Teen Takes On Donor's Immune System 231
Leibel writes "The Australian ABC News is reporting that a 15-year-old Australian liver transplant patient has defied modern medicine by taking on her donor's immune system. Demi-Lee Brennan had a liver transplant. Nine months later, doctors at Sydney's Westmead Children's Hospital were amazed to find the teenager's blood group had changed to the donor's blood type. They were even more surprised when they found the girl's immune system had almost totally been replaced by that of the donor, meaning she no longer had to take anti-rejection drugs. 'Dr. Michael Stormon says his team is now trying to identify how the phenomenon happened and whether it can be replicated. "That's probably easier said than done... I think it's a long shot," he said. "I think it's a unique system of events whereby this happened. "We postulate there's a number of different issues - the type of liver failure that she had, some of the drugs that we use early on to suppress the immune system and also that she suffered an infection with a virus called CMV, or cytomegalovirus, which can also suppress the immune system."'"
ob. (Score:5, Funny)
She's a MUTIE!!! (Score:5, Funny)
Re:She's a MUTIE!!! (Score:5, Funny)
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Warring immune systems? (Score:5, Informative)
Actually, if memory serves, NPR had a short bit on a treatment for negating the need for anti-rejection drugs in kidney transplants--they not only transplanted the kidney, but also bone marrow from the donor, and 5 patients out of 6 were able to go off the anti-rejection drugs.
Article: Bone Marrow + organ = no rejection (Score:5, Informative)
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Re:Warring immune systems? (Score:5, Informative)
Of course the parents genotype is no absolute guarantee, as it is always "momma's baby, daddy's maybe" but it sounds like they have this pretty well nailed down. She really did develop chimerism.
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Self-rejection? (Score:5, Interesting)
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Re:Self-rejection? (Score:5, Funny)
Which would seem to indicate that the immune system BIOS has some kind of PnP support--I guess that'd explain some of the viruses...
Re:Self-rejection? (Score:5, Funny)
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Haven't heard it before? Here goes:
A mechanical engineer, hydraulic engineer, electrical engineer and a computer programmer were riding together in the car, and it stops. They all get out and look at the car. The mechanical engineer checks the tires, the hydraulic engineer checks the brakes, and the electrical engineer checks the voltage on the battery. The computer programmer goes "Guys cmon, all we gotta do is get out of the car and ge
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if you're starting it on cold weather and it doesn't stay running, you can't get it to start again without taking the key out, then putting it back in and trying again. if you don't do that, it'll just turn, but not fire.
my mechanic is baffled too. my personal theory is that when the engine dies, it kills the fuel system until you "reset" it by removing the key.
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BSOD (Score:2, Funny)
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Re:Self-rejection? (Score:4, Interesting)
Re:Self-rejection? (Score:5, Funny)
Worst... pick-up... line... EVER!
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those old 9X's tho could possibly have pulled of something like this...
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Re:Self-rejection? (Score:5, Informative)
Re:Self-rejection? (Score:5, Interesting)
As a person with minimal medical knowledge, does this perhaps open a door to a future possible therapy for other immune system affecting/avoiding diseases? e.g. HIV
Re:Self-rejection? (Score:5, Insightful)
Of course, ABC News isn't exactly a peer-reviewed journal, so I'll reserve full analysis for such time as this patient is written up in the literature, but I'm not seeing anything outside the realms of modern medicine here.
Re:Self-rejection? (Score:4, Interesting)
Is she related to Sigorney Weaver? (Score:3, Funny)
Re:Is she related to Sigorney Weaver? (Score:4, Funny)
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The Company.
But what about her OEM parts? (Score:5, Insightful)
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http://www.neurologyreviews.com/dec04/nr_dec04_bonemarrow.html [neurologyreviews.com]
http://www.chemcases.com/cisplat/cisplat20.htm [chemcases.com]
Graft Versus Host Disease (Score:5, Informative)
Though given a choice, I'd take the GVHD risk, lose the immunosuppressants, and never worry that my liver graft would fail. All in all she's a hella lucky kid.
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It's my hope that more good news will come by (Score:2)
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I really don't see that happening. The best along that line that you could hope for would be a mild to moderate case of chimerism [wikipedia.org].
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It's about as likely.
IYes, I read TFA (Score:4, Interesting)
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And the bad news..... (Score:2, Funny)
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There have been anecdotal (yeah I know) accounts of people receiving transplants and then having personality changes - food preferences or even sexual orientation.
http://www.nexusmagazine.com/articles/CellularMemories.html [nexusmagazine.com]
Whether it's true or not or just self selection bias I don't know. But I won't be surprised if the rest of our organs actually had some influence over what we'd like to put in our stomachs or other "gut feel stuff"
Plus those stem cells do roam about. After a
Cure worse than the disease? (Score:5, Interesting)
CMV is no laughing matter. It's one of the opportunistic diseases that immuno-deficit people have to worry about. It can lead to blindness and a slew of other complications.
The best we can hope for (if CMV is to thank for this effect) is that they can isolate the mechanism and replicate it. You wouldn't want to use CMV in this way.
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The implications are much more profound than that (Score:4, Interesting)
Imagine if they could take a sample of your DNA, correct inherited defects, and then re-implant you with stem cells carrying the corrected sequence. It would mean hope for victims of all kinds of diseases like Tay-Sachs or Kreuzfeld-Jacob.
At the very least, the promise of being able to transfer immunological memory on the marrow level potentially means that all we have to do is find the one person whose immune system wipes out HIV, say, and we can all receive that same immunity.
Re:The implications are much more profound than th (Score:3, Informative)
We effectively already do this. They're called bone marrow transplants [wikipedia.org], and it's been used to treat a number of blood-based or auto-immune diseases for years.
The risk of this procedure aside, one problem is that bone marrow transplants aren't perfect. Take leukemia or sickle cell anemia for instance. Unless every single hemopoietic stem cell is eradicate
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Yes, I realize that. But once you look past the sensationalist headline of "entire immune system" and understand where those cells come from you'll realize that what happened to her is fundamentally no different than what happens to someone who undergoes a bone marrow transplant. The notable things about this case are: (1)the donor's liver cell(s) migrated and differentiated to replace the hematopoietic stem cells and (2) the replacement of the hem
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2 questions (Score:5, Interesting)
As someone who has received a renal Tx and who also has a degree in Anat.,Phys.&Biochem. I have 2 questions.
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Re:2 questions (Score:4, Informative)
True to a certain extent. AB could probably handle O, but AB couldn't handle A or B (just the same as A couldn't handle B or vice versa). Having the A markers yourself, as an AB, doesn't neutralise the problems with the B vs A clashwith your B markers and their A markers).
Certainly, when reciving blood, if she was AB positive, she can be a universal recipient. But that would be for an emergency blood transfusion. In an organ transplant situation it would be too risky.
Just as a side note. The problems with different blood types in blood transfusions is less to do with rejection by the immune system and more to do with the blood cells co-aggulating. With a transplant the problem is more to do with rejection by the immune system.
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If her immune system has been replaced by her donors, won't her other organs/tissues (her own) be rejected by her new (her donor's) immune system?
Yes, but GVHD is not as bad as the combination of host versus transplant graft plus immune suppression. There is some talk of doing BMTs with other solid organ transplants to do exactly what this girl did spontaneously. Also, in the case of GVHD, the immune system is attacking OEM parts so they are healthier to start with than transplanted tissue.
They gave her a liver from someone with a different blood type?!? I know other markers as well as blood type are taken into account (and in hepatic Tx urgency is another factor), but I thought a blood type match was the minimum requirement
Not if you are going to die tomorrow. Once we get the liver equivalent of dialysis, this will change, but until then the threat of death from fulminant liver fai
Re:2 questions (Score:5, Informative)
A better article [yourguide.com.au] on this case described her original blood group to be Type O negative(-) with her new blood group being Type O positive(+).
In this special instance, there would be no reaction. Simply stated, anti-bodies can only be generated for antigens. Thus, you cannot have a humeral immune response based upon a lack of an antigen. This, incidentally, is the same reason why a type AB positive(+) person can receive blood transfusions from any blood group.
This is a good point. I can only guess that because the recipient's blood type was rare (approximately 9% of the population in Australia, according to wikipedia) and that the donors blood type was close (and perhaps their major histocompatibility was good too), other factors like urgency might have taken precedence over the ideal hope of a "perfect match."
-Grym
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A person with group O can receive blood only from another group O person (but can donate to almost everyone else). RhD negative people who don't have anti-RhD antibodies can receive one transfusion of RhD positive blood then become sensitised to the RhD antigen.
On the flipside, RhD positive people don't react to RhD negative blood.
It's important to realise that the ABO and RhD+/
Re:2 questions (Score:5, Informative)
my blood type is O+, the recipient is A+.
Just overnight (Score:2, Funny)
Or, they mixed the test results up (Score:2)
How cool would it be.. (Score:2, Interesting)
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We just might be 5 years away from at least a partial cure.
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Could this possibly be (Score:2, Insightful)
Accidents (Score:3, Insightful)
sounds pretty cool . . . (Score:2, Interesting)
If they can reproduce this situation it'll be huge.
If in fact they do reproduce it, do you think the doctors/researchers will get some sort of Nobel Prize?
But What About...? (Score:2)
But what about all the rest of her body that was still running on the old immune system?
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The vendor will tell her she's running in an un-supported configuration.
She'll have to either upgrade the rest of her body to Immune System 2.0, or revert to a saved image using Immune System 1.0. Unfortunately, they can't be responsible for any data loss from going back to the older version.
It said right in the release notes that Immune System 2.0 wasn't compatible with Immune System 1.0, and they don't have any guidan
Changing our blood (Score:2)
Odds are we'll find a way to create effective blood substitutes well before then, but it would take some complexity out of the whole blood donor - donator process.
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In addition, there are other possible consequences--some blood types, for instance, survive Bubonic Plague a lot more than other blood types, due to the similarity of surface proteins between certain kinds of blood cells
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NPR Story on new transplant techniques (Score:5, Interesting)
This story actually coincides with an interesting story [npr.org] that ran on NPR yesterday about several experimental new transplant techniques that might help future transplant patients avoid having to take anti-rejection drugs, as well.
In particular, the article tells the story of one 28-year-old woman who received a kidney transplant from her mother, who was only a partial match. Prior to the kidney transplant, she also received a partial bone marrow transplant from her mother. The bone marrow transplant essentially caused the patient's immune system to become a "blend" of her own and her mother's, producing T-cells that would attack bacterial and viral antigens just like normal, but leave the transplanted kidney alone.
The results are pretty impressive. The patient originally had to take anti-rejection drugs after her first kidney transplant at age 13, and they caused a host of miserable side effects. After her more recent transplant, however, she's been off the drugs for five years and even ran 2 marathons last year (how's that for healthy?).
Unfortunately, the new technique only works for organs that you intentionally plan on transplanting ahead of time, since the bone marrow has to be transplanted first in a separate surgery. That means that organ donors who die and donate hearts, livers, etc. aren't really an option. But for a transplant from a living donor, this is a very promising new technique (some of the researchers even think that it could eventually make transplants from animals possible).
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Washington Post, too. (Score:2)
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Is doing them at the same time and using immuno-suppressant drugs until the new marrow kicks in too dangerous, or won't work for some reason? I don't think the donor would mind the painful and dangerous marrow donation process, since if they're donating other organs, they're probably done with the marrow, too.
Retro movie remakes (Score:2, Funny)
This is not really as unusual as you think (Score:3, Interesting)
The great thing about Pluripotent Stem Cells is that we may be able to do similar things by altering your own tissue into an embryonic cell, fixing the genetic deficit, and reinjecting the functional cells into your own body, where they can have a functioning immune system that is totally compatible with your own body and not be rejected.
Science Rules!
This is REALLY not as unusual as you think... (Score:2)
Sounds like malpractice. (Score:2, Interesting)
Re:Sounds like malpractice. (Score:4, Insightful)
Despite the best care, sometimes bad things happen and people die. And sometimes the best care isn't possible, and you do the best you can as the doctors did in this case. The ideal is a perfect blood type and HLA match, however failing to act because you don't have a perfect match would have resulted in this child's death. Perfect in this case is the enemy of good.
Unfortunately this sort of attitude creates no end to trouble and causes both inappropriately aggressive therapeutics and diagnostics in the US as opposed to elsewhere. There is a saying amongst OB/Gyns - you don't get sued for the C-Section that you do, you get sued for the C-Section you don't do. So surprise.... the US has a higher section rate for women. Similarly, in the US your child with belly pain is much more likely to get a CT scan to rule out appendicitis. Doing the CT doesn't get you sued, but failing to do it eventually will (because there is always going to be that very small number of kids with an appy that presented very atypically.) However, if you do 500 Abdominal CTs in kids less than 15, you will ultimately cause one excess cancer death in that group. But you won't get sued when the kid dies of renal cell cancer in his 40's. So kids with a very low risk of appendicitis instead of being observed (maybe even at home with responsible parents) will more often in the US get a trip to the donut and the resulting dose of radiation to their more vulnerable bodies.
While it might seem that holding physicians to unreasonable expectations is beneficial, in the long run you will get worse care due to the practice of defensive medicine.
No - damn realistic (Score:2)
There is probably only one good aspect to this: one day lawyers will die because nobody wants to treat them for the risk of getting sued. A sort of Darwinian correction..
chimeras may be rather common (Score:2)
Usually these chimeras are highly assymetric with the alien cells out-numbered by originals by a thousand to one or so. True symmetric chimeras are rare, perhaps due to absorbed twins in the womb.
This has created some pro
Having Crohns disease... (Score:2)
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I would try that long before I did one of those invasive methods.
this might actually be relevant (Score:2)
(I can't believe this actually almost makes sense)
Old news (Score:2)
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How about "Frankenstein"?
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Actually, it was not a mistake; I'm well aware of that.
However, the monster itself has no proper given name, so we have to improvise, and the only name that would be a near universally understood reference is 'Frankenstein'.
Besides, the monster, as a creation of Frankenstein could reasonably called 'a Frankenstein', perhaps even 'the Frankenstein' in the same way we refer to 'a Rembra
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But only once every twenty years to a lifetime.
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No, on House they would have totally misdiagnosed her medical condition, given her an ass transplant, and when that didn't help, checked her for prostate cancer, then Alzheimer's, then gave her some drug that almost kills her, then amputate both legs, then 5 minutes before the show is over, say "hey... maybe it's her liver!".
Then all is well again and she goes home and doesn't even think to sue the incompetent morons for malpractice.