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Comment by davikr | Hacker News Reader

I am so excited for the monoclonal antibody revolution of Medicine. Here's to them getting cheaper someday.

How expensive are they to make these days? There's also one in progress made from human stem cells that blocks a teeth-regrowth-inhibitor, causing mice and ferrets to grow more and new teeth.

It should allow human adults to grow new teeth over a period of 2~5 years, if removal of the old teeth is surgically assisted (the roots are too deep to have it work automatically, thus evolution of the blocker). Oh, and it's systemic as I understand, so usage would involve pulling all the teeth present when starting.

> There's also one in progress made from human stem cells that blocks a teeth-regrowth-inhibitor, causing mice and ferrets to grow more and new teeth.

That's quite an unexpected mix of optimistic, cute, and then disturbing right there.

> Oh, and it's systemic as I understand, so usage would involve pulling all the teeth present when starting.

Never mind, fully disturbing now. :P Though I suppose it might be interesting for folks who've already lost almost all of them...

Hey, my understanding is that they're initially targeting Japanese ~~elderly who have already lost their teeth~~ children who genetically forgot to grow at least 6 of their adult teeth (1 in 10k affected). (https://uniqa.dental/news/tooth-regeneration-drug-trials-in-...)

Also there are many people who have sustained teeth damage bad enough to normally warrant 2+ implants plus fillings for the others, and at that point, it's warranted to think about doing "wisdom teeth removal" for the remaining and growing a new set.

It's obviously not suited for replacing a single lost tooth.

Well, ferrets teeth are very close to humans, so it working for them is already highly suggestive of it working for humans. Then, the antibodies being human ones, and that they even work in mice that are very very different teeth-wise from humans, is enough to warrant trying in humans. This isn't considering the safety (no predicted collateral damage; the antibodies target USAG-1 which has purposes beyond teeth growth inhibition), but yeah.

Also see https://www.popularmechanics.com/science/health/a44786433/hu... ....

> How expensive are they to make these days?

A good question, I can't answer. But I can tell you, when my daughter had her liver transplant, they gave her an insane amount of medications for weeks. They only gave her one shot of a monoclonal antibody "Basiliximab". The syringe with it was escorted by two guards from the pharmacy.

> The syringe with it was escorted by two guards from the pharmacy.

Isn't it only, like, a few thousand dollars? By all means, be careful with it, but you don't see teams of guards at the apple store escorting hardware to the customer.

Was this maybe earlier in development and the price was much higher or something?

A few years ago the pharmacy accidentally keyed in the full price for two months (four injectors) of Humira, IIRC it was like $3k. This is in Northern Europe, probably it's more expensive in the US? Also I don't know if the price has come down since.

Of course it's also a price vs volume thing, but I heard a while back that scaling up bioreactors is the limiting factor for these monoclonal antibodies.

The cost of drugs like these is nontrivial, but much of that is dedicated to ensuring that what gets produced and delivered is actually what you wanted it to be. That is, you can make low quality mabs in a garage if you really knew what you were doing, but producing enough to sell without having patients dying of bacterial infections can't be done in a garage. Quality control combined with experienced production folks is critical.

The cell therapies are really expensive and struggling with manufacturing costs, mabs like these are priced what they are because of market forces.

As long as we don't get the cyberpunk dystopian outcomes like tailored molecules dumped in the water supply to assassinate a specific individual.

> They sent a slamhound on Turner's trail in New Delhi, slotted it to his pheromones and the color of his hair. It caught up with him on a street called Chandni Chauk and came scrambling for his rented BMW through a forest of bare brown legs and pedicab tires. Its core was a kilogram of recrystallized hexogene and flaked TNT.

-- Count Zero, by William Gibson

We're already getting this particular dystopia with computer vision systems. The systems aren't particularly good, but that doesn't entirely matter to the people setting them off: their target lists aren't particularly well-curated either. We're a few hundred years past the point where technology is ever the bottleneck when it comes to making people dead.

Extract from Self-Driving Issues by Randall Munroe. https://xkcd.com/1958

> "I guess it's just that most people aren't murderers?" "Oh, right. I always forget." "An underappreciated component of our road safety system."

Isn't that paragraph describing some kind of homing bomb that's searching for the target ("pheromones and the color of his hair")? Does Gibson have any examples of what you describe, targeted molecules?

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