Stories
Slash Boxes
Comments

News for nerds, stuff that matters

Slashdot Log In

Log In

Create Account  |  Retrieve Password

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.
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."
+ -
story

Related Stories

[+] Two Women Found With HIV-Immune Mutant Gene 723 comments
Trokair writes "China Daily reports that researcher Tuofu Zhu has discovered two women in an HIV Research program that are immune to the disorder via a mutant gene."
[+] Researchers Modify T-Cells, Make Them HIV Resistant 171 comments
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.'"
This discussion has been archived. No new comments can be posted.
The Fine Print: The following comments are owned by whoever posted them. We are not responsible for them in any way.
 Full
 Abbreviated
 Hidden
More
Loading... please wait.
  • by Geoffrey.landis (926948) on Sunday November 09 2008, @12:52PM (#25695001) Homepage
    I'll be really interested to see if this result can be replicated.
    • by Anonymous Coward on Sunday November 09 2008, @12:57PM (#25695035)

      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.

      • by ScrewMaster (602015) * on Sunday November 09 2008, @01:02PM (#25695097)

        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.

        • by jcr (53032) <jcr@@@mac...com> on Sunday November 09 2008, @01:32PM (#25695353) Journal

          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

          • by SlashBugs (1339813) on Sunday November 09 2008, @01:59PM (#25695549)

            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.

              • by geckipede (1261408) on Sunday November 09 2008, @02:00PM (#25695557)
                Most of the drug treatments seemed like a viable strategy at one point. HIV mutates extremely rapidly though, and it seems able to bypass almost anything we can throw at it. If the new types of drugs can reduce the virus's ability to replicate effectively enough that it doesn't get an opportunity evolve a way round then in theory it could work. The problem with that is that you would need to administer the drug reliably on schedule for every infected person all the time and that doesn't happen. The treatments are expensive, and even worse, enough people see HIV/AIDS as some sort of punishment for promiscuity that some people are denied treatments intermittently because people don't feel comfortable giving it to them.
        • by Pax681 (1002592) on Sunday November 09 2008, @01:52PM (#25695485)
          IIRC i watched a TV doc about HIV immunity and how it was found. there is a link to the black death here too.

          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!
    • by MSTCrow5429 (642744) on Sunday November 09 2008, @01:03PM (#25695103)
      With the severely limited number of people with known immunity to HIV, and the pain of removing bone marrow, I'm wondering if more than a mere handful of people can be treated via this method.
      • by Chaos Incarnate (772793) on Sunday November 09 2008, @01:11PM (#25695189) Homepage
        Couldn't the recipients, who will generate the new bone marrow, then be used as donors?
        • by eln (21727) on Sunday November 09 2008, @01:19PM (#25695249) Homepage

          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.

      • by DebateG (1001165) on Sunday November 09 2008, @01:24PM (#25695287)
        I think the end goal is to use this method for autologous stem cell transplant (when the donor is the same as the recipient) rather than allogeneic (when the donor is different). Currently, there are technologies such as small interfering RNA (siRNA) that let you suppress a specific gene through genetic engineering. They are widely used in research, although there are many hurdles before they make the transition to clinical use. It would go something like this:
        1. Draw out someone's own stem cells
        2. Permanently express the CCR5 siRNA in their stem cells by culturing them with a virus
        3. Wipe the person's bone marrow out by total body irradiation
        4. Reinfuse the altered stem cells

        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.

  • by Anonymous Coward on Sunday November 09 2008, @12:56PM (#25695025)

    1) Be born with natural HIV immunity.
    2) Sell bone marrow to desperate people.
    3) Profit!

  • by haaz (3346) on Sunday November 09 2008, @01:17PM (#25695235) Homepage

    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.

  • by Malevolent Tester (1201209) on Sunday November 09 2008, @02:02PM (#25695573) Journal
    What relevance do sexually transmitted diseases have here?
    • by jimicus (737525) on Sunday November 09 2008, @01:11PM (#25695179) Homepage

      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.

        • by DebateG (1001165) on Sunday November 09 2008, @01:32PM (#25695351)
          Well, there are two problems with this. Firstly, hematopoietic stem cells don't last very long in culture. Lots of people are trying to figure out why, but I'm not optimistic that this problem will be solved any time soon since the cells normally exist in a complex microenvironment in the marrow that we don't really understand yet. But more importantly is the issue of MHC typing. While you need someone who has the CCR5 mutation (which is pretty rare), you also need to have someone who matches your MHC type. Think of MHC as the molecules that allow your body to identify self from non-self. The more MHC matches you have with the donor, the less chance you have of developing a life-threatening disorder called graft vs. host disease. Ideally, doctors want someone related to you, but if those people don't match, you have to do an unrelated donor search. Generally, finding a MHC match requires a large registry search that takes weeks to months to carry out, and many people, especially non-whites (due to the lack of representation of those elasticities in the bank), do not have a match.
    • by dogberto (102257) on Sunday November 09 2008, @01:14PM (#25695207)

      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

    • by FooAtWFU (699187) on Sunday November 09 2008, @01:18PM (#25695243) Homepage

      Leave it to a U.S. institution to be concerned with profiting from a possible cure for HIV.

      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...