"Doctors say marrow transplant may have cured AIDS"

[GreenPartyVoter]

Source: AP

BERLIN – An American man who suffered from AIDS appears to have been cured of the disease 20 months after receiving a targeted bone marrow transplant normally used to fight leukemia, his doctors said Wednesday.

While researchers — and the doctors themselves — caution that the case might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims 2 million lives each year. The virus has infected 33 million people worldwide.

Dr. Gero Huetter said his 42-year-old patient, an American living in Berlin who was not identified, had been infected with the AIDS virus for more than a decade. But 20 months after undergoing a transplant of genetically selected bone marrow, he no longer shows signs of carrying the virus.

Read more: http://news.yahoo.com/s/ap/20081112/ap_on_he_me/eu_med_aids_treatment

[Warpy]

1. there were 3 sets of identical twins they found in the 80s

one with HIV and one without, and they tried bone marrow transplants from the healthy twin then.

That's when they discovered the virus's ability to hide within nerve cells. The transplants were a failure, all of them, for AIDS cures.

I sincerely hope for the best outcome for the patient above, that the transplant has afforded him more healthy years.

I just know what the earlier attempts produced.

[chitty]

2. That was then - this is now.

Medicine has come a long way in 20 years.

[targetpractice]

5. The difference in this case...

...is that the transplanted bone marrow was from a donor who was naturally resistant to HIV due to a genetic mutation. Natural HIV resistance is rare is and is caused by a double-mutation that makes T-cells that lack the surface protein HIV needs to enter and infect cells.

In the twin example you cited... The donor twin was HIV-negative NOT HIV-resistant like the donor in this new case.

UPON EDIT: I am over-simplying, but the key in this case is HIV resistance is present in the donor marrow.

[Warpy]

9. In that case, it might work

although he'll still be susceptible to HIV's effects on the other side of the blood/brain barrier, which is what happened to the study twin I happened to know.

HIV is diabolical. Just when they think they might have found a way to kill it, it seems to find another place to hide.

[poverlay]

13. That's amazing. I've been wondering for years why they don't find a way to block that receptor. A

naturally occuring "lack" is fascinating. It's like nature is just handing us the cure. "Here ya go... All you have to do is use it."

Simplified I know. Thanks for the factoid.
It's been a long time since advanced Bio.

[targetpractice]

16. "Here ya go... All you have to do is use it."

But, who gets the patent rights?

Maybe that's why we are hearing about this somewhat intuitive approach from a clinician rather than a research lab or drug company?

[Thor_MN]

17. The people alive today are the offspring of survivors of numerous plagues

evolutionary chokepoints where large percentages of the population were killed. The survivors had a natural resistance, a mutation that was not visible until disease wiped out the people that did not have it. The survivors then pass that resistence on to their descendants by simply having children. Evolution has kept us on this planet for a bit of time, it's just how things work. The interesting thing is if we can keep from destroying ourselves.

[poverlay]

22. Ever since I read "The Stand" I've been hoping like crazy that I'm one of those with the

lucky mutation. Then again I'm not sure I'd want to be left behind in a world where 99% of the population has been wiped out. Terry Brooks' "Word and Void" stuff and Stirlings' "Emberverse" series paint a mighty bleak existence after such apocalyptic events as plagues. Then again it would be nice to go to Disneyland and not have to wait in any lines. Of course you would have to deal with the inevitable "Mommy? Daddy? What's wrong with Mickey? (I'm rambling~ sorry...)

Anyway

I'm not sure we could completely wipe ourselves out, but I'd lay a bit of cash on the odds of setting our civilization back substantially.

[shakrat]

11. Reminded me of:

Tyrell: The facts of life... to make an alteration in the evolvement of an organic life system is fatal. A coding sequence cannot be revised once it's been established.
Batty: Why not?
Tyrell: Because by the second day of incubation, any cells that have undergone reversion mutation give rise to revertant colonies like rats leaving a sinking ship; then the ship sinks.
Batty: What about EMS recombination?
Tyrell: We've already tried it - ethyl, methane, sulfinate as an alkalating agent and potent mutagen; it created a virus so lethal the subject was dead before it even left the table.
Batty: Then a repressor protein; that would block the operating cells.
Tyrell: Wouldn't obstruct replication, but it does give rise to an error in replication so that the newly formed DNA strand carries with it a mutation, and you've got a virus again... but this, all of this is academic. You were made as well as we could make you.
Batty: But not to last.

[Avalux]

3. I want to believe this is true. However -

HIV hides lives in reservoirs in many places in the body; not strictly in T-cells - the white blood cells that would be wiped out and replaced with new ones from the bone marrow transplant. It is impossible to 'find' all of these places and nothing actually kills the virus. That's why I am extremely skeptical.

If there is any validity to this case, it will be published in a scientific journal for peer review. We'll see.

[targetpractice]

4. The new T-cells...

...lack the surface protein that HIV requires for infection because the marrow donor was HIV-resistant due to a genetic mutation. If any HIV remained in the body over time, it wouldn't be able to infect the new T-cells because they lacked the required surface protein for HIV to bind and enter the cell.

UPON EDIT: I am over simplifying, but this is very promising news, I believe.

[Avalux]

6. You have given a very simple premise -

and again, I hope it turns out to be correct. There will need to be very extensive tests done on this gentleman before a determination can be made. All data will need to be published and until that happens I take this article with a huge grain of salt.

[targetpractice]

7. I did oversimplify...

...I'm adding a caveat to my posts.

[aquart]

8. You should be skeptical. AND hopeful.

No damn reason you can't be both at once. I am.

[thereismore]

10. Yes HIV persists in reservoirs, but the point is that all new T-cells will

be resistant to HIV infection, so as the old infected ones die, the new ones will be HIV-free. HIV only infects T-cells, maybe dendritic cells as well, but the newly made T-cells will be impervious to HIV, so I would think that the viral load will gradually go to 0 as the old T-cells die.

[Q3JR4]

12. This is AMAZING!

We probably won't know for sure if he is HIV-free for a while. But seriously, if there is any truth to the case even if it can never be replicated, the whole thing is AMAZING.

I'm crossing my fingers that this leads to the breakthrough we've been looking for for the last 30 years.

Q3JR4.

[99 Percent Sure]

14. They Need More People - This sounds like the Dolly as cloned

cow case (also the supposed human clonining that never was) that started in Europe, and we all know how that ended, poor Dolly.

We'd very much like a cure, but this doesn't sound like it.

[targetpractice]

15. Welcome to DU!

I'm not sure why you would dismiss it so easily. Gene therapy appears to be a very promising approach for HIV treatment.

BTW, this is nothing like Dolly, the cloned sheep. She died prematurely due to a retrovirus commonly found in sheep... not as a result of the cloning process.

[Ilsa]

18. And keep in mind that more donors would need to be identified:

"some people carry a genetic mutation that seems to make them resistant to HIV infection."

I'm certain that plenty would be willing to volunteer for the testing and procedure, just as they are for leukemia. I'm on the bone marrow registry.

[latebloomer]

19. Thank you, Ilsa!

I had a stem cell transplant for leukemia from an anonymous donor last December, and I'm doing well.

I am awestruck by the generous people who are willing to go thru this for total strangers.

:yourock:

[Ilsa]

21. Aw Thanks. Those of us with good health shouldn't mind it. And the procedure

can be done under local or general anesthesia. With some good follow up painkillers, a person should get some good vibes by helping others with what nature has provided for them!

Glad you were able to be treated. They haven't called upon me - yet.

[crikkett]

20. *cough* stems cells *cough*