HHC Researchers Lead Groundbreaking HIV and Genomics Study
In a Q&A, Dr. David K. Stein, talks about his gene editing research at Jacobi Medical Center and the potential to one day help HIV patients control the virus without medication.
David K. Stein, MD, Director of Adult HIV Research at HHC Jacobi Medical
Center and Associate Professor of Clinical Medicine at Albert Einstein
College of Medicine, leads a team of researchers in the Bronx who have
helped to develop a method to genetically modify T-cells within the body
to make them more resistant to HIV, the human immunodeficiency virus that
causes AIDS. The results of the study were recently published in the prestigious
New England Journal of Medicine. Dr. Stein talks to HHC TODAY about what
this means to HIV treatment and how this local research could impact advancements
in other illnesses and infections.
Q: What significant new ground does your research cover?
Dr. Stein: This is the first use of gene editing. We’ve essentially manipulated the genes of a person’s cells to be used in the treatment of HIV, the virus that causes AIDS.
Q: How did you do that?
Dr. Stein: We treated five patients with HIV from Jacobi and another seven patients from the University of Pennsylvania. We removed the T-cells from each patients’ blood and then modified the cells with genome editing technology to remove a particular protein that the HIV virus utilizes to invade and destroy the T-cells. Those T-cells were then inserted back into each patients’ bloodstream to see how they would survive.
Q: What did you discover?
Dr. Stein: The modified T-cells showed an ability to travel to areas affected by HIV and the ability to resist the virus. That’s huge! We also proved this approach can be done safely. Our initial results suggest it can be well tolerated with minimal side effects.
Q: Why focus on T-cells?
Dr. Stein: T-cells are a type of white blood cell that scans the body for cellular abnormalities and infections, and are an essential part of the body’s immune system. The HIV virus is known to target T-cells in the body. That makes people with AIDS particularly susceptible to a variety of diseases and infections that their bodies could have otherwise fought off through a normal immune reaction.
Q: How do your findings apply to the treatment of HIV?
Dr. Stein: We demonstrated that the cells that had their genes affected were able to survive and not be affected by the virus. No other non-drug treatment has shown this. The method used here could potentially lead to HIV patients becoming less reliant on medication in the future, or even developing higher levels of resistance to the virus.
Q: Could this become the standard of care for HIV patients?
Dr. Stein: It is too early to say. But we have established a significant amount of ground work that can support other studies. If we continue to show promise, we may one day be able to treat patients by modifying their genes and without the need for costly drug therapies.
Q: How can this research help advance the treatment of other illnesses and infections?
Dr. Stein: Similar technology could be used in the future to target problematic genes and cells to reduce disease for a variety of other illnesses and infections as well.
Q: How did you get into the field of HIV research?
Dr. Stein: I was initially interested in research on fungal infections. But when I came to HHC, other physicians in our group were doing HIV research. They allowed me to help in their studies and I got hooked. The breakthroughs in my early years here inspired me.
Q: What other HIV research are you working on at Jacobi?
Dr. Stein: At any given time we are running a dozen or more different trials in the HIV clinic. Some employ new drug therapies, and some are radically different in their approach to treating patients. Many folks don’t know that Jacobi has an extensive history of pioneering HIV/AIDS research and treatments. We had the first pediatric day-care for AIDS patients. We also engineered the first wide-scale rapid oral HIV testing of emergency room patients, which became the standard across HHC.
Q: Do you think science can continue the pace of the progress it’s made against the HIV virus in the last several decades?
Dr. Stein: I am very optimistic that further progress can be made. I believe we will one day have a cure if we continue to work for one. And you never know, that cure could come out of one of our own research projects at HHC!