Oct 8

Oct 8 The Story of HeLa and Henrietta Lacks

100 Ideas, Cancer, History of genetics, Women in genetics

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Human cells are a lynchpin of biomedical research. Studying human cells in the lab allows us to understand more about how they work, investigate the causes of disease, and design new treatments. But growing cells in the lab isn’t as easy as you might think.

As it turns out, growing cells outside the human body is a tough task. Until the 1950s, whenever a researcher wanted to look at human cells, they needed to take them from a person and use them within a matter of days, after which the cells inevitably died. This annoying habit made research on human cells incredibly tricky.

So in the early 1950s, George Otto Gey, a researcher at John Hopkins University in Baltimore, Maryland, set about trying to develop techniques that would allow him to grow human cells outside the body - a technique known as ‘tissue culture’. Gey and his wife Margret spent years trying to grow any cells they could get their hands on. Gey even called himself “the world’s most famous vulture, feeding on human specimens almost constantly.”

One day, Gey was contacted by a cancer surgeon named Richard Wesley TeLinde, who was studying different types of cervical cancer in the hopes of improving diagnosis and treatment. TeLinde asked for Gey’s help in growing and comparing the cells from different types of cervical tumour. Of course, Gey, seeing more cells for his quest, accepted.

TeLinde worked at John Hopkins hospital in Baltimore, closely tied to the university. It was a charity hospital, treating patients that were unable to pay medical bills. All of the patients were poor, and many were Black. Like many other doctors at the time, TeLinde felt that because the patients in the public wards were receiving free care, it was fine to use them in research often without their knowledge. So he began collecting tumour samples from the operations he performed on patients at the hospital, without bothering himself with the hassle of asking for their permission.

When a new sample was taken, it would be sent over to Gey’s lab and inevitably land on the desk of Mary Kubicek, Gey’s 21-year-old assistant.

Kubicek would meticulously sterilize her equipment, carefully slice the sample into squares and drop them into a test tube of culture medium, designed to provide everything the cells needed to grow. She sealed each tube with a stopper and labelled the sample with the first two letters of the patient’s first name, and the first two letters of their last name. Then she popped them in an incubator, waited patiently, and inevitably watched them die within a few days.

Until one day in February 1951, one tube of cells didn’t die.

In fact, they multiplied at a terrifying pace, doubling in numbers every 24 hours. They didn’t just live a little longer than other cells. They continued living in the culture medium indefinitely as long as they had food, warmth, and space to grow. They were the first cell line to survive outside the human body—the first immortal cells. The label on the sample tube read ‘HeLa’.

After his discovery, Gey appeared on TV, hailing these HeLa cells as the key to understanding and conquering cancer. Meanwhile, the real ‘HeLa’ – Henrietta Lacks, had no idea her cells were causing such a stir in the world of biomedical research.

Who was Henrietta Lacks?

The day that Henrietta’s cells were taken from her without consent, she had travelled to John Hopkins from her home in Turner Station, Maryland, where she lived with her husband and children.

Around a week earlier, Henrietta visited her local doctor complaining of unexpected bleeding and a ‘lump on her womb’. The doctor assumed it was syphilis, but when Henrietta tested negative he sent her to John Hopkins, the only hospital in the area that treated Black patients. The gynaecologist on duty took a small sample of cells for diagnosis and sent her home to wait for the results.

Unfortunately, it wasn’t good news.

The diagnosis was malignant cervical cancer, and Henrietta’s doctors advised that she should return to the hospital as soon as possible for radiotherapy.

When she arrived back at Johns Hopkins, Henrietta signed a simple form giving permission for ‘proper care and treatment’. She was then anaesthetised while tubes filled with radium were placed in her cervix. But first, while she was unconscious, the surgeon took samples of her cancer for TeLinde, who dutifully despatched them to Gey’s laboratory.

A few days later, the radium tubes were removed, and Henrietta was sent home to recover. She returned to Hopkins for a second radium treatment a couple of weeks later. The initial results looked good - her tumour was shrinking and after the second treatment, had vanished entirely.

But weeks later, the cancer was back, and it was spreading rapidly. More radiation therapy with ever-increasing doses followed. The treatment left her skin charred, but the pain and the tumours persisted, with new growths appearing almost daily.

Eventually her treatment was stopped, seemingly a lost cause, and she continued to deteriorate, all the while suffering horribly. For the last weeks of her life, she was strapped to her hospital bed to stop her from falling out as she thrashed in pain.

Henrietta Lacks passed away on October 4th 1951, aged just 31, and was buried in an unmarked grave. But a small part of her was very much still alive.

The impact of HeLa on research

Realising the incredible value of Henrietta’s cells for cancer research, Gey began sending samples of HeLa cells to any scientists who asked for them. Soon, the cells were being mass-produced in a factory and shipped all over the world for 10$ a vial.

Their success wasn’t a surprise. After decades of trying and failing to grow cells in the lab, here was a cell line that seemed ideal for research. Their cancerous nature made them hardy and relatively easy to grow, but in many ways they still behaved like healthy human cells, producing regular proteins and signalling to each other.

The cells were also susceptible to infection, which made them ideal for studying viruses and bacteria. HeLa became the go-to human cells in biomedical research, and quickly made their way to labs all over the world.

Henrietta’s cells fuelled a boom in biomedical research. They were instrumental in early genetic research too. They taught us about how diseases worked, including cancer, polio, HPV, HIV, herpes, mumps, measles, Zika, and many more. They have even been used recently in COVID-19 research.

They helped us develop vaccines, including the HPV vaccine that is now given to girls to prevent the development of cervical cancers like Henrietta’s. I’ve used HeLa cells myself in my own research back during my PhD, adding in extra bits of DNA in search of genetic control switches that can turn genes on or off.

But Henrietta’s family remained oblivious to the fact that her cells were now growing in labs all over the world and fuelling a now multibillion-dollar industry. Henrietta herself was even erased from the story, with the researchers spreading the pseudonym Helen Lane or Helen Larsen to throw inquisitive journalists or family members off the trail.

In fact, the Lacks family found out about Henrietta’s cells by chance in 1973 during a dinner party conversation. The family, who had little education, only understood that part of Henrietta was still alive and being kept in a laboratory somewhere. They were terrified and angry, but they didn’t know who to contact to find out what was going on.

Around the same time, scientists were noticing something strange going on in their cell cultures.

They had long joked that HeLa were so hardy they could survive on doorknobs, but it turned out that the cells could float through the air on dust particles, hitch a ride on equipment or lab coats, or travel through ventilation systems. And if one HeLa cell landed in a culture, it took over.

HeLa contamination was becoming a real problem, calling into question the results of many studies.

It was the quest for a test for HeLa contamination that eventually led Henrietta’s family back to her cells. When the family were asked for blood samples for genetic testing, they were sucked into a world of scientific research that they didn’t understand and nobody took the time to explain.

When they found out that Henrietta’s cells were being bought and sold while they were living in poverty without health insurance, they were furious. They launched a campaign to recoup some of the money they felt fairly belonged to the family, and control over how the cells were used. But the family was largely ignored, and their campaign went on for decades.

It wasn’t until 2013, after yet another controversy, that they finally got to have some input on the use of Henrietta’s cells. This time, researchers had published the genome sequence of HeLa and made publicly available to download without prior knowledge or permission from the Lacks family. This was the final straw.

After the family objected to the publication, citing privacy concerns, the data was taken down. The HeLa genome is now stored at the National Institutes of Health and researchers who wish to use the data must apply to the HeLa Genome Data Access working group at the NIH, which includes two members of the Lacks family.

Beyond the ethical issues, and the fact that these cells were taken from a poor Black woman without her consent, there are also scientific issues with the cells, leading people to argue that it’s high time that HeLa cells were retired from use in research.

HeLa have been growing in laboratories for decades and mutating all the time. As a result, the HeLa cells that are growing now are probably quite far removed, genetically speaking, from the original cells taken from Henrietta’s body.

Some have even suggested that they’re so far from the human cells they once were, that they have become their own species, proposing the name Helacyton gartleri, named after Stanley Gartler, the molecular biologist who first discovered that HeLa cells had contaminated other cell cultures.

There are further practical problems with using HeLa cells in research. Their rapid growth and frequent mutations makes them unstable - different batches can be highly variable, making it difficult to replicate scientific results.

But even if we retire HeLa, there are plenty of ethical conundrums left regarding cell lines and using biospecimens in research.

Although nearly 70 years have passed since Henrietta’s cells were taken without her knowledge or consent, in the UK and the US scientists are still legally allowed to use leftovers from blood tests, biopsies, and surgeries for research without asking or telling the patient, as long as identifying details are removed first.

Yet in an age where DNA sequencing is becoming increasingly routine, is there any such thing as a ‘deidentified’ sample that contains your DNA?

In 2011, The US Department of Health and Human Services proposed updating the rules to require a patient’s consent for using their cells in research. Still, the proposals were dropped after lobbying from scientists who believed the restrictions would hinder crucial research.

So if you have ever had a medical procedure that produced ‘leftover’ biological material, like your blood, urine, or tissue; your cells could be growing merrily in a lab somewhere, just like Henrietta’s.

Ethical issues and outrage aside, the story of Henrietta Lacks and her HeLa cells reminds us that behind every human specimen used in research is a person with their own story. So when the next medical breakthrough comes - and right now a coronavirus vaccine would be handy... - let’s make sure we thank the patients, Henrietta included, who made the research possible.

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