Woman appears cured of HIV after umbilical-cord blood transplant
wsj.com
wsj.com
https://investors.modernatx.com/news/news-details/2022/IAVI-...
I have a feeling mRNA tech will be regarded as one of those medical discoveries on par with penicillin, but only time will tell.
This assumes that the drugs are proteins, correct?
Note that binding to the same active site as something the body produces is also a strategy for imagining that you produce less of that thing. There's "binding to the same active site [and triggering it]" and there's "binding to the same active site [and plugging it]".
As to how often this strategy is used... what other strategies are there? You produce the effect you want by triggering it to occur. You inhibit the effect you don't want by blocking it from occurring.
You could think of something like a lactase supplement to help you digest milk, and that wouldn't be binding to active sites of your own molecules, but it still works by binding to particular sites on the lactose. Chemicals have their effects through chemical reactions.
> Note that binding to the same active site as something
> the body produces is also a strategy for imagining that you
> produce less of that thing. There's "binding to the
> same active site [and triggering it]" and there's "binding to
> the same active site [and plugging it]".
This is how caffeine works. Broadly, it binds to the adenocine receptors and prevents the adenocine from binding. Adenocine makes us tired (less alert) and caffeine inhibits that process.Genetic engineering is already used to manufacture some chemicals by modifying the DNA of microbes to produce the necessary enzymes. The microbes then consume the precursor chemicals and synthesise the product.
Indeed every natural bioactive chemical is manufactured by proteins in the form of enzymes.
So the mRNA for the necessary enzymes could be given to a person, and their own cells would become short term chemical factories for their medication.
The problem is getting the cells to synthesise the right amount of a drug, and mRNA is quickly destroyed so would require repeated dosing just like regular drug administration. For something permanent CRISPR-Cas9 would be required to edit the actual DNA of the cells.
A DIY biohacker cured his lactose intolerance by engineering a virus to modify his cells to produce the lactase enzyme in his digestive tract. I think the results lasted several months in that case but could be wrong, may have been permanent. Video of the project on YouTube.
[1] https://clinicaltrials.gov/ct2/results?term=vaccine&cond=Hiv...
If you can design an mRNA vaccine that encodes those proteins directly, you won't have to design vaccines with the mere hope that the immune system will develop the right antibodies in response to them.
From what I understand about HIV vaccines, finding the right inoculant that elicits the correct HIV eliminating antibody response is the hard part that mRNA vaccines might be able to tackle directly.
Since the hospital we are using (Stanford LPCH) has a research program that will come collect it with no extra steps on our side, it seemed like a good choice.
https://sd25.senate.ca.gov/news/2017-06-26/california-umbili...
Unfortunately, public donations are only an option in some locations.
This was from 2017 and is basically the same as a reference I found from 2007. Has there been any actual changes in the state of the art since it was published?
If I had a kid and enough disposable income I'd do it without even thinking about it to be honest
Yes, it makes sense without a predisposition. Things like HIV with the woman cited in the article, cerebral palsy due to a near drowning accident, etc. could all be use cases. Our own team has a sales exec who used stem cells for a knee injury he got in track & field in high school. Another has a grandfather who used it for dementia.
BTW, a lot of our clients self identify as having <75k in income. Our pricing is 35-85/mo. for 8 years to cover 20 years of storage. :D so hopefully you don't need to allocate too much disposable income. It's still an investment for sure, but many think it's worth it. Myself included obviously haha
https://www.cbc.ca/news/canada/toronto/cord-blood-bank-of-ca...
Also, from the same article, does anyone has more information on this:
> there's a very low probability that someone's own stem cells can be used to treat them, according to Health Canada.
Good luck to you and your partner.
https://www.acog.org/clinical/clinical-guidance/committee-op...
because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from continued placental transfusion.
https://health.clevelandclinic.org/what-you-should-know-abou...
:)
Just wanted to echo, this is really, really, important.
Donating is definitely awesome, but there's a lot of research surrounding how cord blood transplantation from related donors (or yourself) increases your chance of survival from a stem cell transplant vs. using an unrelated donor. https://www.nejm.org/doi/full/10.1056/nejm199708073370602 - there's a chance of rejection. This woman found a partial match, but she was lucky. I assume she's only 2 races or a common mix i.e. half white, half something else
Finding a match later on can also be much more expensive than keeping your own!
From what I've read, there's a tradeoff with time prior to removal however. The earlier in your life you take them out and freeze them, the higher their regeneration factor is. The DPSC (Dental Pulp Stem Cells) should always be there as long as the tooth is alive.
After some brief research I concluded it was probably a waste of money for us as donors, but it's probably valuable to donate for someone else. I haven't yet asked our obstetrician whether that's an option.
http://pediatrics.aappublications.org/content/pediatrics/119...
Curing latent Chicken Pox, HPV, and the other common viruses would be a fantastic improvement over our vaccination boosters that are fantastic, but still probabilistic.
Even if it doesn't cure it, but reduces symptoms and duration, I'd be happy.
What if... the common cold is like a folk tradition of viruses that do us little harm and keep our immune system on its toes, and that as such a "cure for the common cold" is the wrong thing to want?
To be clear I am no kind of biologist and I have no reason to believe this is anything other than a silly idea, but I still like it.
The common cold is a low level respiratory infection caused by a known suite of virus candidates. If we made ourselves permanently immune to those without going through the mucus and sore throat part there would be no negative consequences.
The flip side: what if... the common cold causes small amounts of permanent damage, or damage that doesn't show up until much later in life? What if all viruses are this way, and preventing infection/bad infection in the first place is an enormous net benefit?
1) Parasites
2) Generic (as opposed to human) bacteria
3) Mild, latent infections which co-evolved with humans
The problem is that most diseases like colds, flus, smallpox, measles, etc. are relatively recent in evolutionary terms. They rose with the rise of civilizations. In hunter-gatherer times, things like colds didn't exist.
I am not saying that your claim definitely is wrong, but it does sound a lot like other claims that many people believe are not valid. So my initial reaction is "extreme skepticism".
Even if these viruses didn't exist before modern civilization, how do we know that they aren't at all relevant for immune system "fitness" in modern humans?
I understand we can slip into the naturalistic fallacy easily, but at the same time I appreciate the line of reasoning as a first approximation because of how complicated the human body and nutrition is, and how messed up our public health situation is thanks to the modern diet. Even though I acknowledge this situation is attributable to processed foods and sugars, and not to whole grain consumption which I think is fine/good for most people, it is still the delta between modernity and how our bodies evolved that is the culprit.
Let's put it this way. The Paleo community is probably totally wrong about whole grains, but right about a lot of things.
And it has to be said that we do appear in fact to know with a good degree of certainty that at least one of the common cold viruses is very, very new in humans.
OC43 (a coronavirus) almost certainly arrived in humans in the 1890s (and is now thought to be what caused the deadly "Russian Flu" pandemic).
And we have another one to add now.
It has a whole chapter on the hygiene hypothesis, which parts have been debunked, which parts have weak scientific evidence, and which parts have strong scientific evidence.
I don't think I wrote anything out-of-line with mainstream science. It might be wrong -- scientific knowledge progresses, and we're still learning a lot -- but it's not "paleo diet" junk science.
The key mistake you're making is to assume the immune system benefits from some form of "fitness;" it doesn't. It's not a muscle to be exercised. Diseases harm you and getting sick is not good.
There are exceptions.
The key thing to remember is that the immune system does most of the damage to your body in most diseases; viruses and bacteria rarely kill you, since collateral damage from your immune system fighting them usually kills you first. There's a fine balance of how active the immune system ought to be. Parasites dampen your immune system. We co-evolved with parasites, and without them, your immune system is a little bit overactive (which may contribute to the massive recent rise of autoimmune diseases, allergies, etc.).
We know that modern diseases aren't helpful because at this point, we understand how they work. Modern viruses and bacteria -- which evolved with civilization -- are incredibly specific to humans. They "spoof" signals your body uses, for example to modulate the immune system's response. Historically, we'd have diseases which attacked many types of animals, and didn't do that; those were very different.
To give an analogy to defending a city, there's a difference between a broad attack and a targeted attack. Classic diseases are a bit like invaders at the city walls. Modern diseases are a little bit like spies and saboteurs.
Can you please provide links to any evidence that it's false? I'm curious.
https://www.focusforwardfilms.com/films/72/fire-with-fire
IIRC the first patient of this treatment has recently marked 10 years in remissions.
https://cei.org/blog/human-achievement-of-the-day-using-hiv-...
The hospital's own article about it:
https://www.chop.edu/stories/relapsed-leukemia-emilys-story
I could not find info on that particular trial. Here's one that is happening now:
https://clinicaltrials.gov/ct2/show/NCT04276870
I found no details about how the treatment uses HIV. If it is used, it is used to modify the patient's T cells in the lab. So HIV is not curing leukemia, but it is used to prepare T cells which cure leukemia.
Launch HN: Anja Health (YC W22) – Freezing stem cells at birth for future health - https://news.ycombinator.com/item?id=30305959 - Feb 2022 (147 comments)
(I wouldn't normally link to a Launch HN like that but this topic is so unusual and specific that I figure it counts as interesting.)
> plancentas are so valuable that physicians - especially in Europe - sometimes prefer to take them for themselves to sell to cosmetics research for ~$50k
I wonder if there's a hybrid approach where you could share the placenta/umbilical cord w/other companies and get free storage.
Yes, education I'd say is in the top 10 or 50. But how can you possibly fill out the top 1000 without including umbilical cord stem cells?
Just a few things off the top of my head.
I would actually argue that the chances of using it are actually much higher & it would make the top 1000 options in terms of expected ROI. Using type 1 diabetes as an example:
By age 18, approximately 1/300 people in the US develop type 1 diabetes
https://www.medicalnewstoday.com/articles/240160#1 -> here's an article demonstrating how cord blood has successfully reversed type 1 diabetes
and that's just for diabetes. Consider the chances and corresponding research around cerebral palsy, hair loss, heart failure, liver disease, cancers, and more that stem cells - and specifically cord blood stem cells - have been successfully used for.
NHS hospital sells placentas for cosmetic use
https://web.archive.org/web/20210217162113/https://www.teleg...
Not 50k a pop, but shows that it does happen.
No, you found one article.
> Not 50k a pop, but shows that it does happen.
It shows it did happen, 13 years ago.
Compare with the claims made by Anjahealth's CEO.
(1) an 'NHS hospital in the UK' is not 'doctors in the EU', (2) it is universally condemned, (3) the beneficiary is apparently a US company (4) Consent was obtained but for different reasons (medical research), which put the hospital in hot water, as it should. (5) the amount is nowhere near the one claimed. (6) it is a donation, clearly still a quid-pro-quo. (7) this is outrageous enough that it made the newspaper. (8) 2008.
To use this in a commercial setting, to pretend it's an ongoing and common thing and that doctors in the EU profit from this is absolutely disgusting. Besides that I sincerely hope that that hospital had the book thrown at it, and suspect the company is at fault and not the hospital.
Accusations like that against doctors should not be made lightly, especially not for your own personal financial gain.
Finally: placentas are used for good research, they are a rich source of stem cells and hard to come by proteins, some hospitals do collect them for this purpose (as the hospital in the article pretended to do), and by making the argument that they are mostly used for cosmetics manufacture it harms the main reason hospitals will pass them on: to help with various medical research programs, which the company is essentially in competition with.
It's a straight up case of FUD with unsupported accusations of insane profits on unethical behavior against a group of people that have taken a pretty expensive oath as well as operating under strict regulations.
edit: some more research later:
It appears the hospital was unaware of what the company did:
" She added: "We have spoken to Sigma-Aldrich already and asked them to revise the consent form so it is more explicit. We partook in the scheme on the understanding that the placentas would be used for medical research."
She added mothers were given information about the process during ante-natal care and placentas were only ever taken with their consent.
She added: "We do receive a donation for this service, but we are not paid for it as such. The distinction is that even if we didn't receive a donation, we would still offer mothers the opportunity to donate their placentas for research, rather than have them incinerated."
Sigma-Aldrich, which has a facility in Fancy Road, Poole, denied its human placental by-products are used in the manufacture of any cosmetic products, but a spokesman admitted they may be used in their development and testing. "
https://www.bournemouthecho.co.uk/news/2279703.placenta-ange...
Based on the information available the hospital made yet another questionable call here, revising the consent form isn't the solution, the solution is to stop working with this company because it clearly can't be trusted.
> Dr. Kristal pointed out, with slight hesitancy, that research hospitals could have a financial motive to keeping women's placentas given that "a lot of bigger hospitals have—or, at least, had—contracts with pharmaceutical and cosmetic houses to sell the placentas." The hospitals I spoke with denied this allegation, but it's perhaps worth noting that Baylor Hospitals—which is notorious for refusing to let moms take home their placentas—is also part of a national study to evaluate the efficacy of using cells derived from human placenta to treat Crohn's disease.
Or another report:
https://www.medpagetoday.com/special-reports/exclusives/8273...
> One of the most widely used products for lower extremity wounds, Lantis said, is EpiFix, which is made by MiMedx. It is synthesized from "dehydrated human amnion/chorion membrane" -- placental material -- according to the company's website. In 2013, the FDA warned the company about marketing the product without approval, which the firm eventually obtained.
> If women knew more about the money, power, and scandal behind their donations, they might see donation differently, Turner said.
> "What if women were given the full account, that some biobank is going to acquire it, process it, assign it value, and then it's going to be marked up and sold again," Turner said. "Some women might think twice."
These are just in the first page of google results. It's shady but not exactly illegal (apparently) to ask mothers on the operating table to sign off on "donating" their placentas.
If such donations are regularly solicited, I don't find it that surprising that hospitals profit off of them one way or another. I do agree the CEO should back up her claims.
She went apoplectic.
Observing his first 3 months, I strongly believe that he needed the iron.
Next time, no doctors. The nurses were wonderful.
Also I hope gene therapy becomes democratized. It shouldn't be limited to big Rx developing these solutions.
I think the "go fast and break things" mindset is scarier here than the debates about whether or not we have the right to play God.
That's the sort of blood that writes regulations. Experimental medicine has a long, clumsy and cruel tradition.
https://www.sciencehistory.org/distillations/the-death-of-je...
Thanks for this.
"Meanwhile, journalists and federal health officials discovered several troubling lapses in the conduct of the study. For example, the researchers had earlier told the FDA they would tighten up the trial’s eligibility criteria, but they never followed through. When two patients suffered serious side effects, the scientists did not immediately inform the agency or put the study on hold as required. It turned out Jesse’s pretrial test results showed he had poor liver function, indicating he arguably shouldn’t have received the OTC gene injection.
But perhaps most damning were failures in the informed-consent process. Researchers hadn’t told Jesse about the earlier patients’ side effects or about two lab monkeys killed by high doses of adenoviruses. If he had been properly briefed about these previous issues, he might have dropped out of the study and still be alive today. Wilson was also accused of a conflict of interest: he had a stake in the company that owned the gene-transfer technology and stood to benefit if the trial succeeded.
...
The investigations drew attention to wider problems in oversight of gene-therapy experiments and human research generally. For example, the FDA and NIH revealed that 691 volunteers in gene-therapy experiments had either died or fallen ill in the seven years before Jesse’s death; only 39 of these incidents had been reported promptly as required. The agencies tightened monitoring of trials, increased inspections, and created a new system for reporting serious side effects, among other steps. Penn responded to the crisis by strengthening the institutional review boards that oversee its trials, putting in new protections for patients, and prohibiting researchers from having financial stakes in their trials."
Truly nothing new under the sun.
For 100 dollars, you can obtain a full copy of your genome from a service like 23andMe and run it across a parsing tool such as https://www.codegen.eu to find genetic predispositions to all kinds of medical maladies. I found numerous bad SNPs in my genetic data that I correlated to confirmed family cases. I also discovered genes I have that reduce my response to certain pharmaceuticals or cause harmful reactions. Why take a risky shotgun approach when you can know in advance if something will or will not work for you?
It's literally like looking into a crystal ball of ailments that are plaguing you now or in the future. Forget about bouncing around from specialist to specialist for years and years; read your genome to get the answers you seek today. It's your source code.
Prevention will be the key, rather than reacting.
The suspicion of it requiring triggering GvHD is exceedingly terrifying as a dice roll, though.
[1] - https://www.newscientist.com/article/mg23431244-400-immune-w...
This article makes it seem like HIV can be cured or at least decimated in 100 days.
I’m all for this STD whack-a-mole, just go down the list and revert to consequence freedom
honestly I should rephrase because I don't think we've ever had it, maybe in some isolated societies pre-colonialism, but now we've never been closer even though sex-education is currently based on so much fear.
and yes, combining both strategies of protection alongside testing + early fixing reduces the negative consequence even more even when not preventing absolute exposure to disease.
https://en.wikipedia.org/wiki/CCR5#Potential_costs
There may be downsides for carriers of the mutation when fighting infections by other viruses. But nothing completely obvious (unlike, say, in sickle cell anemia).
https://www.npr.org/sections/health-shots/2019/03/05/7003618...
#1066 - Mel Gibson & Dr. Neil Riordan
Mel Gibson took his aging father to an america doctor in panama who harvests umbilical stem cells and it pretty much gave him a new lease on life. They also help with hard to heal injuries
https://www.skepdoc.info/beware-stem-cell-clinics-that-offer...
Science Vs. podcast has just released a great episode on the kinds of misinformation spread there...
/s
[0] https://www.nytimes.com/2022/01/13/health/pig-heart-transpla...
If this country didn't have an absolutely horrible criminal justice system, I would love something where inmates can sign up for experimental procedures in exchange for a full pardon. But knowing America, this was just encourage prosecutors to push inmates to get unnecessary procedures.
Never worry about paywalls again :-)
Made me wonder if fasting might help. A quick search found anecdotal support for "definite maybe".
https://www.quora.com/Can-prolonged-fasting-help-fight-HIV-A...
It's a means to gatekeep me out of medical discussion because people don't like the idea that I'm getting healthier when doctors say that cannot be done and rather than engage in meaningful discussion, I fairly often receive a dismissive pile on of replies in a way that I do not believe is the norm for HN.
I don't have to defend it or prove a claim. I didn't make a claim. I stated as clearly as I know how that it made me wonder x and so I did a search.
This should not be drama of any sort. Other people routinely make conversation on medical topics and aren't given a hard time for it. Other people in this discussion are making conversation about donating cord blood to research.
No one is required to be a medical professional to participate in medical discussion here. No one is required to defend their interest in such subjects.
Except apparently me. Probably because of my personal situation and people having some issue with that.
If anything, at least in this case I can see that providing a Quora page as "supporting link" works against you - because of the low quality of most Quora content. You mused about a possibility, and the comment engaged with your point at face value with a very reasonable response. They did not ask you to meet a "higher standard" or provide evidence for your idea. You escalated the discussion from there by suggesting that the Quora page is "supporting" - which it really isn't. Making conversation is fine, but if you're going to try to back up your ideas with links, its natural that people will engage with the validity of the source. If you'd linked to a publication, for example, they'd have to engage with the science of it. In this case since its Quora, what's there to engage with? Anecdotes tell us nothing - perhaps 99.95% of people who tried it had no improvement and just didn't talk about it. This is not gatekeeping, nor are you being targeted, at least in this specific case. If you'd shared your own experience, that would give us something to discuss. For example, my ex is living with HIV, and it was a long road of treatments before he was out of the woods. His health was pretty poor when he was first diagnosed, and he was unresponsive to the first line of antiretrovirals (his particular strain was resistant) and it was upto me to manage his health on a daily basis. I can't speak to your specific personal situation that you speak of, but I can appreciate that sharing them on a forum doesn't offer us any extra cred with online strangers.
I know essentially nothing about HIV. I know a little something about using fasting to successfully treat an incurable condition.
I didn't share that because it is routinely ridiculous levels of drama for me to comment on that and some people here absolutely remember me and target me.
I have some mental models for why I think fasting is beneficial. I didn't share those because those amount to "personal opinion" and I can't back them up.
I am happy to hear medical reasons why fasting is unlikely to work for HIV. That's mostly not the substance of the feedback I got initially.
I also agree with you that people on this forum are on balance likely to dismiss non-mainstream medical approaches. If you are open minded about these and want to discuss them without prejudice, you'll often be met with responses that may be snarky or unfairly dismissive. That's the unfair reality of holding non-mainstream ideas. By default, they are off-piste, niche, etc...
However, I didn't see anything like that in any of the responses here. A very valid point was raised that you support your proposition (ie that HIV might be helped by fasting) with a Quora link. People who are not closed to the idea will find that the link just contains some anecdotal information which at best can confirm sub-conscious pre-concieved biases, but not be a robust argument.
Worse, it plays into the hand of those who are outright dismissive because you served them a perfect strawman to attack.
Ultimately, with any discussion forum you have to consider the audience. People don't owe you anything and particularly a forum like this where things are supposed to be debated based on merit, the bar to debate claims is relatively high.
All these considered, it would've been better to simply ignore the quora link, or at least strongly annotate it saying it is just anecdotal and should not be taken as supporting evidence.
I want to say that people who respond in the way you're mentioning are very likely a minority. A lot of people will read your comments and reply nothing at all. That's probably most of us, and therefore, any given comment's largest audience. That would have been me, had I not decided to comment this a little after I read your comment.
What I described above is a persistent pattern. I don't believe I'm imagining it nor overreacting.
I don't know some means to escape it without talking about it some.
It's certainly not the entirety of my experience here. I wouldn't hang here so much if it were all downside.
I was actually trying to acknowledge your good intentions. Thank you.
HN is not an academic paper, a Wikipedia article, a matter of journalism, a speech&debate exhibition or anything other than an informal discussion on the internet. In such discussions, people are allowed to quote from memory and personal experience, speculate, and occasionally be wrong... and I find the pressure to not do this to be not just a little disrespectful and dehumanizing. If people want all comments cited to ACM standards, there won't be any comments.
Let's posit that I'm completely batshit insane and deluded and imagining that I have a genetic disorder and imagining that I'm getting better when doctors say that cannot be done. Let's assume the critics and haters are correct in that regard.
It has zero bearing on whether or not fasting would help with HIV. Even if you sincerely believe that I'm completely nuts, you could have a constructive good faith discussion with me about the medical details of how HIV works and whether or not fasting has any reasonable hope of being useful treatment for that specific condition.
And if I were nuts, talking to me about exactly how HIV works without being ugly and dismissive might make me less crazy and help find my way back from insanity to some kind of healthy relationship to reality whereas the kind of engagement I all too often get on medical topics is crazy making.
[0] https://www.researchgate.net/figure/Natural-Progression-of-H...