Eradication of HIV by transplantation of CCR5-deficient hematopoietic stem cells.

Eradication of HIV by transplantation of CCR5-deficient hematopoietic stem cells.
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DOI:
10.1100/tsw.2011.102
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发表时间:
2011-05-05
影响因子:
--
通讯作者:
Ganepola S
Ganepola S
中科院分区:
其他
文献类型:
--
作者:
Hütter G;Ganepola S

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今天,在艾滋病毒大流行爆发30年后,尽管治疗战略有了很大改进,但仍然无法治愈这种疾病。最近,我们描述了在HIV-1感染患者中成功的造血干细胞移植,移植了具有天然抗HIV感染能力的供体来源细胞。这些造血干细胞移植、增殖并分化为成熟的髓细胞和淋巴细胞。迄今为止,该患者在同种异体移植后4年多未需要任何抗逆转录病毒治疗。在分析外周血细胞和不同组织样本,包括肠道、肝脏和大脑时,没有检测到病毒载量或前病毒DNA。我们的报告提出了进一步针对HIV的靶向治疗策略的希望,并代表了携带有益基因的异体干细胞的成功个性化治疗。然而,这个病例引发了关于这个病人是否完全根除了艾滋病毒的争议。在这里,我们给出了开放的问题,未解决的方面,和临床后果有关这一独特的情况的更新。
Today, 30 years after the onset of the HIV pandemic, although treatment strategies have considerably improved, there is still no cure for the disease. Recently, we described a successful hematopoietic stem cell transplantation in an HIV-1–infected patient, transferring donor-derived cells with a natural resistance against HIV infection. These hematopoietic stem cells engrafted, proliferated, and differentiated into mature myeloid and lymphoid cells. To date, the patient has not required any antiretroviral treatment, more than 4 years after allogeneic transplantation. In the analysis of peripheral blood cells and different tissue samples, including gut, liver, and brain, no viral load or proviral DNA could be detected. Our report raises the hope for further targeted treatment strategies against HIV and represents a successful personalized treatment with allogeneic stem cells carrying a beneficial gene. However, this case has ignited a controversy regarding the question of whether this patient has achieved complete eradication of HIV or not. Here we give an update on open questions, unsolved aspects, and clinical consequences concerning this unique case.
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