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German Doctor Cures an HIV Patient With a Bone Marrow Transplant
Posted by
Soulskill
on Sun Nov 09, 2008 12:50 PM
from the not-an-easy-one-though dept.
from the not-an-easy-one-though dept.
reporter writes "HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Until now, HIV has no cure and has led to the deaths of over 25 million people. However, a possible cure has appeared. Dr. Gero Hutter, a brilliant physician in Germany, replaced the bone marrow of an HIV patient with the bone marrow of a donor who has natural immunity to HIV. The new bone marrow in the patient then produced immune-system cells that are immune to HIV. Being unable to hijack any immune cell, the HIV has simply disappeared. The patient has been free of HIV for about 2 years. Some physicians at UCLA have developed a similar therapy and plan to commercialize it."
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DieNadel writes to share that naturally occurring proteins called "zinc fingers" are being used in a new approach to AIDS treatment. Using modified T-Cells with the zinc fingers, researchers at the Pennsylvania School of Medicine have shown a reduction in viral load in mice. "'By inducing mutations in the CCR5 gene using zinc finger proteins, we've reduced the expression of CCR5 surface proteins on T cells, which is necessary for the AIDS virus to enter these immune system cells,' explains first author Elena Perez, MD, PhD, Assistant Professor of Pediatrics at Penn. 'This approach stops the AIDS virus from entering the T cells because it now has an introduced error into the CCR5 gene.'"
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Like to see this replicated (Score:5, Insightful)
Re:Like to see this replicated (Score:5, Funny)
I'll be really interested to see if this result can be replicated.
I'll be really interested to see if this DONOR can be replicated.
Parent
Re:Like to see this replicated (Score:5, Informative)
I'll be really interested to see if this result can be replicated.
I'll be really interested to see if this DONOR can be replicated.
I've been expecting something like this ever since the discovery of HIV-immune [wired.com] individuals. So yes, the donor can be replicated.
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Re:Like to see this replicated (Score:5, Interesting)
One thing I've been wondering about is whether it would be possible to fight infection just by making a protein that binds to CCR5 and does nothing else. I'm presuming that HIV can't attach to the receptor if there's something in the way.
Would any molecular biologist reading this please tell me if this works or not?
-jcr
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Re:Like to see this replicated (Score:5, Informative)
Background for non-biologists: HIV typically gains entry to cells by binding two molecules on the healthy cell surface. These are CXCR4 and CCR5. About 1% of white males (other genders/races vary slightly) don't have CCR5; they seem completely healthy and their cells are highly resistant to HIV infection. So blocking the activity of CCR5 seems like an easy way to stop viral infection with no exprected side effects. Tricky to do, but probably worth the effort.
Anyway, the answer is "yes", sort of. Several antibodies and small peptides are in trials to block the CCR5 receptor; some are showing promise in animal trials.
The most famous is Maraviroc, a small molecule that binds CCR5 and stops is from binding HIV. It's sold by Pfizer and currently in use as an anti-HIV drug.
Another interesting possibility is gene therapy. Another group has recently made CD4 T cells (one of the cell types that HIV infects) express a small molecule to block their own CCR5 receptors, which works very well. I haven't seen a paper on it, but you should also be able to use similar techniques to completely shut down CCR5 production (using virus- or plasmid-borne shRNA, for example).
Finally, another group has managed to make rabbits produce antibodies against CCR5 receptors (Vaccine
Volume 26, Issue 45, 23 October 2008, Pages 5752-5759). Those antibodies are able to bind to CCR5 and completely block HIV infection, which is great. Stimulating an immune response against the patient's own immune cells sound a bit dodgey to me, but my immunology isn't great: maybe there's a well-established way around this problem that I just don't know about.
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Re:Like to see this replicated (Score:5, Informative)
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Re:Like to see this replicated (Score:5, Interesting)
AS it was discovered that the very same genes that help immunity from the black death are same for HIV.
if you have none of this gene pair "switched on" then you are gonna get ill quick and die......
if you have one of the pair on then you will go on for a few weeks THEN come down with symptoms.
However with BOTH genes switched on you are immune but carry the black death/HIV virus. Was on the discovery channel....
It was also apparently found that is was only ethnic Europeans who had this gene switched on... this led to some conspiracy theories about HIV/AIDS being created to be targeted at non whites.
NEVER let it be said that a late night spliff to chill out whilst Discovery is on is a waste of your chill time!
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Re:Like to see this replicated (Score:5, Interesting)
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Re:Like to see this replicated (Score:5, Interesting)
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Re:Like to see this replicated (Score:5, Interesting)
Right now, there's a ban on selling organs for donation in this country. However, bone marrow transplants are expensive. If the recipient could later be used as a donor, the ability to pay them for their marrow (thus allowing them to more easily pay for the original transplant) could really help move this thing along. Even if a marrow recipient is reluctant to donate his own marrow, if he had a very large medical bill and was offered money to donate, he would be much more likely to do so.
Of course, given the limited number of naturally HIV-immune people in existence today, it would drive up the price of a transplant in the short term as they demand high prices for their marrow, but in the long run it would even out as we create more HIV-immune people.
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Re:Like to see this replicated (Score:5, Informative)
On the contrary, bone marrow transplants are the cheapest transplants.
In essence, bone marrow transplantation is just an intravenous injection.
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Re:Like to see this replicated (Score:5, Interesting)
The advantage of this method is that, since the stem cells are coming from your own body, there is no graft vs host disease (which is essentially like standard organ rejection, but instead the organ rejected is your entire body being rejected by the graft... you can imagine that this is very bad). Of course, you still have the problem of developing leukemia later from the total body irradiation and viral integration into an important gene. You also have a high risk of death upfront when you spend several weeks without a functional immune system when the transplant is taking. But nevertheless, it's exciting.
Parent
Re:Like to see this replicated (Score:5, Funny)
Can you throw a little House into that? Like, say autoimmune a few times, maybe "at least it isn't lupus" or something? Amyloidosis?
Parent
Re:Like to see this replicated (Score:5, Insightful)
It's a beautiful little village with an excellent church and museum, if you ever get a chance to visit.
Parent
found the missing second to last step! (Score:5, Funny)
1) Be born with natural HIV immunity.
2) Sell bone marrow to desperate people.
3) Profit!
I know what bone marrow transplants do to people (Score:5, Insightful)
My late mother had a bone marrow transplant (BMT) to treat her pre-leukemic condition and try to prevent it from becoming full-bore leukemia. To do this, they blasted her whole body with radiation (sorry, don't know which frequency), which killed her existing bone marrow. They then inserted/transplanted his sister's bone marrow. Now, I am not a doctor, so I'm probably leaving out a lot of important steps here. But because of the radiation dosage, she lost her hair, a lot of weight, and the ability to keep food in her for any length of time.
Yes, we knew this was coming. In fact, she had worked as a radiation oncologist for decades before her diagnosis with myelodysplasia. The irony abound.
Unfortunately, either the transplant didn't take or the weakness was too much for her. She passed away on November 16, 1999. Two weeks after I'd gotten married. And some of you may remember my then-wife from what happened five months later [slashdot.org]. Yeah, life kinda sucked.
I do want to see the HIV/AIDS pandemic curbed, and I do what I can to help people who have it live a little better. But a BMT is a major, major procedure. It's not guaranteed to be a death sentence, but it's not guaranteed to work, either. Is it worse than HIV/AIDS? That question is beyond my pay level to try and answer. I just have one story from one BMT that unfortunately did not go well. I am thankful that no one in my family has had HIV/AIDS. But I just don't know if this is the best way to deal with it once someone is infected.
Re:I know what bone marrow transplants do to peopl (Score:5, Informative)
BMT is a major, major procedure.
With about 30% mortality, I've read.
-jcr
Parent
Re:I know what bone marrow transplants do to peopl (Score:5, Interesting)
But I just don't know if this is the best way to deal with it once someone is infected.
I'd say it isn't, given the nature of a bone marrow transplant (such things always seems so easy on TV.) Still, there may be other ways to transfer this genetic protection to an individual (a retrovirus maybe) so this qualifies as significant progress.
Parent
Erm, this is Slashdot (Score:5, Funny)
Re:Is it for real this time? (Score:5, Funny)
I am not aware of anything that would require a condom for its movement.
Parent
Re:Is it for real this time? (Score:5, Funny)
Over the years, I've witnessed probably 640 articles on a cure for HIV either having been discovered, or very near.
Well, 640 articles should be enough for anyone.
Parent
Re:So you need immune bone marrow? (Score:5, Informative)
Is there a way to create or replicate this bone marrow? Or will this immune donor be continually used for every AIDS patient in the world?
It's not quite as simple as that. As I understand it, there are different bone marrow types - just like you get different blood types - and for a transplant to be successful, you want to be transferring to someone with the same type. So for every HIV+ patient, you need to find a donor who is not only of the right type, but is also naturally immune.
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Re:So you need immune bone marrow? (Score:5, Informative)
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Re:What I'd like to know is... (Score:5, Informative)
Yeah there is...
Currently, the theory is that HIV immunity is provided by a mutation of the CCR5 receptor. In particular, it seems to provide an immunity also to the bubonic plague--it is as a result of the bubonic plague that this recessive mutation has manifested itself today in somewhat greater numbers in certain populations--natural selection, so to speak at work.
check out:
http://www.wired.com/medtech/health/news/2005/01/66198
http://en.wikipedia.org/wiki/CCR5
Parent
Re:Nice to hear.... (Score:5, Insightful)
Sure, I'll leave it to them to do that, if you'll at least leave it to a US institution to invest in a ton of experimentation, research, development, refinement of the techniques, overcoming regulatory hurdles, patient trials...
Parent