US Pharm. 2015;40(4):HS-24.

A Yale University–led team has identified a promising new combination immunotherapy to enhance the body’s ability to fight chronic viral infections and possibly cancer. Their study was published on March 23 in Nature Medicine.

Viruses that cause chronic infection, such as HIV and hepatitis B and C, persist in the body despite attack from T cells. Over time, T cells weaken to the point of “T-cell exhaustion.” To circumvent this process, the research team—led by Susan Kaech, associate professor of immunobiology at Yale School of Medicine—scrutinized two pathways.

The first pathway is triggered by prostaglandin E2 (PGE2), a lipid known to suppress the immune system’s response to tumors. The research team studied mice with viral infections and observed that PGE2 levels rose during chronic infection. The increased PGE2 reduced both the number of T cells and their antiviral functions. It was then determined that T-cell function increased when both PGE2 and the second pathway, PD-1, an inhibitor of T cells, were blocked.

The researchers found they could achieve the same boost to T cells by administering celecoxib (Celebrex), a nonsteroidal anti-inflammatory drug commonly used to manage pain. One important implication of the study, therefore, is the potential use of NSAIDs as adjunct therapy to treat patients with chronic infections and cancer.