If it can diagnose can it cure also using T cell immune techniques

Hello Dr. Ashwani Kumar

Yes, it is possible. CRISPR/Cas systems are emerging as powerful tools for nucleic-acid detection techniques, specifically in the targeting of cancer mutations. Studies show that the RNase and DNase capabilities of the CRISPR/Cas systems can be used to detect and diagnose tumor-specific biomarkers such as microRNA (miRNA) and circulating tumor DNA (ctDNA), which is the tumor-derived component of circulating cell-free DNA (cfDNA).

CRISPR/Cas-based diagnostics will help to reduce the need for invasive methods such as tissue biopsies. CRISPR/Cas9 may serve as an alternative for cancer diagnosis which could be a highly sensitive and minimally invasive technology.

But more work needs to be done before CRISPR/Cas-based diagnostics can be fully realized in clinical settings. This type of technology is very promising. It will be able to offer great advantages over the present diagnostic system that are being used due to the possibility of detecting cancer at earlier stages, thereby improving patient prognosis.

Regarding your second question..

Identifying cancer related genes and removing them with CRISPR Cas is a possibility.

There are some drawbacks using this technology.

A major pitfall is that CRISPR sometimes cuts DNA outside of the target gene, what’s known as “off-target” editing. Such unintended edits could be harmful and could even turn cells cancerous.

Another potential roadblock is getting CRISPR components into cells. Researchers are exploring different ways to fine-tune the delivery of CRISPR to specific organs or cells in the human body. Some are testing viruses that infect only one organ. Others have created tiny structures called nanocapsules that are designed to deliver CRISPR components to specific cells.

There are also concerns about how the body, in particular, the immune system will react to viruses carrying CRISPR or to the CRISPR components themselves.

Regarding your third question..

If it can diagnose can it cure also using T cell immune techniques.

Using CRISPR/Cas technology, one can use CRISPR gene editing to alter immune cells so that they will recognize mutated proteins specific to a person’s tumor. Those cells can then be safely set loose in the body to find and destroy their target. One may use gene editing to create personalized treatments, and engineering immune cells called T cells so as to better target tumors. The mutations are different in every cancer, although there may be some shared mutations, but they may be in a minority.

One can design proteins called T-cell receptors that are capable of recognizing the tumour mutations. CRISPR genome editing could be used to insert the receptors into the T cells of the patient, and then the engineered cells could be infused in the patient.

Engineered T cells called CAR T cells have been approved for the treatment of some blood and lymph cancers, but solid tumors have posed a particular challenge. CAR T cells are effective only against proteins that are expressed on the surface of tumor cells. Such proteins can be found across many blood and lymph cancers, which means there is no need to design new T-cell receptors for each person with cancer.

But the problem lies with solid tumors. Common surface proteins have not been found in solid tumors. Moreover, solid tumours provide physical barriers to T cells, which must circulate through the blood, travel to the tumour and then infiltrate it to kill the cancer cells. Tumour cells also sometimes suppress immune responses, both by releasing immune-suppressing chemical signals and by using up the local supply of nutrients to fuel their rapid growth.

So, there is a need to engineer the T cells in such a way that they not only recognize cancer mutations but also are more active near the tumour. This may be done by removing the receptors that respond to signals that are immunosuppressive, or by sometimes tweaking their metabolism so that they can more easily find an energy source in the tumor environment.

I am attaching a list of references pertaining to CRISPR Clinical Trials.

https://www.synthego.com/blog/upcoming-crispr-trials#crispr-cancer-therapies

https://innovativegenomics.org/news/crispr-clinical-trials-2022/

https://innovativegenomics.org/news/crispr-clinical-trials-2021/

Best Wishes.

The problem with such an approach is that unlike other non-cancerous conditions, where you may have only to correct a fraction of the defective cells, to largely alleviate the condition in question; with cancer you have to correct all the problematic cells. A hallmark of cancer is its rapid mutation rate, this results in a large spread in the susceptibility of the cells for therapy response. Thus the therapy will apply an evolutionary pressure to select for lower-responding cells. This is just one of the reasons why cancer has proven such a difficult disease to treat.