4 ms·

So bone marrow transplant from someone with natural resistance (the same gene as the Chinese CRISPR kids?)? Wouldn’t this have happened by chance before 6-7 ye

So bone marrow transplant from someone with natural resistance (the same gene as the Chinese CRISPR kids?)? Wouldn’t this have happened by chance before 6-7 years ago when the first case was reported?

michaelmcdonald 4y ago
I'm guessing that HIV positive patients who also develop a type of cancer that can receive bone marrow transplants as treatment are rare. Bone marrow matches are extremely rare. Add to that: bone marrow matches with the particular mutation (CCR5-delta 32) can only compound that rarity. All this adds up to poor odds.
- gojomo 4y ago
  Indeed. But rapid advances in genetic therapies mean it may someday be possible to 'upgrade' a patient's existing marrow in-place, with just the necessary new genes.
jfengel 4y ago
They couldn't do it at all until they had really good HIV-suppressing drugs. You won't do a transplant into somebody with an active HIV infection. They still won't do it if they can avoid it. This an extreme measure, killing off the entire immune system and replacing it. They still need to find a donor who is sufficiently compatible, and then has the right set of genes. So it just took time for all of the pieces to fall into place.
- deleted 4y ago
  [deleted]
- imtringued 4y ago
  Use this to treat diabetes type one, do a pancreas transplant and replace the immune system so it does not reject the transplant.
  - sp332 4y ago
    Usually, just the transplant part is sufficient. https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/how-a-pancreas-transplant-can-cure-diabetes/ https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/h...
    - looperhacks 4y ago
      It's mentioned in the comments of the article, but "just the transplant" is not really enough. You still need heavy immune suppressants, which is rarely worth the side effects.
  - jfengel 4y ago
    That would be fantastic, but there are enormous tradeoffs. This is massive, massive surgery that comes incredibly close to killing the patient. They are unlikely to do it if the disease can be controlled with an insulin pump, which is far less invasive. Insulin pumps are far from perfect solutions. (Somebody close to me has one and I can observe what a massive pain in the ass it is, among other places.) But surgery like this is going to have to come a long way before it's routine enough to replace a therapy that is aggravating but sufficient.

michaelmcdonald 4y ago

I'm guessing that HIV positive patients who also develop a type of cancer that can receive bone marrow transplants as treatment are rare. Bone marrow matches are extremely rare. Add to that: bone marrow matches with the particular mutation (CCR5-delta 32) can only compound that rarity. All this adds up to poor odds.

gojomo 4y ago
Indeed. But rapid advances in genetic therapies mean it may someday be possible to 'upgrade' a patient's existing marrow in-place, with just the necessary new genes.

jfengel 4y ago

They couldn't do it at all until they had really good HIV-suppressing drugs. You won't do a transplant into somebody with an active HIV infection. They still won't do it if they can avoid it. This an extreme measure, killing off the entire immune system and replacing it. They still need to find a donor who is sufficiently compatible, and then has the right set of genes. So it just took time for all of the pieces to fall into place.

deleted 4y ago
[deleted]
imtringued 4y ago
Use this to treat diabetes type one, do a pancreas transplant and replace the immune system so it does not reject the transplant.
- sp332 4y ago
  Usually, just the transplant part is sufficient. https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/how-a-pancreas-transplant-can-cure-diabetes/ https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/h...
  - looperhacks 4y ago
    It's mentioned in the comments of the article, but "just the transplant" is not really enough. You still need heavy immune suppressants, which is rarely worth the side effects.
- jfengel 4y ago
  That would be fantastic, but there are enormous tradeoffs. This is massive, massive surgery that comes incredibly close to killing the patient. They are unlikely to do it if the disease can be controlled with an insulin pump, which is far less invasive. Insulin pumps are far from perfect solutions. (Somebody close to me has one and I can observe what a massive pain in the ass it is, among other places.) But surgery like this is going to have to come a long way before it's routine enough to replace a therapy that is aggravating but sufficient.