An Approach to the Cure of HIV using Cord Blood Hematopoietic Cell Transplantation

SPG biomed Pub Date : 2019-01-01 DOI:10.32392/BIOMED.48.3
L. Petz
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Abstract

The cure was reported in the New England Journal of Medicine in 2009 by Dr. Gero Hütter and associates from Germany (1). The patient, Timothy Brown, had acute myeloid leukemia and HIV infection and is now referred to as “The Berlin Patient”. It was well known at that time that HIV-1 enters host cells by binding to a CD4 receptor and then interacting with either CCR5 or the CXC chemokine receptor (CXCR4). Homozygosity for a 32-bp deletion (delta32/delta32; CCR5-/-) in the CCR5 allele results in an inactive CCR5 gene product and consequently confers high resistance against HIV-1 infection. Following transplantation using stem cells from an adult donor who had the CCR5-/mutation, HIV could not be detected in Timothy Brown’s peripheral blood, spinal fluid, lymph nodes, bone marrow, brain or GI mucosa as assessed with RNA and proviral DNA PCR assays. Further, there has been no recurrence of HIV in more than 10 years. Thus, the “Berlin Patient” has had a functional cure if not a sterilizing cure of HIV.
脐带血造血细胞移植治疗HIV的研究
2009年,德国Gero h tter博士及其同事在《新英格兰医学杂志》(New England Journal of Medicine)上报道了这一治愈方法。该患者名叫Timothy Brown,患有急性髓性白血病和HIV感染,现在被称为“柏林患者”。当时众所周知,HIV-1通过结合CD4受体进入宿主细胞,然后与CCR5或CXC趋化因子受体(CXCR4)相互作用。32bp缺失的纯合性(delta32/delta32;CCR5等位基因中的CCR5-/-)导致CCR5基因产物失活,从而赋予对HIV-1感染的高抗性。使用携带CCR5-/突变的成人供体干细胞进行移植后,在Timothy Brown的外周血、脊髓液、淋巴结、骨髓、脑或胃肠道粘膜中检测不到HIV,用RNA和前病毒DNA PCR检测。此外,10多年来没有艾滋病毒复发。因此,“柏林病人”即使不能绝育治愈艾滋病毒,也已经有了功能性治愈。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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