Slashdot Mirror
Teen Takes On Donor's Immune System
Leibel writes "The Australian ABC News is reporting that a 15-year-old Australian liver transplant patient has defied modern medicine by taking on her donor's immune system. Demi-Lee Brennan had a liver transplant. Nine months later, doctors at Sydney's Westmead Children's Hospital were amazed to find the teenager's blood group had changed to the donor's blood type. They were even more surprised when they found the girl's immune system had almost totally been replaced by that of the donor, meaning she no longer had to take anti-rejection drugs. 'Dr. Michael Stormon says his team is now trying to identify how the phenomenon happened and whether it can be replicated. "That's probably easier said than done... I think it's a long shot," he said. "I think it's a unique system of events whereby this happened. "We postulate there's a number of different issues - the type of liver failure that she had, some of the drugs that we use early on to suppress the immune system and also that she suffered an infection with a virus called CMV, or cytomegalovirus, which can also suppress the immune system."'"
kids these days.
must... stay... awake...
Kill her! Who knows what other powers she might have?
Sounds like carbosilicate amorph warfare to me...but then, who'dathunk that the Australians would go in for that schlock?
Actually, if memory serves, NPR had a short bit on a treatment for negating the need for anti-rejection drugs in kidney transplants--they not only transplanted the kidney, but also bone marrow from the donor, and 5 patients out of 6 were able to go off the anti-rejection drugs.
In Xanadu did Kubla Khan
A stately pleasure dome decree
So if she takes on her donor's immune system, how does that prevent her from rejecting her own body tissues?
Is she related to Sigorney Weaver? That may have unexpected consequences, in the long run. What was the name of the company treating the girl again?
Wouldn't her new immune system see the rest of her body apart from the liver as a foreign invader, and attack it?
Edith Keeler Must Die
With these developments, it's my hope that more good news will come by. Let me hope that the recipient will not eventually "inherit" the donor's "bad" or weak characteristics. What about DNA? Suppose that the recipient's DNA changes to the donor's?
...and the two most interesting words in it were "...stem cells..."
After 18 months she turned into a clone of the 50 year old male liver donor. Doctor's response, "hey at least the liver works".
If CMV was really the cause of this strange, but fortunate, occurence, that's a tough one.
CMV is no laughing matter. It's one of the opportunistic diseases that immuno-deficit people have to worry about. It can lead to blindness and a slew of other complications.
The best we can hope for (if CMV is to thank for this effect) is that they can isolate the mechanism and replicate it. You wouldn't want to use CMV in this way.
I'd rather have someone respond than be modded up.
The implications for immunology and organ transplants are amazing, but it goes even further than that. If you can induce stem cells to penetrate a patient's bone marrow, then you open the door to all kinds of innovations.
Imagine if they could take a sample of your DNA, correct inherited defects, and then re-implant you with stem cells carrying the corrected sequence. It would mean hope for victims of all kinds of diseases like Tay-Sachs or Kreuzfeld-Jacob.
At the very least, the promise of being able to transfer immunological memory on the marrow level potentially means that all we have to do is find the one person whose immune system wipes out HIV, say, and we can all receive that same immunity.
Do what you can, with what you have, where you are.
As someone who has received a renal Tx and who also has a degree in Anat.,Phys.&Biochem. I have 2 questions.
America, Home of the Brave.
... liver costs will skyrocket.
and will be issuing an embarrassing retraction here in a few days :)
..to be able to transplant a new immune system into a patient with, say, some immune deficiency virus.. and potentially be able to add years to their life. Maybe you wouldn't need to bother with the anti-rejection drugs since the immune system of the patient would already be suppressed by the virus. I know it probably can't work that way, but I imagine that any major breakthroughs in the study of the human immune system will have relevance in AIDS/HIV research.
Wow, that's awesome. The first thing I thought of was, "wow, that was a lot of rep to farm to switch from scryer to aldor."
I'm a sad sad man.
a lab error?
All your immune systems are belong to us.
If doctors are able to replicate the immune system replacement, might we have a treatment for HIV/AIDS in patients that are able to (nearly) eliminate the virus, but suffer from an extremely damaged immune system?
I for one welcome our new mutant overlords.
I prefer Flambe as apposed flamebait.
Once again the human body demonstrates the brilliance of its design...
And yes, it will blend.
Just today, I read an article about a new treatment to prevent rejection in transplants, that mirrors this story almost exactly.
Except that the treatment involves explicit transplantation of the original donor's bone marrow into the recipient, in addition to the organ being transplanted. Mostly for live-donor transplants from related donors.
It often takes accidents or other strange happenstances to spur innovation and invention. See Penicillin or any other number of other examples.
Even those who arrange and design shrubberies are under considerable economic stress at this period in history.
If they can reproduce this situation it'll be huge.
If in fact they do reproduce it, do you think the doctors/researchers will get some sort of Nobel Prize?
I think we need to get a nice chunk of that liver and grow one for everyone...
New Medical Technique Frees Transplant Patients From Lifetime Anti-Rejection Drugs January 24, 2008 9:32 a.m. EST
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
But what about all the rest of her body that was still running on the old immune system?
"It's the height of ridiculousness to say for those 9 lines you get hundreds of millions."
Yes, its called Graft Versus Host Disease (GVDH), and is a common complication of bone marrow transplantation. If it happens, it manifests as skin, liver, and gut problems mostly. Liver obviously isn't going to be a problem for her, and it sounds like from the original NEJM article I just read that she hasn't had any other manifestations of GVHD. If you are going to get bad GVHD its usually early on, so she's out of that woods, but there is always chronic GVHD manifestations that will show with time.
Though given a choice, I'd take the GVHD risk, lose the immunosuppressants, and never worry that my liver graft would fail. All in all she's a hella lucky kid.
What would be really neat is if in 150 years, we could use this trick to make everyone's blood O-negative.
Odds are we'll find a way to create effective blood substitutes well before then, but it would take some complexity out of the whole blood donor - donator process.
-Rob
Biblical fiscal responsibility
Is it due to her bone marrow mysteriously becoming populated with stem cells from the donor which has caused the change in both her blood type and her immune system?
"He Who Dares Wins"
This story actually coincides with an interesting story that ran on NPR yesterday about several experimental new transplant techniques that might help future transplant patients avoid having to take anti-rejection drugs, as well.
In particular, the article tells the story of one 28-year-old woman who received a kidney transplant from her mother, who was only a partial match. Prior to the kidney transplant, she also received a partial bone marrow transplant from her mother. The bone marrow transplant essentially caused the patient's immune system to become a "blend" of her own and her mother's, producing T-cells that would attack bacterial and viral antigens just like normal, but leave the transplanted kidney alone.
The results are pretty impressive. The patient originally had to take anti-rejection drugs after her first kidney transplant at age 13, and they caused a host of miserable side effects. After her more recent transplant, however, she's been off the drugs for five years and even ran 2 marathons last year (how's that for healthy?).
Unfortunately, the new technique only works for organs that you intentionally plan on transplanting ahead of time, since the bone marrow has to be transplanted first in a separate surgery. That means that organ donors who die and donate hearts, livers, etc. aren't really an option. But for a transplant from a living donor, this is a very promising new technique (some of the researchers even think that it could eventually make transplants from animals possible).
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Andy Grove: "Not Much."
Is she hot?
"They saved Hitler's liver!"
One line blog. I hear that they're called Twitters now.
Parent is not "redundant". Please punish the retarded moderator. Thank you.
In Medical Genetics, we are very aware that the mother can frequently have immunities from all the embryonic stem cells from all her children, as well as her mother's children, and that later children have such stem cells and immunities from all their siblings - including from many of the non-viable pregnancies (not as much the ones that don't survive a few weeks, but stillborn children). Twins - fraternal, as identical have same germ line - share the cells of their siblings. Some twins are reabsorbed into the other twin, as well, resulting in a surviving child with both genetic structures, one predominant but the other continuing to "live" inside the body in survivor cells.
The great thing about Pluripotent Stem Cells is that we may be able to do similar things by altering your own tissue into an embryonic cell, fixing the genetic deficit, and reinjecting the functional cells into your own body, where they can have a functioning immune system that is totally compatible with your own body and not be rejected.
Science Rules!
-- Tigger warning: This post may contain tiggers! --
Just when we think we've got everything figured out, some little twerp comes along and throws a monkey wrench in the works!
Is it normal to transplant livers across blood types? This sounds like a nearly missed case of malpractice.
but then again, commenting on a katz story is almost as self-serving as the katz story itself. -tensionboy
Stop them now!
I Am Legend
...A "House" episode
Slashdot is too nerdy for me.
I would have thought that if the donor's immune system took over the recipient's, then OK it would not attack the new liver which it recognized as its own, but I'd be concerned about it attacking EVERYTHING ELSE that was the recipient's own. So the liver donor, who would have rejected anything translplanted into him from this girl, is NOT rejcting her entire (less liver) body?? Weird...
In Australia the donor immunes you.
Sylar.
How long after the writer's strike ends do you think it will be before this shows up as an episode of House?
I think this actually hits the nail very firmly on the head. Sure, there must be a way to go after those who screw up if it is clear incompetence, but the way things are going lawyers are killing good practice medicine.
There is probably only one good aspect to this: one day lawyers will die because nobody wants to treat them for the risk of getting sued. A sort of Darwinian correction..
Insert
Chimeras are indviduals containing cells from two genomes. Mother-offspring chimeras maybe as high as 30%. Less common are sibling chimeras, via twin wombs or mother. And still more rare are father-offspring chimeras via organalles carried by the sperm and surviving fertilization.
Usually these chimeras are highly assymetric with the alien cells out-numbered by originals by a thousand to one or so. True symmetric chimeras are rare, perhaps due to absorbed twins in the womb.
This has created some problems with genetic forensics. I remember Dateline running a piece on it. For example, a daughter did not have her mother's mitochondria, but the chimeric other. This didnt come out until detailed testing was done and the mother lost the kid for a while. Chimeras complicated the indentification of remains of the last Tsars family. I forget whether it was the living relative or Tsar who was chimeric. One athlete in a doping scandal tried to complain he was a chimera and that threw off results, etc. This could complicate some some court cases, more likely the safer false-negatives than false-positives.
Im under the impression that chimeras are most feasible in the womb and infants before the immune system has a strong sense of self-identity. But adults may not be impossible either through intentional or accidental stem cell transplant.
The flip-case is auto-immune where the immune system attacks its host body. Possibly some of these case may be one half of chimera attacking the other.
So the Aztecs could have actually transplanted animal heads on human bodies and trained them as temple guards?
Which is that the most important part of this story is the fact that the girl is Australian! Zonk would never have posted it otherwise.
We effectively already do this. They're called bone marrow transplants, and it's been used to treat a number of blood-based or auto-immune diseases for years.
The risk of this procedure aside, one problem is that bone marrow transplants aren't perfect. Take leukemia or sickle cell anemia for instance. Unless every single hemopoietic stem cell is eradicated (unlikely), there is a risk that the original cell populations will reproduce and the disease will eventually come back.
Umm... no.
Tay-Sachs disease is a lysosomal storage disease which becomes most problematic in the nerve cells of the brain. For obvious reasons, unlike a bone marrow transplant, you can't remove/replace all of the nerve cells of the brain without killing the patient.
Creutzfeldt-Jakob disease is, to put it simply, mediated by a prion (a malfolded protein that induces normally folded proteins to also misfold) which can be either genetic in origin or acquired. Even in the case of genetic CJD, the protein would is expressed in every cell of the body, so a bone marrow transplant would not address the problem. Furthermore, even in the best case scenario where you could replace the entire defective genome without killing the patient, because the defective prion is self-replicating in nature, unless you ALSO replaced every protein in their body too (which, if you could do that, you effectively just be making a whole new body for the person--a cure for all diseases) you'd be in the unique situation of having treated the genetic form of CJD, only to be effectively left with the acquired (and still deadly) form.
Yeah sure. If you're willing to inflict one of the most invasive, riskiest, and painful procedures in medicine upon the entire world's population just for immunity to one disease, I guess you could [/sarcasm].
-Grym
... i wouldnt mind at all changing my immune system to something a little bit more sane.
HI O WISE PRINCE. WHT TOOK U SO DAM LONG?
Sure you don't mean the ancient egyptians?
Or the Goa'uld?
Tsukasa: All I really want, is to be left alone...
Perhaps she collected # Two Bloodgrass # Six cloves of Garlic # Five Nightshade leaves # Blood of an Argonian # Ashes of a powerful vampire And this saved her from her cursed liver!
In Soviet Russia, livers reject you!
(I can't believe this actually almost makes sense)
Kwisatz Haderach
Sell the spice to CHOAM
This Mahdi took Shaddam's Throne
It was conclusively demonstrated years ago that any old liver will do as long as it's paired with fava beans and a fine chianti.
September 2011: Looking for Cocoa/iOS work in Boston area Cocoa Programmer Quincy, MA
Please use "assimilated" or "adopted". Don't make these stories difficult to understand.
All nice, but can you imagine what it would do for sports? This would be the ultimate doping.
Don't fight for your country, if your country does not fight for you.
Actually, I was just recently reading about how common it is for transplant recipients -- ESPECIALLY liver and kidney -- to cease the immune response to the transplanted tissue over time. This is hardly a "unique" event. The only really unusual part is the blood type change.
But then we'd lose all immunitizations the donor didn't have. Unless the plan was to keep switching immune systems every time a new disease was contracted....
"Action without philosophy is a lethal weapon; philosophy without action is worthless."
The Washington Post is also covering the new transplant technique, with a different human interest story attached.
Maybe she should have her hair plugs removed? Were she to do that, she'd be completely healed.
concrete5: a cms made for marketing, but strong enough for geeks.
You mean the patient they've been studying hadn't had a liver transplant?
She really did develop chimerism. So according to religious dogma does she now have 2 souls? Did the donor give up half a soul? Why won't anyone answer my questions about chimeras and specific gravity of holy water? When are these brilliant scientists going to investigate that is what I want to know!
While this does happen naturally (as in this story), scientists have also found a way to "force" this to occur by also transferring bone marrow of the donor to the recipient at the same time as the organ:
http://www.physorg.com/news120335571.html
This was reported on digg.com previously, and also again today.
libertarianswag.com
Bone marrow transplant isn't what happened to this girl. Her entire immune system replaced itself w/o help or pain. This is what the GP was refering to. So why the /sarcasm?
Space Shuttle was a program that strapped humans to an explosion and tried to stab through the sky with fire and math
Or get re-immunized?
Space Shuttle was a program that strapped humans to an explosion and tried to stab through the sky with fire and math
Quick, breed her to keep her genetic material!
XML is like violence. If it doesn't solve the problem, use more.
Since the expression "to take on" often means "to fight", it's easy to read the title as meaning the exact opposite of what occurred. If there was an article titled "EFF takes on RIAA's legal tactics" you wouldn't think it meant that the EFF was now using RIAA's tactics but rather was fighting against them.
If the donor's immune system had replaced hers then it would have attacked her.
Slashdot should try thinking about the issue instead of a race for the wittiest pun.
is this like a update or a reformat? because if its like a reformat that this might be the cure for aids...think about it...HIV wipes out your immune system right? well if you let it then hit your body with a new immune system then it might fail and the person might be cured...I'm just a tech but in the computer world if a virus wipes out your securty software you install a new piece from a protected source and kill the virus...
-Ours is the wisdom of Solomon, the magic of Merlyn, the fall of Icaris.
CT is in a somewhat unique clinical position. MDs recognize that radiation dose is a bad thing, but (assuming trends haven't changed much recently) most think of a single CT dose as comparable to a dose from a single radiograph, when it is usually several times higher. Therefore, when weighing risk/benefit they are underappreciating the risk of the long-term risks of the procedure (increased chance for cancer--although those numbers are admittedly very approximate, especially for unusual populations such as children) as opposed to the obvious immediate benefit (potential for catching something dangerous). This is a problem of education, and one reason why medical physicists need to be educators in their workplaces.
I would agree that CT is overutilized as an imaging modality. However, CT is a unique situation that makes it a poor choice for displaying the tendency of modern American MDs to overdiagnose or overtreat. For CT, the problem is that there is apparently a widespread misunderstanding of the risk of the procedure. For most other situations, I would bet that the risk/benefit ratio is not the problem: it's more likely to be either patient demands that the doctor _do_ something, fear of malpractice suits (as you mentioned), or it could even be an attempt to "get their money's worth." That last point is definitely more prominent if you look at MRI as a modality: the units are extremely expensive and yet have minimal risk if used properly. My feeling is that, if MRI is overprescribed, it is probably for reasons of cost-recovery--which is also very sad.
That would be great if it would work for HIV. I've read several stories that the descendants of the people who survived/evolved to fight the Black Plague that they are immune from the HIV virus as well.
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The Borg have arrived... resistance is futile. You will be assimilated.
Can we have your liver?
If my call is important, why am I talking to a recording?
Yes, I realize that. But once you look past the sensationalist headline of "entire immune system" and understand where those cells come from you'll realize that what happened to her is fundamentally no different than what happens to someone who undergoes a bone marrow transplant. The notable things about this case are: (1)the donor's liver cell(s) migrated and differentiated to replace the hematopoietic stem cells and (2) the replacement of the hematopoietic stem cells was not the directed or intended result of any human intervention.
First of all, what happened to this girl was a fluke. The article said as much. Her amazing case was the result of a series of unlikely (and clinically undesirable/risky) events and circumstances. Specifically, she was: taking immuno-suppressants, received an organ transplant from a special organ in the body known to regrow itself, was probably infected with cytomegalovirus, and even then benefited from an unusual migration of donor cells into the bone marrow that just happened to differentiate correctly and (even more amazingly) out-compete the host hematopoietic stem cells. She's lucky to be alive and most certainly didn't have a pleasant experience getting through it.
I'm sorry if my post came off as snarky, but I cannot disagree more with the GP. In fact, I'm almost positive that he doesn't have the slightest clue what he's talking about. Tay Sachs and CJD (which he butchered the spelling for, by the way) has nothing to do with the article at all. I honestly think it's an embarrassment that on a scientifically-centered forum that his comment is rated +5.
Even his speculation is, in my opinion, is entirely baseless and ill-conceived. It's unlikely that any sort of preventative treatment will ever come out of this case. We already have established methods for "replacing" an "immune system," which, by virtue of its drastic nature would almost certainly be much more reliable. And even if you thought you could replicate the circumstances of this case, there's absolutely no way you could get a human trial ethics board to sign off on giving immuno-suppressants and intentionally infecting people with CMV to develop a preventative measure against an STD, of all things. And even IF you could develop such a treatment you could never give it to the entire population because there would be the obviously disastrous problem of creating an immunological monoculture.
-Grym
God or no God, that's a bloody miracle. I hope this girl has an amazing and wonderful life.
The phenomenon described in the article is not uncommon during bone marrow / stem cell transplants when the transplanted cells do not originate with the recipient. In 2001 my wife underwent a bone marrow transplant as the result of AML leukemia. The bone marrow used in her transplant came from an unrelated male donor. When it had been determined that the graft had taken, the changes observed were: 1. Altered blood type - from B- to A+ and 2. Genetic conversion from "XX" to "XY". It should be noted that the genetic transformation only occurred in the blood. Genetic karyotyping of cells other than the blood retain the "XX" characteristic associated with females. Subsequently, I am surprised that what was experienced as the result of the liver transplant did not occur sooner. Anyhow, solve this puzzle and ultimately increase the success rate associate with various organ transplants.
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Careful. It doesn't take comments much different from that to start a mob ;)
That's the point -- the "rest of her body" took on the identity of the foreign invader, so it's all harmonised now.
HIV can infect other cells than just those of the immune system, for one thing.
However, many diseases are caused by malfunctions of the immune system, including asthma, lupus, IBS, rheumatoid arthritis, and multiple sclerosis. Type I diabetics can't produce insulin because their pancreatic beta cells have been destroyed by such an autoimmune response. This could be huge.
Also known as females:
Why does X-inactivation result in chimeras, individuals with genetically distinct areas of their bodies? In female mammals one X chromosome in every cell is inactivated. The inactivation occurs early in development when the embryo consists of only a few cells. The inactivation is random - one X chromosome may be turned off in one cell and the other X chromosome inactivated in a neighboring cell. Once a chromosome is turned off it remains turned off in all descendent cells. With respect to their X chromosomes, female mammals are chimeras. A chimera is an organism composed of different genotypes. Some areas of their bodies have one X chromosome turned off and other areas have the other X chromosome inactivated. An example of X-linked chimeras that can be seen visually are female cats that are heterozygous at the orange coat color locus. Orange is a locus on the X chromosome. Females with one allele for orange color and one for non-orange (tortoise shell and calico cats) have blotches of orange and other colors all over their bodies. Each blotch of color is composed of cells descended from a single cell in the embryo at the time of X-inactivation.
"Prepare to be assimilated."
>True to a certain extent. AB could probably handle O, but AB couldn't handle A or B
Sorry but your totally wrong on this one, a person with AB blood can definitely get an organ of AB, A, B and O. A quick google will confirm that
- and it is probably due to the author of the article or the good mr Zonk not understanding the issue. It would seem obvious to me that if she no longer has her own immune system, but the donor's, then it would attack the rest of her body even as it left the liver alone.
The article doesn't say whether the hospital has checked the genetic identity of the girl's immune cells, but it could be that either her immune system has accepted the foreign immune cells as their own, or her immune system has been 'reprogrammed' to consider the foreing liver cells as 'own'.
So which institution is she going to be given to for disection err I mead study :)
I was wondering the same thing. Why wouldn't they put something so simple in the main article? So if the donor had O negative blood also, the liver would not have been rejected and she wouldn't have had to take drugs? I was under the impression that blood type wasn't the only thing that made a host's immune system attack a transplanted organ, but I could be wrong. If that isn't the only cause then you'd still be left with the new immune system attacking the host's other organs for the same reason...
In Medical Genetics, we are very aware that the mother can frequently have immunities from all the embryonic stem cells from all her children
In my wife's case it went beyond immunity - she was, um, uncomfortably, lactose intolerant before pregnancy - after carrying our daughter, she can now down an XL ice cream with the best of us.
Some twins are reabsorbed into the other twin, as well, resulting in a surviving child with both genetic structures, one predominant but the other continuing to "live" inside the body in survivor cells.
There was a neat paternity case recently (let's see if I don't butcher this) that wound up with a woman's children being born of her gestational twin's ovaries. That is, the childrens' biological mother was an aunt who never lived.
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If she leaves blood at the scene, prove innocence with a cheek swab.
If she leaves anything else, prove innocence with a blood test.
Gotcha. Thanks for explaining it.
Space Shuttle was a program that strapped humans to an explosion and tried to stab through the sky with fire and math