Ever heard of HeLa Cells?

Occasionally in my microbiology studies I’ve encountered mention of HeLa cells, but didn’t really know what they were. Recently, in the virology course I’m currently enjoying so much (https://www.coursera.org/course/virology), the lecturer referred us to a 2010 book called “The Immortal Life of Henrietta Lacks”, by Rebecca Skloot (which I’ve downloaded but am yet to read).  It turns out that HeLa stands for Henrietta Lacks, a black American woman who died of an aggressive cervical cancer in 1951. Without her permission, doctors took some of her cells and gave them to a scientific researcher, who discovered that her cells could be propagated indefinitely – a new generation of cells would reproduce every 24 hours, and they continued reproducing this way without ever stopping. These were the first human cells to be kept alive and grown in the laboratory. Apparently today, almost every laboratory in the world has HeLa cells in storage, and probably billions of her cells live on. These cells have contributed to all kinds of medical research, including development of vaccines and chemotherapy, and have been the subject of 74,000 scientific papers.

Henrietta Lacks
The most famous photograph of Henrietta Lacks

HeLa-cells-DNA-2
These are HeLa cells, the DNA is yellow, the mitochondria pink, and the actin filaments are light blue.  Cell DNA is the reproduction/genetic material; mitochondria are the energy-producing material; actin filaments are kind of like the “bones” of the cell.

It has become a story beyond the science that she has contributed to. Her family found out that her cells were being used in this way some time after her death, and it has become a story of medical ethics, race relations, power plays, etc. Her family were poor and uneducated with strong religious beliefs, and for years they believed that a part of their mother remained alive, which caused a lot of angst.

This year the story has expanded further, as scientists sequenced her genome, meaning that they now have all the information required to predict all sorts of medical information about Henrietta and her descendants. The genome sequence was made public without her family’s permission. But a couple of weeks ago, for the first time in over 60 years, her family were invited by the National Institutes of Health, to join a Working Group formed to deliberate on the use of this genome sequencing. They are now the third generation on from Henrietta, and the first generation with a decent education, so they are able to understand the complicated science explained to them, and are contributing to discussions from an informed point of view.

Very recently scientists discovered why Henrietta’s cancer was so aggressive. The Human Papillomavirus (HPV), which we began vaccinating against 6 years ago thanks to the vaccine developed by Australian Profeesor Ian Frazer, is responsible for cervical cancer – a fact only discovered in the past decade or so. In the past year or so, researchers discovered that Henrietta’s HPV infection entered her cervical cells near a tumor gene in the cell which, when it gets “switched on” by the virus, is highly sensitive to the virus and reacts aggressively – hence an aggressive form of cancer occurred in Henrietta (ie it developed quickly and killed her quickly), a response which probably won’t occur in someone else infected by the same virus, when the virus enters their cells at a different point. This aggressive cell reproduction is probably why HeLa cells can propagate indefinitely, when other human cells die out.

Historically, this is such an interesting story, as it connects to so many other interesting stories related to HPV and the new(ish) vaccine. For example, when the new HPV vaccine was introduced in 2007, we only vaccinated girls. The target was pre-pubescent girls, so that they would receive the vaccine before their sexual debut, so that they would be protected before their first potential exposure to HPV. It was marketed as a “Cancer Vaccine” in order to promote the use of a vaccine against STIs, as it was thought that parents may refuse the vaccine if they were led to believe it had something to do with their very young girls being sexually active. That isn’t to say that the facts were hidden, but that the cancer aspect to the vaccine was highlighted. As it turns out, there was very little opposition to the vaccine. At that time it was very expensive – around $500 for the full course (of three doses). This year, we started vaccinating boys too, and the cost of the vaccine was slashed down to around $5 per dose. The reason for vaccinating boys as well, is to provide “herd immunity”, meaning when enough of the population is vaccinated, then unvaccinated people are less likely to be exposed to the virus. (Once upon a time we also only offered Rubella vaccine to girls, whose unborn babies are at risk of serious damage caused by exposure to the virus – but now everyone is given Rubella vaccine, for herd immunity).

Regarding opposition to vaccination, there are pockets of this in Australia, and the “Australian Vaccination Network” (AVN) is probably the most famous Australian organisation on this – I think there’s talk of them being forced to change their name to the Australian Anti-Vaccination Network. They are led by a woman with no medical background, Meryl Dorey, who hits the media fairly regularly. There is a responsive organisation who I belong to, called Stop the Australian Vaccination Network, who respond to AVN’s various claims with the objective facts.

In around 2009, the HPV vaccine was delivered to a rural area in India. 70,000 women die from cervical cancer each year in India(!). The vaccine was administered in this particular area to 14,000 girls. Within 6 months, 4 of these girls had died, and there was a huge media outcry. It turned out that two of the girls had died from poisoning, one from a fever of unknown origin, and one from drowning. But because of the media outcry, the government halted the program. As is nearly always the case with these media histrionics, the fact that none of the girls died from anything vaccine-related, went largely unreported. But I think that the program did re-commence eventually.

Back to Henrietta Lacks. A couple of weeks ago when her family met with the National Institutes of Health in Baltimore, Maryland USA, an agreement was reached whereby those cells held by the US Government are stored privately, and can only be used with permission of a panel which includes Lacks family members. She will also be acknowledged on all papers using her cells for their research, which has never happened before. They are encouraging non-government labs with her cells to do the same, but I doubt this will happen as her cells are in test tubes all around the globe.

Read more here:

http://www.the-scientist.com/?articles.view/articleNo/36937/title/Q-A–NIH-Brokers-HeLa-Genome-Deal/
http://news.nationalgeographic.com/news/2013/08/130816-henrietta-lacks-immortal-life-hela-cells-genome-rebecca-skloot-nih/
http://www.indianexpress.com/news/-death-of-andhra-girls-unrelated-to-hpv-vaccine-/722771/
http://www.abc.net.au/news/2013-05-10/hpv-vaccine-cost-dramatically-cut-in-new-deal/4681170