A new study in Nature Shows that the issuance of a single injection of gene therapy at birth can offer HIV serocation protection, explaining a critical window at the start of life which could reshape the fight against pediatric infections in high -risk regions.
This study is among the first to show that the first weeks of life, when the immune system is naturally more tolerant, can be the optimal window to provide gene therapies which would otherwise be rejected at older ages.
“Nearly 300 children are infected with HIV every day,” said the first author Amir Ardeshhir, an associate professor of microbiology and immunology at the National Research Center Tulane, who conducted the study alongside colleagues researchers from California National Primate Research Center. “This approach could help protect newborns in high-risk areas during the most vulnerable period of their lives. »»
In the study, non-human primates have received gene therapy that programs cells to continuously produce anti-HIV antibodies. The moment has proven to be essential to punctual treatment offering long -term protection.
Those who received treatment during their first month of life were protected against infections for at least three years without the need for a booster, which potentially means the coverage of adolescence in humans. On the other hand, people treated at 8 to 12 weeks showed a more developed and less tolerant immune system that has not accepted treatment so effectively.
This is a unique treatment which corresponds to the critical period when these mothers victims of HIV in areas limited in resources are the most likely to consult a doctor. As long as the treatment is delivered near birth, the baby’s immune system accepts it and believes it is part of itself. “”
Amir Ardèshhir, associate professor of microbiology and immunology, Tulane National Primate Research Center
More than 100,000 children acquire HIV each year, mainly by mother-child transmission after the birth of breastfeeding. Antiretroviral treatments have managed to remove the virus and limit transmission, but accession to treatment and access to doctors decrease both after childbirth, especially in areas that have limited access to health care.
To provide treatment, researchers used an adeno-associated virus (AAV), an harmless virus that can act as a cargo truck to deliver genetic code to cells. The virus was sent to muscle cells, unique in their longevity, and provided instructions to produce largely neutralizing neutralizing antibodies, or BNAB, which are able to neutralize several HIV strains.
This approach has solved a long -standing problem with the BNAB. Previous studies have revealed them effective in fighting HIV, but they required repeated perfusions, which are expensive and pose logistical challenges in low -resource contexts.
“Instead, we transform these muscle cells-which are long life-into micro-users that continue to produce these antibodies,” said Ardehir.
The newborns have shown greater tolerance and expressed high levels of BNAB, which managed to prevent infection during simulated breastfeeding and subsequent exhibitions imitating sexual transmission. Older infants and juveniles were more likely to have produced anti-drug antibodies that closed the treatment.
Researchers also found that exposing the fetuses to antibodies before birth helped older infants to accept gene therapy later, avoiding immune rejection that often occurs with age.
However, Ardeshir said that a unique injection at birth offered a more profitable and more achievable real solution, while putting less load on the mother for a follow -up visit.
Questions remain on how the results result in infants and human children, which can be less sensitive to the treatments delivered by the AAV. The study also used a virus strain of similar-human immunodeficiency, which does not reflect the variety of HIV strains.
In the event of success, however, this treatment could considerably reduce the transmission rates of the mother to the child from HIV in high -risk regions such as sub -Saharan Africa, where 90% of pediatric HIV cases can be found. It can also be adapted to protect against other infectious diseases such as malaria, which disproportionately affects young children in low -income countries.
“Nothing like it was possible to achieve 10 years ago,” said Ardeshir. “It was a huge result, and now we have all the ingredients to face HIV. »»
This research was supported by the resources of the basic subsidy of the National Primate Research Center of the National Institutes of Health, P51OD011104 and the basic subsidy of the California National Research Center, P51OD011107.
