Doctors Will Test Gene Editing On HIV Patients 263
Soychemist writes "Some people have a mutation that makes them highly resistant to HIV, and scientists think that they can give that immunity to anyone with a new type of gene therapy. The first human trials will start at the University of Pennsylvania this week. Researchers will draw blood from people with drug-resistant HIV, clip the CCR5 gene out of their T-cells with a nuclease enzyme, grow the modified cells in a dish, and then return 10 billion of them to the patient's bloodstream. Those cells will be immune to the virus, and they will keep the patient's T-cell count up even if the rest are destroyed. 'We will see if it is safe and if those cells inhibit HIV replication in vivo,' said the lead researcher. 'We know they do in the test tube.'"
might as well guinea pig at that point (Score:5, Insightful)
What's the worst that could happen, they screw it up and you die?
Re:might as well guinea pig at that point (Score:5, Insightful)
What's the worst that could happen, they screw it up and you die?
Or they could not treat you and you'd die.
Re:might as well guinea pig at that point (Score:5, Funny)
Re:might as well guinea pig at that point (Score:5, Insightful)
Or you volunteer, and be the one to get the placebo.
In which case, you are no worse off, and at least get careful observation and conventional treatments for your symptoms.
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It's HIV, not a headache. Would a placebo really make that much difference to whether someone starts producing antibodies to fight it?
Re:might as well guinea pig at that point (Score:5, Informative)
You could be worse off, as the study may require that you go off the regular HIV cocktail you are taking to suppress it.
They would find it hard if not impossible to get ethical approval for that kind of study. If an effective treatment exists, controlled trials are controlled against that, and not against a placebo.
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There would be volunteers, especially sex workers. [please, no seemingly obligatory replies with additional volunteer types]
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+1, Interesting? Really?
You kids today. You make karma whoring too easy.
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+1, Interesting? Really?
You kids today. You make karma whoring too easy.
Interesting.
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Re:might as well guinea pig at that point (Score:5, Insightful)
This is what we need. Medicine is far too conservative in so many cases. Death would be a welcome accident in many diseases of terminal illness. Not saying the patient shouldn't decide, but they should certainly have the option to try experimental treatments if they want.
Re:might as well guinea pig at that point (Score:4, Insightful)
This is what we need. Medicine is far too conservative in so many cases.
I think we need more engineers involved in Medicine, particularly on the implementation side. I wish I could point to this but I remember reading about a scientist who had invented something quite revolutionary who spent the next seven years rebuilding his machine to be small enough for general use. That is the kind of job which should be given to an engineer, but it won't keep the scientist employed.
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I have heard similar stories about medical devices like the artificial heart but I was under the impression engineers were involved but I could be wrong.
Re:might as well guinea pig at that point (Score:4, Informative)
There are lots of engineers involved. My father ran a small medical startup some years ago and they made a very high tech (for the time) artificial ventilator that used rapid pulses of air rather than the typical high pressure slow pulses. They did lots of experiments on animals and had to jump through all kinds of hoops with the FDA just to be allowed to put the ventilator on a human subject. Essentially the only way, after the animal trials, to get the ventilator on a human patient was for the patient to be unresponsive to conventional treatment, at significant risk of death without intervention, and received signed autorization from the patient or guardian. (get those living wills drawn up and signed if you haven't already!)
It took years, huge personal and venture capital investment, and eventually the company was bought out and I think the techology disappeared or otherwise got incorporated into standard ventilators. I posted this to illustrate all the work that needs to go into a medical device before it is allowed to be tried on humans... and even then, promising, even successful technology does not always make it in the marketplace. Believe it or not, Doctors are some of the *worst* luddites around and it is incredibly difficult to get enough momentum for a new technology to take hold.
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Re:might as well guinea pig at that point (Score:5, Informative)
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I'm no biochemist, but according to wikipedia the virus already has other methods of entering cells. Nevertheless, I think this kind of research should be done anyway, more experience in this gene-editing business would be nice, and if a few people live a few years longer and happier, that's a nice bonus.
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HIV resistant people are carriers of the virus yet it's not a terminal disease for them. As such, it's a win-win situation for both man and virus. If the virus mutates to a more agressive variant that circumvents the resistance and kills the patient then that strain of HIV is dead and gone(maybe stored in a fridge somewhere).
Is it likely such a mutation would happen in all resistant carriers? No way. And considering that todays model of HIV is actually less agr
Oblig, Blade Runner (Score:2)
Roy: Why not?
Tyrell: Because by the second day of incubation, any cells that have undergone reversion mutations give rise to revertant colonies like rats leaving a sinking ship. Then the ship sinks.
Roy: What about EMS recombination.
Tyrell: We've already tried it. Ethyl methane sulfonate as an alkylating agent a potent mutagen It created
Re:might as well guinea pig at that point (Score:5, Funny)
What's the worst that could happen, they screw it up and you die?
You'll lose all your body hair; become a human-biting-albino that're very sensitive to sunlight; start biting humans and then turn them into your kind; you'll keep your biting until the T-virus in your body because air-bourne infecting disease, when you'd find no human alive for you to bite.
I didn't mean it'd happen, but since you asked for the worse...
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It sounds like the equivalent of giving low doses of antibiotics to people or animals with conventional diseases.
Antibiotic resistance [wikipedia.org]
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Uhh how would the donors die? Their aids virus molecules don't suddenly evolve when the patients' do. Life is prototype based, like javascript, not class based, like java.
Re:might as well guinea pig at that point (Score:5, Informative)
Mod parent down - didn't RTFA (Score:4, Informative)
The test subjects have drug resistant HIV.
Re:might as well guinea pig at that point (Score:5, Insightful)
And just like anti-bioitics. After a certain period of time these drugs become ineffective. Hell, if you start missing doses or cant afford them it could easily be game over.
The people in these studies are failing current treatment methods. There is nothing left at this point.
Re:might as well guinea pig at that point (Score:5, Insightful)
These drugs are expensive and the majority of individuals who have HIV don't have access to these them.
Those drugs are expensive in (mostly Western) countries that kowtow to pharmaceuticals and have not stood up and supported generics.
India was the first country to start cranking out generics and is probably the sole reason that Big Pharma dropped prices from $10,000~15,000 per year to less than $1,000 on what are now considered second-line drugs.
Generics were the only thing pulling down insane prices and the USA's response was to setup TRIPS (Trade-Related Aspects of Intellectual Property Rights) which enormously complicated the process of issuing compulsory licenses.
Off the top of my head: India, Brazil, Thailand and South Africa have all issued compulsory licenses for AIDS drugs.
AFAIK, Thailand and Brazil are the only two countries to do so post-TRIPS.
In response to Thailand's compulsory license, the price of one drug dropped by half for many other developing countries. OTOH, a major pharmaceutical said they wouldn't be applying for licenses to sell new drugs in Thailand... and the USA put Thailand on a watch list of countries considered to be committing intellectual property theft. So it was something of a Pyrrhic victory for Thailand.
Long story short: Big Pharma's bottom line is getting in the way of preventing major health catastrophes in developing countries.
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HIV research is in danger of being halted because it's not seen as profitable; now that *would* be a major health catastrophe.
Re:might as well guinea pig at that point (Score:4, Interesting)
With modern antiretroviral drugs HIV positive patients can live for decades
Have you looked at federal expenditures on medical care lately? Let's face it, with skyrocketing costs of all of these medical treatments, we're going to need to rethink who lives and who dies, particularly when it comes to preventable diseases that are hideously expensive to treat.
HIV, lung cancer, some forms of heart disease, ultimately, people will just have to be made comfortable unless they plan on paying for their medical care themselves. It would be one thing if people got insurance for HIV and lung cancer through private insurers who accepted the risks, but, once all taxpayers have to accept that risk, well, its an entirely different contract.
In that sense, this new genetic treatment is the shape of things to come, where the government experiments on treating on some people with some new drug, because, they aren't going to get anything else.
Re:might as well guinea pig at that point (Score:4, Insightful)
No, the only thing we need to rethink is how the pharma companies can ever justify selling a medication that costs $200 for a single dose.
You know, Chris Rock summed it up nicely. No one will ever cure AIDS, the money isn't in the cure, it's in keeping you alive and helping you live with it. Just get your "fix" and live for one more day.
Everybody hates Kevin (Score:2)
Re:might as well guinea pig at that point (Score:5, Insightful)
Yeah, because Chris Rock has a unique level of insight into the realities of drug development
It's bullshit. Utter bullshit of the kind that can only come from the cynicism and arrogance that follows total cluelessness.
Do you think bio-medical researchers are some kind of wizards? Do you think we know so much that we have the luxury of being able to pick and choose between solutions? Bullshit.
Do we know how the human body works? No, we do not.
Do we know how diseases work? In most cases, no.
If we did - Cancer is a good example of an illness known in great detail - does that mean we know what to do about it? It does not.
If you have an idea of what to do - does that mean it'll work? It doesn't.
If it works in lab, does that mean it'll work in a live human? It does not. (see the first point)
Do you know how many drug concepts (that is, ideas) that make it to becoming a finished, FDA-approved drug? It's not even one in ten thousand. With a situation like that, you do not have the luxury of picking and choosing. You go with whatever idea you have, and you take it as far as it'll go. If you're lucky, it might turn into a drug. And it most certainly won't work exactly as imagined from the start.
Do you know how Viagra, that blockbuster bestseller of 'lifestyle' drugs came about? It was a side effect of a drug originally developed for angina and pulmonary hypertension - a heart drug. The main factor in drug development remains: luck.
But if you still think there are plenty of good, uninvestigated options for AIDS drug development out there, I suggest you go do it yourself. Maybe then you'll gain some real insight into how complicated reality really is.
Re:might as well guinea pig at that point (Score:4, Funny)
Enough with the negativity. I want my monkey-man, goddamnit!
Re:might as well guinea pig at that point (Score:5, Insightful)
Ah you poor blinkered fool. The pharmas spend all their time playing these kind of tricks, and very little time actually developing ANYTHING new.
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In Malcolm Gladwell's story in The New Yorker, Gladwell discusses the evolution of Prilosec, a popular heartburn medication that, in one five year stretch alone, earned twenty-six billion dollars. With the patent about to expire in 2001 a good thing was about to come to an end for the drug patent's owner, AstraZenneca. The company set out to create the "new and improved" version of Prilosec, one that would qualify for a new patent and keep the money machine rolling. Ultimately, the company discovered that by making a very subtle change in the chemical engineering of Prilosec, they would have an entirely new drug. But to be issued a patent, they had to prove that the new version was better than the old. They decided that their best opportunity was to focus their testing on something called erosive esophagitis, a condition where stomach acid bubbles up and harms the lining of the esophagus.
For the first month of the study, the new drug's impact on this problem was identical to Prilosec's. Bad news for the drug company. But in the second month, tests showed that there was a 90% heal rate with the new drug versus 87% with Prilosec, a difference of only 3% for one month but good enough to qualify for patent protection. Thanks to this small and insignificant improvement, AstraZenneca gained FDA approval, was awarded a new patent and put the drug on the market under the name Nexium. The cost for a month's supply of Nexium is about $120. The cost for the now generic version of Prilosec? About $20 for a month's worth of pills.
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Buy The Generic (Score:2)
Ummmm.....
If you don't think the extra 3% is worth $100 a month then
BUY THE GENERIC
Having an approved drug is not a license to print money! You still have to sell the thing. When you actually look at the history of pharma companies, this sort of name brand extension only works for about 5 years unless you have a trully novel improvment.
They probably spent about 300-500 million to get that new drug...I know it didn't work because prilosec and its generics are all OTC now. The company failed at maintaining
Re:might as well guinea pig at that point (Score:5, Insightful)
I'm sure your stance would change if you were someone who was in need of treatment and didn't have the appropriate medical insurance.
Probably would. But the way I see it now is, I smoke, I've smoked for 20 years, and I'm starting to get the first reduced lung function and I should quit but probably won't and I'll die from it, dragging myself and the rest of society down for a million bucks in chemo and treatment. What's up with that? Why should I keep 50 kids out of college because I was a dumbass? That's not right. Same thing with HIV. For the most part, you can prevent HIV. You can stay monogamous as much as you can. Don't be a slut, and use a rubber. Don't use needles. Sometimes you have to think about what your impact is on society.
I think the real problem is the outrageous cost of treatment. Some drugs being manufactured have higher marketing costs then they do for research.
Maybe the stuff is expensive because it is, well, actually complicated to research, make and produce. Science is a craft and crafts are expensive. I don't doubt that the workflow in a pharma company is probably retarded, and that makes it more expensive, but, at the same time, the problem is really that all the knowledge is completely new, so there's no automation in any of the research. It's not like McCoy can just drop a blood sample into the computer and whip up a batch of cure.
Anyway, you seem to have a rather callous view on who should or shouldn't get treatment and I think its deplorable.
That's Democracy. If you want to have private health insurance, have private insurance. Otherwise, accept that, there's going to be people who will make the argument that we should not blow too much medical money on sufferers of illnesses resulting from lifelong self indulgence or excessive risk taking.
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And people who know what they are talking about will point out that the availability of antivirals drastically reduces the rate at which the disease spreads in the population, encourages people to get tested ( which again reduces the rate at which it spreads ), and that the costs to society asso
Be honest, its not health, its freedom (Score:2)
Seriously, you can blame the victims of the disease all you like, at the end of the day the virus will spread if measures are not taken, and we are all better of by offering infected individuals treatment, no matter how stupid they were when they got infected.
This is just all not true and its really just buzzwords for doing the "right thing." The social interest that you advocate protecting is not public health but overall freedom. If we really wanted to do what is best for the public health, we would pro
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I prefer to look at it from the other angle. No country in the world has a social healthcare system that will give people unrestricted access to any and all available treatments. In the UK this is often most
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So, HIV is mostly preventable, eh? Go tell that to one or two of the millions of kids infected at birth. Make sure you look them in the eyes when you do.
How about the millions of Americans who weren't told smoking is BAD(tm) when they were young? For your second exercise in compassion, go visit a cancer ward one of these days and try to pick the old folk who deserve treatment for kidney cancer from the undeserving. Make sure you tell them what you decided.
Re:might as well guinea pig at that point (Score:5, Insightful)
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How about the millions of Americans who weren't told smoking is BAD(tm) when they were young?
We've known smoking is bad now for 40 years.
For your second exercise in compassion, go visit a cancer ward one of these days and try to pick the old folk who deserve treatment for kidney cancer from the undeserving
For your first exercise in reality, why don't you go see the billing department of said cancer ward, and you pick who you are going to pay for, out your paycheck. Let me know how much you pay, and how mu
Re:might as well guinea pig at that point (Score:5, Insightful)
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But the way I see it now is, I smoke, I've smoked for 20 years, and I'm starting to get the first reduced lung function and I should quit but probably won't and I'll die from it, dragging myself and the rest of society down for a million bucks in chemo and treatment.
Don't worry - I'm sure you can cure that with a Powershell script, you irritating prick.
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Don't worry - I'm sure you can cure that with a Powershell script, you irritating prick
I probably could, actually. Except for its screwed up syntax, Powershell is the greatest scripting environment ever.
Re:might as well guinea pig at that point (Score:5, Funny)
Hope not, that would mean no more Slashdot :(
You must be old here.
Re:CANCER (Score:5, Informative)
For the most part, T-cells die off naturally.
People infected with HIV do not have to deal with a problem of too many t-cells, so in this case it's not much of a concern.
Most importantly though, T-cells do not replicate to create more T-cells. They come from a type of lymphocyte starter cell (a stem cell essentially), which reproduces in the bone marrow.
Taking t-cells from your body, and then reintroducing them to your body will not give you leukemia (literally meaning "White Blood", refers to various cancers of white blood cells).
More than likely this is just a test, not *the cure*. The point being to see if the modified t-cells survive long enough to keep the count from dropping (as it would via a normal HIV infection). If it does work, then we can start developing methods to modify bone-marrow in order to make the new t-cells your body creates have the altered gene.
Of course, I'm not an expert, and the article is unfortunately slim on details, so this is basic speculation.
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i know a while ago i saw an article where someone who naturally had the immunity gene donated bone marrow to someone with HIV - and the bone marrow transplant took and the person gained immunity and their immune system was able to attack the virus succesfully.
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Yes, but stem cell transplantations carry a significant risk of treatment-related mortality. The transplant was performed because the patient had recurrent leukemia, IIRC - a scenario in which the mortality associated with the leukemia itself made the risk of treatment worth it.
Something like this is less invasive, if less permanent. Periodic treatments could result in lasting immunocompetence even with HIV, since there will always be an available reserve of T-cells that the virus cannot infect. That is, un
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Right now HIV can't attack cells that are missing that gene, and people with that mutation are rare enough that it isn't advantageous/necessary for HIV to develop another mechanism. However if you inject cells with this mutation into someone that doesn't normally have it, and they don't manage to clean out all the HIV from the person's system, then the combination of both of those cells in proximity is about as good as possible an environment for HIV to develop a mutation that ca
Re:might as well guinea pig at that point (Score:5, Funny)
CGI super demons... who cannot be stopped by AIDS alone.
AIDS cured on Slashdot? (Score:3, Funny)
Price Tag? (Score:4, Interesting)
Hopefully the researchers are successful in their endeavours but you've got to wonder about the costs associated with such a procedure. With something like a 33 million estimated people infected with HIV world-wide I wonder what percentage would actually be able to afford treatment :/
Poor Vivo (Score:2)
'We will see if it is safe and if those cells inhibit HIV replication in vivo,'
Alas, poor Vivo. I knew him, Horatio.
bravo (Score:5, Insightful)
While strides have been made in HIV treatment, it's still a death sentence. Doctors can keep the patient alive longer, but they can't prevent the inevitable.
With so many people in the developing world suffering from HIV, it would be nice to see something like this fast tracked. I am sure that some of those folks, now intimately familiar with their own mortality, would be eager to participate knowing that they could potentially help other people.
Re:bravo (Score:5, Insightful)
Life itself is a death sentence. We all die sooner or latter, it's merely a matter of how long it takes and many HIV positive patients die from unrelated causes ( such as car accidents ). If you catch HIV when you're 70 there's a good chance you will die from some completely unrelated condition, such as stroke, heart failure, or lung cancer from a lifetime of tobacco abuse. Not saying an HIV infection is to be taken lightly, but believe it or not, it is far from the worst diagnosis you can get.
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Life itself is a death sentence.
Possibly not if we get the ability to directly edit our genes.
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Heck they might not even get past the first word.
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Yes indeed my observant friend, death is in fact also a disease. I say death to death!!!
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The doctor could say, "Hey don't tell anyone I said this, but there's this place in Switzerland where you can go get yourself euthanized before it gets really bad".
Or imagine a diagnosis where the doctor runs away from you screaming, "Stay away from me!".
And that's just a start.
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I doubt they view this as a 'cure'. It's research, in both gene therapy and HIV.
If it works, I'd assume the next step would be to try to develop a procedure where they did this to bone marrow cells - the cells that produce T-cells - and thus let the body create its own HIV-resistant T-cells. That might work well enough to be a 'cure' - an HIV patient with leukemia was given an HIV-re
Re:bravo (Score:5, Informative)
Actually, this is far from the truth. I am an HIV-positive individual and based on the fact that my HIV was detected early and also that I started on HIV medications within the first year of contracting it my lifespan has been extended to the point where I will most likely live a full life. Before contracting HIV I thought it was a terrible thing to have and that I would kill myself if I ever got it. I have news for you: it is a terrible thing, but just like everything else in the world you get over it and with HIV medications having nearly NO side effects and once-to-twice daily dosing it makes life worth living.
While some may speculate on whether or not I really know what I'm talking about, I do. I am a healthcare professional. For those of you who are wondering why I didn't post this under my account, I would rather not taint Google's results with gossip for my next employer. :)
Re:bravo (Score:4, Insightful)
Actually, I figure this is exactly why /. has ACs. We put up with nearly every other AC troll post so that occasionally we can read 'Confessions of a HIV+ Slashdotter'. I don't need to know your identity to read your anecdote. Also, I respect your right to privacy and AC posting more in this case than if you were merely stating a preference for Windows over Linux.
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Doctors can keep the patient alive longer, but they can't prevent the inevitable.
Technically that's true, with or without HIV
M-x genotype-mode (Score:5, Funny)
You *know* there's going to be an Emacs mode for gene editing.
Gene editing? (Score:2, Redundant)
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or gene vim vs. emacs
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I think of my accidental select-all, delete-key combos:
"Oh shit... undo, undo!"
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Potential Failure RIsks: (Score:5, Informative)
There are 3 big risks / problems I see with this approach:
#1: The modified T-Cells attack the host after they are reintroduced. Think of it like auto-immune disease or transplanted-organ rejection. This could cause effects ranging from a mild food allergy to death. Anyone know how much damage 10 billion rogue T-cells could do? I sure don't; however, I do know that they aren't a straight 1 T-Cell used up for each 1 antigen.
#2: Unmodified T-cells attack the modified T-Cells because the surface of the modified T-Cells (i.e. the CCR5 protein) could possibly trigger an immune response. This would render the modified T-Cells kind of pointless. Seems like this would have better chance of working on patients with full blown AIDS rather than merely HIV+.
3: Modified T-Cells survive and are unaffected by HIV; however, these surviving modified T-Cells are just clones of the one original T-Cell that the lab modified. So in essence, you have injected the test subject with 10 billion of the same T-Cell. Unless the doctors have a way of massaging the genes on a representative sample of T-Cells, then this is kind of useless to the patient. What good are 10 billion T-Cells if they are each only good for tagging one antigen? Meaning, that the 10 billion T cells could only respond to a single stimulus, i.e. they could all only fight one strain of the common cold, but not anything else.
Disclaimer: I have a BA in bio from a public ivy; however, my GPA wasn't that great, and I didn't pursue a career in the field. I very well could be overlooking something substantial in immunology etc.
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It sounds like what they're thinking of doing is more like: (1) draw up 10 billion T-Cells, (2) use an enzyme to cleave off the CCR5 proteins, (3) filter out the enzyme+proteins, and (4) reinject the T-Cells. Ie, I don't think issue 3 would crop up (or, at least, it'd be much more limited in scope). The real issue, as I see it, is that those 10 billion T-Cells will eventually die. Not knowing enough about how proteins on the cell membrane are created/carried over during mitosis, it'd seem the biggest iss
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It sounds like what they're thinking of doing is more like: (1) draw up 10 billion T-Cells, (2) use an enzyme to cleave off the CCR5 proteins, (3) filter out the enzyme+proteins, and (4) reinject the T-Cells.
Proteins aren't cleaved, a zinc finger nuclease is used to mutate the CCR5 gene so that it is the HIV resistant type. These are then cloned.
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I don't think 1 will be a problem. All T Cells have a CCR5 membrane protein, but the HIV resistant ones have a mutant type CCR5 protein. CCR5 is the way in which T cells get infected by HIV, and people with mutant type CCR5 genes survive quite well.
2 may be a problem, and I think will be the biggest hurdle here.
3 Shouldn't be a problem. Zinc Finger nucleases are able to delete the genes from a bunch of different cells at once. The idea is that you get a whole lot of T-Cells, Remove the 32 base pair segm
Unanswered questions (Score:3, Informative)
Alas, I have enough biology to have questions not answered in the short article, but not enough to extract the answers from the referenced paper. (I did notice that the news article was slightly incorrect on one point. They are not actually 'clipping out' the CCR5 gene. They cause a break in the gene which gets imperfectly repaired, so that the gene becomes nonfunctional.)
Are these T cells capable of 'reproducing' and having an unlimited number of descendants? This is not the case for many types of cells - it is part of what makes stem cells special. The paper refers to T4 cell lines, which suggests that they can indefinitely reproduce.
If the treatment works, how long will it last? (If the answer to the previous question is 'no', the answer to this one will likely be be 'about as long as the lifetime of a T cell.' If the answer to the previous question is 'yes', the answer might be 'for a lifetime.'
Do the modified T cells have to come from the patient? If not, the treatment will be much cheaper: Do the extraction and genetic modification once, breed up a big batch, treat dozens of patients. If not, you need to do the genetic modification once for each patient.
Once you have a bunch of immune T cells, will they be able to eliminate HIV from the body? (I suspect not: I understand that as a retrovirus, HIV is very good at hiding dormant for a long while.)
The answers to these questions are the difference between this being a laboratory curiosity and this being the elimination of HIV in developed countries within 5 years.
Re:Unanswered questions (Score:5, Informative)
T cells are produced by the bone marrow. They don't reproduce on their own.
The lifespan of an average T cell is on the order of 10-20 weeks. I believe. Shorter in HIV patients.
Who knows? But not necessarily. After all, you get plenty of foreign T-cells with a blood transfusion. But I don't think anyone is necessarily viewing this treatment as a 'cure' in itself.
That's not known. But they've done it [telegraph.co.uk], with positive effects. Note how 'cure' is put in quotes, as it should be.
That is ridiculous. It's neither.
CCR5 **delta 32** (Score:3, Informative)
Indeed. They seem to be trying to modify CCR5 to be CCR5 delta 32, which is the variant which is less prone to HIV (but not immune). The nonfunctional aspect is very important, as you wouldn't want to simply engineer a foetus to have this gene instead of normal CCR5 genes. From wikipedia:
Mutations (Score:2, Insightful)
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>What's to keep the virus from mutating and avoiding the CCR5 requirement it currently has?
The virus uses the CCR5 receptor as its binding and entry point into the cell [wikipedia.org]. There are other receptors it might/may use, but CCR5 is the predominant one, especially early in the infection. As such, it's the gateway: if you can block it, that massively reduces the viral effectiveness.
The process of developing a treatment for a disease is finding something the disease absolutely needs and targeting that. This is
Not to dampen hopes, but... (Score:5, Insightful)
Instead of just making the typical /. armchair commentary about the zillion ways in which this proposal would be foolish or at best useless, I'm going to give a different angle on this.
First, on a global scale, the most sophisticated HIV treatments are administered to the relatively wealthy. Only when such a treatment is deemed effective does it start to spread down to the poor, due to economics. The old anti-retrovirals of yesterday are today's low-cost options for the millions of HIV+ individuals in developing nations. That's just the reality of the technological development of disease treatment. However, this "trickle-down" mechanism, combined with natural geographic and genetic variations, has led to the evolutionary branching of HIV into significantly distinct strains, with characteristically different disease modalities.
Second, we have as yet no drug that is able to eliminate HIV in the body. The currently available treatments are at best able to turn HIV into a chronic, managed condition. This has some very interesting (some would say alarming) socioeconomic implications. What we are finding is that over time, HAART therapy has evolved from a multiple-dose-per-day regimen that was difficult to maintain, to a more easily managed schedule, leading to better therapy adherence in patients. However, some of these drugs are poorly tolerated in many individuals, and over time, HIV is known to develop multiple resistances due to poor adherence or tolerance. The more disturbing situation, however, is that in many gay communities, the practice of "pre-exposure prophylaxis" has become alarmingly common. What is happening is that some HIV- gay men are obtaining anti-HIV drugs and taking them prior to knowingly exposing themselves to potentially HIV+ individuals through unprotected sex.
From a scientific standpoint, it is fascinating that this development is as successful as it has been. But from the standpoint of a gay man who takes every precaution to educate myself and follow safer sex practices and does everything in my power to serve as a role model for responsible behavior, I find it totally abhorrent that there are guys who expose themselves willingly to HIV in such an unethical manner, in light of all the AIDS deaths that have come before us and all the tireless work of our most brilliant scientists, medical care providers, and public health advocates. They have even given this "PrEP" cute names and euphemisms to disguise the utter insanity of what they are really doing (like they have done with the term "barebacking" to refer to unprotected anal intercourse). If there is anyone on the face of this earth that deserves to die of this terrible disease, it is them. And I don't say that lightly. Some of you might say that these people would have had unprotected sex with or without the drugs, but you have to realize that it is partly through the action of these individuals that drug-resistant HIV is spread. It is for this reason I dare stand in judgment against them.
So this brings me to my third point. The CCR5 discovery is notable in that it confers strong resistance against HIV-1. Two copies of the gene are required for this resistance. However, the transmission of other strains of HIV may not be blocked by the presence of this gene. Even if this therapy were to work, I doubt it would be effective on a large scale. Some of these patients, if you cure them, will simply go out and have more unprotected sex. If you don't believe me, reread the previous paragraph.
The only way human civilization will ever rid itself of the scourge of HIV is if we discover a vaccine or outright cure for all its strains. No chronic management or piecemeal therapy will be sufficient, because there are always people who will do things that will enable the virus to mutate and survive. Ever since the discovery and announcement of the virus in the 80s, this simple fact was apparent to me. But the untold billions of dollars in revenue that HIV research and managemen
Cost? (Score:2)
I don't mean to be a pessimist, but it seems that this will, if approved, be a lengthy and costly procedure.
I'm unaware of the types of legal wrangling for a doctor and a hospital before a procedure is taken. I'm also unaware if there are any ethics reviews done prior to risky operations/treatments (brian, heart, gene therapy). Given at least the legal risks, unless there's a 99.999% success rate, I'm not sure doctors or hospitals will want the procedure in-use (even if the person is likely to die of HIV/AI
Could I have my genes edited, please? (Score:4, Funny)
"I'd like darker skin and, uh... healthy eyes? The latter is kinda more important, so if I can have only one, then that should be it.
On the other hand, if you give discounts for multiple edits, then why not. Throw in a large-penis-gene, too. I hear that's all the rage, these days."
Hmmm (Score:2)
I feel kinda sorry for the HIV Patients they are using as Guinea pigs though.
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Re:Sounds expensive... (Score:5, Informative)
There are people who were born HIV+ because their mother was a carrier, there are people who have been raped and now carry the virus, there are people in the medical field that contract it because some drug addict freaks out while they tend to them. Hell, even though we test blood now many people contracted it through blood transfusions before they tested it.
Oh and by the way. Condoms don't give 100% protection against HIV its about 80-85%.
HIV is a bastard of a virus. Our immune systems can usually handle most viruses without intervention. You cant win on your own against HIV. It will destroy the immune system eventually.
If this treatment is successful at this level. At least we can give life to those who didn't have the choice.
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HIV is a bastard of a virus. Our immune systems can usually handle most viruses without intervention. You cant win on your own against HIV. It will destroy the immune system eventually.
HIV is a bastard because it's relatively benign and very hard to transmit. A normal deadly virus like Ebola kills you quickly, HIV keeps you healthy and able to infect others for years. It's mainly transferred by sex, which is a big bummer for all of us who like to sleep around which includes lots of gay men.
But once you have it, you won't get rid of it. Nothing special either, because most people live with the chicken pox virus for most of their lives. That usually doesn't kill you, though...
X.
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There are people who have HIV and didnt contract it through sex or drugs.
There are people who were born HIV+ because their mother was a carrier, there are people who have been raped and now carry the virus
Does not compute.
There are people who were born HIV+ because their mother was a carrier, there are people who have been raped and now carry the virus, there are people in the medical field that contract it because some drug addict freaks out while they tend to them. Hell, even though we test blood now many people contracted it through blood transfusions before they tested it.
Care to back this up with anything? Although I agree with you 100% in spirit and i don't doubt that it HAS happened more than once, how about sticking to facts instead of what comes off as even more alarmist than a Fox News story on people sticking razor blades in Halloween candy? Or is "getting needle stabbed by a crazed junkie" now the most likely way one will contract the disease?
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There's a myth going around africa, or at least some of the countries in africa (and having found a link it appears a lot more than just africa) that sex with a virgin will cure AIDs... As a result of this there are many many young women who have been raped by an AIDs suffered who have subsequently contracted the disease.
Does compute perfectly, just because it hasn't happened to you does not mean it hasn't happened.
http://www.scienceinafrica.co.za/2002/april/virgin.htm [scienceinafrica.co.za]
Re:Sounds expensive... (Score:5, Insightful)
I should add that this isn't a reason not to pursue research for cures for HIV. It's a very interesting problem and this technique may have broad application if it works. Also in some parts of the world HIV is very common and hard to avoid.
Just as we would treat a heart attack in a 400 lb man, so we should also treat someone with HIV as best we can.
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Is that HIV mutates *very* rapidly.
I wonder if anybody has worked out how many permutations there are.
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No, I'm pretty sure that was caused by holywood directors wanting to make a buck ;)