Going on a Gut Feeling: The New Cancer Treament

On 6 May, coincidentally the 157th birthday of Sigmund Freud, the ornate Festsaal of the Austrian Academy of Sciences was in full swing (with classical music tribute and a cocktails reception to boot) to welcome the President of the Royal Netherlands Academy of Arts and Sciences (also knighted) Hans Clevers for the 7th annual Landsteiner lecture, "Stem Cells of the Bowel: Bright Side, Dark Side."

Academy members and science aficionados alike filled the Festsaal, including Austrian chemist and father of the oral contraceptive pill Carl Djerassi.

Organised by the Research Center for Molecular Medicine (CeMM) the series is held in honour of Austrian biologist and physician Karl Landsteiner, who made possible the safe transfusion of blood back in 1900.

"Hans Clevers’ academy is a role model for our academy," noted Giulio Superti-Furga, the Scientific Director of CeMM during the opening ceremony. Clevers is the only European to date to win the $3 million (approximately €2.3 million) Breakthrough Prize in Life Sciences. Also known as the "new Nobel" (and as the "Facebook prize" as Mark Zuckerberg is among the founding members), the award promotes the idea that "societies need more heroes who are scientists."

Clevers’ lecture summarised the last ten years of his lab’s work, mixed in with a historical "who’s who" in stem cell biology and personal accounts of lab life – from his attempts at reading the 1745 doctoral thesis of German physician Johann Lieberkühn from Latin with a dictionary, to stem cell pioneer Charles Philippe Leblond, who at age 94 thought that "PowerPoint was a tool for sharpening pencils."

The discovery of gut stem cells, and the growing of "mini-intestines" in culture, has not only made possible important strides in understanding the development of colon cancer, but also is expected to have a major impact on regenerative medicine and future cancer treatment. Clevers and his colleagues are planning to use the mini-intestines as "living band-aids" to repair the damaged insides of patients, a therapy they have already shown to be safe and effective in mice.

"Don’t forget that tumors, no matter how large they are, begin from a single cell," Clevers explained, as he demonstrated the movement of cancerous vs. healthy cells with the help of detailed 3-D animations. The animations highlighted the small intestine, an area covered with fringe-like villi (think shag carpet) and the place where most nutrients are absorbed after digestion and a model for cancer development.

Every five days the small intestine is renewed, calling for some 200 grams of cells produced every day from stem cells. The stem cells divide and become the needed new cells, pushing their way to the top of the fringe villi in a kind of "clonal conveyor belt." Once they reach the tip, the cells die off and are replaced by new ones. Over time this rapid replacement can lead to errors.

In cell terms, that means cancer.

It’s a huge breakthrough. By understanding how these stem cells function, personalised treatments could be designed for patients previously without hope. His lab’s work has just begun, but Clevers is clearly excited about the possibilities:

"Wouldn’t it be great if you could transplant a small part of healthy gut tissue, from a living donor," Clevers mused, "and save not just one, but many patients?"