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Blood :干细胞移植手术治愈艾滋病毒感染者的证据

  1. 干细胞
  2. 艾滋病

来源:译言网 2010-12-15 10:36

2007年,柏林一名感染HIV病毒的白血病人接受了干细胞移植手术。医生为他移植了可以抵抗艾滋病毒的干细胞,并借此成功地治愈了他的艾滋病毒感染。负责这一病例的医生们最近证实了这个消息。 上述案例首次被公之于众是在2008年波士顿举行的逆转录病毒以及机会感染会议上。

2007年,柏林一名感染HIV病毒的白血病人接受了干细胞移植手术。医生为他移植了可以抵抗艾滋病毒的干细胞,并借此成功地治愈了他的艾滋病毒感染。负责这一病例的医生们最近证实了这个消息。

上述案例首次被公之于众是在2008年波士顿举行的逆转录病毒以及机会感染会议上。之后,柏林的医务人员在2009年2月的新英格兰医学杂志(New England Journal of Medicine )上详细地介绍了这个案例。关键在于移植到病人体内的骨髓很特殊---它来自于一个先天对HIV病毒免疫的骨髓捐赠者。先天免疫是因为此人特殊的基因档案(genetic profile)使得它体内不存在艾滋病毒赖以传播的CCR5辅助受体。CCR5是一种趋化因子,在HIV体内传播中它的作用就如同笔记本电脑的“充电基座”,大部分HIV病毒必须附着在它之上才能进入并感染CD4细胞。(CD4 是一种T细胞,HIV病毒感染并破坏它---译者)

柏林医务人员近日在Blood 杂志上发表了一份后续报告,声称经过细致的检测,“完全有理由确定这一HIV感染病例已被完全治愈。”(生物谷Bioon.com)

生物谷推荐原文出处:

Blood   DOI 10.1182/blood-2010-09-309591.

Evidence for the cure of HIV infection by CCR5Δ32/ Δ32 stem cell transplantation

Abstract

HIV entry into CD4+ cells requires interaction with a cellular receptor, generally either CCR5 or CXCR4. We have previously reported the case of an HIV-infected patient in whom viral replication remained absent despite discontinuation of antiretroviral therapy after transplantation with CCR5{Delta}32/{Delta}32 stem cells. However, it was expected that the long-lived viral reservoir would lead to HIV rebound and disease progression during the process of immune reconstitution. In the present study, we demonstrate successful reconstitution of CD4+ T cells at the systemic level as well as in the gut mucosal immune system following CCR5{Delta}32/{Delta}32 stem cell transplantation, while the patient remains without any sign of HIV infection. This was observed although recovered CD4+ T cells contain a high proportion of activated memory CD4+ T cells, i.e. the preferential targets of HIV, and are susceptible to productive infection with CXCR4-tropic HIV. Furthermore, during the process of immune reconstitution, we found evidence for the replacement of long-lived host tissue cells with donor-derived cells indicating that the size of the viral reservoir has been reduced over time. In conclusion, our results strongly suggest that cure of HIV has been achieved in this patient.

 

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