Khalid Khizer, Padda Jaskamal, Wijeratne Fernando Ransirini, Mehta Krutagni Adwait, Almanie Abdulelah H, Al Hennawi Hussam, Padda Sandeep, Cooper Ayden Charlene, Jean-Charles Gutteridge
Internal Medicine, JC Medical Center, Orlando, USA.
Internal Medicine, AdventHealth & Orlando Health Hospital, Orlando, USA.
Cureus. 2021 Aug 27;13(8):e17507. doi: 10.7759/cureus.17507. eCollection 2021 Aug.
Human immunodeficiency virus (HIV) infection is a major global public health issue. Despite this, the only treatment available in mainstay is antiretroviral therapy. This treatment is not curative, it needs to be used lifelong, and there are many issues with compliance and side effects. In recent years, stem cell therapy has shown promising results in HIV management, and it can have a major impact on the future of HIV treatment and prevention. The idea behind anti-HIV hematopoietic stem/progenitor cell (HSPC)-directed gene therapy is to genetically engineer patient-derived (autologous) HSPC to acquire an inherent resistance to HIV infection. Multiple stem-cell-based gene therapy strategies have been suggested that may infer HIV resistance including anti-HIV gene reagents and gene combinatorial strategies giving rise to anti-HIV gene-modified HSPCs. Such stem cells can hamper HIV progression in the body by interrupting key stages of HIV proliferation: viral entry, viral integration, HIV gene expression, etc.Hematopoietic stem cells (HSCs) may also protect leukocytes from being infected. Additionally, genetically engineered HSCs have the ability to continuously produce protected immune cells by prolonged self-renewal that can attack the HIV virus. Therefore, a successful treatment strategy has the potential to control the infection at a steady state and eradicate HIV from patients. This will allow for a potential future benefit with stem cell therapy in HIV treatment.
人类免疫缺陷病毒（HIV）感染是一个重大的全球公共卫生问题。尽管如此，目前主要的治疗方法是抗逆转录病毒疗法。这种治疗方法无法治愈，需要终身使用，而且在依从性和副作用方面存在诸多问题。近年来，干细胞疗法在HIV治疗中显示出了有前景的结果，并且它可能对HIV治疗和预防的未来产生重大影响。抗HIV造血干/祖细胞（HSPC）导向基因治疗背后的理念是对患者来源的（自体）HSPC进行基因工程改造，使其获得对HIV感染的固有抗性。已经提出了多种基于干细胞的基因治疗策略，这些策略可能赋予HIV抗性，包括抗HIV基因试剂和产生抗HIV基因修饰HSPC的基因组合策略。此类干细胞可通过中断HIV增殖的关键阶段（病毒进入、病毒整合、HIV基因表达等）来阻碍体内HIV的进展。造血干细胞（HSC）也可能保护白细胞不被感染。此外，经过基因工程改造的HSC能够通过长期自我更新持续产生受保护的免疫细胞，这些免疫细胞可以攻击HIV病毒。因此，一种成功的治疗策略有可能在稳定状态下控制感染并从患者体内根除HIV。这将为未来干细胞疗法在HIV治疗中的应用带来潜在益处。
