Gene Based Therapy for HIV

UCLA AIDS Institute researchers report they have been able to remove a specific cell receptor from human cells that is critical for binding HIV. Using a siRNA molecule called short hairpin RNA ( shRNA) to induce RNA interference in human blood stem cells, they were able to inhibit the expression of an unneeded cell receptor called CCR5. Individuals who lack this receptor are naturally resistant to HIV. Please find the article in this months- Blood, Journal of the American Society of Hematology.
Now for my thoughts. This represents a paradigm shift and a completely new strategy for treatment of HIV in currently infected individuals. Depending on how difficult this shRNA was to transplant, the treatment could potentially be of value in high risk populations as a new type of vaccine. Are there other receptors for viruses or parasites representing potential targets for this type of therapy- HBC, HCV for example. This is one of the most exciting potential therapies I have come across- eliminating the expression of a particular receptor to effect change in disease susceptibility. It's particularly interesting from the perspective of regenerative medicine, perhaps eliminating receptors that have been identified with disease in the course of replacing tissue with adult stem cells. This is very exciting and most promising. I'm certain we'll be hearing more about this type of receptor modification treatment in the next few years.

No more surgery in 2010

Having survived its multiple surgical traumas as the economy went over the cliff in the final quarter of 2008- after being T-boned by the exorbitant speculative run up in oil prices earlier that year- the economy has spent 2009 in the Surgical ICU experiencing repeated intubations, central lines, tapering with ventilator settings, MRSA and VRE infections, dialysis and multiple codes. Somehow it's survived. Unfortunately as we enter 2010 the doctors are still pressing for more surgery and drug interventions although common sense may finally have taken hold and the 'no extraordinary measures' order signed. This may be a time for tax incentives for new hiring and accelerated depreciation on purchases, but not a time to continue deeper interventions that will result in permanent iatrogenic problems. And please- we don't need more 'shovel ready' projects. Frankly I never want to hear that phrase again. I don't want to be caught up in traffic while one individual fills a pothole and 10 construction workers look on- all to artificially lower the unemployment rate. We need real increases in productivity to do battle in a world economy, not wasteful big government spending.
Indeed the current political stalemate is exactly what is needed- a standoff between the surgeons and the physicians over what should be done for the patient. Let them glare at each other and make threats as to why their actions are the only ones capable of saving the patient. As the year begins, there is increased hiring in the life sciences. Let's allow the patient to get up and take a few steps down the hallway. Perhaps they'll be discharged by the end of the year.