Cholesterol test? CBC panel? How about an immunome scan or an x-ray of your immune system? In the next decade, a fast and accurate genetic analysis of a patient’s natural defense system may be a regular feature of his or her annual check-up lab work. The applications are poised to disrupt healthcare, not just for disease diagnosis, but for truly personalized therapy development as well.
The human adaptive immune system – the part of us that responds to pathogens and remembers them to fight future invasions – is nature’s most finely tuned diagnostic and therapeutic for most diseases. Until the recent developments of sequencing and bioinformatics, decoding the genetics of a patient’s immune response wasn’t possible or practical. The medical community could not fully leverage this remarkable resource.
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Chad Robins Chad Robins is the co-founder and CEO of Adaptive Biotechnologies, a commercial-stage biotech company that aims to translate the genetics of the adaptive immune system into clinical products to diagnose and treat disease. Prior to co-founding Adaptive, Chad held numerous executive-level positions in medical technology, investment and real estate companies. Chad holds an […]
Soon, deep reading the immune system will be a reality, as the future of healthcare, in fact the future of health, is being shaped by the proliferation of actionable data and the imperative to move from a healthcare system focused on “sick” care to one that is focused on maintaining and optimizing health. Data lakes, improved screening technologies and perfected analytics are unlocking a new field of immune system genomics – immunomics.
The adaptive immune system both detects and treats most diseases, including cancer, autoimmune disorders, and infectious diseases, in exactly the same way. It does this through specialized cells– T cells and B cells – that each have receptors on their cell surface called T-cell receptors (TCRs) or B-cell receptors (BCRs) that act as scanners. When there is a match between the immune cell receptor and a disease-specific signal, or antigen, the immune response begins. The same immune cell that detects disease springs into action to respond to the disease, acting as both an ultra-specific diagnostic to identify the disease and a natural therapeutic to clear the disease. Databases of T-cell and B-cell receptors are ripe for artificial intelligence (AI) and machine learning applications to create diagnostic algorithms. The sequencing of the human immune system is underway, revealing the genetic code for circulating immune cells that could yield potential targets for therapies or vaccines.
There are also efforts underway to combine immunosequencing expertise with artificial intelligence and machine learning to map the trillions of T-cell receptors in our immune system to the millions of diseases that they diagnose and treat. This can help to create a diagnostic tool to define and interpret patient immunomes. The results should reveal in near real-time the patient’s inner health even before any disease manifests in a noticeably symptomatic way.
The applications of immunomic information should disrupt healthcare the way Airbnb invented a new hospitality industry and Uber redefined “gig economy.” Disease diagnoses of the 2020s will begin to transform from ruling out illnesses using multiple, costly and incremental medical tests. Instead, one blood draw could unmask a patient’s immunomic profile, ruling in the presence of disease. This precise health and disease diagnostic has the potential to help healthcare professionals guide patients to options of truly personalized treatments and disease interventions.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Immune-driven medicine should be particularly promising for patients who have such hard-to-diagnose illnesses as lyme disease and celiac disease. Patients with these diseases, and other infectious diseases and autoimmune disorders, often bounce between specialists and undergo unnecessary or irrelevant tests that extract high physical, emotional and financial costs, taking months, and often years, before figuring out what’s making them sick.
Immunomics has the potential to help clinicians and researchers to better understand the relationship between diseases and our bodies natural ability to diagnose and treat them. This knowledge should further open the doors to precision medicine in ways currently impossible to explore until recent advances in AI and machine learning. These advances are enabling us to read and translate the massive amount of data stored in our immune systems at scale.
Immunomics also is priming the transformation of personalized therapeutics. The sequencing of the human immune system is making it possible to map TCR sequences to a specific disease signal. This map will make it possible to see what diseases the immune system has fought or is currently fighting. The map will also help us to identify the most promising TCR candidates for therapeutic development for patients that share a common antigen for cancer, an autoimmune disorder or infectious disease. This same genetic information can be applied to develop therapies personalized to a patient’s unique disease. This may allow for improved efficacy and safety, much lower risks of therapeutic failure and ultimately deliver a greater likelihood of health benefits for patients.
We are inspired by the ways immunomics is being used to enrich our understanding of the human body like never before; to fundamentally alter the way therapeutics are researched and developed; and to more precisely and quickly diagnose patients so they can receive treatment earlier with a better chance of improved outcomes. If we continue to use our endless curiosity to power these innovations, the future of medicine is limitless.
Photo: Eraxion, Getty Images
Chad Robins is the co-founder and CEO of Adaptive Biotechnologies, a commercial-stage biotech company that aims to translate the genetics of the adaptive immune system into clinical products to diagnose and treat disease. Prior to co-founding Adaptive, Chad held numerous executive-level positions in medical technology, investment and real estate companies. Chad holds an MBA from The Wharton School at the University of Pennsylvania and a BS in Managerial Economics from Cornell University.
