The world’s first female AIDS cure born!How amazing is stem cell therapy?
Source: New health in the 21st century.Author: Ji Yuanyuan.Photo source: Graph worm.For more health science popularization, please pay attention to our health public account, # Hong Kong Health TV ## 100 Doctor Lecture Hall # After the “Berlin patient” and “London patient”, the world’s third case of long-term remission of AIDS through stem cell transplantation appeared!At the 29th Conference on Retroviruses and Opportunistic Infections (CROI) in Denver on February 15, a team from Weill Cornell Medical College reported a case study:An HIV-infected woman with acute myeloid leukaemia (AML) who received a stem cell transplant from a donor naturally resistant to HIV was hiv-free for 14 months after she stopped her AIDS drugs.She became the first woman and only the third person in the world to be cured of AIDS.According to publicly available information, the only two AIDS patients successfully cured with such stem cell transplants were a white man in Berlin and a Latino man in London.AIDS (HIV) is short for acquired Immune deficiency syndrome, caused by infection with the HIV virus.HIV is a virus that attacks the body’s immune system, it is the most important in the body’s immune system as the main target of CD4 + T cells, a large amount of damage the cells, after several years or even 10 years or more after the incubation period to develop AIDS patients, make human body immune function, loss due to the resistance to extreme loss will appear a variety of infections,Late period often produce malignant tumor, down to systemic exhaustion and death.Since 1981, when the U.S. Centers for Disease Control and Prevention published the first report of five cases of AIDS in the Journal Morbidity and Mortality, mankind has been fighting against AIDS for 40 years.At present, the global AIDS situation is still grim.By the end of 2020, there were 37.6 million people living with HIV worldwide and 1.5 million new HIV infections in 2020, according to unaids.In recent years, AIDS has been transformed from a deadly disease into a chronic disease that can be treated but is difficult to cure, thanks to the launch of several innovative drugs to treat it.Therefore, how to completely cure HIV has become a hot topic of concern in the medical field. At present, the emergence of the third AIDS cured patient in the world is of great clinical research value for the industry and also a great confidence boost for patients.In fact, this kind of stem cell transplant has already been used to cure HIV cases.Nature published an exciting report on the “London patient” who was “clinically cured” of HIV for 18 months after receiving a stem cell transplant.Before the London patient, there was the Berlin patient, who had leukemia as well as AIDS.The patient received a stem cell transplant in Berlin in 2007. After a period of treatment, doctors found that his leukemia and AIDS were gone.He was also hiv-free for 12 years and was considered cured of AIDS.”This is the third case that has been cured in this condition, and the first reported from a woman,” Sharon Lewin, president-elect of the International AIDS Society, said in a statement.The study is an observational study of the International Network of Clinical Trials on Maternal/Child/Adolescent AIDS (IMPAACT) P1107, led by Dr. Yvonne Bryson of UCLA and Dr. Deborah Persaud of Johns Hopkins University, according to publicly available information.The study, which began in 2015, looked at the progression of disease in 25 hiv-infected patients who received CCR5 δ 32/ δ 32 cord blood stem cell transplantation for cancer, hematopoietic disease, or other diseases.CCR5 is the receptor for HIV to invade and infect human cells. When CCR5 δ 32/ δ 32 is mutated, cells lack the CCR5 receptor and HIV cannot be infected.For leukemia patients infected with HIV virus, first of all through chemotherapy to kill cancer cells, in the transplantation of hematopoietic stem cells with CCR5 gene mutation, it is possible to cure leukemia at the same time, so that the HIV virus in the patient can not be infected, so as to gradually eliminate HIV, achieve long-term remission of AIDS, or even cure.According to public records, the 64-year-old woman had been on antiretroviral therapy (ART) for four years to control HIV in her body when she was diagnosed with acute myeloid leukemia. She had been doing well but HIV was still detectable.Then, in 2017, she became one of the first patients to receive a cord blood stem cell transplant.Cord blood contains a mutation in a gene called CCR5 that prevents HIV from entering cells.Only a small percentage of people, mostly of Northern European descent, are known to have a mutation in the CCR5 gene that makes them naturally resistant to HIV.At the same time, she received partially matched hematopoietic stem cells from an immediate family member (parent, child or sibling).The umbilical cord blood stem cell transplant put her in remission and made HIV undetectable.She stopped taking her ART drugs 37 months after the transplant, and still had no signs of HIV infection 14 months after stopping treatment altogether.Based on this study, we conclude that cases of long-term REMISSION of HIV following stem cell transplantation suggest that CCR5 δ 32/ δ 32 stem cell transplantation should be considered for remission and cure of HIV patients who require hematopoietic stem cell transplantation for other diseases.What’s so amazing about stem cell therapy?Stem cell therapy, also known as regenerative medicine, is the “third medical revolution” after drug therapy and surgery.In recent years, stem cell therapy has become one of the most important research areas in the forefront of life sciences worldwide.In addition to the breakthrough in HIV, stem cell transplants are also being used in rare diseases.In Korea, the application of stem cell transplantation is also underway.According to 21st Century Business Herald, the Children’s Hospital of Fudan University in Shanghai has completed the first stem cell transplant with stat3-deficient hyperige syndrome in China on November 25, 2021.Kiki suffers from a rare genetic disorder called high IgE syndrome caused by a defective STAT3 gene.Half a month after qiqi was born, she suffered from repeated systemic rashes and stomatitis. At about 1 year old, she began to suffer from repeated and multiple skin and soft tissue abscesses, lung infection, otitis media and lymphadenitis.Kiki spent most of her first six years in hospital, undergoing repeated hospitalizations and four surgeries.In April 2020, kiki admiring mother came to find professor ZhaiXiaoWen pediatric hospital affiliated to fudan university in Shanghai, professor zhai combined with a child’s clinical manifestation and laboratory index with doubt kiki immunodeficiency disorders, and do the family genetic testing, the results show that there are consistent with clinical manifestations of disease of children with STAT3 gene defect,After gene function assessment by Professor Wang Xiaochuan’s team in department of Immunology, the child was diagnosed as high IgE syndrome caused by STAT3 gene defect.According to Professor Zhai Xiaowen, this kind of children is very rare, the incidence of only one million, the conventional treatment is to prevent infection and anti-infection treatment, giving intravenous gamma globulin support treatment.But some children, like Kiki, with severe symptoms, have uncontrollable infections and poor quality of life.There are only 14 cases of remission after hematopoietic stem cell transplantation in the world, and there is no precedent for transplantation in China.Therefore, After more than a year of thorough communication with parents and preparation for anti-infection support and treatment, Professor Zhai’s team designed and determined the treatment plan of cord blood stem cell transplantation.In August 2021, Qiqi was admitted to the transplant ward of the Hematology Department of The Children’s Hospital of Fudan University and began stem cell transplant treatment.On September 9, Qiqi successfully received the umbilical cord blood stem cells, and about 3 weeks after transplantation, the healthy donor cells grew in Qiqi’s body. After testing, they completely replaced the original defective cells, and Qiqi’s disease was completely cured.After more than two months of observation and follow-up, Qiqi’s immune function indicators gradually tended to normal, skin and lung infections gradually recovered, Qiqi gained a new life.In addition, in the field of skin disease treatment, stem cell technology research is the focus of attention in recent years.At present, stem cell therapy in the study of skin disease of preclinical models all get good results, including skin damage repair, atopic dermatitis, psoriasis, systemic scleroderma and autoimmune disease caused by skin damage, such as graft versus host disease has been reported, such as stem cell therapy for these inflammatory skin disease with good safety and effectiveness.However, Yan Yuehua, director of the department of dermatology at Pudong Hospital affiliated to Fudan University, told 21st Century Business Herald that stem cells should not be used for a long time, especially after the skin has been repaired.Modern studies have shown that stem cells may be persistent, and when used too much, may cause excessive cell proliferation, resulting in skin roughness, pigmentation and other symptoms.”Because stem cells have a diversity of growth and differentiation, clinical research on skin stem cells is mainly focused on fat stem cells and mesenchymal stem cells. As for the therapeutic effect of this, it is still under research, and stem cell therapy has not yet been and will not be marketed.”Yan yuehua said.From the perspective of the market, except for hematopoietic stem cell transplantation, no stem cell therapy has been approved and marketed by relevant national departments in China.However, several products are already in clinical trials.According to public reports, as of November 2021, China had 111 clinical research filing programs for stem cells, and 111 institutions for clinical research filing.In addition, the top eight indications for current stem cell clinical studies are cancer, hematology, immune system diseases, cardiovascular disease, bone and rickets, neurology and central nervous system diseases, skin diseases, and diabetes, according to ClinicalTrials.gov.At present, China has 5 million leukemia patients, 290 million cardiovascular disease patients, 114 million diabetes patients, 94 million Alzheimer’s patients and 14.6 million blood tumor patients waiting for more active and effective treatment.In the future, with the clarification of regulatory policies and the approval of relevant research projects and drugs, the market potential of China’s stem cell industry is huge.To this end, in recent years, the state and local authorities have continuously issued relevant regulations and supportive policies to boost the development of stem cell research and industry.For example, on 24 August 2020, CDE issued the Draft Technical Guidelines for Clinical Trials of Human Stem cells and Their Derived cell Therapeutics.Prior to this, CDE also issued the “Technical Guidelines for Pharmaceutical Research and Evaluation of Human Stem cell Products (Draft)”.On March 12 last year, the Standing Committee of the Shenzhen Municipal People’s Congress held a forum to solicit opinions on the legislation of the Regulation on promoting the Cell and Gene Industry in Shenzhen Special Economic Zone (Draft).On January 26 this year, the construction of socialism with Chinese characteristics on the shenzhen first demonstration zone opinions on some special measures to relax market access, which clearly put forward optimization for examination and approval of the human genetic resources access service, explore to set up the human genetic resources management platform of examination and approval, stem cell therapy, immune therapy, gene therapy and other new type of medical products, technology research and development.Stem cells are a kind of cells with self-renewal and multidirectional differentiation potential, which have broad application prospect and market space in life science and medical field.With the continuous liberalization of regulatory policies, the industrial development environment continues to improve, and the industrial application space will also be opened.