In the Existential Hope in Practice essay series, our fellows write about concrete ideas and practical examples of how to build a great future.
When chronic disease becomes curable
By Jakub Lála
In brief:
Allergies, asthma, and eczema are not minor inconveniences; they are quiet constraints on travel, food, sleep, focus, and social life.
The immune system is becoming programmable. Cell therapy, cancer vaccines, engineered antibodies, and protein design are already proving this in severe disease.
The first cures for common immune burdens will probably come from cancer, rare disease, and severe immune disorders, where risk is easier to justify.
As these tools become safer, more accessible, and easier to manufacture, they should move down the severity curve toward conditions medicine currently asks people to manage.
The hopeful future is not better coping, but an immune reset: a world in which chronic immune disease is no longer accepted as a fact of life.
As much as I try to live a normal life, my allergies, asthma, and eczema have been among the major constraints on my life: I rarely eat out, I am afraid of staying at Airbnbs, and I often avoid visiting my friends’ apartments.
All of this goes unnoticed, with most of my friends not even aware of it. It all carries a fear deeply embedded in my psyche – a feeling too complex to convey. Only those who carry these chronic burdens themselves, or love family members who do, can really understand.
My story is specific, but the thread is common. Almost everyone carries some quiet health burden – chronic back pain, brain fog after a COVID infection, or just getting the common cold more often than your peers. These are often not immediately life-threatening, but they drain mental bandwidth, leaving less room for focus and creativity.
Too common to cure
Economic data misses the trips not taken, the invitations declined, the constant awareness of risk. But even in measurable terms, the case for treating them stops being merely sentimental: hay fever can cost employers more than migraine, depression, or diabetes, and poorly controlled allergic disease can impair productivity by up to 60% in bad weeks.
Many of these chronic illnesses have no cures at all – only symptom-management treatments that work unreliably and are hard to adhere to. Antihistamines have helped me, but I have never found one that does not leave me drowsy. This is the strange economic trap: when the default treatment costs only a few dollars a pop, the unmet need becomes easier to ignore.
Down the severity curve
Thankfully, the story does not end with management and resignation. The immune system is becoming programmable, and with that, it becomes possible to imagine something more ambitious than lifelong coping. The first cures will be built in cancer wards, rare disease trials, and severe immune disorders – in places where the suffering is legible, the market is large, and the need is impossible to ignore. As these tools mature, they will move to less severe diseases. We can already see that happening across three fronts: cell therapy, cancer vaccines, and engineered antibodies.
Cell therapy – where a patient’s immune cells are extracted, reprogrammed to recognize a misbehaving cell, and then re-injected – has seen tremendous success in cancer, and is now moving toward reprogramming cells directly inside the body. Cancer vaccines – built on the same mRNA platform that made the COVID shots possible – are showing early success in melanoma and pancreatic cancer. For moderate-to-severe allergies, asthma, and eczema, there has been a gradual adoption of engineered antibodies – proteins designed to block the specific immune signals that keep disease switched on.
Dupixent, an antibody made by Sanofi and Regeneron, has become one of the best-selling drugs in the world – reaching nearly $18 billion in sales last year alone – largely by treating these immune-related conditions. Common immune conditions are not too small or too soft for biotech; they are one of its next markets.
The future I care about is one where this logic becomes routine: eczema reset before it shapes a child’s confidence; asthma treated before it becomes a lifelong inhaler relationship; severe allergies made obsolete enough that a lunch with colleagues stops carrying anxiety. Dupixent’s expansion into new indications suggests why this is plausible: multiple diseases may be different outputs of shared immune switches – toggles we can effectively tune.
What if these conditions are not separate symptoms to manage, but different visible manifestations of a deeper immune imbalance? If so, relieving these burdens may cut deeper than it seems. Some studies link allergic disease to biological-age markers, asthma age acceleration to mortality risk, and severe eczema to higher mortality risk. As advanced immunotherapies become safer and cheaper, the prize is not just symptom relief, but correcting a deeper dysregulated immune state.
Such a serious-to-broader indication arc has already played out before with GLP-1s like Ozempic and Wegovy. These drugs were originally developed for a severe disease (diabetes), then moved outward into obesity, and now even into a much broader consumer lifestyle drug market.
It is reasonable to expect chronic immune conditions to follow a similar path: first trialed for narrower, legible indications, and only later adopted more broadly, including off-label use (when a doctor prescribes a treatment for something beyond its original regulatory approval). When we empower individuals to take their fate into their own hands, we will uncover a new wave of work in this space, building tools toward the burdens most of medicine has learned to tolerate.
When the patient becomes the builder
I first realized I could contribute to such an effort while watching Martin Pačesa’s lecture on BindCraft – a computational protein design pipeline – where they generated protein binders against dust mite and birch pollen allergens. Suddenly, my scientific path and my personal story aligned. The future stopped looking like something that would simply happen to me, and started looking like something I could help build. These tools are becoming mature enough to feel almost point-and-click. In my own recent work, I designed a CAR construct for cell therapy that was experimentally validated to be functional. I have never done serious work at a biology bench; yet I was able to design a successful CAR from behind the screen of a laptop.
I am not arguing that the average citizen will discover the next blockbuster drug. But these tools lower the activation barrier for scientifically literate people who could contribute, but never had an obvious way to start. LLMs make the basic work more accessible: asking questions, reading papers, understanding mechanisms, and forming hypotheses. Computational design tools then make it easier to turn those hypotheses into candidate biological interventions. With models like GPT-Rosalind, or similar life-science efforts from Anthropic, this ability to move from curiosity to intervention will only become stronger.
The point is that these digital tools are becoming increasingly powerful for biology, but they become most powerful when they reach people with a reason to care – people are fundamentally driven by their own burdens. That is why, in one of the recent FDA panels on gene and cell therapy, almost all the panelists seemed to have a family member with a rare condition they had devoted their lives to treating. Another perfect example comes from GitLab’s founder, Sid Sijbrandij, going founder mode in response to his own cancer.
The bottleneck is thus not only scientific, but cultural at its core. The biotech sector needs to feel close enough to people to make them feel that their own burdens are tractable. If we inspire a generation to work on chronic disease, and build a shared expectation that even ordinary burdens can become biotech problems, we may reach a grander future of consumer biotech.
What it takes to make cures routine
The path from proven-in-cancer to suitable-for-allergies is not straightforward, and there are a few limitations worth laying out. The whole severity-curve argument depends on safety. A therapy can be dangerous if the alternative is cancer; it has to be extraordinarily safe if the alternative is hay fever. Some cell therapies can still come with serious side effects – including cytokine release syndrome, where immune cells overreact and trigger a dangerous whole-body inflammatory reaction.
A second risk runs deeper. Allergies, asthma, and eczema have all become more common in the last fifty years, and one debatable explanation – the so-called ‘hygiene hypothesis’ – is that our too-clean modern environments deprive the immune system of the microbial exposure it evolved to expect. If we engineer our way around the symptoms without asking why the immune system started misbehaving in the first place, we risk building an increasingly fragile human shell atop a deteriorating biological foundation. This may become even more relevant as we begin to deliberately enhance immune function beyond its natural baseline, for example in response to future pandemics.
Lastly, CAR-T therapy costs now exceed half a million dollars, so personalized therapies for common illnesses will likely reach the wealthy first, as most technologies do. We already see this with Dupixent, where even with insurance, copays can run into thousands per year, and access varies hugely by country. This is uncomfortable, but early expensive markets are also how platform medicine develops: manufacturing improves, delivery becomes standardized, regulators become familiar, and costs fall. The goal is not boutique medicine forever; it is to bend the cost curve until the same tools can reach the burdens most medicine has learned to tolerate. That makes safety, access, and cost the work ahead, not reasons to stop imagining cures.
No longer something to live with
Living with eczema and allergies has made me deeply grateful for the periods when things are under control. Developing a cure for allergies would be more than a scientific milestone; it would be my personal resolution. But the first step, for all of us, is simpler than that. It is to stop mistaking familiarity for inevitability. These conditions are not acceptable, not minor, not just something to live with. They are quiet constraints on eating, traveling, sleeping, working, and loving freely – and, thankfully, the kind of burdens a more mature biotech civilization should not have to accept forever.
About the author
Jakub Lála is a computational protein designer and ML researcher at Imperial College London. He works at the intersection of AI and biotech, with a focus on biomolecular design, immunotherapy, and scientific agents. He is the lead developer of BAGEL, a framework for programmable protein design, and previously worked on AI agents for scientific research at FutureHouse. He is also a Deep Venture Fellow at HCVC, and a co-founder of In Silico and Nucleate’s AI in Biotech initiative. He is interested in how better tools can make biology more engineerable, opening up new possibilities for next-generation therapeutics.
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Thanks for sharing such a deeply personal and ambitiously inspiring journey. Excited to follow where your work takes the field ahead :)