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While traditional vaccines are designed
ADULT to prevent disease, researchers are
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VACCINES Which ones do you need?

GUIDE working on something new: therapeutic

vaccines, vaccinations that treat an illness
Which Vaccines Do
Adults Need? after you have it.
Chickenpox Vaccine for
Adults Therapeutic vaccines have the potential to
Hepatitis A Vaccine change medical treatment radically and
HPV Vaccine
may be able to treat all sorts of scourges,
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such as:
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HIV
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Alzheimer's disease

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"We're at a fascinating crossroads in the
development of therapeutic vaccines," ARTICLE
Tips to Protect Your Health
says Hildegund C. J. Ertl, MD, program
leader in the Immunology Program at the
Wistar Institute at the University of ARTICLE

Cold and Flu Pennsylvania. "We understand so much Immunization Charts for Adults and
Kids
Living Healthy more about the underlying science."
Vaccine Guide

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But Ertl and other experts urge cautious VIDEO
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optimism. While therapeutic vaccines Which Vaccines Are Safe During
Pregnancy?
seem to be on the horizon, they've
seemed that way for a long time. ARTICLE

CONTINUE READING BELOW Vaccines for Hepatitis A and B

"I remember when therapeutic vaccines

ARTICLE
were first developed for skin cancer in the
Who Should Get an HPV Vaccine
1960s," says Richard L. Wasserman, MD,
PhD, clinical professor in the department
of pediatrics at the University of Texas TOOL
Contagious Diseases: What Can You
Southwestern Medical School in Dallas. Catch?
"But forty years later, we still don't have
one." VIDEO
Eating for a Healthy Immune System
How Do Therapeutic Vaccines Work?
Standard preventative vaccines work by ARTICLE

helping your immune system develop Pneumococcal Vaccines for Adults

immunity to a weakened or dead form of a
germ. Then, when you actually come into
contact with the live germ, your immune
system knows how to fight it off.

Therapeutic vaccines would be used after

a person contracts a disease, yet they
would still work by boosting your own
immune system's response to an illness.

While the immune system works very well

most of the time, some illnesses -- like
cancer, HIV , and Alzheimer's -- don't
trigger an effective immune response. In
the case of some cancers, the immune
TOOLS AND RESOURCES
system simply fails to recognize the
invading cells. Other viruses, like HIV, can Quiz: Preventing Disease
overwhelm the immune system and shut
Can Adults Get Mumps?
it down before it can work.
Shots for Travelers
Therapeutic vaccines help by forcing the
immune system to recognize a virus or What Vaccines Do Adults Need?
cancerous cell. Some specific types of
Test Your Adult Vaccine IQ
therapeutic vaccines include:
Immune-Boosting Foods
Antigen vaccines. When an antigen is

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introduced into the body, it provokes

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the immune system to create an NEWSLETTERS
antibody to fight it. Some researchers
Food & Fitness
are working on vaccines that will use Women's Health
specific cancer antigens to force the Men's Health
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immune system into action.

Dendritic cell vaccines. Dendritic Enter email address

cells are immune cells which prowl

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Researchers have had some success

in removing dendritic cells from a
person, "loading" them with dead
tumor cells or dead viruses, and then
injecting them back into the person.
Once the dendritic cells have been
"taught" how to recognize the
invading cells, they may spur the
immune system to attack.

DNA vaccines. One problem with

many therapeutic vaccines is that the
effects wear off. After a vaccination,
the immune system might be
aggressive for awhile, but eventually
return to normal. Some researchers
hope they can inject bits of DNA into
cells, instructing them to keep the
immune system revved up and alert.

Tumor cell vaccines. These vaccines

use actual cancer cells that are
removed during surgery. The cells are
then killed -- so they can't cause
cancer growth -- and tweaked in
some way, often by adding new
genes or chemicals. They are then
introduced into the body. The hope is
that the modified gene will get the
attention of the immune system,
which will then target other cancer

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cells. Some of these vaccines are

autologous (using cancer cells from
your own body), others are allogeneic
(using cells that came from someone
else).

What Diseases May Therapeutic

Vaccines Treat?
The number of diseases researchers hope
to treat with therapeutic vaccines is
enormous.

"Someday, we might make vaccines for

Alzheimer's , neurological diseases,
arteriosclerosis, and maybe even obesity,"
says Ertl. Other targets for therapeutic
vaccines include viruses like herpes and
hepatitis and even nicotine addiction.

The list of diseases is impressive, but Ertl

and other experts say that most of these
vaccines are in very early stages of
development. Here are a few examples of
therapeutic vaccines being studied.

HIV. Researchers have been looking

for a therapeutic HIV vaccine for
decades, but they have made some
progress.
One approach had researchers
loading dendritic cells with killed
AIDS viruses and then injecting them
back into the person, triggering an
effective immune response. In one
2004 study of 18 people injected with
the vaccine, the amount of virus in
the blood dropped by 80%. After one
year, eight of the people still had a
90% drop in their viral levels.

Alzheimer's Disease . One

experimental vaccine for Alzheimer's
disease may help the immune
system attack a protein that plays a

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key role in the illness. By getting the

immune system to attack the protein,
the vaccine might slow down the
progress of the illness.
A study of the vaccine was suspended
in 2002, when 6% of the subjects
developed brain inflammation.
However, researchers kept tracking
the people who received the
vaccines. After a year, about 20% of
the people were making antibodies
to the protein, meaning that their
immune system was attacking it. This
group also scored slightly better on
memory tests than people who had
not received the vaccine.

Cancer. A cancer vaccine has been

the Holy Grail for many
immunologists, and dozens of
vaccines have been tested in dozens
of types of cancer. Vaccines are being
developed for breast cancer,
colorectal cancer, kidney cancer,
leukemia, lung cancer, lymphoma,
melanoma, ovarian cancer, prostate
cancer, and pancreatic cancer, among
others.
One prostate cancer vaccine,
Provenge, was shown to lengthen the
life of men with widespread disease.
It also is a dendritic vaccine --
dendritic cells are taken from a man,
"taught" to recognize tumor cells,
and reinjected into the body. In a
group of 127 men with metastatic
prostate cancer , the men who
received the vaccine lived four and a
half months longer than the men who
didn't.

One vaccine that will help prevent

cervical cancer, Gardasil, is likely to

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be approved by the FDA soon. Studies

show that Gardasil will block the
underlying cause of 70% of all
cervical cancers. Another similar HPV
vaccine, Cervarix, is also in the
pipeline. However, these aren't truly
therapeutic vaccines -- they work by
preventing infection with a virus (HPV
or human papillomavirus) that can
lead to cervical cancer.

Effective Therapeutic Vaccines: The

Barriers
While researchers have worked hard at
developing therapeutic vaccines for
decades, the results have tended to be
disappointing.

"Unfortunately, the role of immunity in

diseases like cancer is much more
complicated than we are smart," says
Wasserman. "There are a lot of interesting
observations to suggest that therapeutic
vaccinations might work, and we've
learned a lot in forty years of researching
them. But we still have a long way to go."

Some researchers think that part of the

problem is that diseases like HIV create
such high levels of virus in the blood
that the immune system is quickly
overwhelmed. Experts hope that lowering
the viral load first and then using a
therapeutic vaccine could make for better
results.

Wasserman observes another risk.

Standard vaccines help your immune
system target foreign invaders, but when
you're dealing with a disease like cancer,
the tumor cells are very similar to normal
healthy cells, creating a new danger.

"A cancer vaccine might not be able to

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distinguish between cancer cells and

normal healthy cells," says Wasserman. "It
could wind up attacking both of them,
causing an autoimmune disorder."

Ertl stresses that therapeutic vaccines will

never be a substitute for preventative
vaccines.

"If you have a choice between a

preventative vaccine and a therapeutic
vaccine, I would always recommend
prevention," says Ertl. "Preventing a
disease is always easier and safer than
treating it."

Ertl notes that researchers and drug

companies are extremely careful when
making a preventative vaccine. Making a
healthy person sick is simply
unacceptable. But "the accepted risks are
going to be higher for a treatment that's
given to someone who is already sick," she
tells WebMD.

Therapeutic Vaccines: Keeping

Perspective
While therapeutic vaccines are exciting,
none is close to being used outside of
clinical trials. So if you or a loved one is
sick now, you need to rely on other
treatments. You could also talk to your
doctor about taking part in a clinical trial.

But Ertl says that, in the future,

therapeutic vaccines could be crucial for
diseases that we learn how to treat but not
prevent.

"There are some diseases, like

Alzheimer's, that we just don't have a clue
how to prevent with a vaccine," she says. A
preventative vaccine might be unlikely or
impossible, while a therapeutic vaccine
could be more feasible.

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Researchers are making progress, says

Ertl, but there's still a lot to learn.

WebMD Feature | Reviewed by Louise Chang, MD

Sources $ © 2006 WebMD, Inc. All rights reserved.

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