Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Bay Area Reporter - November 3, 2005
Matthew S. Bajko, m.bajko@ebar.com
"There is the potential to utilize embryonic stem cells to protect against HIV. We need to have therapeutic remedies that work better than the toxic drugs we are using now," said Jerome Zack, Ph.D., associate director of both the University of California at Los Angeles AIDS Institute and Institute for Stem Cell Biology and Medicine.
"Stem cells represent one of the Holy Grails of HIV research, allowing one's own body to fight the disease instead of these terribly toxic retrovirals," added Jeff Sheehy, Mayor Gavin Newsom's adviser on HIV and AIDS policy.
Sheehy, who serves on the Independent Citizens' Oversight Committee for the state's stem cell institute, organized the morning discussion to highlight the potential of stem cell research to treat HIV and AIDS. The institute, formally known as the California Institute for Regenerative Medicine, opened its headquarters in San Francisco's Mission Bay on Tuesday.
Wednesday marked the one-year anniversary of the passage of Proposition 71, which will provide $3 billion in state-backed bond money as grants to researchers investigating the potential of stem cells to treat and cure a multitude of diseases. Some of that money will most likely be funneled into research looking at how stem cells can be utilized against HIV.
"HIV is a very unusual disease and is not usually associated with stem cells because it's an infectious disease and does not have a genetic component. But it does affect the immune system. The immune system derives from adult stem cells," said ICOC board member David Baltimore, Ph.D., a Nobel Laureate and president of Caltech. "HIV infects mainly CD4 T-cells, which are the central cells of the immune system."
The key characteristic of HIV infection is an evasion of the normal immune function and a direct attack on the immune system itself, said Baltimore. HIV uses numerous "tricks," he said, to fool the body's normal responses to a virus, thus allowing it not only to survive but confound researchers who believed they could quickly develop a vaccine to protect humans against HIV as has been done with polio, smallpox, and hepatitis.
"If we are going to make a vaccine we have to be smarter than nature because nature hasn't figured out a way to knock out HIV. We have never faced a problem like that before," said Baltimore. "I have been saying for some time now we need to think of extraordinary methods not ordinary methods to vaccination and therapy."
One idea is to use gene therapy to manipulate stem cells into delivering new immune cells that can ward off HIV, said Baltimore. The Gates Foundation awarded him a $14 million grant to investigate such an approach using embryonic stem cells.
"If it works there are lots of other chronic diseases it could be feasible to use on as well," he said.
At UCLA, 15 percent of the university's gene therapy trials are AIDS-related, said Zack. Behavioral studies are also planned to study whether the public will use such stem cell remedies as they become available. One approach being studied is putting an antiviral gene in bone marrow stem cells that would block the reproduction of HIV.
"As it divides every one of those cells should be protected against HIV," said Zack.
One study already under way is looking at using adult stem cells to provide "intracellular immunization" against HIV, said Dr. Ronald Mitsuyasu, director of UCLA's Center for Clinical AIDS, Research and Education. Mitsuyasu and colleagues are using ribozymes to deliver cells to a person's body that are protected against HIV.
The first phase of the study was begun seven years ago with only 10 patients. The gene transfer was not only successful, he said, but there were no safety concerns related to the technique. In some patients the gene still appeared three to five years after being given the new cells, he said. The researchers are now enrolling patients into the second phase of the trial.
"We expect to see a slower rise of HIV virus in people given the treatment" compared to those given a placebo, said Mitsuyasu, who expects to know the results from the study in 2007.
As someone who is HIV-positive, Sheehy said the emerging science around stem cells gives him hope the future of HIV treatment and care is just around the corner.
"Science can move rapidly. All those patients looking to the stem cell institute for hope should know that hope can happen over night," he said.
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