A Bone Marrow Transplant to Treat a Leukemia Patient Also Gives Him Virus-Resistant Cells; Many Thanks

The startling case of an AIDS patient who underwent a bone marrow transplant to treat leukemia is stirring new hope that gene-therapy strategies on the far edges of AIDS research might someday cure the disease.

The patient, a 42-year-old American living in Berlin, is still recovering from his leukemia therapy, but he appears to have won his battle with AIDS. Doctors have not been able to detect the virus in his blood for more than 600 days, despite his having ceased all conventional AIDS medication. Normally when a patient stops taking AIDS drugs, the virus stampedes through the body within weeks, or days.

was very surprised," said the doctor, Gero Hütter.

The breakthrough appears to be that Dr. Hütter, a soft-spoken hematologist who isn't an AIDS specialist, deliberately replaced the patient's bone marrow cells with those from a donor who has a naturally occurring genetic mutation that renders his cells immune to almost all strains of HIV, the virus that causes AIDS.

The development suggests a potential new therapeutic avenue and comes as the search for a cure has adopted new urgency. Many fear that current AIDS drugs aren't sustainable. Known as antiretrovirals, the medications prevent the virus from replicating but must be taken every day for life and are expensive for poor countries where the disease runs rampant. Last year, AIDS killed two million people; 2.7 million more contracted the virus, so treatment costs will keep ballooning.

While cautioning that the Berlin case could be a fluke, David Baltimore, who won a Nobel prize for his research on tumor viruses, deemed it "a very good sign" and a virtual "proof of principle" for gene-therapy approaches. Dr. Baltimore and his colleague, University of California at Los Angeles researcher Irvin Chen, have developed a gene therapy strategy against HIV that works in a similar way to the Berlin case. Drs. Baltimore and Chen have formed a private company to develop the therapy.

Back in 1996, when "cocktails" of antiretroviral drugs were proved effective, some researchers proposed that all cells harboring HIV might eventually die off, leading to eradication of HIV from the body -- in short, a cure. Those hopes foundered on the discovery that HIV, which integrates itself into a patient's own DNA, hides in so-called "sanctuary cells," where it lies dormant yet remains capable of reigniting an infection.

But that same year, researchers discovered that some gay men astonishingly remained uninfected despite engaging in very risky sex with as many as hundreds of partners. These men had inherited a mutation from both their parents that made them virtually immune to HIV.

The mutation prevents a molecule called CCR5 from appearing on the surface of cells. CCR5 acts as a kind of door for the virus. Since most HIV strains must bind to CCR5 to enter cells, the mutation bars the virus from entering. A new AIDS drug, Selzentry, made by Pfizer Inc., doesn't attack HIV itself but works by blocking CCR5.

About 1% of Europeans, and even more in northern Europe, inherit the CCR5 mutation from both parents. People of African, Asian and South American descent almost never carry it.

Dr. Hütter, 39, remembered this research when his American leukemia patient failed first-line chemotherapy in 2006. He was treating the patient at Berlin's Charité Medical University, the same institution where German physician Robert Koch performed some of his groundbreaking research on infectious diseases in the 19th century. Dr. Hütter scoured research on CCR5 and consulted with his superiors.

Finally, he recommended standard second-line treatment: a bone marrow transplant -- but from a donor who had inherited the CCR5 mutation from both parents. Bone marrow is where immune-system cells are generated, so transplanting mutant bone-marrow cells would render the patient immune to HIV into perpetuity, at least in theory.

There were a total of 80 compatible blood donors living in Germany. Luckily, on the 61st sample he tested, Dr. Hütter's colleague Daniel Nowak found one with the mutation from both parents.

To prepare for the transplant, Dr. Hütter first administered a standard regimen of powerful drugs and radiation to kill the patient's own bone marrow cells and many immune-system cells. This procedure, lethal to many cells that harbor HIV, may have helped the treatment succeed.

The transplant specialists ordered the patient to stop taking his AIDS drugs when they transfused the donor cells, because they feared the powerful drugs might undermine the cells' ability to survive in their new host. They planned to resume the drugs once HIV re-emerged in the blood.

But it never did. Nearly two years later, standard tests haven't detected virus in his blood, or in the brain and rectal tissues where it often hides.

The case was presented to scientists earlier this year at the Conference on Retroviruses and Opportunistic Infections. In September, the nonprofit Foundation for AIDS Research, or amFAR, convened a small scientific meeting on the case. Most researchers there believed some HIV still lurks in the patient but that it can't ignite a raging infection, most likely because its target cells are invulnerable mutants. The scientists agreed that the patient is "functionally cured."

Caveats are legion. If enough time passes, the extraordinarily protean HIV might evolve to overcome the mutant cells' invulnerability. Blocking CCR5 might have side effects: A study suggests that people with the mutation are more likely to die from West Nile virus. Most worrisome: The transplant treatment itself, given only to late-stage cancer patients, kills up to 30% of patients. While scientists are drawing up research protocols to try this approach on other leukemia and lymphoma patients, they know it will never be widely used to treat AIDS because of the mortality risk.

There is a potentially safer alternative: Re-engineering a patient's own cells through gene therapy. Due to some disastrous failures, gene therapy now "has a bad name," says Dr. Baltimore. In 1999, an 18-year-old patient died in a gene therapy trial. Even one of gene therapy's greatest successes -- curing children of the inherited "bubble boy" disease -- came at the high price of causing some patients to develop leukemia.

Gene therapy also faces daunting technical challenges. For example, the therapeutic genes are carried to cells by re-engineered viruses, and they must be made perfectly safe. Also, most gene therapy currently works by removing cells, genetically modifying them out of the body, then transfusing them back in -- a complicated procedure that would prove too expensive for the developing world. Dr. Baltimore and others are working on therapeutic viruses they could inject into a patient as easily as a flu vaccine. But, he says, "we're a long way from that."

Expecting that gene therapy will eventually play a major role in medicine, several research groups are testing different approaches for AIDS. At City of Hope cancer center in Duarte, Calif., John Rossi and colleagues actually use HIV itself, genetically engineered to be harmless, to deliver to patients' white blood cells three genes: one that inactivates CCR5 and two others that disable HIV. He has already completed the procedure on four patients and may perform it on another.

One big hurdle: doctors can't yet genetically modify all target cells. In theory, HIV would kill off the susceptible ones and, a victim of its own grim success, be left only with the genetically engineered cells that it can't infect. But so far that's just theory. All Dr. Rossi's patients remain on standard AIDS drugs, so it isn't yet known what would happen if they stopped taking them.

In 1989, Dr. Rossi had a case eerily similar to the one in Berlin. A 41-year-old patient with AIDS and lymphoma underwent radiation and drug therapy to ablate his bone marrow and received new cells from a donor. It is not known if those cells had the protective CCR5 mutation, because its relation to HIV hadn't been discovered yet. But after the transplant, HIV disappeared from the patient's blood. The patient died of his cancer 47 days after the procedure. Autopsy tests from eight organs and the tumor revealed no HIV.

POC tour!

last week we have our tour at the phil. orthopedic center located at quezon city.all of us in the group were excited and very eager to see the conditions of all the patients, most of them are for long term therapy and rehabilitation. as we enter in the nursing education building i was shocked because of a huge number of nursing students were waiting for their clinical instructor. it was a very special day for our mentor bacause it's her birthday and now on her golden year. as we go on to the different areas of the hospital my heart was touched by the conditon of many children with potts disease the most common cause of their stay in the hospital. many of them have their traction, cast and braces. i was really emphatic during that time. another area in the hospital was for the male ward mostly of them are also bedridden because of injuries inflicted to them such as vehicular accidents, fall, gun shots etc. our tour last only for about 4hours but poc will be one the hospital that i will never forget and will leave a memory for a lifetime!

Bisphenol-A it is really harmful?

Polycarbonate, a type of plastic, meets at least two of these three criteria for harm. It contains an ingredient, Bisphenol-A (BPA), which has garnered a lot of attention lately because of its use in baby bottles and its potential to damage developing humans and animals. Studies have found that BPA can migrate out of the plastic into foods and beverages, and then into you.


The bonds that hold BPA molecules together in a polycarbonate can disintegrate over time, when heated, or exposed to acidic or basic substances. Because of this, the BPA is never really safely locked away.* It’s that freewheeling, loose BPA that attaches to the food or beverage in a polycarbonate container and then leaches into your body.


In the body, BPA acts as an endocrine disruptor—masquerading as a sex hormone. This is a particular problem for sexual development, which is dependent on precise hormone signaling: Grow now! Develop hair! Don’t have breasts—you’re a boy! Studies have shown that BPA can harm developing rodents, even in small amounts. The question is whether it can harm humans in the amounts to which we are regularly exposed.


This spring, the Canadian health authority decided to try to ban baby bottles made from polycarbonate plastic. Even though the authorities concluded that the amount of BPA getting into people is less than a safe level, Canadian health officials worry that even very low levels of BPA could harm developing infants and children. Tony Clement, Canada’s Minister of Health said in his speech, “it is better to be safe than sorry.”


The United States Food and Drug Administration says that for now, BPA is safe for humans of all sizes and ages because more than three times less BPA gets into us than the level the government deems safe (0.05 mg per kilogram body weight per day**). But in a review published in 2007 in the journal Reproductive Toxicology, scientists argue that there have been more than 40 studies showing BPA causes harm in doses lower than the human safe dose.

Meanwhile, after reviewing over 200 individual BPA studies, a National Institutes of Health toxicology panel concluded that there is “some concern” that the amount of BPA coming out of polycarbonate baby bottles or the lining of cans can harm developing humans. “Some concern,” the report explains, means halfway between “negligible concern” and “serious concern.” It’s not definitely deadly, but it’s not safe either.

To sum up, people are not exposed to BPA at the level that the United States government says is dangerous. But many doubt the accuracy of that “safe level.” If knowing there’s even a small bit of BPA in polycarbonate bottles is enough to put you off, it may be time for you to switch to another food/beverage storage system.

Hormones released during sexual intercourse!

Then there is the biochemistry of the orgasm itself. Research shows that during ejaculation, men release a cocktail of brain chemicals, including norepinephrine, serotonin, oxytocin, vasopressin, nitric oxide (NO), and the hormone prolactin. The release of prolactin is linked to the feeling of sexual satisfaction, and it also mediates the “recovery time” that men are well aware of—the time a guy must wait before “giving it another go.” Studies have also shown that men deficient in prolactin have faster recovery times.

Prolactin levels are naturally higher during sleep, and animals injected with the chemical become tired immediately. This suggests a strong link between prolactin and sleep, so it’s likely that the hormone’s release during orgasm causes men to feel sleepy.

(Side note: prolactin also explains why men are sleepier after intercourse than after masturbation. For unknown reasons, intercourse orgasms release four times more prolactin than masturbatory orgasms, according to a recent study.)

Oxytocin and vasopressin, two other chemicals released during orgasm, are also associated with sleep. Their release frequently accompanies that of melatonin, the primary hormone that regulates our body clocks. Oxytocin is also thought to reduce stress levels, which again could lead to relaxation and sleepiness.

What about the evolutionary reasons for post-sex sleepiness? This is trickier to explain. Evolutionarily speaking, a man’s primary goal is to produce as many offspring as possible, and sleeping doesn’t exactly help in his quest. But perhaps since he cannot immediately run off with another woman anyway—damn that recovery time!—re-energizing himself via sleep may be the best use of his time.

And although there is conflicting information as to whether women feel sleepy after sex, a woman often falls asleep with the man anyway (or uses it for some key cuddling time), which is good news for him: it means she is not off finding another mate. When the man wakes up and she’s still there, he just might be ready to go again.

It’s also possible that sleepiness is just a “side effect” associated with a more evolutionarily important reason for the release of oxytocin and vasopressin. In addition to being associated with sleep, both chemicals are also intimately involved in what is called “pair bonding,” the social attachment human mates commonly share. The release of these brain chemicals during orgasm heightens feelings of bonding and trust between sexual partners, which may partially explain the link between sex and emotional attachment. This bond is favorable should the couple have a baby, as cooperative child rearing maximizes the young one’s chances for survival.

The bottom line is this: there are many potential biochemical and evolutionary reasons for post-sex sleepiness, some direct and some indirect—but no one has yet pinpointed the exact causes. One thing, however, is certain: we females better get used to it, because it doesn’t look likely to change anytime soon.

I will leave frustrated American women with one final thought: if you are upset at the ubiquity of the post-sex snoring phenomenon, remember that things could be a lot worse. A recent survey of 10,000 English men revealed that 48 percent actually fall asleep during sex.

Talk about coitus interruptus!

Congratulations to New Nursing Board Exam passers

After four years of hardship and training in the nursing schools a new batch of board passers was released by the phil regulatory commission last 2 weeks ago. many was shocked because of the result i would like to emphasize our 4 topnotchers who make it through the way of success, again they made our school one of the best performing nursing schools in our country, this is a living proof that it is not on the school but it is on the student wether he can make it. again i would like to congratulate Batch 2008 nurses. and im hoping that i could make it also next year!

7 Habits of Highly Defective Dating!

1. Dating tends to skip the friendship stage of a relationship.
C.S. Lewis describes friendship as two people walking side by side toward a common goal. Their mutual interest brings them together. In dating romantic attraction is often the cornerstone of the relationship. The promise of dating is “I’m attracted to you; therefore, let’s get to know each other”. The premise of friendship, on the other hand is “We’re interested in the same things; lets enjoy these common interest together.” If romantic attraction forms after developing friendship, it’s an added bonus. Intimacy without commitment is defrauding. Intimacy without friendship is superficial. A relationship based solely on physical attraction and romantic feelings will last only as long as the feelings last.

2. Dating often mistakes a physical relationship for love.
Focusing on the physical is plainly sinful. God demands sexual purity. And he does this because he is holy. He also does it for our own good. Physical involvement can distort two people’s perspective of each other and lead to unwise choices. God also knows well carry the memories of our past physical involvements into marriage. He doesn’t want us to live with guilt and regret. Physical involvement can make two people feel close. But if many people really examined the focus of their dating relationships, they’d probably discover that all they have in common is lust.

3. Dating often isolates a couple from other vital relationship.
Dating is about two people focusing on each other. Unfortunately, in most cases the rest of the world fades into the background. If you’ve ever felt like a third wheel when hanging out with two friends who are dating each other, you know how true this is. In Proverb 15:22 we read “Plans fail for lack of counsel, but with many advisers they succeed.” If we make our decision about life based solely on the influence of one relationship, we’ll probably make poor judgments. The exclusive attention so often expected in dating relationship has a tendency to isolate them from the friends who love them most, family members who know them best, and sadly even God, whose will is far more important than any romantic interest.

4. Dating can distract young adults from their primary responsibility of preparing for the future.
One of the saddest tendencies of dating is to distract young adults from developing their God given abilities and skills. Instead of serving in their local church, instead of equipping themselves with the character, education, and experience necessary to succeed in life, many allow themselves to be consumed by the present needs that dating emphasizes. Dating may help you practice a good boyfriend or girlfriend but are these skills we need for marriage? Even if you’re going out with the person you will one day marry, a preoccupation with being the perfect boyfriend or girlfriend now can actually hinder you from being the future husband or wife that person will one day need.



5. Dating can cause discontentment with God’s gift of singleness.
Recreational dating causes dissatisfaction because it encourages a wrong use of this freedom. God has placed a desire in most men and women for marriage. Although we don’t sin when we look forward to marriage we might be guilty of poor stewardship of our singleness when we allow a desire for something God obviously doesn’t have for us yet to rub our ability to enjoy and appreciate what he has given.

6. Dating can create an artificial environment for evaluating another person’s character.
Dating creates an artificial environment for two people to interact in. as a result each person can easily convey an equally artificial image.

7. Dating often become an end itself.
For the man or woman who is ready to get married, the dating scene and the habits it encourages aren’t helpful. It can seem like you’re making something happen but just be getting into holding pattern of one short-term relationship after another.


From the book I Kissed Dating Goodbye of Joshua Harris.