This Friday, Barcelona inaugurated the first center in the State fully dedicated to the study of immunotherapy and one of the only ones in Europe, the CaixaResearch Institute. It is a pioneering center in the world that is born with the objective of studying the functioning of the immune system to use it as a tool for the control and treatment of some of the most frequent diseases in the world, such as cancer, Alzheimer's, or tuberculosis. With an event that was attended by the King of Spain, Felipe VI, the center has opened its doors to try to answer some of the great unknowns of health. For this first year, the infrastructure will have a budget of 10 million euros. When it is fully operational, the CaixaResearch Institute will have more than 400 scientists dedicated to improving people's health and lives through immunology. This discipline is at the forefront of modern medicine, and there are increasingly more treatments aimed at stimulating the body's defenses. In recent decades, immunotherapies have revolutionized the approach to some pathologies that until then had no cure, but their potential is broad and, still, little explored. "This center is being launched with the aspiration of becoming an international benchmark and will seek to develop research that practically improves people's quality of life," claimed the president of the "La Caixa" Foundation, Isidre Fainé. However, he warned that it will be a difficult and complex path and that it will take time to start obtaining results, although he expressed confidence that they will eventually arrive. Fainé presided over the inauguration ceremony, which was attended by King Felipe VI; the president of Catalonia, Salvador Illa; the delegate of the Spanish government in Catalonia, Carlos Prieto; the Minister of Health, Mónica García; and the Minister of Research and Universities, Núria Montserrat, as well as members of the "La Caixa" Foundation's board of trustees and the scientific council of the new center, which is led by the renowned oncologist and researcher Josep Tabernero. In fact, he was the one who explained the mission of the new center: to better understand the immune system and leverage this knowledge to improve health. "The CaixaResearch Institute aims to be a space where basic science, data science, and environmental study converge under the prism of immunology, with collaboration as the norm and innovation from the outset," claimed Tabernero. Attracting talent

The new center, driven by an investment of 100 million euros and an area of 20,000 m², is located opposite the CosmoCaixa Science Museum. The institute already has more than twenty active professionals and, when fully operational, will have the capacity to host 45 research groups and units. This makes it, according to sources from the La Caixa Foundation, a hub for attracting and retaining international talent to Barcelona. The same sources have clarified that the intention is to collaborate with the different institutes and hospitals that make up Catalonia's biomedical research ecosystem, not to incorporate staff from these centers. Among the researchers already working there are four group leaders: Gabriel Rabinovich, a doctor in biochemistry from the Institute of Biology and Experimental Medicine in Buenos Aires; Josep Dalmau, a neurologist and researcher at IDIBAPS-Clínic; Gemma Moncunill, an immunologist specializing in vaccines and infectious diseases; and Héctor Huerga, an immunologist specializing in aging. They will be joined by Maria Mittelbrunn, the current leader of the laboratory of immunometabolism and inflammation at the Severo Ochoa Molecular Biology Center, who has just joined the institute (she will start in the fall), and María Martínez, an immunologist who will join in July after completing her postdoctoral studies at the Champalimaud Foundation in Lisbon.Lines of research

Tabernero has explained that the immune system works on two very complementary levels. On the one hand, there is innate immunity, which acts immediately against external threats such as viruses and bacteria, and on the other, adaptive immunity, which produces a more precise response, capable of recognizing specific threats, learning from them, and generating memory, which protects us when these threats reappear. "It is thanks to this system that, for example, vaccines work and protect us throughout our lives," the expert detailed. Along these lines, the group led by Dr. Moncunill will work to improve the efficacy and duration of vaccines, especially in vulnerable populations, and to understand the impact of infections on the immune system.But the immune system also acts as an internal surveillance system, Tabernero indicated, so it has the capacity to detect and eliminate damaged, infected, or premalignant cells before they can trigger more serious diseases such as cancer. The research of the group led by Rabinovich will be aimed at trying to understand how the immune system can be manipulated to open new therapeutic avenues in cancer, inflammation, and autoimmunity. "When this system fails – whether because it responds little or because it responds excessively – diseases can appear ranging from cancer to autoimmune, cardiovascular, or neurodegenerative diseases, which we are still trying to understand," said the center's scientific leader. Therefore, Dalmau's team will focus on diseases in which the immune system mistakenly attacks certain proteins in neurons and alters the correct functioning of the brain. Finally, Mittelbrunn and his group's work will focus on identifying new therapeutic targets in inflammatory, cardiovascular, and neurodegenerative diseases that allow for improved health in advanced ages.Catalonia is one of the regions in Europe where more clinical trials in cancer are conducted, it has a diverse and increasingly extensive ecosystem of research centers and hospitals, and from 2028 onwards, it will have a large hub of biomedicine crowned with the new Barcelona Biomedical Research Park (PRBB), in the Ciutadella del Conocimiento. For Ernest Nadal, research director of the Catalan Institute of Oncology (ICO), this very favorable context for research in Barcelona is the legacy of many researchers from the city, and from now on they will have a new agent for scientific collaboration. "That they bet on immunotherapy is not by chance. It is one of the most transformative treatments in cancer, but also in other diseases, and there are still many challenges and much room for improvement," he values.

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It has been a year since she received blood transfusions, but until very recently she needed one a day to survive. In the last decade, she tried up to nine different treatments, using all sorts of strategies, such as antibodies, steroids, or immunosuppressant drugs. But none of them had a lasting impact. This is the case of a 47-year-old woman with three complex and serious diseases that caused her immune system – that is, the body's defenses – to mistakenly attack her own cells as if they were an external threat.

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Stimulating the immune system to distinguish tumor cells from healthy cells and selectively attack them has revolutionized the way some cancers are treated. This revolution began with personalized medicines called CAR-T(from the English Chimeric Antigen Receptor T-cells), a therapy in which the patient is their own donor. In this strategy, the patient's T lymphocytes (which are natural defenses) are extracted, genetically reprogrammed in the laboratory to kill cancer cells, and then reintroduced into the bloodstream so that they can attack the tumor. Now, scientists at the University of California are proposing a reprogramming method that avoids having to manufacture the cells outside the human body and has allowed for the successful treatment of aggressive leukemia, multiple myeloma, and even a solid tumor, so far in mice transplanted with human cells.

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Finding therapies to control the progression of cancer is a race against time. Stimulating the immune system to distinguish tumor cells from healthy cells and selectively attack them has been a game-changer. In leukemias, the disease disappears and there are no signs of recurrence after a few years. This revolution would not be understood without the CAR-T (from the English Chimeric Antigen Receptor T-cells), a type of personalized drug. However, in 85% of diseases, cell therapy is not adept at recognizing and attacking tumor cells. So, is it possible to design a similar, but more sensitive, treatment that targets less visible cancers?

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The most aggressive colorectal tumors have learned to evade the immune system and go undetected by its defenses. Although immunotherapies have revolutionized the fight against many types of cancer, colorectal cancer is still one of the leading causes of death worldwide. In most metastatic cases, patients do not respond to these drugs because their immune system does not recognize the malignant cells as a threat. But there is hopeful news. A study led by the Institute for Research in Biomedicine (IRB Barcelona) and the National Center for Genomic Analysis (CNAG) has discovered how these tumors manage to block the immune system and, therefore, limit the effectiveness of immunotherapy, the treatment that reactivates the body's defense cells to attack. The key: the hormone TGF-β. The researchers have found that, through a hormone known as TGF-β, colorectal tumors generate a double barrier that protects them from immune attack. "The issue is that the tumor microenvironment of more metastatic colon cancers is different from that of more benign ones and is characterized by the presence of TGF-β, an immunosuppressive hormone," Dr. Eduard Batlle, ICREA researcher and head of the colorectal cancer laboratory at IRB Barcelona, explained to ARA. "Malignant cells use this hormone to evade detection by T lymphocytes, the cells on which our immune system is based," he clarified.

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In 2018, the Nobel Prize in Medicine was awarded to Japanese scientist Tasuku Honjo and American James P. Allison for their studies on cancer immunotherapy. Their research began in the late 1980s and 1990s, but that basic research has borne fruit, and today immunotherapy is a fundamental therapy in the fight against this disease—or diseases, because there are many types of cancer—which caused nearly 17,000 deaths in Catalonia last year.

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The first thing Carla Borrell thought about when she was diagnosed with cancer was her family. She says that, along with friends and doctors, they were the driving force that kept her from giving up when she was told she had a lung tumor, one of those with the worst prognosis. Her only option was to undergo surgery to have half of her severely damaged right lung removed. The operation left her devastated, requiring more than 120 stitches and nearly a month of hospitalization to drain all the fluid accumulated in her respiratory system, but the tumor disappeared and initial checkups showed a favorable outcome. However, as the weeks passed, they detected metastases in her head, and she had to undergo further surgery.

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Every week, new scientific literature on cancer is published, leaving patients and their families dreaming of possible care. But the revolution against this disease began more than a decade ago, with the approval of the first immunotherapies, which stimulate our body's defenses to attack malignant cells. Patient survival has changed radically thanks to these drugs, which have demonstrated success that was unthinkable a few years ago with traditional treatments. There is still a long way to go: some patients respond very well to treatment, but others relapse over the years, and some with very aggressive tumors continue to have a very poor prognosis. However, the emergence of immunotherapy has marked a paradigm shift in the fight against cancer, and experts maintain that we must continue exploring new forms of treatment to fully exploit its potential.

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A woman who was diagnosed with neuroblastoma, a brain cancer, as a child has been tumor-free for 18 years thanks to treatmentCAR-T cell immunotherapyThe case is covered in a study published in the journal Nature Medicine and it is assumed that the woman is the patient with this type of cancer who has lived the longest without the presence of the tumor until now, which makes the researchers think that she has been completely cured.

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