Paul Edmonds (patient)

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Paul Edmonds

Paul Edmonds, is an American recognized as the oldest individual to achieve remission from both HIV and leukemia. He is known as the "City of Hope Patient" from the hospital where he underwent treatment in Duarte, California. Diagnosed with HIV in 1988 at the age of 33, Edmonds spent over three decades living with the virus until 2018, when he faced a new challenge—a diagnosis of myelodysplastic syndrome, evolving into acute myelogenous leukemia. His journey to recovery, culminating in a stem cell transplant in 2019, at age 63, involved a donor with a rare genetic mutation (homozygous CCR5 Delta 32) resistant to most HIV strains. Edmonds ceased his HIV treatment in March 2021, with subsequent tests revealing no evidence of HIV in his body. [1] [2] [3] [4] [5] Edmonds is among the five known individuals cured of HIV through stem cell transplantation for their blood cancer, alongside the Berlin Patient, [6] [7] London Patient, [8] Düsseldorf Patient, [9] and New York Patient. [10]

See also

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Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce additional normal blood cells. It may be autologous, allogeneic or syngeneic.

<span class="mw-page-title-main">CCR5</span> Immune system protein

C-C chemokine receptor type 5, also known as CCR5 or CD195, is a protein on the surface of white blood cells that is involved in the immune system as it acts as a receptor for chemokines.

Cord blood is blood that remains in the placenta and in the attached umbilical cord after childbirth. Cord blood is collected because it contains stem cells, which can be used to treat hematopoietic and genetic disorders such as cancer.

Juvenile myelomonocytic leukemia (JMML) is a rare form of chronic leukemia that affects children, commonly those aged four and younger. The name JMML now encompasses all diagnoses formerly referred to as juvenile chronic myeloid leukemia (JCML), chronic myelomonocytic leukemia of infancy, and infantile monosomy 7 syndrome. The average age of patients at diagnosis is two (2) years old. The World Health Organization has included JMML as a subcategory of myelodysplastic and myeloproliferative disorders.

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<span class="mw-page-title-main">Timothy Ray Brown</span> First person known to have been cured of HIV/AIDS

Timothy Ray Brown was an American considered to be the first person cured of HIV/AIDS. Brown was called "The Berlin Patient" at the 2008 Conference on Retroviruses and Opportunistic Infections, where his cure was first announced, in order to preserve his anonymity. He chose to come forward in 2010. "I didn't want to be the only person cured," he said. "I wanted to do what I could to make [a cure] possible. My first step was releasing my name and image to the public."

The Berlin patient is an anonymous person from Berlin, Germany, who was described in 1998 as exhibiting prolonged "post-treatment control" of HIV viral load after HIV treatments were interrupted.

<span class="mw-page-title-main">HIV/AIDS research</span> Field of immunology research

HIV/AIDS research includes all medical research that attempts to prevent, treat, or cure HIV/AIDS, as well as fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.

Graft-versus-tumor effect (GvT) appears after allogeneic hematopoietic stem cell transplantation (HSCT). The graft contains donor T cells that can be beneficial for the recipient by eliminating residual malignant cells. GvT might develop after recognizing tumor-specific or recipient-specific alloantigens. It could lead to remission or immune control of hematologic malignancies. This effect applies in myeloma and lymphoid leukemias, lymphoma, multiple myeloma and possibly breast cancer. It is closely linked with graft-versus-host disease (GvHD), as the underlying principle of alloimmunity is the same. CD4+CD25+ regulatory T cells (Treg) can be used to suppress GvHD without loss of beneficial GvT effect. The biology of GvT response is still not fully understood but it is probable that the reaction with polymorphic minor histocompatibility antigens expressed either specifically on hematopoietic cells or more widely on a number of tissue cells or tumor-associated antigens is involved. This response is mediated largely by cytotoxic T lymphocytes (CTL) but it can be employed by natural killers as separate effectors, particularly in T-cell-depleted HLA-haploidentical HSCT.

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Since antiretroviral therapy requires a lifelong treatment regimen, research to find more permanent cures for HIV infection is currently underway. It is possible to synthesize zinc finger nucleotides with zinc finger components that selectively bind to specific portions of DNA. Conceptually, targeting and editing could focus on host cellular co-receptors for HIV or on proviral HIV DNA.

<span class="mw-page-title-main">Shimon Slavin</span> Israeli professor of medicine

Shimon Slavin is an Israeli professor of medicine. Slavin pioneered the use of immunotherapy mediated by allogeneic donor lymphocytes and innovative methods for stem cell transplantation for the cure of hematological malignancies and solid tumors, and using hematopoietic stem cells for induction of transplantation tolerance to bone marrow and donor allografts.

Chen Hu was a Chinese military physician and stem cell researcher. He served as Director of the PLA Institute of Hematopoietic Stem Cell Research and the Beijing Hematopoietic Stem Cell Therapy Laboratory. Known for his research on hematopoietic stem cell therapy for leukemia, he was awarded the State Science and Technology Progress Award in 2015 and the Ho Leung Ho Lee Prize in 2016. In 2017, he and Deng Hongkui engineered resistance to HIV in mice using CRISPR gene editing, and for the first time used the technique on an AIDS patient. He died of a sudden heart attack before their findings were published.

Deng Hongkui is a Chinese immunologist and stem cell researcher. He is a Changjiang Professor, the Boya Chair Professor, and Director of the Institute of Stem Cell Research at Peking University. He was awarded US$1.9 million by the Bill & Melinda Gates Foundation for his research on vaccines for HIV and hepatitis C. In 2017, he and Chen Hu engineered resistance to HIV in mice using CRISPR gene editing, and for the first time used the technique on an AIDS patient.

<span class="mw-page-title-main">Adam Castillejo</span> Second person known to have been cured of HIV infection

Adam Castillejo, also known as "The London Patient", is the second person known to have been cured of HIV infection. Castillejo, who is British-Venezuelan and has mixed European ancestry, lives in London. He has previously worked as a chef and is now a motivational speaker.

Christopher Hourigan is a physician-scientist known for work on measurable residual disease in acute myeloid leukemia.

References

  1. "After decades under a virus's shadow, he now lives free of HIV". Washington Post. 2023-04-03. Retrieved 2024-02-15.
  2. "Paul Edmonds, 5th person apparently cured of HIV, steps forward to share his story - ABC News". ABC News . 2024-02-15. Archived from the original on 2024-02-15. Retrieved 2024-02-15.
  3. "HIV in remission: California man Paul Edmonds 1 of 5 patients cured". USA Today . 2024-02-15. Archived from the original on 2024-02-15. Retrieved 2024-02-15.
  4. "City of Hope Research Featuring the Successful Treatment of the Oldest Patient to Achieve Remission for Leukemia and HIV Published in The New England Journal of Medicine (NEJM)". 2024-02-15. Archived from the original on 2024-02-15. Retrieved 2024-02-15.
  5. Dickter, Jana K.; Aribi, Ahmed; Cardoso, Angelo A.; Gianella, Sara; Gendzekhadze, Ketevan; Li, Shirley; Feng, Ye; Chaillon, Antoine; Laird, Gregory M.; Browning, Diana L.; Ross, Justine A.; Nanayakkara, Deepa D.; Puing, Alfredo; Stan, Rodica; Lai, Lily L. (2024-02-15). "HIV-1 Remission after Allogeneic Hematopoietic-Cell Transplantation". New England Journal of Medicine. 390 (7): 669–671. doi:10.1056/NEJMc2312556. ISSN   0028-4793. PMC  10906479. PMID   38354149.
  6. Brown, Timothy Ray (January 2015). "I Am the Berlin Patient: A Personal Reflection". AIDS Research and Human Retroviruses. 31 (1): 2–3. doi:10.1089/aid.2014.0224. ISSN   0889-2229. PMC   4287108 . PMID   25328084.
  7. Hütter, Gero; Nowak, Daniel; Mossner, Maximilian; Ganepola, Susanne; Müßig, Arne; Allers, Kristina; Schneider, Thomas; Hofmann, Jörg; Kücherer, Claudia; Blau, Olga; Blau, Igor W.; Hofmann, Wolf K.; Thiel, Eckhard (2009-02-12). "Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation". New England Journal of Medicine. 360 (7): 692–698. doi:10.1056/NEJMoa0802905. ISSN   0028-4793. PMID   19213682.
  8. Gupta, Ravindra Kumar; Peppa, Dimitra; Hill, Alison L; Gálvez, Cristina; Salgado, Maria; Pace, Matthew; McCoy, Laura E; Griffith, Sarah A; Thornhill, John; Alrubayyi, Aljawharah; Huyveneers, Laura E P; Nastouli, Eleni; Grant, Paul; Edwards, Simon G; Innes, Andrew J (May 2020). "Evidence for HIV-1 cure after CCR5Δ32/Δ32 allogeneic haemopoietic stem-cell transplantation 30 months post analytical treatment interruption: a case report". The Lancet HIV. 7 (5): e340–e347. doi:10.1016/s2352-3018(20)30069-2. ISSN   2352-3018. PMC   7606918 . PMID   32169158.
  9. Jensen, Björn-Erik Ole; Knops, Elena; Cords, Leon; Lübke, Nadine; Salgado, Maria; Busman-Sahay, Kathleen; Estes, Jacob D.; Huyveneers, Laura E. P.; Perdomo-Celis, Federico; Wittner, Melanie; Gálvez, Cristina; Mummert, Christiane; Passaes, Caroline; Eberhard, Johanna M.; Münk, Carsten (March 2023). "In-depth virological and immunological characterization of HIV-1 cure after CCR5Δ32/Δ32 allogeneic hematopoietic stem cell transplantation". Nature Medicine. 29 (3): 583–587. doi:10.1038/s41591-023-02213-x. ISSN   1546-170X. PMC   10033413 . PMID   36807684.
  10. Hsu, Jingmei; Van Besien, Koen; Glesby, Marshall J.; Pahwa, Savita; Coletti, Anne; Warshaw, Meredith G.; Petz, Lawrence D.; Moore, Theodore B.; Chen, Ya Hui; Pallikkuth, Suresh; Dhummakupt, Adit; Cortado, Ruth; Golner, Amanda; Bone, Frederic; Baldo, Maria (March 2023). "HIV-1 remission and possible cure in a woman after haplo-cord blood transplant". Cell. 186 (6): 1115–1126.e8. doi:10.1016/j.cell.2023.02.030. ISSN   0092-8674. PMC   10616809 . PMID   36931242.