killer cells are not always on top.
what?
Michael kisielewski: Here we develop the approaches of cell therapy, which is based on how to teach killer cells to recognize the elusive tumor cells.
Possible?
Michael kisielewski: more often. Including in the treatment of childhood tumors. I’ll try to explain how this works in practice. We allocated from blood lymphocytes, and outside the body of them get the killer cells. It is the immunologists all over the world, including we have learned to do. Moreover, applied it in practice.
You said “used”? Why not apply now? Were the poor results?
Michael kisielewski: on the Contrary! The results were very encouraging. But in 2017 entered into force the Federal law on biomedical cell products, which is actually equated to the production of any cell product.ktov to drugs with all the consequences. This pushed the practical application of cellular technologies and demanded from scientists, from researchers to organize pharmaceutical production. Unfortunately, we have been doing to this day. Instead of new technology, to justify himself, found practical application. And as far as I know, to this day, there is no certified production of cell products in Russia.
I could give you examples where cellular technology helped to save lives, to get rid of a malignant tumor. But, unfortunately, these examples are rare. And every message on them is akin to a kind of sensationalism, although apparently these technologies could become one of the trends in therapy of malignant tumors.
Michael kisielewski: Cellular technology could occupy a worthy place in system of rendering of medical aid to patients with oncological diseases, but only in cases where their effect is predictable.
how to predict the effect?
Michael kisielewski: the Effectiveness of artificially-grown killer cells could be enhanced if they are introduced directly into the tumor. In our cancer center cellular technology has helped in the treatment of severe 200 patients. This technology treated those patients in which therapy had been exhausted all other traditional methods.
Hundred of the cancer center for me is not very impressive. Especially against the background of frequent cases, when the traditional, tried and tested methods of dealing with the tumor does not give the desired effect. And it is possible to say that cellular technology will find wider application?
Michael kisielewski: sorry, can’t answer: Yes, tomorrow it will be. First you have to create production capacity for the production of cell product. It needs to be sterile manufacturing facilities, equipped with modern high performance equipment, allowing to make a “pipeline” to produce cells.
It’s very expensive? Why such conditions exist even in the leading Oncology centers of Russia? Abroad there. What is stopping us? The same pandemic has shown that we have tremendous opportunities, tremendous resources. Why cell technologies were on the margins?
Michael kisielewski: In our center, in fact, this module has already appeared. Purchased the necessary equipment. But you have to pass certification and obtain permission for the production of biomedical cell products.
let’s Say tomorrow a certificate will appear. Where have these cellular products?
Michael kisielewski: We are now creating genetically modified cells toEllery that are able to recognize tumor cells due to their genetic characteristics and to destroy them. Where do I get these cells? Raw material is the blood of the patient. Let me explain. The usual way climbs 20-50 milliliters of blood. Are lymphocytes. Among the lymphocytes, we find the killers. Conventional blood sampling can be replaced by the hardware allocation of lymphocytes, which contain the killers.
And here comes the main thing: the resulting cells are placed in a special incubator. There they are activated, undergo genetic modification. After that, they can be introduced into the patient, where they themselves recognize the tumor and destroy it. Similar technologies are already used in clinical practice for the treatment of leukemia, including in children. I hope that in the future they will be used to treat other cancers.
Treatment of cell technology is very expensive. If tomorrow all the regulations, if there are no problems with these technologies, they will be available to all who need them or they will be affordable only to the elite? Agree, Kovalchuk, that even the best technology lose their significance if they are only for a narrow circle.
Michael kisielewski: Yes, today is the very high technology that cost a lot of money. In the US, the treatment with genetically modified cells is more than 300 thousand dollars, in China – more than 80 thousand. This is clearly beyond the capacity of MLA. But nonetheless. If we can organize production facilities that will be equipped with high-efficiency equipment, it can reduce the cost, which is not above other high-tech methods of treatment. We have not had no financial problems in the development of these technologies and the purchase of high-tech equipment. I hope there will be no problems in their clinical application and wide availability.
Mikhail V. Kiselevsky, oncoimmunology Professor, doctor of medical Sciences.
Born in Moscow in 1955. Graduated from First Moscow medical Institute named after Sechenov.
the Author of 500 scientific papers.
Under the supervision of Professor M. V. Kiselevsky defended 8 doctoral and 25 master’s theses. Married. Wife Larissa – a lawyer. Son Alexei, the medical examiner.
