4 ms·

Genetic treatment closes door on HIV

43 points by kingsidharth 16y ago

shandley 16y ago
Interesting, but not surprising results. These preliminary studies in humans are technically exciting, but realizing the costs associated with such therapies along with the complex socio-demographics of the infected and at risk populations makes this a relatively unrealistic solution.
- bkudria 16y ago
  Presumably, because the blood cells need to be extracted, modified, and reinserted. How long until that technique is improved?
  - shandley 16y ago
    Cell sorting can be done cheaply, but cheap cell sorting is just that. For this you would want high-purity and low-contamination. The HIV pandemic is hardest hitting in places like Africa and SE Asia. Many of it's victims are extremely poor and do not have access to facilities who could manage this type of experiment successfully and at low risk. The cell-sorting isn't the only expense either. The genetic manipulations costs quite a bit too. A cheap vaccine is still a better alternative, or better yet, social interventions, or a combinatorial approach. It is great to see this type of work pushing the envelope, but I think of this type of stuff more like concept cars. They always look awesome on the show room floor of Detroit, but you never actually see them driving around the streets. Maybe someday in the distant future, but for now, the victims of this pandemic need more realistic options.
    - dstorrs 16y ago
      "It won't help existing victims" doesn't mean we should give up on this. Based on the little bit of data in the article, this sounds like it could work as (or be modified into) a vaccine. I don't mean to sound cold butif we can prevent HIV from spreading then sooner or later it will cease to exist.
michaelcampbell 16y ago
I presume there will be plenty of followup studies to see if/when/how long it'll take for HIV to evolve around this block.
VladRussian 16y ago
we were done with syphilis, then HIV came. Once we're done with HIV, what is the next thing to come?
- kingsidharth 16y ago
  Their hybrid.
  - bioh42_2 16y ago
    Or a magical unicorn! We are just throwing concepts around right? In all seriousness folks, humans and cheetahs and a few other species, are uniquely susceptible to extinction by disease. Something bad happened to us a long time ago and thus we can trace our ancestry to a few individuals! This means one individual group of chimpanzees can have more genetic diversity (and thus greater resistance to diseases) then all of humanity. But if you really want to bet on what the "next big thing" will be, I suggest you put your money on the plain old (and ever new) flu. Also the "next 1918" flu will not care if we've conquered HIV or not.
    - VladRussian 16y ago
      >In all seriousness folks, humans and cheetahs and a few other species, are uniquely susceptible to extinction by disease. Cheetah aren't going to stop using protection just because there is nothing to fear anymore. >Something bad happened to us a long time ago and thus we can trace our ancestry to a few individuals! These few individuals left Africa by crossing the Sinai and went to spread around the world. That was definitely bad for Neanderthals.
      - dstorrs 16y ago
        > These few individuals left Africa by crossing the Sinai and went to spread around the world. That was definitely bad for Neanderthals. And the relevance is.....?
        16y ago
logjam 16y ago
Preliminary results, so caution is obviously warranted. The story of genetic therapy for conditions like cystic fibrosis included initial wide enthusiasm, followed soon after by an apparent therapy-related death during the first clinical trials. Recently, however, there have been good refinements for successfully treating CF genetically.
- InclinedPlane 16y ago
  The limits of our knowledge of biological systems are pretty significant. At this point a lot of our medicines are comparable to newbie programmers trawling google for random code snippets that they then copy and paste into their source, hit compile, at hope it works. We're still just bumbling around and in many cases engineering by luck. That can still pay off but it's important to recognize how horribly limited such a technique is.
- gfodor 16y ago
  In just the last week, great news in the CF world on this front as positive phase 3 study results for the drug VX-770 were released: http://www.cff.org/aboutCFFoundation/NewsEvents/2-23-Phase-3-Study-VX-770-Shows-Positive-Results.cfm http://www.cff.org/aboutCFFoundation/NewsEvents/2-23-Phase-3...
bedris 16y ago
Press release from Sangamo Biosciences, which has some good background information on zinc finger nuclease gene editing technology for those who are not familiar with the technique: http://investor.sangamo.com/releasedetail.cfm?ReleaseID=553112 http://investor.sangamo.com/releasedetail.cfm?ReleaseID=5531... More background on ZFNs: http://www.zincfingers.org/scientific-background.htm http://www.zincfingers.org/scientific-background.htm

43 points by kingsidharth 16y ago

Interesting, but not surprising results. These preliminary studies in humans are technically exciting, but realizing the costs associated with such therapies along with the complex socio-demographics of the infected and at risk populations makes this a relatively unrealistic solution.

bkudria 16y ago
Presumably, because the blood cells need to be extracted, modified, and reinserted. How long until that technique is improved?
- shandley 16y ago
  Cell sorting can be done cheaply, but cheap cell sorting is just that. For this you would want high-purity and low-contamination. The HIV pandemic is hardest hitting in places like Africa and SE Asia. Many of it's victims are extremely poor and do not have access to facilities who could manage this type of experiment successfully and at low risk. The cell-sorting isn't the only expense either. The genetic manipulations costs quite a bit too. A cheap vaccine is still a better alternative, or better yet, social interventions, or a combinatorial approach. It is great to see this type of work pushing the envelope, but I think of this type of stuff more like concept cars. They always look awesome on the show room floor of Detroit, but you never actually see them driving around the streets. Maybe someday in the distant future, but for now, the victims of this pandemic need more realistic options.
  - dstorrs 16y ago
    "It won't help existing victims" doesn't mean we should give up on this. Based on the little bit of data in the article, this sounds like it could work as (or be modified into) a vaccine. I don't mean to sound cold butif we can prevent HIV from spreading then sooner or later it will cease to exist.

michaelcampbell 16y ago

I presume there will be plenty of followup studies to see if/when/how long it'll take for HIV to evolve around this block.

VladRussian 16y ago

we were done with syphilis, then HIV came. Once we're done with HIV, what is the next thing to come?

kingsidharth 16y ago
Their hybrid.
- bioh42_2 16y ago
  Or a magical unicorn! We are just throwing concepts around right? In all seriousness folks, humans and cheetahs and a few other species, are uniquely susceptible to extinction by disease. Something bad happened to us a long time ago and thus we can trace our ancestry to a few individuals! This means one individual group of chimpanzees can have more genetic diversity (and thus greater resistance to diseases) then all of humanity. But if you really want to bet on what the "next big thing" will be, I suggest you put your money on the plain old (and ever new) flu. Also the "next 1918" flu will not care if we've conquered HIV or not.
  - VladRussian 16y ago
    >In all seriousness folks, humans and cheetahs and a few other species, are uniquely susceptible to extinction by disease. Cheetah aren't going to stop using protection just because there is nothing to fear anymore. >Something bad happened to us a long time ago and thus we can trace our ancestry to a few individuals! These few individuals left Africa by crossing the Sinai and went to spread around the world. That was definitely bad for Neanderthals.
    - dstorrs 16y ago
      > These few individuals left Africa by crossing the Sinai and went to spread around the world. That was definitely bad for Neanderthals. And the relevance is.....?
      - 16y ago

logjam 16y ago

Preliminary results, so caution is obviously warranted. The story of genetic therapy for conditions like cystic fibrosis included initial wide enthusiasm, followed soon after by an apparent therapy-related death during the first clinical trials. Recently, however, there have been good refinements for successfully treating CF genetically.

InclinedPlane 16y ago
The limits of our knowledge of biological systems are pretty significant. At this point a lot of our medicines are comparable to newbie programmers trawling google for random code snippets that they then copy and paste into their source, hit compile, at hope it works. We're still just bumbling around and in many cases engineering by luck. That can still pay off but it's important to recognize how horribly limited such a technique is.
gfodor 16y ago
In just the last week, great news in the CF world on this front as positive phase 3 study results for the drug VX-770 were released: http://www.cff.org/aboutCFFoundation/NewsEvents/2-23-Phase-3-Study-VX-770-Shows-Positive-Results.cfm http://www.cff.org/aboutCFFoundation/NewsEvents/2-23-Phase-3...

bedris 16y ago

Press release from Sangamo Biosciences, which has some good background information on zinc finger nuclease gene editing technology for those who are not familiar with the technique: http://investor.sangamo.com/releasedetail.cfm?ReleaseID=553112 http://investor.sangamo.com/releasedetail.cfm?ReleaseID=5531... More background on ZFNs: http://www.zincfingers.org/scientific-background.htm http://www.zincfingers.org/scientific-background.htm