ABOUT AIET AND HISTORY OF AIET
AIET stands for Autologous Immune Enhancement Therapy. AIET is a promising new addition to the family of cancer treatments that includes surgery, chemotherapy, radiotherapy and cancer vaccines. AIET is a treatment method in which Natural Killer Cells (NK cells) and Cytotoxic T Lymphocyte (CTL’s) cells are taken out of a patient's body which are cultured and processed to be activated or to acquire additional functions until their resistance to cancer is strengthened after which the cells are reinfused back to the patient.
Each type of cancer needs specific combination of treatments aimed at the particular kind of cancer. When the spread of cancer is very deep, total removal of the cancer growth by surgery may not be possible. At times, after removing a portion of the cancer growth, radiotherapy and/or chemotherapy may be necessary to treat the remnant portion of cancer. It has been widely recognized that chemotherapy of cancer has profound toxic side effects and has limitations in its efficacy. Radiotherapy is also a very effective mode of treatment in certain types of cancer, with its own adverse effects as well. These two modalities affect not only the cancer affected cells, but also the normal cells.
Now in AIET, the specific type of cells mainly the NK cells and T lymphocytes isolated from the patient’s blood are activated and expanded expanded and activated and then reinfused into the body. Upon encountering a tumor cell, the activated NK cell attaches to the membrane of the cancer cell and injects toxic granules that quickly dissolve the target cell. In less than five minutes, the cancer cell would be dead and the NK cell moves on to its next target. A single NK cell can destroy up to 27 cancer cells before it dies. This is the mechanism by which AIET is effective in Cancer therapy.
Dendritic Cell vaccines are quite a popular form of Immunotherapy in which the Dendritic cells present the tumor antigens to the body's Cytotoxic T lymphocytes for destruction of the tumor cells.
AIET practised in Japan however has an added advantage over Dendritic Cell vaccine because in this the Cytotoxic T Lymphocytes from the patient themselves are directly activated, expanded in the lab and when reinfused back to the patient they can effectively act against the tumor cells.
Autologous Immune Enhancement Therapy (AIET) has a successful clinical history in Japan, Europe and USA for the past two decades. Immuno cell therapy of cancer using Autologous lymphocytes activated in the laboratory was first introduced by Rosenberg and his colleagues of National Institute of Health USA. In the late 80s, they published a turning-point article in which they reported a low tumor regression rate (2.6–3.3%) in patients (n = 1,205) with metastatic cancer who underwent different types of active specific immunotherapy (ASI), and suggested that AIET with specific chemotherapy as the future of cancer immunotherapy.
In the beginning in Immunotherapy, treatments involved administration of cytokines such as Interleukins with an aim of inducing the lymphocytes which will carry their activity of destroying the tumor cells. Thereafter the adverse effects of such intravenously administered cytokines lead to the extraction of the lymphocytes from the blood, activating them, multiplying them in numbers and injected back into the body to destroy the cancer cells. and culture-expand them in the lab and then to inject the cells alone enable them destroy the cancer cells.
This treatment modality has been in practice since early 90s and has several randomized clinical trials in Lung cancer, Gastric Cancer, Ovarian Cancer and Liver cancer which have been published with significant disease free survival rates. One of the largest studies in 1400 patients has proven that the cell based immunotherapy when combined with conventional treatment the efficacy improves by 20-30%.
In 1999, the first private clinic Seta in Japan with a cell processing facility and specializing in immuno-cell therapy was established. Dr.Terunuma et al established the Biotherapy Institute of Japan who apart from offering AIET, have been exploring in depth the finer components of innate immunity against cancer in the form of Cytotoxic T lymphocytes (10, 11). The biotherapy institute in Japan has treated more than 7000 patients so far and treats almost 10-20 patients every day with an overall efficacy of this treatment when added to the conventional treatment more than what is mentioned above.
Since then, the number of such institutes has increased, many cancer patients are opting for this kind of less toxic treatment. Several clinical trials and researches are reported from institutions all over the world, though there have not been any publications in this field from Indian Institutes or hospitals.
Development of this new line of therapy would be a major boost for treating cancer as well as HIV because both are encountered by body’s cell mediated immune mechanism. A currently practiced treatment method in cancer-specific immuno-cell therapy uses Activated Lymphocytes (AL), Natural Killer cells (NK) and Dendritic Cells (DC), the major immune cells which play key role in destroying cancer cells.