Honestly Misiu, I am not sure.. I don't manage HIV
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Posted On: 05/17/2019 11:02:21 AM
Honestly Misiu, I am not sure.. I don't manage HIV or cancer so my understanding here is incomplete. Nader does seem to suggest what LongPenny said, ie. translpanting bone marrow matches from healthy patients treated with leronlimab as donors suggesting these patients precursor cells are now also permanently altered to not express CCR 5? Then when recepient is transplanted they stay this way even after multiplying creating a new immune system that does not posess CCR 5 like a CCR%Delta mutation patient? Seems unlikely to me.
Are there any other other sources of hematopoeisis other than bone marrow in adults which can also reproduce these receptors and act as hidden reservoirs of HIV. Since if this were ture, true can we make all humans immune to CCR 5 HIV, and most cancers, and GVHD by having them take leronlimab, then removing some of their bone marrow, then irradiaiting them to destroy their immune system and then retransplanting it. It seems crazy, but if it works, many people may want to take the risk and undergo this procedure. Also is it the way leronlimab binds CCR5 compared to maraviroc that may makes it more effective--ie it is a partial antagonist only or something else? beside better side effect profile.
However your theory seems more plausible. Maybe Leronlimab lowers CCR 5 HIV to lower levels (even more undetectable essentially) than HAART, then irradiate the patient to destroy their current immune system, and transplant uninfected bone marrow from healthy donor to replenish it. The problem with this theory to me is is again are there hidden reservoirs outside the bone marrow that leronlimab would suppress even more than HAART? This would be necessary for this theory to work since BMT of healthy bone marrow that is not CCR5delta mutation cannot cure HIV currently in patients with undetectible viral loads who are on HAART.
Are there any other other sources of hematopoeisis other than bone marrow in adults which can also reproduce these receptors and act as hidden reservoirs of HIV. Since if this were ture, true can we make all humans immune to CCR 5 HIV, and most cancers, and GVHD by having them take leronlimab, then removing some of their bone marrow, then irradiaiting them to destroy their immune system and then retransplanting it. It seems crazy, but if it works, many people may want to take the risk and undergo this procedure. Also is it the way leronlimab binds CCR5 compared to maraviroc that may makes it more effective--ie it is a partial antagonist only or something else? beside better side effect profile.
However your theory seems more plausible. Maybe Leronlimab lowers CCR 5 HIV to lower levels (even more undetectable essentially) than HAART, then irradiate the patient to destroy their current immune system, and transplant uninfected bone marrow from healthy donor to replenish it. The problem with this theory to me is is again are there hidden reservoirs outside the bone marrow that leronlimab would suppress even more than HAART? This would be necessary for this theory to work since BMT of healthy bone marrow that is not CCR5delta mutation cannot cure HIV currently in patients with undetectible viral loads who are on HAART.
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