German Doctor Cures an HIV Patient With a Bone Marrow Transplant 639
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."
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.
Yeah great and all (Score:2, Informative)
Re:Germans (Score:1, Informative)
Sure, there have been reports of HIV-immune prostitutes in Africa for years. With a large and diverse enough population, there's bound to be a few individuals who are resistant or immune to any given disease.
I'm a little surprised that the solution was as "simple" as a bone marrow transplant. I expected genetic therapy, etc.
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.
Re:Is it for real this time? (Score:1, Informative)
The article states it clearly - 30% mortality rate plus you have to find a donor.
Re:Germans (Score:3, Informative)
Yeah, after reading the article from the original post I did a bit of research on it myself--apparently 1% of all Europeans have this CCR5 mutation? The bad news: about 30% of people who get bone marrow transplants don't survive the procedure, and the CCR5 mutation makes it more likely for them to die of other things lik West Nile Virus.
In any case, this is wonderful news for the scientific community. Even if this doesn't amount to anything it's still a breakthrough that could help piece together the overall picture. Exciting news.
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
Re:What I'd like to know is... (Score:2, Informative)
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.
Re:So you need immune bone marrow? (Score:5, Informative)
Re:Like to see this replicated (Score:3, Informative)
I seem to recall a lecturer visiting my hometown's community college and giving a genetics lecture. During the lecture he claimed that the plague caused a lot of people with the CCR5 receptor that HIV attacks to die off (the plague also attacks CCR5, allegedly), thus creating a non-trivial population of northwestern Europeans who are immune to HIV.
What's the current status of this theory? Google returns quite a few hits, but as I'm not a geneticist, and technically haven't taken a biology class in 13 years, I'm not that qualified to filter out bunk.
natural immunity problem (Score:4, Informative)
Comment removed (Score:5, Informative)
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.
Re:Like to see this replicated (Score:5, Informative)
Re:What I'd like to know is... (Score:4, Informative)
Re:Monetization (Score:5, Informative)
Making money off of a disease which is very much kept in the vague, unclear, opaque situation is evil.
Where is the reproducible proof that HIV exists?
Where is the reproducible proof that HIV causes AIDS?
Go to the (American-run but internationally funded and popular) National Centre for Biotechnology Information here: http://www.ncbi.nlm.nih.gov/sites/entrez [nih.gov] ...and type "HIV" into the search box. You'll get just under 192,000 peer-reviewd articles from groups all over the world, funded by various governments, public and private companies, charities and rich donors. Anything from HIV genome sequences and molecular sctructures through molecular biology, disease progression, transmission studies, all the way to local- regional- and global epidemiological studies. The evidence is pretty damn strong and well understood from the atomic level up to the global level.
Altenatively, click on the "Reviews" tab and it'll give you a mere 24,000 articles assessing, collating and criticising the others. Have fun!
True for HIV, True for HPV.
True for whatever.
When you've finsihsed the HIV evidence, feel free to look up the 15,000 HPV articles (or just 12,600 if you restrict your seach to "HPV AND cancer"). The HPV thing is actually very easy: most viruses carry genes evolved to push cells into their growth phase, because that forces the cells to release and synthesise resources that the virus must hijack to replicate. HPV-associated cancer happens when the viral gene gets incorporated into the cell's DNA (rare, but through well-established mechanisms) and get permanently switched on, making the cell grow and divide constantly. Any biology undergrad could tell you that if you asked. It's more common in the cervix simply because it's out of sight, and doesn't get noticed until it's really big and nasty. (Which is why all sexually actve women should be screened: catch it within the first 5 years and the cure rate is better than 98%. It's an easy cure if you *find* it)
THINK first. Do your research.
My undergraduate degree is in virology and I've just finished a PhD looking at how viruses interact with cancer and parts of the immune system. I've done plenty of thinking, and a hell of a lot o research. Now it's time for *you* to think, and for *you* to do some fucking research.
You're no better than the creatioists who say that evolution's impossible but have never botheres to get a fcuking clue how it actually works.
Re:Like to see this replicated (Score:2, Informative)
TFA states that there was no need to do radiation. The new bone marrow just naturally took over as it was healthier
Re:Like to see this replicated (Score:4, Informative)
Just because Hitler did something doesn't make it bad. I'm sure Hitler ate and drank, but does that make you a nazi when you have breakfast?
Re:Like to see this replicated (Score:3, Informative)
Weellll specifically ole Hitlers attempts to genetically purify mankind by removing classes of people are what is most hated about him... and thats what arth1 is proposing...
Re:Like to see this replicated (Score:1, Informative)
"Medical bills are such a quaint American concept."
Thinking that "free" services provided by the government are actually free is such a quaint European concept.
Re:Like to see this replicated (Score:3, Informative)
Depends how you choose to express the siRNA.
Plasmids are generally pretty safe, if you pick one with decent copy-number control. Something like Epstein Barr virus' dormant plasmid would be pretty good, as it automatically keeps itself to just a few copies of itself per cell and constantly expresses a couple of RNA molecules. Just remove the viral genes and throw your shRNA in there under the same promoter... should work like a charm.
There are also some viruses that always integrate into a specific, safe part of the genome. Adeno-associated virus, for example, always slots itself into the same site (somewhere on chromosome 19 IIRC?) and lies dormant. It has a tiny capacity for payload genes so is often ignored, but if you just want to express a few shRNAs it's be ideal.
But yes, the radiation will still be a bitch. I've seen several patients going through it, who all agree that the treatment is better than the disease, but only just.
Re:Like to see this replicated (Score:5, Informative)
Speaking as an American that's lived on both sides of the pond, with a mother in the states being nearly bankrupted by her cancer treatment and a mother-in-law in europe who had the same level of care with no added costs, I know which system I prefer.
Re:Like to see this replicated (Score:5, Informative)
Re:Like to see this replicated (Score:5, Informative)
If it makes you feel better, I'm at the end of a PhD in the field. So I know more about HIV and AIDS than most of the population and, indeed, am one of the "phoney researchers" who generates the same data that I am, apparrantly, ignoring.
Tell us - what's your Ph.D. in?
Try getting your science from reputable schools or journals rather than mass-market paperbacks.
Re:Like to see this replicated (Score:1, Informative)
Well the GP of this post is not completely off. What they may be referring to is the fact that one prominent researcher's study came to the conclusion that HIV was not highly correlated to AIDS which suggested that HIV was not the causing the AIDS. Immediately he was kicked out of the scientific community as they stated that he should be jailed for life for trying to disprove a current hypothesis (which is the point of being scientific).
However they are definatley wrong when they suggest that HIV and AIDS don't exist. They just may be related in a confounding sort of way ;)
Re:Like to see this replicated (Score:5, Informative)
Black Death is not a virus. It is a bacterium. Yersinia pestis.
Re:Like to see this replicated (Score:3, Informative)
Re:Like to see this replicated (Score:4, Informative)
On the contrary, bone marrow transplants are the cheapest transplants.
In essence, bone marrow transplantation is just an intravenous injection.
This is accurate, but misleading. Bone marrow transplants are cheap as transplants go, but they're still very expensive. The IV injection of the transplant is no big deal, but before it can be done the recipient's own marrow must be destroyed by chemotherapy or radiation treatments, and after the transplant the patient has to be on immunosuppresives and receive regular transfusions until the new bone marrow can establish itself. During that time, the patient also has no immune system, and must be in a hospital or other sterile environment.
The whole process takes 1-2 months, and is far from cheap.
Re:Like to see this replicated (Score:3, Informative)
What they may be referring to is the fact that one prominent researcher's study came to the conclusion that HIV was not highly correlated to AIDS which suggested that HIV was not the causing the AIDS. Immediately he was kicked out of the scientific community as they stated that he should be jailed for life for trying to disprove a current hypothesis (which is the point of being scientific).
Are you talking about Peter Duesberg [duesberg.com], by any chance?
Re:So you need immune bone marrow? (Score:1, Informative)
It's rather simple then, actually.
If it is a known mutation, CCR5, which leads to the immunity... we take a patients bone marrow, isolate the short-lived hematopoietic stem cells... engineer them to have the mutated CCR5 version instead of the wild type... reintroduce modified bone marrow into patient.
No MHC match issues. A difficulty is a targeted mutation method, which thousands of researchers are working on. Showing safety in humans is the really hard step.
I expect this procedure should be done with several different HIV-resistence alleles to have the least chance of the virus developing resistence to the therapy.
I am a molecular biologist, but post AC due to personal privacy policy.
Re:Like to see this replicated (Score:3, Informative)
I can't comment on the relative cost of a BMT to other types of transplants, but to say that a BMT is just an intravenous injection is completely misleading.
An (allogeneic) BMT is essentially the replacement of a recipient's immune system with the immune system of a donor. Before implanting the donor's immune system (which literally is an IV infusion of hemapoetic stem cells) the recipient's own immune system has to be destroyed. This is done with high-dose, whole-body radiation and high-dose chemotherapy, which have numerous, serious side effects. Once the recipient's immune system is destroyed (the treatment's intended effect) they are at extremely high risk of contracting potentially-fatal infections, and for this reason they are hospitalized in special 'clean' BMT units with extremely close monitoring for an extended period of time. It takes many weeks before the transplant (hopefully) engrafts, and then many more months before the new immune system is fully functioning. Once engraftment occurs there is high-probability of acquiring graft-versus-host (GVH) disease (potentially fatal) and this is managed through the use of immunosupressants and close monitoring as an outpatient for many months after the transplant. The good news here is that the immune system usually becomes tolerant of the recipient's body (the graft sees all of the host's tissue as foreign) and the immunosuppressants are eventually not needed, unlike the case for organ transplants.
So is a BMT just an intravenous injection? I think not.
I'm speaking from personal experience; my daughter recently underwent a BMT. The cost? approaching $1M.
Comment removed (Score:4, Informative)
Quick answer (Score:5, Informative)
STD cases are rising every year (NON-CUMULATIVE figures, of course), yet where are all the teenagers dying from 'AIDS'?
The fast answer is that HIV is not a highly contagious disease. In fact, compared to something like measles -- or HPV or active herpes -- it is actually quite difficult to catch HIV. The reason we focus so much attention on it, however, is because unlike herpes or genital warts, you die from it.
That is, until recently. Compared to 1981, we have quite a lot of experience treating AIDS. In fact, the clinical definition of AIDS an HIV-positive patient with fewer than 200 T-cells per cubic millimeter of blood. By definition, if we can stop your T-cells from dying, you don't get AIDS. (But if we stop treating you, you do.)
Other than that, it's 2008. To say that HIV does not cause AIDS at this late stage in the game is akin to denying evolution. The amount of scientific evidence linking HIV to AIDS is simply overwhelming.
I'm not at the tail end of a PhD in biology or anything close, but even I know this much. You do yourself a disservice by approaching scientific topics with blinkers on.
Re:Like to see this replicated (Score:5, Informative)
Well the GP of this post is not completely off. What they may be referring to is the fact that one prominent researcher's study came to the conclusion that HIV was not highly correlated to AIDS which suggested that HIV was not the causing the AIDS. Immediately he was kicked out of the scientific community as they stated that he should be jailed for life for trying to disprove a current hypothesis (which is the point of being scientific).
Part of your claim is mostly true. A prominent researcher (Peter Duesberg) did assert that HIV was not the cause of AIDS. His claims were not based on correlation between AIDS and HIV, however, because all prominent studies show an extremely high correlation -- people with AIDS invariably have HIV. Duesberg's argument was that correlation did not equal causation.
The second part of your claim is inflammatory and inaccurate. It is possible that some individuals expressed the sentiment that Duesberg should be jailed; this would be their own personal opinions. But Duesberg was not "drummed out of the scientific community" by any means. To this day he remains a professor of biochemistry and molecular biology at UC Berkeley. [berkeley.edu]
Comment removed (Score:3, Informative)
Re:Like to see this replicated (Score:3, Informative)
They can't be vectors because the viruses have no chance to multiply in their bodies and die fast.
Same thing as with other viral diseases like measles, flu oder German measles. If you get the inoculation ratio high enough you have herd immunity. It's how smallpox was eradicated. Measles are supposed to go next. Flu has too many varieties for this to work but I hear a new vaccine is under development that works with all strains.
Re:Like to see this replicated (Score:5, Informative)
Excellent post, but I would just like to add a few more caveats. As you probably know, but most people certainly don't, HIV occurs in a wide range of variant strains, which use either CD4 and CXCR4 or CD4 and CCR5. This is a property called "tropism" and HIV strains are classified as X4 or R5 tropic.
But actually, from the data I have seen, few viruses exhibit a really pure tropism. There are a lot of dual-tropic X4R5 virus strains that have some flexibility to use CXCR4 or CCR5 as the opportunity offers itself; this is not surprising, as one variant must be capable of evolving into the other. Also, all patients carry diverse virus populations, because HIV is so sloppy in replicating itself, and a patient may well have 99.9% of R5-tropic viruses and 0.1% of X4-tropic viruses. (0.1% is about the limit of what can be detected with current, and very expensive, methods.)
This is cause for concern. A treatment that blocks the replication of R5-tropic viruses may well favour the replication of X4 strains. There already are indications that this happens in some patients on maraviroc treatment. Driving a virus population to become entirely X4 tropic would probably not be advisable, as there is reason to believe that these strains do more damage. The X4-tropic HIV strains are generally associated with the late stages of infection and the development of AIDS.
Therefore I doubt that anyone is going to advocated bone marrow transplants as a way to treat HIV. The risk is just too big, because this form of treatment is (almost) irreversible. Treatment with maravoric should always be preceded by tropism testing, and can be stopped if it doesn't work.
Finally, 2 years of undetectable viral load in absence of ARV treatment is an impressive result, but IMHO it is still too early to call the patient cured. He may well still have proviral DNA in his cells.
Re:Like to see this replicated (Score:2, Informative)
by removing choice from others, you are playing god you jackass.
What you are proposing would be akin to sterilising anyone who has undergone any sort of life-saving procedure. jackass. asshat. Hitler wanabe and cannot even stand up and proclaim it. weak.
Re:Like to see this replicated (Score:1, Informative)
Maraviroc (and Vicriviroc etc) resistance also occurs. Then there is the matter of tropism and the
CXCR4 receptor. Chemokine Coreceptor 5 moleculer antagonists are not a panacea for HIV, neither
is BMT as the HIV exists in cells outside of the BM. Things are not as simple as this article
suggests.
http://hivinsite.ucsf.edu/InSite?page=ar-06-01#S1X [ucsf.edu]
Re:Like to see this replicated (Score:4, Informative)
i think one of the "protections" given to pharmacists by the conscience clause is that employees cannot be fired or otherwise punished for refusing to fill a prescription based on religious grounds. from Wikipedia [wikipedia.org]:
Re:Like to see this replicated (Score:5, Informative)
It is very widely believed that the VERY slow response to the HIV/AIDS epidemic was inspired by the widespread belief that it is simply punishment for the sins of promiscuity, homosexuality and drug abuse. I don't know where you've been, but that's hardly an accusation from far left field.
There are also confirmed cases of nations refusing to take any action, or permit any treatment for HIV/AIDS on precisely those grounds. Not first world industrials, mind you, but even third world African dirt farms doing it is abhorrent.
Re:Like to see this replicated (Score:5, Informative)
Words fail me. The DEFINITION of AIDS REQUIRES the patient to be 'HIV positive' in order for them to be diagnosed with 'AIDS'... i.e. it's a circular argument, moron...
Well, that's Koch's Postulates for you. If an organism has a disease and you can isolate a pathogen from that organism and then culture that pathogen outside the organism, then introduce that pathogen to another organism and the new organism exhibits the same disease... well, if you can do that, then Koch might say you're onto something. (This HAS been done with HIV/AIDS, by the way.)
By your logic, if the definition of having the flu requires that the patient be infected with a strain of the influenza virus, then it's a circular argument to claim that influenza causes the flu. So long as influenza can be isolated from any organism that doesn't have sniffles, then influenza must not cause flu.
Or to put it even more simply for you retards: TB death - HIV = TB death TB death WITH HIV = 'AIDS'
It is you who are making the circular argument. It is entirely possible to die of tuberculosis without having a compromised immune system -- in fact, it happens all the time -- and these deaths would not be classified as AIDS. A tuberculosis patient who does not mount an immune response is an anomaly, and then doctors must investigate why there is no immune response. Tuberculosis is not caused by a virus, and does not attack immune system cells, therefore a low T-cell count is not considered a symptom of tuberculosis. HIV is a virus and HIV has been shown to attack immune cells, therefore when a patient with both tuberculosis and HIV dies of tuberculosis after having failed to mount an immune response, it seems only logical to suspect HIV. But you argue that HIV does not cause AIDS, and in fact HIV is a harmless virus, and therefore someone who dies of TB with a compromised immune system who also has HIV could not have failed to mount an immune response because of HIV. What, then is the reason for the lack of immune response?
All the scientific evidence proves, beyond ANY doubt, that 'AIDS' is not a sexually transmitted disease, that 'AIDS' 'medications' are what kill people in the West
How? How does it prove this? Please explain, because so far it doesn't seem as if you're adequately informed.
The article you cite is extremely easy to rebut. Like Duseberg's original claims, it does not cite any research later than 1997. HIV/AIDS research has come a long, long way since then. Furthermore, the article only focuses on research into AIDS cases in the U.S. Its hypothesis is that AIDS is caused by the use of AZT and other drugs, including recreational drugs. It furthermore claims that almost all AIDS is found in homosexual men and heterosexual drug abusers. The implication is that behaviors, including sex between men and drug use, are the cause of AIDS.
How does this article explain the AIDS epidemic in Africa, where AIDS is far, far more prevalent than in the U.S.? During the height of the African epidemic, Africans did not have access to AZT or similar drugs, nor did they use cocaine and amyl poppers in any great prevalence. Furthermore, in Africa the AIDS epidemic is primarily a disease of heterosexuals, including females.
How does a behavior-based cause of AIDS explain cases of AIDS in children and hemophiliacs?
How does this theory of AIDS explain why HIV+ patients have had longer lifespans since the beginning of the HAART (highly active antiretroviral therapy) era? If, as you claim, the cause of AIDS is in fact the drugs designed to cure it, then why does giving patients a combination of many such drugs make them live longer than they did when they had just one such drug (AZT)?
Of course, none of you will bother reading it, because you might have to THINK, and you would literally rather DIE, wouldn't you?
I have read it. It is you who are not thinking. In f
Comment removed (Score:5, Informative)
Re:Like to see this replicated (Score:3, Informative)
Re:You know one kind of method for one kind of ill (Score:3, Informative)
The drug is Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) if anyone wants to look it up. It's just a growth hormone that you have produced in your body naturally. They just give you a *lot* of it, causing your stem cells to start dividing. Some stay in your bone marrow, the excess cells move out into the bloodstream, from which they can be painlessly extracted.
I know someone who's had cells extracted that way, and she described it like Marrow (very apt name!) does. The hormone treatment made her feel like she had a cold coming for about a week, and the extraction procedure (required about 2 hours sitting in a comfy chair) was just "really boring".
If you sign up to be a bone marrow donor (you should if you can! Brits check out the Anthony Nolan Trust), that's what you're signing up to do: feel like you have a mild cold, be bored for two hours and hopefully save someone's life.
Very rarely (more common in people 50+) the drug doesn't work well and they do ask if they ca take your cells directly from the bone. I know a woman who had this done too. She stayed in hospital for 2 days after, rested in bed for another 2 days and was back in work after a week. It wasn't great fun, but it healed up perfectly and painlessly after a few weeks. She said it was definately worth it to try saving someone's life.
Re:National conscience clause (Score:2, Informative)