Original subtitles

[announcer] On Tomorrow's World Today...

we explore the cutting-edge advances

that are shaping four different worlds.

The world of inspiration,

where the wonders of the natural world amaze and inspire us.

The world of creation,

where ideas come to life from traditional arts.

The world of innovation,

where ideas and inventions move us all forward.

The world of production,

where innovations are mass produced to improve our lives.

From Inventionland world headquarters,

here's your host, George Davison.

Hi, everyone. I'm George Davison.

And on this episode of Tomorrow's World Today

we're gonna visit the world of innovation,

to explore how healthcare is evolving.

One of the most fascinating things about the human body is,

it's ability to defend itself against foreign invaders.

But when our immune system

can't fight these invaders alone,

we turn to science for help.

And it seems like an impossible mission.

Scientists and researchers not only fighting the viruses and diseases of today,

but also working hard to predict and prevent

the unknown diseases of tomorrow.

From innovations in how our cells may fight cancer

or multiple sclerosis,

to how we've changed the way we're looking at and treating infectious diseases like HIV.

Scientists work day and night to keep us healthy and well in to tomorrow's world.

And while no one can predict the future,

these scientists are tirelessly working

to adapt to our changing health needs.

Just who are these healing heroes

that are working to improve our lives?

I'm sending Greg to explore this world for all of us.

[Greg] Multiple sclerosis or MS,

is a chronic disease that effects the central nervous system.

Negatively impacting the health and daily lives

of the people who suffer from it.

Early in 2022 two landmark studies

were released with an amazing finding,

that the Epstein-Barr virus or EBV was a necessary trigger for MS.

I'm in California at Atara Biotherapeutics

to meet with Dr. AJ Joshi and discuss those two studies.

And their investigational T-cell therapies targeting EBV,

which could potentially change the way we treat MS.

-Hi, AJ. -Hi, Greg.

-Pleasure to meet ya. -Great to meet you, too.

Let's drive right into these two studies.

Now, there's been an association between

MS and Epstein-Barr virus for quite some time.

What makes the information in these studies so different, such a game changer?

Well the question's always in, what does that association really mean?

And stepping back,

Ninety to 95% of us have already gotten Epstein-Barr virus infection.

And once you have it, it is a lifelong infection

that our bodies are able to fully control with our own immune systems.

Now, for MS patients, they seem to have

a bit of a different immune response to Epstein-Barr virus.

And we believe it's that difference

that's what's driving the development of multiple sclerosis.

Now, a lot of this has been theory up until the beginning of this year,

when two studies were just published,

in two of the most respected scientific journals,

and one of those studies specifically called out that Epstein-Barr virus infection

gives your a 32 fold increased risk into developing MS.

Or over 3000%.

It also found that, the brain damage

that you have associated with multiple sclerosis

starts only after you get the Epstein-Barr virus infection.

So when you put all that together,

that really moves us from association to the idea,

the conclusion I should say,

that Epstein-Barr virus is the leading trigger for multiple sclerosis.

Right. Now, I know Atara's taking a fairly novel approach

to fighting this disease, tell me about that.

So we're generating EBV positive T-cells,

so T-cells that can recognize Epstein-Barr virus,

with the hope of eliminating

just those disease causing cells that are really driving the infection.

We're not taking the approach that is taken in many other place,

where they're making cells specifically for one patient

that takes several weeks to make when the patient needs it.

We start out and we build the large inventory of,

essentially, off-the-shelf T-cells.

So that way, whenever a patient has a need,

we're able to deliver on that need very rapidly.

Well, I'd love to see that process.

Fantastic, we've actually arranged a tour for you

-at the manufacturing facility with Alia. -Let's go.

-Alia. -[Alia] Hey, Greg. How are you?

I'm doing great. I'm ready to see this amazing process in action.

[Alia] Great, let's get started.

-So this is the first step? -[Alia] This is the first step.

Sarah will be removing the vial from the cryopod,

where she'll thaw it in the Plasma-Therm.

And the Plasma-Therm will very slowly bring the vial up to temperature.

[Greg] Okay, what'll happen to the vial

once it's brought up to the proper temperature?

[Alia] After we bring it up to the proper temperature,

she's gonna remove it from the Plasma-Therm,

Justin's going to be receiving the vial that we've just thawed,

where he'll transfer the cells from that vial into a new conical tube.

He's then going to resuspend the cells in some media

and create a balance tube so that we're able to centrifuge.

[Greg] After Justin prepares the vial and it goes through the centrifuge,

what happens next?

[Alia] We head over to the bioreactors,

come with me and I'll show you.

[Greg] So, Alia, this is the bioreactor,

which sounds amazingly cool.

[Alia] It is so cool, let me tell you about it.

So it provides a sterile environment for the cells to grow.

It controls their nutrients, it controls their temperature, their oxygen.

And they're really happy in here growing for about seven to 30 days.

[Greg] Can you take that cover off

so I can see what's happening in there?

Yeah, let me show you.

So within here we have an agitator,

which keeps the cells resuspended so they're happy growing.

[Greg] All right, so they've been agitated

and they've done all the growing that they need to do,

what happens to them after that?

[Alia] Then we go on to the cool part and we begin to fill vials.

[Greg] Excellent.

[Alia] All right, welcome to the fill room, Greg.

After the cells are done growing in the bioreactors

they get purified and formulated.

We bring those formulated cells over to the fill room,

where the ultimately get filled into those little vials.

After they get filled in the vials, they'll be inspected,

and ultimately end up in our long-term cryopreservation storage.

[Greg] Now, this is a fully robotic system, can we see it in action?

[Alia] Yeah, absolutely. Melissa, if you'd like to get started.

[Greg] Alia, it feels pretty good to be out of that spacesuit.

Yeah, I can imagine. You did a great job.

But now that we've made it to the end of the line of manufacturing,

we're out of the clean rooms, inspection has been completed.

We're ready for the vials to be stored in their final

cryopreservation storage condition.

[Greg] Well, I'd like to find out more about the cryostorage process.

[Alia] Yeah, absolutely.

I actually think you're supposed to be meeting Matt,

our Vice-President of Operations over there and he'll carry on from here.

-[Greg] Excellent, thank you very much. -Thank you.

-Hi, Matt. -Hi, Greg.

-Welcome to product storage. -[Greg] Thank you very much.

I'm very interested to find out about this whole process.

What can you tell me about cryostorage?

[Matt] Well, it all started from a donor.

We took an EBV positive donor with health immune system,

and we delivered their white blood cells here for manufacturing.

We manufactured an EBV T-cell that can target

EBV infected cells in a patient.

After some quality checks, for froze it, and we cryopreserved it here

to be ready for a patient in time of need.

[Greg] Yeah, now, I mean, all of this looks really cold in there.

What's the shelf life of these cells?

[Matt] That's the beauty of cryopreservation,

the temperatures below -150 C,

we get long-term storage ready for patient delivery.

Excellent. Now, when we talk about genetics and immunotherapy,

clearly it can't be a one size fits all kind of a treatment?

It's not, but all of our T-cell products are tested to the same standard

to help ensure quality and safety.

But there are some key genetic differences that are important for matching.

It's kind of like a blood transfusion.

You wanna find a match between donor and patient based on the genetics.

That's amazing. Matt, thank you very much.

I'm heading off to San Francisco to find out about

some new therapies in HIV and AIDS treatment.

-All right, thanks, that sounds exciting. -[Greg] See ya later.

Over 40 years ago, in 1981,

acquired immunodeficiency syndrome

or AIDS was first identified in The United States.

Now, it wasn't until three years later, in 1984,

that human immunodeficiency virus or HIV

was discovered to be the underlining cause of AIDS.

Now, unfortunately, that discovery was overshadowed

by a cloud of discrimination and silence, all based around a fear of the unknown.

Now, I'm in San Francisco, California,

considered to be the US epicenter of the AIDS and HIV epidemic.

I'm at the National AIDS Memorial Grove.

Created to remember the thousands lost to the terrible disease.

But it's a new day.

And I'm going to meet with Dr. Brian Woodfall,

the global head of infectious disease

for Janssen Johnson & Johnson.

We're gonna discuss new therapies, new treatments,

and new hope in the battle against AIDS and HIV.

-Hi, Brian. -Hi, welcome.

Oh, thanks for having me here.

Now, Brian, as we've seen with the current pandemic

it can be really difficult to fight a disease when you don't know much about it.

You were there at the very beginning of the AIDS and HIV epidemic,

and were in the same position, what was that like for you?

I started in the area in the mid-'80s

and it was incredibly frightening at the time.

We had a new disease, we didn't know what was causing it,

how it was transmitted,

certainly not how to prevent or treat it.

It was incredible exciting to be working on a new medical mystery

and to look for ways that we could bring innovation

to those that were already effected by the disease.

And I know that, to this day, that's what you're working on here at Janssen,

so I'm really excited to find out what's happening.

Come on in, let me show you.

So I wanted to show you a typical lab

where our innovation in science really begins.

Is this what a lab would've looked like even in the beginning of the epidemic?

Absolutely, this is where the bench scientists really made the basic discoveries

that underpinned our advances in the disease.

Now, I know that in the beginning of this,

you had to deal with even more than just the science.

[Brian] For sure, the science was the basis.

But we had to bring together clinicians, academics,

front line healthcare workers,

regulators, patient advocacy groups.

Really took an entire team effort

to make the advances against the disease that we really needed.

Right. Now, what sort of innovations have occurred over the last few decades?

Well, to take it from an invariably fatal disease

to one where you can live generally long and health life

we needed first to find efficacious treatment.

So they were effective and they had to be very safe, of course.

Not only for the short-term when you took them,

but for the long-term, considering people would be

taking them for several decades.

And then they had to be convenient and simple.

So we went from multiple pills multiple times a day,

to one pill once a day,

and now even to injectable treatments that can be given once a month

or once every two months.

So safe, effective, and convenient, those are the watch words.

Absolutely, it has to fit into people's lives

so they are able to take it for long-term

to live longer and healthier lives.

I think that we've made huge progress against HIV

as well all know over the last 30 years.

Going from an invariably fatal and progress illness

to one that, now, if patents have access

to the state-of-the-art treatments

can potentially live for a normal life span with a high-quality of life.

Those scientific principles and learnings we've had along the way

can be applied to other illnesses.

An example of that is hepatitis C,

the things that we've learned in terms of scientific method,

diagnostics, treatments, how to effect the viruses replication in HIV,

were applied to hepatitis C.

And so we very quickly moved from identifying the hepatitis C virus

to a point where we can actually cure it.

Well, Brian, this has been great.

I'm gonna go meet now with James Merson.

And find out more about the future of treatment

-of infectious diseases. -Wonderful.

-James. -Greg.

-Pleasure to meet you. -And you too.

So Brian and I were just discussing Janssen's innovations

when it comes to the treatment of HIV and AIDS.

But what do you think are some of the significant unmet needs

regarding other infectious diseases?

Well, unfortunately, there are many infectious diseases,

which continue to really threaten mankind.

And that's because they continue to spread,

the continue to evolve,

and, unfortunately, effect disproportionately the most vulnerable people.

Janssen's mission is, to discover, develop,

and deliver transformative medicines

to manage these life-threatening diseases.

What are some of the specific diseases you're referring to?

Well, a big one that we're focused on is, hepatitis B virus, HBV.

Which effects about 300 million people worldwide.

And, unfortunately, for those people diagnosed

they have to take an antiviral for the rest of their life.

What we're trying to do in Janssen is, generate a functional cure

where we reset their immune system

so that they can manage this infection

without having to take any medications.

Antimicrobial resistance, where bacteria has become resistant to antibiotics

continues to also be a real scourge for humanity.

About 700,000 people die from antimicrobial infections every year.

And then, there's the acute viral respiratory infections like influenza

and respiratory syncytial virus.

Where, again, 100,000s of people become infected

and, unfortunately, many of those die every year.

James, it's been fascinating learning about the innovations that Janssen's making,

in terms of fighting infectious diseases.

Where do you see this technology heading in the future?

Well, one technology that we're particularly excited about,

as we learn how viruses evolve

and what critical mechanisms that they need to replicate with

we have evolved and we've learned a lot about them.

There's certain Achilles heels for a variety of viruses,

where we can develop antiviral medicines

that take out these Achilles heels.

Looking to the future though, we're now looking to employ

those antiviral drugs for something, we call, pre-exposure prophylaxis.

That is, we have these antiviral medicines on board with the patient

before they even see the virus.

So it's when they try to get infected by this virus,

the medicine's there to prevent them being infected.

All right, well, James thank you very much, this has been fascinating.

I'm heading back to Inventionland and maybe I'll see you there.

I hope so, Greg. Safe travels.

Hi, Dr. Yarema, welcome to Inventionland.

Hi, George, it's great to be here.

Well, I've been waiting for you to get here so we can talk more about

T-cell immunotherapy and the future.

Well, as we saw earlier Epstein-Barr virus or EBV

is one of the most common human viruses.

It infects 19 out of every 20 adults worldwide.

And while that infection is usually silent or latent,

it has been linked to many cancers

and autoimmune diseases like multiple sclerosis.

So latent or dormant means,

basically, it could be inside of me right now and I wouldn't know it.

And then, something might trigger it and it would bring MS out?

Well, for us, what's important about these recent

landmark publications in science and nature is,

they reenforce the idea that multiple sclerosis

isn't a disease that's triggered by

an entire immune system that's gone haywire.

But rather, the problem may very well lie

with a much smaller subset of cells that have been infected with the EBV virus.

Interesting. All right.

So I got these images from your office,

and I was hoping you could, you know, shed a little light on what's going on in there.

Well, at Atara we're investigating

an off-the-shelf T-cell immunotherapy that specifically targets

EBV infected B and plasma cells in people with MS.

Starting with studies in progressive multiple sclerosis,

which has a high unmet need

and effects 100,000s of patients in the US alone.

So what you're looking at, back here, is our manufactured inventory

that we store in these giant freezers.

We manufacture the cells from cells from healthy donors,

and then we store them to be ready for shipping in just a few days

so that the patient receives them

and can begin treatment as quickly as possible.

Oh, my goodness, that's great technology.

-Well, thank you for coming in to Inventionland. -Thank you.

-[George] Bye-bye now. -Bye-bye.

-Hi, Dr. Merson. -Hello, George.

-Welcome to Inventionland. -Thank you.

Well, I was hoping you could talk to us a little bit about

the future of fighting infectious diseases.

Infectious diseases are really important to us at Janssen.

About 15% of worldwide deaths every year are due to infectious diseases.

We're focusing on chronic viral infections, like HIV.

Where 38 million people worldwide live with the disease

and we're looking to simplify their treatments.

Where they may have to just take a treatment once every six months.

For chronic hepatitis B,

where they have to take a medication for life,

where they could end up with liver cancer,

we're looking to reset their immune system

so they can manage the infection themselves.

[George] Interesting.

What about flu and influenza?

Yeah, influenza's a really important one.

Every year about a billion people get infected with that virus.

We're taking a unique approach though,

we're looking to utilize what we call pre-exposure prophylaxis.

That is, we're developing a long acting antivirals

where we may only have to administer

once every three or every six months

through the respiratory season.

Same again for Respiratory syncytial virus or RSV.

Another viral infection of the lung,

where many people throughout the world get infected.

Once again, we're trying to utilize this prep approach using long acting antivirals.

Other respiratory infections we care about are, bacterial infections.

Particularly multidrug resistant bacteria.

Which we estimate by about 2050

about 10 million people will die from these multidrug resistant bacteria every year.

And that's because antibiotics will no longer work.

So we're taking a unique approach there also,

where we're utilizing nature's own way of killing bacteria.

Using phage or viruses

that shred the DNA of bacteria and just kill them outright.

Then lastly, we're very excited about our data sciences approaches.

Where we're taking real world data to be able to identify

wherever the new infections are occurring worldwide,

so we can help with physicians utilize the best treatment to manage their patients.

I'm excited if you're excited, keep up the great work.

-Thank you, George. -Thanks for coming.

Well, thank you for joining us for another episode of Tomorrow's World Today.

I'm your host, George Davison.

Reminding you that inspiration is the source for new ideas.

What will you do with yours for Tomorrow's World Today?