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 They were even more surprised when they found the girl's immune system had almost totally been replaced by that of the donor, meaning she no longer had to take anti-rejection drugs.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
...and the two most interesting words in it were "...stem cells..."
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.
..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.
a lab error?
And now she is finding that she lusts after herself.
Kindness is the language which the deaf can hear and the blind can see. - Mark Twain
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.
whenever she needs a new body part, she'll just go and hack one off another person's body and use it. Now, she just needs a cool nickname
How about "Frankenstein"?
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?
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.
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.
It's about as likely.
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).
Anonymous Luddite: "What do you think of the dehumanizing effects of the Internet?"
Andy Grove: "Not Much."
I'd not take that therapy, m'self--I've got AB+, so you can throw pretty much anything into me and I'll take it. Also, it's not just the blood type of the red cells that matters--the plasma has a type, as well, and it turns out that AB+ plasma can be given to anyone without any trouble.
;-p
In addition, there are other possible consequences--some blood types, for instance, survive Bubonic Plague a lot more than other blood types, due to the similarity of surface proteins between certain kinds of blood cells and those found on plague bacteria--changing everyone to the same blood type would thus increase the likelihood that some lucky bacterium could wipe out the human race with a fortuitous mutation.
In Xanadu did Kubla Khan
A stately pleasure dome decree
"They saved Hitler's liver!"
One line blog. I hear that they're called Twitters now.
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! --
Actually that might happen.
;).
There have been anecdotal (yeah I know) accounts of people receiving transplants and then having personality changes - food preferences or even sexual orientation.
http://www.nexusmagazine.com/articles/CellularMemories.html
Whether it's true or not or just self selection bias I don't know. But I won't be surprised if the rest of our organs actually had some influence over what we'd like to put in our stomachs or other "gut feel stuff"
Plus those stem cells do roam about. After all there's been reports of mothers having cells of their sons in various parts of their bodies - brains etc.
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
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
...A "House" episode
No, on House they would have totally misdiagnosed her medical condition, given her an ass transplant, and when that didn't help, checked her for prostate cancer, then Alzheimer's, then gave her some drug that almost kills her, then amputate both legs, then 5 minutes before the show is over, say "hey... maybe it's her liver!".
Then all is well again and she goes home and doesn't even think to sue the incompetent morons for malpractice.
That's a very common mistake, but actually "Frankenstein" was the name of the doctor who created it, not the monster himself!
Actually, it was not a mistake; I'm well aware of that.
However, the monster itself has no proper given name, so we have to improvise, and the only name that would be a near universally understood reference is 'Frankenstein'.
Besides, the monster, as a creation of Frankenstein could reasonably called 'a Frankenstein', perhaps even 'the Frankenstein' in the same way we refer to 'a Rembrandt' or 'a Van Gogh'.
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.
The Borg have arrived... resistance is futile. You will be assimilated.
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.