Medical Pioneer Died Before his Nobel was Announced. His Work Gave New Direction to AIDS, Cancer Research.

Ralph Steinman was one of those ideal candidates for a Nobel Prize. First, he discovered something revolutionary in the human body – scarce but powerful “dendritic” cells, which act as the command centers of the immune system.

 Then, the scientific community scorned him for it. His grant applications were rejected and he had a tough time getting papers published, said Laurie Gilmcher, a professor of immunology at Harvard School of Public Health. But he stuck with it, she said, even when nobody believed him.

That was back in the 1970s. Now, in dozens of clinical trials around the world, researchers are using dendritic cell-based treatments in attempt to combat HIV, diabetes, melanoma, prostate cancer, and other diseases.

Sadly, these treatments weren’t advanced enough to stop Steinman’s own pancreatic cancer, which is a particularly relentless disease. The Rockefeller University biologist, 68, may never have known that he was awarded the 2011 Nobel Prize for Physiology or Medicine. He died three days ago, and the prize was officially announced today.  

The Nobel Prize isn’t normally awarded posthumously, but in this case, the committee will probably make an exception. According to a story in Reuters, the Nobel committee didn’t learn of his death until after they’d made the announcement. It would be terrible if they decided to rescind it now.

Dendritic cells made up just .1 percent of the bloodstream, but they have a potent effect on the immune system, said Luis Montaner, an immunology professor and HIV researcher at the Wistar Institute in Philadelphia.

These cells get their name because they have a lot of membrane surrounding them, giving them a branched shape, he said. What these cells do is educate your immune system to go after various germs or cancer cells. These are your body’s sentinels.

Dendritic cells do this by picking up pieces of pathogens and “presenting” them to other immune cells, such as T cells, the way you might present a bloodhound with a sample of someone’s scent.

In clinical trials, cancer patients are getting experimental therapies in which their own blood is treated to reprogram the dendritic cells. In some cases, the dendritic cells are exposed to certain key proteins that are unique to cancer cells. That prompts those dendritic cells to activate other immune cells to attack the cancer.

The reason your immune system doesn’t always do this on its own, Montaner said, is that it’s busy, always going after pathogens or foreign bodies. And cancer cells can evolve ways to hide from the immune system.

Some news stories reported that Steinman treated himself for his cancer. I haven’t been able to substantiate this, but treatments involving dendritic cells are already being widely tested for other cancers. Steinman’s institution, Rockefeller University, is conducting one for melanoma.  

Harvard’s Glimcher says understanding dendritic cells has also been of huge importance in research on autoimmune diseases such as lupus and rheumatoid arthritis.

Sadly, another pioneer whose work was crucial to understanding this aspect of the immune system, Charles Janeway, died a few years back.  Had he been alive today, she said, he would surely also be included in the prize.

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