World’s first WOMAN cured of AIDS with umbilical cord blood?

2022-06-11 0 By

Globally, nearly 38 million people are infected with HIV, and about 73 percent of them are receiving treatment.Antiretroviral drugs can control HIV, but curing AIDS is a decades-long struggle.In the absence of any treatment, the patient’s immune system will gradually be destroyed by HIV, until it loses almost all of its immunity and becomes infected with various diseases and malignancies.On February 15, the New York Times reported that a mixed-race middle-aged and elderly woman being treated at Weill Cornell Medical Center in New York may be the third person in the world to be cured of AIDS, and the first woman to be cured of AIDS.The team saw her as a scientific breakthrough, first because of her gender and ethnic background;Second, because of innovative treatments.The two previous patients were men cured of HIV through bone marrow transplants: Timothy Ray Brown, the “Berlin patient” with acute myeloid leukemia, and Adam Castillejo, the “London patient” with Hodgkin’s lymphoma.However, bone marrow transplantation is a high-risk and highly conditioned operation. It is not realistic for most AIDS patients to treat cancer and cure AIDS at the same time by replacing the patient’s immune system with another person’s immune system.The reason is that the donor must have enough human leukocyte antigen to match the patient and carry a genetic mutation that prevents HIV infection.The mutation, which occurs in about 1 percent, has only been found in about 20,000 donors, most of them of Northern European descent.In other words, patients who lack similar ancestry have a particularly low chance of finding a suitable donor.Even if the surgery is completed, it can cause serious side effects such as graft-versus-host disease.The Berlin patient almost died after the transplant, lived 12 years hiv-free, and died of recurrent leukemia.Let’s go back to the story of the biracial woman we started with.She was known as the “New York Patient” because of where she was treated.Her success has led to a possible cure with fewer side effects for AIDS patients suffering from hematological malignancies.In June 2013, the New York patient was diagnosed with HIV and was given antiretroviral drugs to control his viral levels.In March 2017, she developed acute myeloid leukemia.In August 2017, the woman received a new transplant procedure involving cord blood.Cord blood is blood that remains in the placenta and umbilical cord after childbirth and contains various types of stem and progenitor cells.Cord blood also needs to match human leukocyte antigen and carry genetic mutations that prevent HIV infection.But compared with adult stem cells used in bone marrow transplants, cord blood is more adaptable, does not need to be a close match to the recipient and causes fewer complications.In addition, unlike bone marrow registries, cord blood banks are easier to screen in large numbers for the presence of desired genetic mutations.The New York patient received cord blood that was only a “partial match” to her human leukocyte antigen.At the same time, she received hematopoietic stem cells from a close relative that were also a “partial match” to her HUMAN leukocyte antigen.These hematopoietic stem cells provide a temporary immune defense for the body during transplantation until cord blood cells dominate, greatly reducing the risk of transplantation.Both cord blood and hematopoietic stem cells were only partial matches, but the combination that led to their ultimate success is not fully understood.The researchers speculate that cord blood may have provided an added benefit for the transplant.The New York patient was discharged 17 days after transplantation without GVHD;At 37 months after the transplant, she stopped taking antiretroviral drugs;After another 14 months, the patient showed no signs of HIV infection.However, not everyone agrees with the “cure” conclusion.Yvonne Bryson, a pediatric infectious disease specialist at the University of California, Los Angeles, used the term “remission” instead.If business as usual continues in a few years, the New York patient may have been cured.What’s more, new treatments are still available to a limited number of people, especially THOSE with blood-based malignancies.And even if it is less destructive than traditional bone marrow transplants, it is still a dangerous method of stem cell transplantation.Speaking to NBC, Dr. Deborah Persaud, a pediatric infectious disease specialist at Johns Hopkins University School of Medicine, said:While we are all excited about the potential for a cure for new cases of HIV, stem cell treatments can only work for a small number of people and are still not a viable strategy for the millions of people infected with HIV, such as those without potentially fatal cancers.At any rate, the mountain of an AIDS cure is finally moving a bit.”We estimate that about 50 patients a year in the United States could benefit from this procedure,” said Dr. Koen Van Besien, director of transplant services at Weill Cornell Medical Center.Using a partially matched cord blood graft greatly increases the likelihood of finding a suitable donor for such patients.▲ Self-healing patients. Images from:Acpjournals patient in New York is called the third “cure” case, there are some previous “self-healing” without stem cell transplantation treatment patients, such as “San Francisco patients” and “esperanza patients”, their own immune system to cure HIV, known as “elite controllers”, the researchers are studying the immune mechanism of behind.