Chapter 124: The Royal Swedish Academy of Sciences (11)
“Mr. Forsberg, are you really okay with this?” asked a bearded man with a good build. It was the Secretary General Kanius; he was a permanent member who held the highest position at the academy.
“It’s alright,” Forsberg replied with a grin.
“I am worried that you are being too reckless with your body. Science is important, but your body is important as well,” Kanius said.
“I’m really fine. And Doctor Ryu’s idea is quite convincing. Both technologies are so stable that they don’t need any other approvals.”
“...”
“But since this is the first case of combining and using them together, this clinical case could conflict with medical laws. I hope you could ease them if they come up, Your Royal Highness,” Forsberg said to Desideria.
Song Ji-Hyun flinched. It seemed like she was surprised that Desideria was a princess. Young-Joon was also surprised, but it didn’t really show.
Forsberg added, “Because even if this treatment goes wrong, I don’t want it to hold Doctor Ryu back. My work in the scientific community is done and I’m just reviewing Nobel Prize nominees now, but Doctor Ryu is a young scientist who has much to do.”
“...”
Desideria stared at Forsberg silently, then said, “I will promise you in the name of the Swedish Royal family.”
“Then we will prepare the treatment to administer to the patient,” said Young-Joon.
“I look forward to it,” Forsberg said with a chuckle like he found it interesting.
Young-Joon, who said goodbye to the scientists and the Crown Princess and stepped outside, headed straight to the lab. It was the lab he borrowed from Karolinska.
Professor Kakeguni appeared with the dendritic cell-promoting kit. On the sterile bench, Young-Joon added Cas9 into the MEM solution, which was heated to thirty-seven degrees, and mixed in the promoting kit.
As they were busy with the procedure, a guest visited the lab. It was Crown Princess Desideria. She came to the lab with her security team and entourage, rang the doorbell and waited outside. She thought that she shouldn’t go into the lab without authorization.
When Young-Joon came outside, Desideria asked him a question.
“Doctor Ryu, can you really cure Professor Forsberg? I didn’t get the chance to ask you before because we were in front of the professors.”
Young-Joon nodded.
“Of course.”
“... Please, I am asking you. He is the most important person at the academy. He sacrificed his whole life to look after patients and teach students.”
Forsberg was a national hero in Sweden. He was the greatest doctor in the country. He had a similar level of respect and recognition as Professor Lee Guk-Jong[1] in Sweden. It was not an exaggeration to say that he had sacrificed his entire life for medicine. He had collapsed five times from overworking when he was a surgeon at Karolinska and looked after patients. He was also very open to new technologies, so he spent nights reading new papers. If he found a technology that was even a little bit more advanced than what he had, he was the first to adopt it. He wasn’t just a regular doctor at a hospital; he was someone who had continuously led medicine in Sweden.
“He is probably well-known in the pharmaceutical and biology community. Is this the first time you’ve seen him?” Desideria asked.
“I... Yes, I didn’t know him. I’m sorry,” Young-Joon replied in embarrassment.
“Because Doctor Ryu is young,” Kakeguni, who was now behind him, said as he put his hand on his shoulder. “How many people do you think would recognize Mendel if he came back alive and showed up here? Scientists do not know faces of people from the past who they haven’t met in research. The scientists’ pictures aren’t published in the papers.”
“I see.”
Desideria nodded.
There was no way for Young-Joon and Forsberg to meet in the research field since Forsberg had already retired and become part of the Nobel Committee when Young-Joon was in graduate school.
“But there are a lot of professors in my age group that know Professor Forsberg, even though medical doctors are quite different from scientists in pharmacology and biology,” Kakeguni said.
Desideria added, “Professor Forsberg is one of eighteen lifetime members of the Royal Swedish Academy of Sciences. If you cure him, the Royal family of Sweden and the academy will be deeply grateful to you both.”
Young-Joon nodded.
“I will make sure to succeed.”
* * *
It was early in the morning. The dendritic cell promoter, a monumental masterpiece made by Kakeguni, was created. Usually, they included a material that was like a map to find cancer cells in the promoter, but this time, Cas9 was added. Additionally, information about the structure of fourteen genes was added into the promoter in the form of RNA.
“We will begin.”
Marcus injected the treatment into Forsberg’s veins with trembling hands.
‘Can you check it?’
Young-Joon was observing it, but with Rosaline.
—I will turn on Synchronization Mode for you.
The substances flowing in Forsberg’s veins were expanded enormously and created an image in Young-Joon’s retina. Time had slowed down. He was able to slowly observe the molecular phenomenon in Synchronization Mode, which could distinguish picoseconds and angstroms.
Like a rocket was docking at the space station, one RNA molecule attached to one Cas9. This RNA was a map for finding the target gene. For this treatment, fourteen types of RNA were added; it was to manipulate fourteen genes. Cas9 would find the target location with the RNA map and cut it.
Pshhh...
With the sound of the phospholipid disintegrating, the promoter knocked on the dendritic cell membrane. Like it was being engulfed softly in bubbles, the Cas9 moved into the cell. The dendritic cell began packaging the Cas9 in a substance called MHC. The package popped up to the cell surface again, and then made contact with an immune cell that was floating nearby. There was no way, but Young-Joon felt like he could hear the cells talking to each other
—It’s a new antibody.
The dendritic cell handed the Cas9 over to the immune cells.
—I will check it.
The immune cell swallowed up the Cas9. At that moment, the Cas9, which had infiltrated the cell, suddenly became active and moved to the immune cell’s DNA. The Cas9 read the RNA map and searched the huge library of genetic material that contained three billion letters.
At last, it found the target gene.
—E1K
Snip!
Cas9 cut the gene where E1K was located. The cutting of DNA, the core of biological processes, was a very serious thing for immune cells. The DNA repair mechanism was activated in the immune cell. However, a few bases that came with Cas9 interfered with the repair. It was like cutting a knee with torn cartilage with a scalpel and putting in metal pins. The DNA was torn apart, and a portion of the gene variant was put in and left to heal naturally.
A much larger amount of E1K poured out of the newly formed and edited gene. The immune cells were moving differently now.
—Whoosh!
They traveled through the blood vessels and ran towards the tumor rapidly.
—Beep!
A signal came from the tumor. It was a PD-L1 signal that stopped immune cells.
—Ting, ting, ting.
However, the substances that the tumor was pushing out could not pierce the immune cell membrane and just bounced off.
—Boom!
The immune cell crashed into the tumor and began to dig deep into the interior.
‘T-cell infiltration.’
Young-Joon wanted to eat some popcorn while watching the biological process he had learned from textbooks. It was as thrilling as an action movie.
—Pahh!
The perforin secreted by the immune cell blasted away three cancer cells. As their cell membranes had been broken, they became slimy and collapsed.
—Crash!
Three more cancer cells were destroyed by another shot.
‘... It’s not going to take long.’
It was more powerful than Young-Joon had expected. It was even more effective than the chimeric immunotherapy that he used on Lee Yoon-Ah. It had to be, as the immune cell had fourteen edited genes; even excluding E1K, it had thirteen additional target genes to improve the power of the immune cells. These genes enhanced tumor attraction, resisted the inhibitory substances secreted by the tumor, increased the ability to penetrate into the tumor, or increased the amount and power of cytotoxic substances released to destroy the tumor.
‘I can edit up to forty genes in immune cells at once when I use Professor Kakeguni’s method.’
Young-Joon had only targeted fourteen genes to minimize the risk of side effects, but it was already powerful.
‘I should optimize this technology and push for commercialization once the cancer lab is done in America.’
Young-Joon may really conquer one day.
He stopped Synchronization Mode. The last thing that he saw were tens of thousands of immune cells swarming toward the tumor.
* * *
The conference was over. The scientists at A-Gen or A-Bio had already returned to Korea, or they were enjoying their vacation and traveling all over Europe.
However, Young-Joon was still at Karolinska. It was the last day of reviewing the Nobel Prize nominees. The final decision was going to be submitted to the Royal Swedish Academy of Sciences tonight.
Of course, the biggest issue was the countereffect of the immune checkpoint inhibitor.
“I explained the mechanism in which it occurs through lab mice. But now, the mouse experiment isn’t that important.”
“Since a clinical case was reported,” said Professor Herrekr.
Jamie Anderson gulped. The hyperprogression that occurred in Forsberg’s body was a huge shock to Oliver, the inventor of the immune checkpoint inhibitor, and to him as well.
“But this is only the first case. And we don’t really know if the patient had a mutation in EGFR, right?” Jamie said. “Judges, the immune checkpoint inhibitor has been administered to many patients, but this is the first time hyperproession has occurred. It is ridiculous to devalue an important drug like this just because of a single incident.”
“I am not saying that we should not use immune checkpoint inhibitors. Of course, it is still valuable and an important drug,” Young-Joon said. “But it can induce hyperprogression in patients with EGFR mutations. In that sense, it is true that the value decreases a little in terms of versatility.”
Jamie Anderson clenched his jaw and glared at Young-Joon.
The immune checkpoint inhibitor was developed at the Cold Spring Laboratory, and the director of that lab was Jamie Anderson. He put his name as a corresponding author on every paper published from there. What this meant was that the value of the immune checkpoint inhibitor decreasing also impacted Jamie Anderson.
“The things that Doctor Ryu has said still require additional experiments and cross-examination,” said Jamie Anderson.
“That is true since it says that less than ten percent of the papers in Science or Nature will survive fifty years later. I might be wrong, so we must cross-examine it. When the paper is published, many scientists will test the relationship between immune checkpoint inhibitors and EGFR genes.”
“But Doctor Ryu, we can’t delay the Nobel Prize until then, can we? We can’t cancel the Nobel Prize just because of one clinical case and mouse experiment. Professor Oliver should receive the award.”
Jamie Anderson was being stubborn.
“...”
The Karolinska professors sighed worriedly and glanced at the two of them. They were Swedish, and they were doctors. Not just any doctor, but doctors at Karolinska. Here, Forsberg was a legendary person, and they were obviously uncomfortable with the immune checkpoint inhibitor that had destroyed him. As such, they were already leaning towards Young-Joon and Kakeguni, but Jamie Anderson did not back down easily.
The confrontation lasted for a moment. Then...
“Sorry, I’m late.”
Marcus, who was one of the judges, came in. Surprisingly, he was pushing a wheelchair. It was Forsberg.
“Professor!”
Surprised, the Karolinska professors all bolted up.
“Should you be out like this?” they asked, worried.
“Ah, it’s fine. I am recovering quite quickly,” Forsberg said with a chuckle as if he was in a good mood.
He stared at Young-Joon, then turned to face Jamie Anderson. contemporary romance
“It’s been a while, Anderson.”
“... Yes, it has. How are you feeling?” Jamie Anderson asked with a frown.
“Hahaha. I trusted your name and used the immune checkpoint inhibitor, but I almost died. But Professor Kakeguni and Doctor Ryu Young-Joon saved me,” Forsberg replied. Then, he asked the professors, “So, how is the process going? Who are you leaning towards?”
“Professor Forsberg has no right to participate in the judging process,” Jamie Anderson said firmly.
“Oh, of course I don’t. I just asked because I was curious. I have no intention of interfering with the process. However, Director Anderson, you know...”
“Know what?”
“My right as a lifetime member of the Royal Swedish Academy of Sciences has not been suspended. Lifetime means until I die, but I’m still alive thanks to Doctor Ryu and Professor Kakeguni.”
“...”
“When the review is complete, the Karolinska Nobel Conference will vote, then present a letter to His Majesty the King that includes the name and achievements of the final selected candidate, saying that we should give the Nobel Prize to this person,” Forsberg said. “If I’m lucky, I think I will read that letter beside His Majesty as well. I think I will be able to leave the hospital quickly at this rate.”
Jamie Anderson grit his teeth. Forsberg smiled.
“And Director Anderson, I think I am going to be suspicious of whether it was due to racism if someone is eliminated, so I hope you make a wise decision and present the letter.”
1. a very famous and well-respected doctor in Korea ?