All language subtitles for T.W.T.S05E03.1080p.WEB.h264-CBFM_track3_[eng]

[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?