The functional cure for HIV - can it be applied to autoimmune diseases?

fuzzybabybunny

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From what I read about the functional cure recently publicized in the news, the bone marrow stem cells from the donor eventually replaced the recipient's entire immune system. His immune system couldn't combat HIV, but his new one can.

Can the same procedure be applied to people with life threatening autoimmune diseases then? Replace their immune system with a normal one?
 

Gibsons

Lifer
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IMO, it might be possible, but probably not a great idea.

One of the big problems with transplants is graft vs host disease. That is, the transplanted immune system recognizes the host cells as foreign, and responds against it. This is really bad. For this reason, bone marrow transplant donors are carefully screened to see that their immune system (at the MHC or HLA genes) is as close to the recipients as possible. Now, if the immune systems are a really close match, there's a reasonable expectation that the same autoimmune diseases would occur from the transplanted cells.
 

fuzzybabybunny

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did u end up finding mousey?

No. I have a close 22-year-old friend who is dying from Wegener's Disease and not respondng to traditional treatments. I want to know if it's possible to save her by replacing her immune system with another one like what was done with the HIV patient.

Her doctor's appointment is next week but I want to get an idea if it's possible. She has a twin brother without the disease.
 

Meghan54

Lifer
Oct 18, 2009
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Possibly, but good luck getting any insurance co. to actually pay for it......
 

Gibsons

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No. I have a close 22-year-old friend who is dying from Wegener's Disease and not respondng to traditional treatments. I want to know if it's possible to save her by replacing her immune system with another one like what was done with the HIV patient.

Her doctor's appointment is next week but I want to get an idea if it's possible. She has a twin brother without the disease.

The chance that her brother is a compatible donor is roughly 1/4, the same as any other siblings. For something like Wegener's... well hell, I'd certainly be willing to try it if I was in that situation, assuming a compatible donor was set up. Getting it paid for is another matter.
 

fuzzybabybunny

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The chance that her brother is a compatible donor is roughly 1/4, the same as any other siblings. For something like Wegener's... well hell, I'd certainly be willing to try it if I was in that situation, assuming a compatible donor was set up. Getting it paid for is another matter.

I'll do more research on the MHC and HLA genes. Do you work in the medical field?
 

fuzzybabybunny

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I'm an immunologist.

Thanks for the advice. So I'm not completely barking up the wrong tree then with the HIV functional cure stem cell bone marrow transplant thing?

I don't want my friend to die :( She's so scared...
 

GoSharks

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No. I have a close 22-year-old friend who is dying from Wegener's Disease and not respondng to traditional treatments. I want to know if it's possible to save her by replacing her immune system with another one like what was done with the HIV patient.

Her doctor's appointment is next week but I want to get an idea if it's possible. She has a twin brother without the disease.

My advice would be to use PubMed/Google Scholar to find published articles (which you may then be able to bring to an MD's attention, or to get the authors' attention) instead of theorizing with a layman's knowledge...
 

Mark R

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Oct 9, 1999
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From what I read about the functional cure recently publicized in the news, the bone marrow stem cells from the donor eventually replaced the recipient's entire immune system. His immune system couldn't combat HIV, but his new one can.

Can the same procedure be applied to people with life threatening autoimmune diseases then? Replace their immune system with a normal one?

Yes. This is an experimental technique for treating automimmune diseases.

What's more surprising is that you don't need a donor. You can take the patient's own stem cells, store them, and then retransplant them after destroying the immune system with massive dose chemotherapyy.

It seems that many automimmune diseases seem to occur because the immune system 'learns' that certain parts of the body are nasty invaders. With the immune system destroyed, the memory is lost, and when the stem cells are reimplanted and the immune system grows back, it no longer has the tendency to attack the body again. The concern is that the disease may recur, but this doesn't appear to be that common, such that the technique is regarded as an acceptable option for extremely severe autoimmune disease.

The self-transplant (or autograft) is much less nasty than a donor transplant. An autograft only carries a fatality rate of around 5-10%, whereas a donor transplant is in the 25-50% range. This is due to 2 major problems - with a donor transplant, you have to be absolutely certain you've completely killed the host immune system, otherwise it will reject the transplant (so much higher doses of chemotherapy), and 2nd you've got the risk of graft-vs-host disease where the transplant rejects the body - even without GVHD, a donor transplant still requires very high dose immune suppression drugs for life.
 

Gibsons

Lifer
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Thanks for the advice. So I'm not completely barking up the wrong tree then with the HIV functional cure stem cell bone marrow transplant thing?

I don't want my friend to die :( She's so scared...

I wouldn't say you're completely wrong. Has her brother or any other sibling been tested for compatibility?
 

PlasmaBomb

Lifer
Nov 19, 2004
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No. I have a close 22-year-old friend who is dying from Wegener's Disease and not respondng to traditional treatments. I want to know if it's possible to save her by replacing her immune system with another one like what was done with the HIV patient.

Her doctor's appointment is next week but I want to get an idea if it's possible. She has a twin brother without the disease.

The fact that her twin isn't the same sex as her means that they may not be that close a match (non-identical twins would be as close as a brother and sister)

From wikipedia - http://en.wikipedia.org/wiki/Twin#Fraternal_.28dizygotic.29_twins
Fraternal twins, like any other siblings, have an extremely small chance of having the same chromosome profile.

Dissimilar chromosomes would put you at risk of graft vs host :(
 

PlasmaBomb

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Nov 19, 2004
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Yes. This is an experimental technique for treating automimmune diseases.

What's more surprising is that you don't need a donor. You can take the patient's own stem cells, store them, and then retransplant them after destroying the immune system with massive dose chemotherapyy.

It seems that many automimmune diseases seem to occur because the immune system 'learns' that certain parts of the body are nasty invaders. With the immune system destroyed, the memory is lost, and when the stem cells are reimplanted and the immune system grows back, it no longer has the tendency to attack the body again. The concern is that the disease may recur, but this doesn't appear to be that common, such that the technique is regarded as an acceptable option for extremely severe autoimmune disease.

The self-transplant (or autograft) is much less nasty than a donor transplant. An autograft only carries a fatality rate of around 5-10&#37;, whereas a donor transplant is in the 25-50% range. This is due to 2 major problems - with a donor transplant, you have to be absolutely certain you've completely killed the host immune system, otherwise it will reject the transplant (so much higher doses of chemotherapy), and 2nd you've got the risk of graft-vs-host disease where the transplant rejects the body - even without GVHD, a donor transplant still requires very high dose immune suppression drugs for life.

Great post Mark :thumbsup:
 

Gibsons

Lifer
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The fact that her twin isn't the same sex as her means that they may not be that close a match (non-identical twins would be as close as a brother and sister)

From wikipedia - http://en.wikipedia.org/wiki/Twin#Fraternal_.28dizygotic.29_twins


Dissimilar chromosomes would put you at risk of graft vs host :(

Ignoring identical twins, the chance for a match between siblings is roughly 1/4.

It kind of/should be a lot higher since rejection is dominant and the result of a few hundred genes, but it's a special case.