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This article is original by Translational Medicine Network.
Please indicate the source for reprinting.
Author: Daisy Guide: 40 years ago (1981), AIDS first entered the world's attention
.
People at the time might not have imagined that the rare disease that first appeared in only a few people became a global disease that has lasted for 40 years and has profoundly affected society
.
However, there is a group of "elite controllers" who can naturally suppress the virus without the need for antiretroviral drugs or even stem cell transplantation
.
In addition to the two previously closely watched "San Francisco patients" and "Esperanza patients", they broke the long-standing dogma that HIV infection is a lifetime change, and the new research focuses on a larger group of elite controllers , Reveals how elite controllers can eliminate HIV infection without drug treatment, and finds the difference between elite controllers and people who need life-long antiretroviral therapy
.
Some people diagnosed with HIV can eradicate the virus without antiretroviral drugs or even stem cell transplantation.
They have the ability to suppress the virus naturally and achieve a medically verifiable cure
.
Scientists call such small groups "elite controllers", reflecting their unique ability to control one of the most notorious viruses
.
In recent months, two of these patients have gained fame in the scientific literature, and each patient is mainly named after a code name: "San Francisco Patient" and "Esperanza Patient"
.
Both are women who have attracted attention in medical journals and scientific conferences for eliminating HIV from their bodies
.
In addition to these two well-known examples, the new research of the Ragon Institute in Boston focuses on a larger group of elite controllers — 58 people in total — who can also control the virus with their unique biological capabilities
.
The elite controllers were compared with 42 HIV patients receiving antiretroviral therapy.
These patients represent the vast majority of HIV-infected people in the world
.
Immunologists at the institute stated in the journal Science Translational Medicine that they have discovered a series of profound new clues that point to the abnormal ability of elite controllers to eradicate the virus
.
One reason is the strong immune response, but another research focus is that the latent viral gene sequence is stranded in the human genome
.
These sequences tend to be embedded in chromosomes in remote areas, where they are less likely to replicate, but more likely to be detected by the immune system
.
Researchers published an article titled "Signatures of immune selection in intact and defective proviruses distinguish HIV-1 elite controllers": https:// "What does it mean to be infected with HIV" opens a new window
.
It is estimated that 38 million people worldwide are infected with HIV
.
Since the HIV pandemic began 40 years ago, millions of people have died worldwide
.
Most patients take antiretroviral drugs for life to control the virus, but elite controllers can easily suppress HIV for a long time without the need for drugs
.
Although the San Francisco patient was infected with the virus in 1992, she has controlled the virus for decades
.
Her existence-and the existence of other elite controllers-broke the long-held dogma that HIV infection is a lifetime
.
These new discoveries have joined more and more studies, and may eventually lay the foundation for future drug interventions to help the vast majority of AIDS patients eliminate the virus.
The principles of these drug interventions are what scientists have learned from elite controllers, and they have achieved them.
The so-called "eliminative cure"
.
The first author of the study, Dr.
Xiaodong Lian, and his colleagues wrote: “There is increasing evidence that effective cellular immune response is feasible for durable drug-free control of HIV-1 replication
.
” Lian and the Other members of the team studied what they called the subtle “footprints” of the immune system, revealing how elite controllers can eliminate HIV infection without medication
.
Data from their experiments indicate that the human immunodeficiency virus that survives in elite controllers may face greater pressure from immune system cells
.
As a result, the virus cannot evade the powerful army of the immune system
.
The Boston research team understands that the immune system is a veritable "arsenal" with powerful antiviral activity
.
However, for most people infected with HIV, the immune response is severely impaired, which is why antiretroviral drugs are essential for survival
.
These drugs work by preventing the virus from replicating
.
Lian asserted in the report: "We have fully tracked the impact of the antiviral immune response on the complete and defective proviral sequence from elite controllers, referring to the viral state of HIV inserting its genetic material into the host cell's DNA
.
" The term “protovirus” (provirus) is not only the key to understanding what Dr.
Lian and his colleagues are studying, but also the key to understanding the persistence of HIV infection in the vast majority of people who are infected with the virus and rely on antiretroviral drugs
.
A provirus is a genetic sequence that has integrated itself into the host's DNA
.
This stealth behavior keeps the virus in a latent state-and hides in the body
.
When the host cell replicates, HIV does not replicate like a virus that spreads freely, but replicates "insidiously", which means that when the cell is stationary and does not replicate, HIV will not replicate either
.
And because the original virus sequence has penetrated into the host's DNA, the immune system will not warn of the presence of HIV during the incubation period of the original virus
.
In fact, when HIV integrates into the host's genetic machinery by copying its genome into the host's DNA, it creates a so-called virus pool
.
The team of Lian and Ragon Institute found that for elite controllers, the function of HIV infection is different.
They came to this conclusion by studying intact and defective proviruses because they all exist in the chromosomes of elite controllers.
In
.
They also found that controllers had fewer mutations in the original virus than those in need of antiretroviral therapy
.
Mutations usually evolve to help the virus evade recognition by T cells
.
Another finding reported by the Ragon team showed that the original viruses of elite controllers are more likely to be isolated in chromosomal regions, where they are not easy to replicate, but can be easily detected by the immune system "patrols"
.
These findings have helped immunologists — the Ragon Institute and immunologists around the world — highlight the difference between elite controllers and patients who require life-long antiretroviral therapy
.
Lian wrote: "Recent research has begun to reveal significant differences between elite controllers and the viral hosts that persist in most antiretroviral therapy patients
.
" All these new findings help uncover the phenomenon of elite control.
Some mysteries
.
The Ragon Institute reported in Nature last year that the San Francisco patient, an elite controller, did not have a complete sequence of the provirus in the genome
.
She is not infected with HIV at all
.
According to research by the Ragon Institute, this suggests that the immune system of San Francisco patients may have completely eliminated the HIV virus reservoir of women
.
Scientists call this rare phenomenon "elimination therapy
.
"
Two other patients, the late Timothy Brown from California, commonly known as the "Berlin patient", and Adam Castillejo from the United Kingdom, known as the "London patient", were both declared cured of AIDS
.
However, both individuals received stem cell transplantation, which allowed their immune systems to eliminate the virus
.
Rown's blood dying from cancer rebounded sharply in 2020
.
Neither the San Francisco patient nor the Esperanza patient has had a stem cell surgery that can provide patients with a new blood supply, that is, bone marrow transplantation
.
Like the San Francisco patient, the elite controller Esperanza patient from Argentina did not have a complete HIV provirus when scientists studied an astonishing 1.
19 billion blood cells and 500 million tissue-related cells
.
Last month, scientists from the Ragon Institute published a report on her case in Annals of Internal Medicine
.
https:// The researchers summarized their studies on patients with Esperanza.
All the results of the study indicate that for patients who cannot do this on their own, they may eventually There is a "feasible cure for elimination", and more research needs to be done
.
"The general consensus is that elite, drug-free control of HIV-1 replication is in most cases mediated by host immune factors.
However, elite control may not only be due to the existence of an effective antiviral immune response to suppress ongoing Virus replication," Lian and colleagues concluded
.
"We also evaluated a single provirus sequence and its corresponding chromosomal location to fully analyze the provirus pool landscape of complete and defective proviruses from elite controllers
.
These studies show that the complete proviruses in elite controllers Atypical reservoir characteristics
.
"Reference: https://medicalxpress.
com/news/2021-12-hiv-patients-unique-biology-harbor.
html Note: This article aims to introduce medical research progress and cannot be used as a reference for treatment options
.
If you need health guidance, please go to a regular hospital for treatment
.
Popular·Article Basic Research [Science Sub-Journal] Transforming artificial lungs-lizards provide amazing methods! Intestinal flora [Nature] Did you take hypoglycemic drugs ineffective? Because the intestinal microflora is in the process of cancer treatment [PNAS] Chinese medicinal materials thyme and oregano have found anti-cancer compounds for disease diagnosis and treatment [Nature Sub-Journal] This is another step towards changing the US$70 billion global diagnostic industry! Protein biosensors can measure toxic drugs for cardiovascular disease in cancer, arthritis, and organ transplant patients [JAMA Sub-Journal] Are you stressed? Stress increases the risk of cardiovascular disease! Scientific research [Cell Sub-Journal] Why do pain and anxiety speed up the breathing rate? The scientific research "Science" announced the breakthrough of 2021: a problem that has troubled biologists for 50 years was solved by AI and realized the dream of a Nobel Prize winner!
Please indicate the source for reprinting.
Author: Daisy Guide: 40 years ago (1981), AIDS first entered the world's attention
.
People at the time might not have imagined that the rare disease that first appeared in only a few people became a global disease that has lasted for 40 years and has profoundly affected society
.
However, there is a group of "elite controllers" who can naturally suppress the virus without the need for antiretroviral drugs or even stem cell transplantation
.
In addition to the two previously closely watched "San Francisco patients" and "Esperanza patients", they broke the long-standing dogma that HIV infection is a lifetime change, and the new research focuses on a larger group of elite controllers , Reveals how elite controllers can eliminate HIV infection without drug treatment, and finds the difference between elite controllers and people who need life-long antiretroviral therapy
.
Some people diagnosed with HIV can eradicate the virus without antiretroviral drugs or even stem cell transplantation.
They have the ability to suppress the virus naturally and achieve a medically verifiable cure
.
Scientists call such small groups "elite controllers", reflecting their unique ability to control one of the most notorious viruses
.
In recent months, two of these patients have gained fame in the scientific literature, and each patient is mainly named after a code name: "San Francisco Patient" and "Esperanza Patient"
.
Both are women who have attracted attention in medical journals and scientific conferences for eliminating HIV from their bodies
.
In addition to these two well-known examples, the new research of the Ragon Institute in Boston focuses on a larger group of elite controllers — 58 people in total — who can also control the virus with their unique biological capabilities
.
The elite controllers were compared with 42 HIV patients receiving antiretroviral therapy.
These patients represent the vast majority of HIV-infected people in the world
.
Immunologists at the institute stated in the journal Science Translational Medicine that they have discovered a series of profound new clues that point to the abnormal ability of elite controllers to eradicate the virus
.
One reason is the strong immune response, but another research focus is that the latent viral gene sequence is stranded in the human genome
.
These sequences tend to be embedded in chromosomes in remote areas, where they are less likely to replicate, but more likely to be detected by the immune system
.
Researchers published an article titled "Signatures of immune selection in intact and defective proviruses distinguish HIV-1 elite controllers": https:// "What does it mean to be infected with HIV" opens a new window
.
It is estimated that 38 million people worldwide are infected with HIV
.
Since the HIV pandemic began 40 years ago, millions of people have died worldwide
.
Most patients take antiretroviral drugs for life to control the virus, but elite controllers can easily suppress HIV for a long time without the need for drugs
.
Although the San Francisco patient was infected with the virus in 1992, she has controlled the virus for decades
.
Her existence-and the existence of other elite controllers-broke the long-held dogma that HIV infection is a lifetime
.
These new discoveries have joined more and more studies, and may eventually lay the foundation for future drug interventions to help the vast majority of AIDS patients eliminate the virus.
The principles of these drug interventions are what scientists have learned from elite controllers, and they have achieved them.
The so-called "eliminative cure"
.
The first author of the study, Dr.
Xiaodong Lian, and his colleagues wrote: “There is increasing evidence that effective cellular immune response is feasible for durable drug-free control of HIV-1 replication
.
” Lian and the Other members of the team studied what they called the subtle “footprints” of the immune system, revealing how elite controllers can eliminate HIV infection without medication
.
Data from their experiments indicate that the human immunodeficiency virus that survives in elite controllers may face greater pressure from immune system cells
.
As a result, the virus cannot evade the powerful army of the immune system
.
The Boston research team understands that the immune system is a veritable "arsenal" with powerful antiviral activity
.
However, for most people infected with HIV, the immune response is severely impaired, which is why antiretroviral drugs are essential for survival
.
These drugs work by preventing the virus from replicating
.
Lian asserted in the report: "We have fully tracked the impact of the antiviral immune response on the complete and defective proviral sequence from elite controllers, referring to the viral state of HIV inserting its genetic material into the host cell's DNA
.
" The term “protovirus” (provirus) is not only the key to understanding what Dr.
Lian and his colleagues are studying, but also the key to understanding the persistence of HIV infection in the vast majority of people who are infected with the virus and rely on antiretroviral drugs
.
A provirus is a genetic sequence that has integrated itself into the host's DNA
.
This stealth behavior keeps the virus in a latent state-and hides in the body
.
When the host cell replicates, HIV does not replicate like a virus that spreads freely, but replicates "insidiously", which means that when the cell is stationary and does not replicate, HIV will not replicate either
.
And because the original virus sequence has penetrated into the host's DNA, the immune system will not warn of the presence of HIV during the incubation period of the original virus
.
In fact, when HIV integrates into the host's genetic machinery by copying its genome into the host's DNA, it creates a so-called virus pool
.
The team of Lian and Ragon Institute found that for elite controllers, the function of HIV infection is different.
They came to this conclusion by studying intact and defective proviruses because they all exist in the chromosomes of elite controllers.
In
.
They also found that controllers had fewer mutations in the original virus than those in need of antiretroviral therapy
.
Mutations usually evolve to help the virus evade recognition by T cells
.
Another finding reported by the Ragon team showed that the original viruses of elite controllers are more likely to be isolated in chromosomal regions, where they are not easy to replicate, but can be easily detected by the immune system "patrols"
.
These findings have helped immunologists — the Ragon Institute and immunologists around the world — highlight the difference between elite controllers and patients who require life-long antiretroviral therapy
.
Lian wrote: "Recent research has begun to reveal significant differences between elite controllers and the viral hosts that persist in most antiretroviral therapy patients
.
" All these new findings help uncover the phenomenon of elite control.
Some mysteries
.
The Ragon Institute reported in Nature last year that the San Francisco patient, an elite controller, did not have a complete sequence of the provirus in the genome
.
She is not infected with HIV at all
.
According to research by the Ragon Institute, this suggests that the immune system of San Francisco patients may have completely eliminated the HIV virus reservoir of women
.
Scientists call this rare phenomenon "elimination therapy
.
"
Two other patients, the late Timothy Brown from California, commonly known as the "Berlin patient", and Adam Castillejo from the United Kingdom, known as the "London patient", were both declared cured of AIDS
.
However, both individuals received stem cell transplantation, which allowed their immune systems to eliminate the virus
.
Rown's blood dying from cancer rebounded sharply in 2020
.
Neither the San Francisco patient nor the Esperanza patient has had a stem cell surgery that can provide patients with a new blood supply, that is, bone marrow transplantation
.
Like the San Francisco patient, the elite controller Esperanza patient from Argentina did not have a complete HIV provirus when scientists studied an astonishing 1.
19 billion blood cells and 500 million tissue-related cells
.
Last month, scientists from the Ragon Institute published a report on her case in Annals of Internal Medicine
.
https:// The researchers summarized their studies on patients with Esperanza.
All the results of the study indicate that for patients who cannot do this on their own, they may eventually There is a "feasible cure for elimination", and more research needs to be done
.
"The general consensus is that elite, drug-free control of HIV-1 replication is in most cases mediated by host immune factors.
However, elite control may not only be due to the existence of an effective antiviral immune response to suppress ongoing Virus replication," Lian and colleagues concluded
.
"We also evaluated a single provirus sequence and its corresponding chromosomal location to fully analyze the provirus pool landscape of complete and defective proviruses from elite controllers
.
These studies show that the complete proviruses in elite controllers Atypical reservoir characteristics
.
"Reference: https://medicalxpress.
com/news/2021-12-hiv-patients-unique-biology-harbor.
html Note: This article aims to introduce medical research progress and cannot be used as a reference for treatment options
.
If you need health guidance, please go to a regular hospital for treatment
.
Popular·Article Basic Research [Science Sub-Journal] Transforming artificial lungs-lizards provide amazing methods! Intestinal flora [Nature] Did you take hypoglycemic drugs ineffective? Because the intestinal microflora is in the process of cancer treatment [PNAS] Chinese medicinal materials thyme and oregano have found anti-cancer compounds for disease diagnosis and treatment [Nature Sub-Journal] This is another step towards changing the US$70 billion global diagnostic industry! Protein biosensors can measure toxic drugs for cardiovascular disease in cancer, arthritis, and organ transplant patients [JAMA Sub-Journal] Are you stressed? Stress increases the risk of cardiovascular disease! Scientific research [Cell Sub-Journal] Why do pain and anxiety speed up the breathing rate? The scientific research "Science" announced the breakthrough of 2021: a problem that has troubled biologists for 50 years was solved by AI and realized the dream of a Nobel Prize winner!
