CUTAG of the Week: New Treatment Options?
Read this news link titled "Gene Therapy Shows Promise in Controlling HIV"
http://www.aidsmeds.com/articles/Sangamo_genetics_1667_24579.shtml
Based on this week's discussion on HIV, genetics, treatment, and, the news article above, do you think gene therapy has a promising future as a treatment for HIV/AIDS? Describe the strengths and limitations of your argument.
OR choose one of the four following activities and share your response in the "Comment Section below":
1. You can share the new, 'surprising' information you learned
2. Ask a question that needs additional clarification,
3. Share a news link relevant to the discussion.
4. Reply to another student's comment.
Since we're talking about HIV in class, this is a great article that was published just a few days ago.
ReplyDeletehttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0087487;jsessionid=45989588E197E4F67E74FC14365E554A#s5
The article evaluates the medicinal properties of root extract from the native South African plant, Pelargonium sidoides (common name Geranium), in treating HIV-1, the most common strain of HIV in the world. This is a great article to read especially since we just recently discussed in class how the HIV virus infects your cells. If you read the article, you'll recognize a lot of familiar scientific terms such as CD4 cell surface receptors. The results presented in the article are very compelling and could potentially open up a whole new "herbal medicine" based field for HIV-1 treatment. This would have an incredible impact in medicine and diversify the types of treatments we would have to combat the HIV pandemic.
Nice!
Deletehttp://www.sciencedirect.com/science/article/pii/S0378874109002712
This is so cool! I looked into this a bit further and it turns out that there is actually extensive research done on the topic of herbal anti-viral therapy for HIV-1. There are five extracts that look promising from the Geranium plants. It's great that there are plants that can inhibit the activity of HIV-1 as well as reducing the replication of the virus. However with all that said, the chemokine receptors were only inhibited HIV-1 activity by 33% in the instances of plant extraction. I think we would need something with a stronger power to really have a huge impact on the war against AIDS. It's also great that herbal medicine is being taken more seriously in modern medicine!
This article shares some very exciting news about the future of AIDS treatment. As genetics has proven to be a very difficult science to understand thus far, it is great to read about such incredible progress being made. Even still, this treatment is still in the very early stages; it has only been tried on 11 people, with only 3 of the subjects experiencing the complete desired results. Clearly researchers still have a long way to go, but their findings are quite promising. However, I am interested to know if there are any side effects associated with treatment, or with any gene therapies. I'm not really educated on the matter, but I would assume that altering one's DNA in some way would have some side effect. I look forward to learning about the possible side effects in the future!
ReplyDeleteI never really thought much about genetic therapy before this class because it's never been a topic I've looked into but this article shows that the future is promising for research in HIV treatments. Given the amount of people worldwide who have HIV/AIDS, a lot of research has been going on and it's exciting to see that there has been some progress in the genetic therapy from the article on the CCR5 receptor for a few people. It would be better if the therapy had worked on more than 3 people, but it shows that they are heading in the right direction. The researchers made sure to point out that "sustained functional control of HIV in the absence of ART is possible," showing that they also know there is a long way to go.
ReplyDeleteI'm excited to learn more about genetic therapies for other major diseases as well as HIV. It's extremely interesting to think that genetics can play such an enormous role in many diseases along with environmental factors.
Even though we have yet to find cures for many diseases, like HIV/AIDS, it's really amazing how much progress has been made and how much we have done and discovered in science. Regarding the article, like Lindsay, I also thought it would have been better if the therapy worked on more than 3 of the participants. However, this is an extremely good start in dealing with HIV. Although this therapy does not fully cure HIV, I hope continuous research with this sort of therapy will prove to more effective in the future for those with HIV and hopefully one day we can find an absolute cure for HIV/AIDS.
ReplyDeleteBefore reading the article posted above, I had no idea such genetic therapy for HIV/AIDS even existed. Thus, I found this article very interesting. I learned that you can genetically engineer cells, by removing the CCR5-expressing gene, and then reinfuse that cell back into the body. Although the treatment does look good so far in the sense that viral load was shown to decrease and increase CD4 cells, the study is too small and not far enough along to be considered reliable and valid. It is definitely exciting to think that gene therapy could help to cure HIV/AID once the research is completed.
ReplyDeleteSo far, the gene therapy seems promising. However, there still has a lot be done. Very few individuals were used for the trials, and I think that more studies need to be done. While I think it looks promising and I’m hopeful, I remain cautious on how close to a HIV cure this therapy is. Researchers tend to overvalue their data and can be purposely misleading. But I'm optimistic and believe that we are always moving closer to finding a possible cure with all the new research that appears.
ReplyDeleteThis article has more updated information on this therapy: http://investor.sangamo.com/releasedetail.cfm?ReleaseID=803951
A new HIV vaccine that allows HIV infected individuals to produce T-cells designed to fight HIV has recently appeared in the news. Clinical trials that are going involve over 1,000 patients are set to start in spring 2014.
http://www.policymic.com/articles/78021/new-vaccine-may-eliminate-hiv-completely
I think that gene therapy is the correct avenue of targeting HIV infection because I think it will eventually grant us with the ability of focusing on HIV prevention rather than regulation. However, I think there are a few shortcomings with this study. First and foremost, those who are eligible for this treatment must have one non-functional version of the CCR5 receptor. In addition, this therapy would only be targeted against a certain versions of the retrovirus such as the "CCR5 tropic" strain.
ReplyDeleteI can't help but wonder if we managed to intervene with T-cell development if we would be able to have T-cells already waiting in our nodes (like the thymus, lymphoid organs, etc) ready to respond if we ever came in contact with HIV. Nevertheless, to achieve this we would have to discover a way to prep the body against infection, possibly through vaccination. But, vaccination is another issue in itself because it has proven to be difficult to weaken the HIV virus enough to where it still stimulates an appropriate immune response. In addition to this proposition, I think it would also be beneficial to look into encouraging CCR5 receptor mutations that prevent the integration of HIV into the CD4T-cells. To accomplish this, I think more research on the integration of these mutations into those in which it does not naturally occur in would be necessary.
The idea of gene therapy to control and treat HIV is very promising, especially since from what I knew, there are not many options for treatment for HIV. However, in reading this article, there were only 11 participants in the study, and some of them were not even able to be included in the results. The sample size and results of the study are not enough for me to be able to completely support the use of gene therapy, as there are probably some dangers that come with it also. I think before gene therapy can be completely credible for HIV treatment, more research needs to be done, with more study participants. However, I will agree that since positive results came from the study in the article, gene therapy is promising, but I think more research is needed.
ReplyDeleteI am still a little confused about the process of this gene therapy, with the chemokines that we discussed in class though.
Ever since my first molecular biology class, I've always found gene therapy to be an interesting way to target various genetic diseases. I see it as an innovative and resourceful way to solve a lot of genetic health problems. We are using the body's own material to "rewrite" our DNA and our bodies, making them healthier. I believe that gene therapy has a promising future as a treatment for HIV/AIDS, and this study helped make that clear. Strengths were the positive results that they found in some of the participants, lowering the viral load to an undetectable amount is a strong feat. However, the study was weak in it's small n. There were only 11 participants, and some of them were not included int eh final analysis. This sample size is very small to support the generalizations made. However, this study does serve as a great starting point for more research involving gene therapy.
ReplyDeleteGene therapy is an innovative way to combat genetic diseases and should be further explored. It's also a great way to target HIV/AIDs from a public health aspect, working at a primary prevention level.
This therapy look very promising and makes me fairly optimistic about the future of HIV treatments. However, I am still skeptical about how effective this therapy will be in treating the entire HIV population. First of all, the study only included 11 participants, 3 of which were not included in the study because of the low levels of the virus that latches to CCR5 and CXCR4. Another was not far enough in the study to be evaluated. This makes me questions the effectiveness of the therapy and the accuracy of the data presented. This information also makes me question how many people with HIV can actually use the treatment. If these 3 people did not qualify for the treatment, what does this mean for the HIV infected population? How many will actually be able to use this treatment? The sample size just seems too small to provide generalizable data.
ReplyDeleteSecondly, the study says only 3 of the 7 participants achieved an undetectable viral load and only 1 maintained the undetectable status through week 19. Though this is promising, it still makes me question just how effective this will be.
Finally, I understand this is just a brief article but there isn't enough information for me to really feel completely optimistic. For example, there is not much of a timeline presented. As far as we know, these results are only based on 19 weeks of therapy. It doesn't discuss any other possible effects or any other details about the participants, like their different viral loads. I'm curious to see how the therapy progresses, but this is still a great starting point.
I found the article “Gene Therapy Shows Promise in Controlling HIV” extremely interesting. I never knew that it was possible to control HIV through gene therapy; I previously thought that it was only antiretroviral treatment that was effective. One question that I have about gene therapy is about side effects. Antiretroviral treatment can have severe side effects, and each drug class has different side effects (Reust, 2011). For example, non-nucleoside reverse transcriptase inhibitors are associated with neuropsychiatric symptoms, rash, and liver toxicity, and nucleoside/nucleotide reverse transcriptase inhibitors are associated with lactic acidosis, lipodystrophy, and hyperlipidemia (Reust, 2011). Reading the gene therapy article made me wonder what kinds of side effects gene therapy for HIV treatment has on the body.
ReplyDeleteSource:
http://www.aafp.org/afp/2011/0615/p1443.html
I think gene therapy has a promising future for HIV/AIDS treatment. I’m glad to see progress in treating HIV/AIDS however there’s a lot more work that needs to be done. Although this method does seem effective for 7/11 of the participants who qualified, there was a very small sample size; therefore more research would have to go into larger sample sizes. Also follow ups need to be recorded to see how effective this treatment is, as it may only last a week, a year, etc, and other possible side effects it may have. Although this treatment may be only temporary, I do find it promising and am hopeful that brings us one step closer to finding a cure for HIV/AIDS.
ReplyDeleteTo be honest, I do not have an extensive knowledge on gene therapy but I am extremely pleased to hear that more HIV treatments are at least being explored further than ARV (anti-retroviral therapy). It's important in the world of science that we do not become complacent with research and continue to explore our interests. After reading the article, "Gene Therapy Show Promise in Controlling HIV", I do believe this area of treatment has the potential to be gold standard and successful process of eliminating HIV and reducing our chances infection. There is proof that the genetic therapy extracting the functional CCR-5 gene, knocking out the expressive parts, and re-infusing it to the body does effectively reduce the viral load that HIV infected patients experienced. The downside of the research is the small sample size of 11 individuals. I think this research should be spread to other knowledgable, powerful scientific organizations who can take the results and really run with them, testing HIV patients who are willing and want to find a cure. Also, a downside is that there are also other causes of HIV, both genetically and epigenetically, so it is only a very small step in eliminating the virus from infecting humans altogether. Danny Lim's point about follow ups is also very important; we must follow up the participants to test how long the results last, whether there are any specific factors that inhibit the therapy and so on. All in all, I am very pleased to hear there has been progress in treating HIV/AIDS and trying to keep our population healthy from a virus that is a very serious threat.
ReplyDeleteMy knowledge of gene therapy is limited but based on what we learned in class and the news article, I think it has a promising future in treating HIV/AIDS. As the article stated, gene therapy can be used to target the CCR5 receptors that the virus latches onto. Three of the participants achieved undetectable viral load for 8 weeks. Although this is a small number, some positive results were achieved so I think gene therapy is worth exploring to see if it has more potential to treat the virus. Since HIV/AIDS affects a huge population of people worldwide, it is important to follow any leads in terms of treatment.
ReplyDeleteHowever, there are cons to gene therapy. For example, in the article, gene therapy can only be used against the virus if it is CCR5 tropic. Moreover, only individuals born with one non-functional version of the two genes were used in this study so the results cannot be generalized to all HIV patients. In addition, it is also worth considering that gene therapy is a relatively new treatment so there aren't any research available on how safe the treatment is. Also, I don't believe that any long term results have been achieved by gene therapy so a lot more research will have to be put into it. Finally, there are ethical issues regarding gene therapy. Some people believe it is intrusive because information about their genetic make-up can negatively impact their lives.
Like many of the other commenters have stated, gene therapy has always been really interesting to me, though I didn't understand much about it. The article "Gene Therapy Shows Promise in Controlling HIV", as well as what we have been going over in class this week made the subject a little clearer for me. I understand that HIV is transmitted by the virus binding our CCR5 chemokine receptors, and that in the kind of therapy being proposed, this would not happen because of of a therapy that knocks out genes that express the receptor. I think this a great thing, as it has proven to slow the progression of HIV, which is a disease that has so confused and flustered scientists and physicians alike for so many years. I wonder if this gene therapy can also work in a preventative function: such that individuals who do not have HIV can undergo genetic testing to see if they have the non-functioning CCR5-expressing gene. Then, individuals who do have this and feel like they are at risk for developing HIV due to other lifestyle choices can perhaps choose to undergo this gene therapy as a type of vaccine against developing HIV that is CCR5 tropic. This would definitely be an advantage to the use of gene therapy. However, a disadvantage to this still exists because even if this was developed, the cells of these people could still be infected HIV through CXCR4 receptors, as the article states. Could this gene therapy be done for the latter type of receptor as well, or are there too many genes which control the expression? Still, HIV is not caused only by the infusion of the virus into cells through these receptors- the virus has to enter the human body through contact with bodily fluids, and this still happens often, as 3 million people worldwide live for the virus. For this reason, in order to really stop the virus there is need for a cure, as these types of therapies can only slow profession, and research is still not clear on how long these therapies work for in the human body.
ReplyDeleteAfter reading the article I believe gene therapy does have a promising future as a treatment for HIV/AIDS. The Phase II clinical trial has shown positive results in one patient and potential in at least two others. Since scientists have yet to yield results such as these, any advancement is a good start. However, a few aspects of the study could be improved for further research into this method. Although this study is only in the Phase II trial, the sample size for this test was extremely small. Since researches have seen some success already, I think it would be best to increase the sample size tremendously. Additionally, the scientists are limited to those carriers with the "CCR5 tropic" and those who only have 'one non-functional version of the gene.' As with any new treatment study there are certain limitations. At this point, I think scientists should expand their sample size and if possible attempt to create a modified, similar treatment to work with subjects in which the virus also binds to CXCR4 receptors. Regardless of these limitations, the progress thus far seems promising. Although the idea of gene therapy may raise ethical issues for some, with control and proper education I believe people will learn to accept gene therapy in regards to life-threatening issues such as HIV/AIDS.
ReplyDeleteI briefly researched the CXCR4 receptor and found that HIV strains that infect via the CXCR4 receptor are only discernible late in infection. Based on this information, I understand why the researchers could not include 3 of the 11 participants in the final evaluation of the treatment. These participants were infected by variants of HIV that cannot be detected right away. I would like to know if these hard-to-detect strains, strains that infect through the CXCR4 are common. It seems that variants attacking through the CCR-5 receptor are more common, but I imagine there is still a portion of the HIV-infected population affected by strains that operates through the CXCR4 receptor. This treatment won't be able to control their HIV at all. It might even lead to disappointment in those who initially qualify for the treatment, but then find out they are ineligible due to having a strain that is not CCR-5 tropic. However, this study does exhibit gene therapy's promising future in HIV/AIDS treatment. It can only improve, and I hope that a similar therapy will soon be available to control CXCR4-operating strains of HIV.
ReplyDeleteI have never heard much about gene therapy before this article. However after reading this article, I can see that scientists are gaining more understanding about our genes. I find it very interesting that scientists are able to determine the connection between HIV with CCR5 receptors. The only criticism I had was that the study had 11 subjects, yet 4 of them could not participate. I feel as though they should have tested on more subjects to get a good sample size. Though their conclusion was that the infusion resulted in a suppression on the virus, I would like for them to test on more people to determine the success rate of their findings. Although I am still skeptical about gene therapy, I think it is a good start for controlling diseases. The scientists have already discovered the CCR5 receptor that HIV latches on, which shows the improvement and advancement of our knowledge and technologies. HIV is life-threatening and any help to control this can save a person's life. Once scientists are able to build upon this knowledge, we can possible control all diseases in the future. I am wondering if there are any cons to gene therapy?
ReplyDeleteBased on this week’s discussion on HIV, genetics, and the article, I think it is safe to say there is promise in gene therapy as a treatment for HIV/AIDS. Current ARV therapies are a lifelong process, and without them people with HIV/AIDS will begin to see a decrease in their health within a short time. Although I had to reread and go through the steps a few times to understand the full process, it seems as though these gene therapies have the potential to eliminate the lifelong treatments that many people living with HIV/AIDS have to deal with. Essentially, the process we talked about in class refers to the CCR5 receptor, which is where the virus initially enters our cells. However, those with the CCR5-∆32 mutation protect them against certain strains of HIV. If we can remove 32 base pairs and give people this mutation, the virus won’t be able to enter and replicate in the cells, thus protecting people from it.
ReplyDeleteThe strengths of this therapy are that, as that article mentions, there were long-term increases of CD4 cells in those who were treated. A downside of the ARV treatments is the continuous lifelong treatment. However, if gene therapy was done in a relative short term span, this eliminates the long-term aspect and provides a shorter treatment which improves the quality of life for those living with HIV. In addition, it significantly lowered the impact of the virus. Many people mentioned the small sample size number. I can’t argue that this is very true, and results certainly can’t be generalized to the general population yet. However, to support this research, I found an article from http://www.nature.com/nbt/journal/v25/n12/full/nbt1367.html that highlights a few other ways of doing gene therapy on HIV patients. It mentions altering protein-based inhibitors, RNA based inhibitors, T-cells, and others. As a few people mentioned, there are many steps involved in the process of the virus entering and replicating the cells. Even if using the CCR5 mutation helps currently, the virus may be able to adapt and form a way to replicate in a different way. However, research has clearly been under way using a variety of gene therapies that could prevent the virus from replicating in various ways. Therefore, I believe that gene therapy has a strong future in improving the quality of life of those with HIV/AIDS and potentially helping preventing some from developing the disease, as well as lowering the impact of the virus in those who already have the disease.
While I find the recent advances in gene therapy to be exciting and potentially promising, I can’t help but wonder how new treatments and tests will be paid for. The article “Gene Therapy Lurches Ahead, Sees Thorny Future Questions on Price,” discusses this issue. Treatments are not cheap, and insurance companies will likely do whatever they can to avoid being forced to pay for such therapy.
ReplyDeleteThis is similar to an issue mentioned in the article “My Medical Choice,” by Angelina Jolie. She states that gene testing and potentially lifesaving preventative treatment should be accessible to all women, regardless of their background or where they live. She explains that testing for BRCA1/2 costs upwards of $3,000, which is more than many women can afford. What Jolie fails to recognize is that if a person has trouble paying $3,000 for the testing, how are they going to finance surgery if the testing reveals they do have the BRCA1/2 gene and a mastectomy, for example, is recommended? While most health insurance policies in the United States (given the recent implementation of the Affordable Care Act), will pay for a percentage of the surgery, there are still high out-of-pocket costs that the patient will have to pay. Furthermore, $3,000 worth of medical care or testing may be better spent on cheaper interventions, such as immunizations, which are not available in all parts of the world. While we may have figured out how to test and treat genetic diseases using gene therapy, we have a long way to go in figuring out how to pay for it.
Source:
http://www.xconomy.com/national/2014/01/27/gene-therapy-lurches-ahead-sees-thorny-future-questions-on-price/?single_page=true
The article is interesting, but I don't think that gene replacement is a viable treatment method. It can be a "working-cure" which is excellent for HIV patients (who can afford what I can only assume is a fairly expensive and long-term procedure) but leaves reservoirs of the virus in the body. From the public health perspective, it is more interesting to look at the potential of gene replacement therapy being used in the same way a vaccine is used, for high-risk individuals, but obviously only possible if the technology surrounding GRT improves.
ReplyDeleteThis article (http://news.sciencemag.org/health/2010/06/can-gene-therapy-cure-aids) goes into a case study in more detail about techniques being used to attempt to cure HIV using GRT, if anyone is interesting. Personally I agree with it, in that GRT as of now is only a replacement for antiviral drugs in that it can lessen the side-effects of HIV but not cure the disease itself.
As many students have discussed, despite the flaws with this study (11 participants, 7 evaluated, only 3 achieved undetectable viral load) the results are very encouraging. I think gene therapy is an auspicious technique as treatment for HIV/AIDS as well as many other diseases. There are many benefits to gene therapy, such as limited side effects compared to drug cocktails, no drug resistance or tolerance, and most importantly, providing a cure instead of delaying the disease or easing the symptoms. This study reminds me of the treatment done on Timothy Ray Brown, "The Berlin Patient" in 2007. He had leukemia and the doctors did a bone marrow transplant from a "donor with a rare genetic mutation called CCR5 delta32 that makes stem cells naturally resistant to HIV infection" - the same gene used here in gene therapy, he is thought to be the first man "cured" of HIV and he still has undetectable levels of HIV. Unfortunately, the same treatment was tried on two Boston patients, and it was thought to have worked, but 32 weeks after treatment, HIV returned. These results demonstrate that we are on the right path, but there is still a lot of research to be done.
ReplyDeleteHere's a link to the two Boston patients.
http://www.cnn.com/2013/12/07/health/hiv-patients/
Based on the evidence provided, and on emerging mechanisms of gene therapy, I think there is a promising future for the development of a treatment for HIV. Although some of the patients maintained an undetectable viral load for an extended period of time, it was only effective with 3 out of 7 of the observable participants. Clearly this particular treatment would require a much higher success rate (and a larger scale of study participants) before it could be considered "successful", but it does encourage and support further investigation of the control of the CCR5 receptor via genetic therapy.
ReplyDeleteThis treatment is promising for the future of HIV treatment, but it is not a viable treatment method. That being said I excitedly await new approaches for treating HIV through gene therapy.
The amount of the subjects tested and evaluated is too small. I would like to see this study done with a larger sample size such as 100 people with HIV. However, I do think gene therapy has a promising future because it 'customizes' treatment for individuals. Gene therapy can help eliminate the trials and errors of testing several medications. With gene therapy, providers and scientists can narrow treatment by understanding the specific genes that are affected. The one problem I see with gene therapy is the cost. I feel like gene therapy would be expensive because it is advanced.
ReplyDeleteIn class I learned that HIV can get into a host T-cell by binding to CCR5 receptors. I also learned that deletion in the gene 32 is a protective factor because it prevents HIV from binding to CCR5. I though this was interesting because whenever someone mentions mutation or deletion in the gene, I automatically assume a horrible adverse effect however in this case it is beneficial.
I think gene therapy will have a promising future as a treatment for HIV/AIDS. Coming this far with being even able to do with a huge epidemic that occurred long time ago and coming to a point being able to put a stop to it or prevent it, it has been a great achievement. Gene therapy is basically manipulating the blood cells and basically picking out the bad and putting in the new genetically engineered cells into the body. The thing now it has limitations only due to the fact is only works for the CCR5 cells compared to the other cells that also need to be targeted. The strengths are that it has been working for many other people in the experiment but it did work for many other people that have been participated. I feel with how much they have achieved to this point, they have the ability to target all the mutated cells having to do with HIV/AIDS.
ReplyDeleteAfter reading the article "Gene Therapy Shows Promise in Controlling HIV," I have come to understand a little more about the future benefits of gene therapy in the treatment of HIV. As we learned in class, HIV binds to the CCR5 receptors in a host T-cell as its initial method of infection. The article discusses the knocking out of genes whose expression results in the activation of CCR5 receptors, which would prohibit the "tropic CCR5" HIV virus from latching onto T-cells. Though results do show promise, I do hold one hesitation in that the sample size of the study was very small. I would hope, in the future, that a larger sample size would be used to get a better gage of the effectiveness of this new therapy on a population with the topical CCR5 HIV virus.
ReplyDeleteTo better understand the implications that must be considered when developing new gene therapies, I found the article "Partial Considerations in Gene Therapy for HIV Cure," to provide helpful insight. Page 4 of the article lists the following obstacles that prevent the application of gene therapy to cure HIV infection: (a) the difficulty of applying a rare disease therapy, such as gene transfer, to the large AIDS population; (b) resolving the
safety of cytotoxic conditioning required for cell-based gene therapy; (c) clinical trial design issues, including: 1, correct identification of target population based on thorough risk-benefit analysis, and 2, the lack of validated cell-based endpoints defining efficacy; (d) development of a safe method for selection of gene-modified cells; and (e) the restrictive cost of manufacturing and technology. What I found most helpful in relation to the assigned article was part c, which discussed clinical trial development. As stated previously, one concern that I had with the previously mentioned study was that the sample size was small. After reading this second article, it makes sense that initially the sample size would be on the small side, as it could be difficult to find patients who are at the exact stage of the disease and/or fall into the target population category.
Though at first I struggled with understanding the basic components of HIV infection on a genetic level, it has become more clear to me when reading about gene therapy studies and how researchers have thought about HIV infection in reverse in order to discover beneficial treatments.
Source: http://download.springer.com/static/pdf/10/art%253A10.1007%252Fs11904-013-0197-1.pdf?auth66=1391908735_c711aac4b5c13dd90f54e6930cca355b&ext=.pdf
This gene therapy article is quite exciting because, as it states, "this is the first evidence that sustained functional control of HIV in the absence of ART is possible." ART, while successful in many cases, is very problematic in others. They require that patients strictly adhere to complicated medication regimens, they are very costly, and they often come with many side effects, with some being more severe than others. An alternative treatment option to ARV could revolutionary in controlling HIV. However, I'd imagine that once this gene therapy technique became a viable option, through more trials, it would be even more expensive than ARV. However, at least with this treatment option, it only requires a single infusion, as opposed to long term ARV treatment. Hopefully, over time, the price could be reduced to something more affordable. Nonetheless, much more research would need to be done in gene therapy before it became a treatment option. This study only had 11 participants at the beginning. This already low sample size was then reduced to 7. While this data alone isn't usable, it does point to a promising future. It will be exciting to see where this gene therapy research leads.
ReplyDeleteI agree with most classmates in that gene therapy for HIV is promising although it is not proactive enough for my taste. The sample size is tiny, but promising. However, public health concerns much broader populations and whether people like it or dislike it, funding and distribution is a huge factor. Gene therapy is extremely costly and will have to be put through rigorous testing which includes much more people and their results. Being proactive means we must define gene therapy as a viable way to eliminate HIV altogether in patients as this is the only way benefits would outweigh costs. For most people gene therapy is a far too expensive luxury and to add another concern it is very unpredictable. Without knowing what future risk it poses to patients (such as creating a more violent strain of disease or having adverse effects on genes in the body) we will not know if it is the best option for widespread cure. This being said I think gene therapy can help scientists learn more about the specific genes that contribute to the overall puzzle, thus helping discover a more effective inexpensive treatment. Currently gene therapy stands on the fence...a pandoras box or a miraculous cure all, either way the process needs to be perfected and then we can start discussing if we think it is a watershed component in public health for the fight against HIV, for now it is only speculation and predicted potential.
ReplyDeleteGene therapy wasn't the first thing that came to my mind when thinking of treatments for HIV, but as many others said, it is method with a promising future. The results of the study discussed in the article provided very positive and promising results, however the main critique that I have, which has been a popular one, is the small sample population that the study used. Considering that only 7 of the 11 total participants actually partook in the study doesn't say much for the total population of individuals who are at risk or are currently dealing with HIV. I do think that in order to further the development of gene therapy as a treatment for HIV, more studies with larger sample populations need to be conducted to make sure it is as efficient and beneficial to the greatest number of patients possible. As a whole, gene therapy provides a great amount of hope and positivity to working towards a cure and to help eliminate the virus. Further implementation is definitely essential to the overall success of gene therapy as a HIV treatment. I hope there is more work done with gene therapy and HIV in the future!
ReplyDeleteI found this news very interesting and exciting. The fact that patients suffering from HIV will be able to better control their disease without the use of ART provides so much hope for the millions suffering.
ReplyDeleteI am a little confused however as to the logistics of the studies being conducted. How are these studies being funded, and will funding continue to be provided? Also, how would the results differ if the studies had been conducted with a larger study population? In addition, if such a large proportion of the participants were not qualified for the study, how would this affect the availability of treatment to HIV patients in the future?
Although the results of the study were very promising, these points do make me question the validity of the study.
I think gene therapy does have a promising future in controlling HIV. I think a major strength of using gene therapy is that it can be personalized - your set of genes can be manipulated to control contracted HIV. This specific gene therapy in the article targeted CCR5 receptor genes and manipulated them to inhibit entry of the HIV virus. The new therapy only worked for 3 of 11 study participants, however this is because we all have a different genetic makeup. In the future, scientists can work on therapies that will address the many different ways the HIV virus enters a host T cell, not just the CCR5. For instance this study highlighted that the gene therapy they were testing didn't work on three participants who had virus that also latched on both to the CCR5 and CXCR4 receptor. Hopefully a future therapy can address this situation as well. It would be amazing to one day be able to draw blood from an HIV positive patient and be able to tailor a gene therapy to an individual's need.
ReplyDeleteA limitation to gene therapy is that it is a new field and therefore there is a lot of uncertainty, risks and possible unforeseen long-term side-effects. We must take caution and really know and understand the risks before gene therapy can be widely used. Also a limitation of gene therapy for HIV is that although it shows to be an effective treatment for controlling HIV in this study, it is no cure.
Overall, gene therapy seems to be an effective treatment that could greatly bring down the incidence of AIDS in the future, however it is still a new field and requires much more investigation.
I definitely thing gene therapy is the way to go for future HIV treatment, and can probably be applied to cancer treatments or other diseases where there is a genetic factor. I am, however, skeptical of the study due to the low amount of patients enrolled. I do think it is a promising start and would love to see it studied in a larger population and see if the results hold.
ReplyDeleteI do have a question about gene therapy though. How exactly is the new gene incorporated into a person? Is it through medication or some other sort of medical procedure? I know the article talked about re-engineering red blood cells but do they alter the receptors of every blood cell? I would like clarification.
When I read this article, I did not know exactly what antiretroviral therapy (ART) was; after doing an online search, I found that the standard ART “consists of the combination of at least three antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease.” http://www.who.int/hiv/topics/treatment/art/en/index.html
ReplyDeleteIn addition, I also found that ART could have adverse effects such as increasing the risk of developing cardiovascular disease, diabetes, and osteoporosis. http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/31/adverse-effects-of-arv
From what we learnt in class about gene therapy, I think it may be the closest “cure” we potentially have for HIV without the need for ongoing ART. Ideally, these engineered immune cells should function as normal CD4 cells, but without the presence of CCR5 receptors. The CCR5 receptors are the beginning of HIV infection, and to eliminate it is to prevent the whole process of infection. If scientists perfected this kind of gene therapy for all HIV-infected persons, it would be beneficial for everyone in the long run; patients won’t have to endure multiple visits to the doctors and health care costs will decrease. However, much precaution must be taken before finalizing gene therapy for HIV patients. Like ART, there can be adverse effects to it like our lymph system overreacting to these engineered cells. Moreover, more research should be done on HIV gene therapy until it can be declared as a legitimate intervention for HIV. But so far, the future for HIV patients seem promising.
I think gene therapy offers a promising future for HIV treatment. Current HIV treatment requires a daily cocktail of antiretroviral medications over a lifetime, referred to as antiretroviral (ARV) therapy. While ARV therapy is effective at reducing the effects of the HIV virus and reducing HIV transmission at the population level, it is tedious and costly for patient. Patients on ARV treatment must be disciplined and take their medications regularly. This can be extremely difficult to track. Furthermore, ARV medications are expensive and can cost HIV patients a fortune over a lifetime. Gene therapy would offer patients the ability to obtain treatment at a one-time cost with no need for a cocktail ARV treatment regimen.
ReplyDeleteThe potential to offer gene therapy for HIV treatment is extremely beneficial from an efficiency and quality of care standpoint. However, the obvious limitation with this treatment is that has not been tested rigorously. This study alone only had 11 participants, 7 of which were found to be eligible for the gene therapy treatment. More research on gene therapy must be done with larger sample sizes in order to confirm its effectiveness and feasibility.
The path that gene therapy is paving is truly amazing. Who knew an idea conceived several decades ago would become a running alternative method to treating genetic diseases. After reading "Gene Therapy Shows Promise in Controlling HIV," I have no doubt that this alternative method of treatment will be successful, but not for another several years. Just like those above me have stated, the study is unreliable at the moment. With the study having only 11 participants, the sample is really small, no way close to even representing a population. Once these scientists have extended their research to include hundreds (and even a thousand) participants will only then the study will be reliable.
ReplyDeleteFor now, this study can only raise hope for those affected by HIV. In the meantime, the best bet is to continue using available treatments and medications already available for patients with HIV.
It seems to me that the incorporation of gene therapy as a form of treatment for HIV/AIDS and other life threatening diseases can be very beneficial to society as a whole. I found an article about the use of gene therapy in children that are born with a disease in which they lack immune defenses. This immunodeficiency disease is called SCID-X1, and the gene therapy includes using a “self-inactivating” virus to deliver and introduce the correct gene into the children’s blood stream. The introduction of these new cells decreases the risk of these children succumbing to their deficient immune systems. They are also showing no signs of cancer, which was a side affect in children with this disease that were given earlier versions of this gene therapy about a decade ago. With the success of gene therapy with SCID-X1, researchers in Boston are now looking to create similar treatments for sickle cell disease and thalassemia. It is exciting to see that further research is being done in order to develop and improve new gene therapy treatments for diseases that affect many people in the US and around the world.
ReplyDeleteSource: http://www.npr.org/blogs/health/2013/12/07/249335960/gene-therapy-keeps-bubble-boy-disease-at-bay-in-8-children
I definitely agree that gene therapy is a promising medical breakthrough that can change the way we treat HIV. However, I do agree with other students that this study has yet to show reliable findings as there were only 11 participants. Another limitation that I found is that the treatment only works for viruses that use CCR5 receptors. What about those other viruses that do not use the CCR5 receptors? This study may have positive results, but that's mostly for those who have viruses that are CCR5 tropic.
ReplyDeleteAlthough many questions are still being raised, I can see this new gene therapy opening doors to many other innovative researches regarding the control of HIV. Moreover, these findings can lower the cost of treatments for people who are still relying on continuous ARV therapy. HIV treatment still has a long way to go, but these researches are contributing enormously to the list of methods that will hopefully be proven to be successful someday.
After reading and talking about gene therapy in class, I think it has great potential to treat diseases previously considered incurable. Medicine is an ever-changing field, as new research and practices are introduced regularly. Gene therapy, while still a relatively new treatment, has proven to have very positive outcomes. Diseases like cancer and HIV are extremely scary to patients, because they are dangerous. In an article in The Economist this week, gene therapy researched is discussed. The article talks about the research of Luigi Naldini of the San Raffaele Telethon Institute for Gene Therapy, who uses a cell vector derived from HIV to insert the correct gene into the target cells. This is interesting because we are conditioned to think of the HIV disease as dangerous and deadly, but the way that it infects a cell could be extremely helpful in healing broken genes.
ReplyDeleteThe Economist article:
http://www.economist.com/news/science-and-technology/21595888-fixing-bodys-broken-genes-becoming-possible-ingenious
Reading the article "Gene Therapy Shows Promise in Controlling HIV" made me very hopeful for possible cures to diseases such as HIV. At the same time, I was aware of how many small success stories there are of gene therapies that never make it to the public for clinical use. This article did make the treatment sound promising, since there was a significant improvement in the patients even without the use of antiretroviral therapy. The clinical trial should be repeated so then it can be applied to the public on a much broader scale. I found an interesting article from The Economist about gene therapy on several diseases other than HIV. This includes liver disease, Choroideremia, metachromatic leukodystrophy, Wiskott-Aldrich syndrome, and more. It is interesting to read not only about gene therapy on HIV, but also these other illnesses related to genes. The link to the article is posted below.
ReplyDeletehttp://www.economist.com/news/science-and-technology/21595888-fixing-bodys-broken-genes-becoming-possible-ingenious
Although I think gene therapy may be helpful in the treatment of disease in the future, the current techniques are risky and the associated benefits remain unknown. However, this is not to say that I am not hopeful advances in medicine, genomics, research, and technology may eventually lead to the success of gene therapy for diseases such as HIV. In the article Gene Therapy Shows Promise in Controlling HIV, I was intrigued by the method used by researchers to suppress the amount of viral DNA in the blood. Ultimately, what caught my attention was the small sample size. The data makes the case for gene therapy stronger, but I would like to see the results from a larger population as well as follow-up studies.
ReplyDeleteI found a great article, published in October 2013 in the Genetic Engineering and Biotechnology News, HIV Researchers Seek a Potential Cure that references the above study by Sangamo BioSciences. It mentions that currently antiretroviral therapy (ART) is the most regarded type of treatment. However, this method does not restore normal CD4 cell counts in a majority of subjects. The article goes on to further explain other types of treatments such as Stem Cell Therapy as a potential cure for HIV. There seems to be a few types of treatment possibilities heavily invested upon in research and I am optimistic that one (or more) will prove to be effective in the near future.
Article: http://www.genengnews.com/gen-articles/hiv-researchers-seek-a-potential-cure/4997/
After reading this article and from what we learned in class, gene therapy seems like a good step in the right direction towards curing HIV. However, I agree with what Naziyya said above about how this study has some limitations. This study has limitations from the small sample size of 11 people and also only 7 were able to complete it. Therefore, I think it is necessary to conduct further research on this topic to really discover its reliability and validity.
ReplyDeleteI agree with that fact that the price of gene therapy is a problem. In this article from the LA times (http://articles.latimes.com/1990-11-08/business/fi-5652_1_human-gene-therapy) it states that the new pricing paradigm of gene therapy must "strike a balance between pharmaceutical profit and public health" in order to be cost effective enough for people to go through with it. Despite the fact that it is pricy, my question is, if we invest in gene therapy in curing certain diseases, how much money would we save in other areas such as, medications, treatment, interventions, etc? That would be helpful to know when analyzing the costs and benefits of gene therapy.
Aside from the price, I think gene therapy is a good step in the right direction to curing diseases that were otherwise known as "incurable."
Gene therapy definitely has a promising future in controlling HIV/AIDS, although I wouldn't necessarily say that it is promising as a treatment just yet. My main concern is that the therapy was only tested on eleven people and found successful in three cases. This seems like way too small a number needed to make a claim that gene therapy could be a successful treatment for HIV/AIDS.
ReplyDeleteAfter this week's discussion and reading the news article above, yes, it does seem that gene therapy is headed in a positive direction in terms of treating HIV. Like many of my colleagues, the sample size of the study is very concerning. With such a significant portion removed out of the original eleven participants for final analysis, and only less than 50% showing beneficial results of achieving undetectable viral load, the study does not present itself as a "game-changing" revelation.
ReplyDeleteNonetheless, the small sample of subjects is understandable as these are human subjects in a study involving modifying genes that regulate the immune system. Any unexpected or adverse effect can be detrimental. Thus, even three people showing such results should be regarded as progress in a still emerging field. It is known that a substantial portion of the natural population has mutated versions of the CCR5 receptors, and they do not present any immunodeficiency. Using that ideology, this study has the right intentions and basis for possibly bringing gene therapy as a viable means to HIV treatment. Perhaps the most astonishing result of the study is the long-term increased CD4 cell count. As these cells play a vital role in messaging immune cells to fight off pathogens and foreign bodies such as HIV, this is great news for gene therapy moving forward. The fact that this therapy is even being tested on human subjects right now shows that there has already been considerable progress at the animal testing phase. Therefore, a few adjustments to the current approaches in gene therapy can possibly culminate soon in the future, an effective treatment for HIV.
I think gene therapy could definitely have a future role in controlling HIV/AIDS. However, due to the small sample size, it's hard to tell from the information extracted from this study whether or not gene therapy will play a large role. I found it interesting how varied the results were, even with only eleven people. I didn't know that HIV can attach onto multiple receptors, so that changes my opinions slightly on how we can combat HIV/AIDS. Because HIV can attach to multiple receptors, the job of preventing/stopping HIV is much more difficult that if it were only one receptor. This means that any cure/treatment we find may not even work for half of all HIV/AIDS patients, since in this study only three of eleven cases were reported as subsided. My biggest take from this article and from this week is that ending HIV/AIDS will be more difficult than many people think it will be, but we can start by doing things like gene therapy.
ReplyDeleteThe article "Gene Therapy Shows Promise" surprised me because this is a huge breakthrough for HIV patients. It is so exciting to a HIV patient to be able to go a certain amount of time without ARV treatment. I dont know how affective this treatment is because the sample size is really small.
ReplyDeleteIn another article by Willy Bogers, there has been a breakthrough for a vaccine that affects the CCR5 receptor in the vaginal area so HIV infection cannot infect through the vaginal rout. They have found that this vaccine inhibits one certain HIV infection from infecting someone. This also excites me because this can prevent some HIV that is transmitted through intercourse. Its so fascinating to me how much research is finding cures for certain diseases and how far we've come even in the past 10 years.
Source: http://www.aidsmeds.com/articles/Sangamo_genetics_1667_24579.shtml
http://journals.lww.com/aidsonline/Fulltext/2004/01020/A_novel_HIV_CCR5_receptor_vaccine_strategy_in_the.3.aspx
Unfortunately my computer has been dysfunctional this week and I thought I had posted a response earlier.
ReplyDeleteWhile gene therapy seems promising, only 3 out of 11 participants had long lasting effect due to the treatment. The experiment needs to be done on a more larger scale, generating more valuable data that could be more generalize-able to the population of HIV/AIDS patients.
Also worthy of note was the participant who only experienced the effects of gene therapy for a limited amount of time. More research needs to be done to see how long the effects of gene therapy would last in a patient, whether they would require frequent doses, etc. Researchers should conduct more follow up sessions on the participants who had experienced favorable effects of the gene therapy to see if any changes occur in their status.
I've been looking for Acne Scar Treatment hauz khasThanks for sharing this.
ReplyDeleteBeen a HIV positive is just like been through hell; well special thanks to God almighty for using Dr. Zaki the greatest spell caster in curing my HIV disease. I was diagnosed of this disease in the year 2008. Thou I was taking my medications buy I was not myself. Until last two weeks. My friend came to me and told me that he saw many testimonies on how a spell caster cured people HIV disease. Thou I never believe in spell, I said to myself "seen is believing" I took his name and searched it on GOOGLE, I saw many testimonies myself. Quickly, I copied his email dr.zakiherbalhome@gmail.com I emailed him, he gave me a form to fill which I did, then he called me and told me that his gods required some items in which he will use in casting a curing spell on me. And di told him to get the listed items needed to prepare my cure because by then i have little faith in him, few hours later he called me and told me he is through preparing the cure. so he send it to me I got my parcel, it was a herbal cure as described by Dr. Zaki. I took the herbal cure and after taking it for a week and some days. He told me to go for check up, I went to the hospital and had a hiv test, I was tested HIV negative. Quickly I called him and tell him what happened he congratulated me. I promise to tell the world about him. You can contact via email or phone number dr.zakiherbalhome@gmail.com
ReplyDeleteAfter reading these articles, I think it is pretty clear that direct to consumer companies like 23andme are a great modern-day convenience. Such companies use incredible modern technology and make it available to the average person – a feat that most would not have imagined possible, even as recent as 10 years ago. While there are minor negative aspects, just like most other things in this world, I feel they are overshadowed by the immeasurable good that such companies can do.
ReplyDeleteFirst off, I would like to dismiss both these articles from the start. After reading and watching the short video, it seemed to me that such articles should be considered more like propaganda than anything else. Yes, the stories they reported were true, however each case only really highlighted one specific example without much consideration for other thoughts, opinions or perspectives. The CNN article about the man trying to create a family tree for the entire world and host the largest family reunion ever is just foolish. While this is interesting to discuss the fact that almost everyone is related to each other in some way, this is not news by any means. These sorts of things were known before companies like 23andme existed, and claiming that Obama is your “14th cousin” is fun, but also pointless. By no means can this be used as an argument against such services.
The article that reports about the divorce of a family as a result of these genetic tests is also a poor example. While this may be true, it is a single case out of thousands of others who have used the service. While I feel for the family, I also do not blame the company in any way as responsible. Making the choice to use such services exposes you to these sorts of possibilities, even extreme cases such as these. It would be like outlawing cars after one fatal accident because of the danger. Anyone who uses a car knows the potential for injury – but it remains their choice to do so. I view these DTC companies with a similar perspective, but almost less seriously because they are not physically harming or causing death to anyone.
DTC companies like this have the potential to do so many great things. Rather than causing harm or death as compared above, they have the potential to do the opposite. Average people, who may not have the opportunity or ability to receive genetic testing for various reasons, can now actively choose to do so from their own home without the need for doctor approval, or any other “middle man.” This allows people to actively find out any health concerns, exposures, or risks that they may be susceptible to, with the opportunity to intercept or treat before these problems become serious. With some diseases or disorders, knowing before hand could be life saving. But in the end, this is all on them. The consumer has the ability to find out, but no obligation. No one to persuade them or even encourage – it is all on their own terms. I do think it is important that companies warn customers about the potential to discover unwanted information, but beyond that it is each person’s own responsibility. For these reasons, I do think we as a society are ready for the “genomic revolution”. At least as it currently stands.
He that work and never ask for anything thanks Dr CUBA for good work for healing my brother for HIV sickness he was very sick for a year + and my daddy have spend so much money on medical care and drug he have being taking to some many place for healing… even different pastor have pray for him it get worse every 6hous the man that heal with 45mins is here the man that the lord god have giving the power to put every thing in place the man that give a word and never fail my kid brother was just chatting one day when he see this post of jack about the curing of HIV virus by Dr CUBA he run to my daddy and tell him about the man my daddy decided to call him and confirm it if it is true about the cure the man just assure him about his work that the great power of is for father and his gods cure any disease include HIV/AID, Ebola, Rota virus, Smallpox ,Hepatitis well we have hope on him which we give a try to after 45 mines my big brother started getting better as am write this comment his is at work now what a miracle….. if you need help from Dr DR CUBA contact him now my friend through his email or phone number drcubatemple@gmai l.com Add DR CUBA on WhatApp +2347038965900
ReplyDelete