Finding common ground with arthritis could help cancer patients

From teabags to tinctures, smoothies to supplements, there’s no shortage of products that claim to boost the immune system. These seemingly simple solutions make it appear that getting our immune system in gear is easy – but nothing could be further from the truth.

Our immune system is incredibly complex. It wages a daily battle against potential infections or other threats, while striking a balance to protect healthy tissues from friendly fire. Too little action, and threats to our health could slip through the net. While too much action can see our body turn against itself.

Both situations present unique challenges for research. And by studying diseases that are tied to the immune system in different ways, scientists may find common ground that accelerates progress.

This approach is the foundation behind our new partnership with Arthritis Research UK. Launched last year, this exciting new collaboration is funding innovative research projects focused on the common ground between both arthritis and cancer, with the hope of bringing benefits for both diseases.

Joining the dots

“We know that in autoimmune diseases like rheumatoid arthritis, where the immune system attacks the body, the immune response is overactive and so the aim is to dampen it,” says Dr Stephen Simpson, Arthritis Research UK’s director of research.

“We’re also increasingly finding that in cancer, a good immune response can have an impact on tumour growth. When that goes wrong, the disease can progress.

“These are opposite sides of the same coin.”

Experts say the evidence linking cancer and autoimmune diseases like rheumatoid arthritis has been mounting for some time.

“In essentially all autoimmune conditions, a fundamental driver of disease is over-aggressive inflammation caused by the immune system,” says Professor Adrian Hayday, one of the project’s leads from the Francis Crick Institute and King’s College London.

It makes sense that if you’re apparently hitting the same points in the immune response, there’s a chance these two separate fields can learn from one another

– Dr Stephen Simpson

“It’s also been clear for years, from both population-based and clinical studies, that aggressive immune inflammation is also a major risk factor for certain cancers. The best example is probably hepatitis, which can lead to liver cancer.”

But that wasn’t the only spark to ignite interest from both fields.

“After cancer patients started being treated with new drugs that successfully unleash the immune system – called checkpoint inhibitors – suddenly we saw a number of them were developing autoimmune diseases like rheumatoid arthritis, or type 1 diabetes,” Hayday says.

“It makes sense that if you’re apparently hitting the same points in the immune response, there’s a chance these two separate fields can learn from one another,” adds Simpson.

“Here we have a real opportunity to look at these common checkpoints.”

Not only that, both scientists are quick to highlight another bridge between inflammatory diseases and cancer – unchecked cell growth. Among many examples of overactive inflammation, relentless cell growth is what leads to thickening of the skin in people with psoriasis. While in cancer, this is the fundamental process that leads to tumours.

“We can see that both these layers are interlinked,” Simpson says.

“They’re rich areas to learn from.”

Links that last

After a successful three-day workshop last year, involving researchers from both sides and patient advocates, three research projects were funded and are now underway. The first is looking at molecules that control the immune system across rheumatoid arthritis and cancer, with the aim of better understanding how the immune system responds to both diseases. This could identify new ways of predicting who may benefit from drugs that affect the immune system.

Project two is investigating why unregulated cell growth in the joints of patients with rheumatoid arthritis doesn’t lead to cancer, shedding light on how cancers develop and potentially highlighting new treatment avenues for arthritis. The final project seeks to answer a long-standing question around how the body sees these diseases.

“There’s been a long-held idea that cancer might, in a fundamental way, be a wound that doesn’t heal,” says Hayday.

“Perhaps that’s also what arthritis is. It’s an exciting idea to have emerged from the workshop.”

We need to continue melting boundaries that exist between scientific disciplines

– Professor Adrian Hayday

While these projects have funding for one year initially, this marks the beginning of collaborations that ignite a new wave of research. And it’s the doors this could open that have both Simpson and Hayday excited.

“Research takes a long time,” says Simpson. “But the hope is that this we’ll find something that stacks the odds in our favour of finding a new treatment for either disease.”

“By bringing these research communities together, I really think we’re going to get a new perspective on how the immune system interacts with tissues,” adds Hayday.

“We need to continue melting boundaries that exist between scientific disciplines, because progress is motivated by people asking smart questions.

“These come from bright people speaking with one another, and having the courage to say what likely will and won’t work.”

From our Grand Challenge awards to arranging scientific conferences, this new partnership is just one example of the many ways that Cancer Research UK is committed to supporting collaborative research. Not just in the UK, but worldwide.

And with so much still to learn, it certainly won’t be the last.

Justine