Oh, Im not a doctor.

My response:

Patient: Are you sure youre a doctor?

Me: Oh, Im not a doctor.

If you are a regular reader of ERV, one of the Big Ideas I hope you take away from this blog is 'Viruses are not Bad Guys' (more, more, this list isnt exhaustive, Ive written about this a million times).

Yes, we tend to notice them when they make us sick. But the fact of the matter is, they are super little creatures who have been evolving on this planet for millions and millions and millions of years, and have figured out how to do fantastic things that we can take advantage of for research and treatment purposes.

Analogy: Yeah, a pack of wolves can kill you. But domesticated dogs are fantastic companions, they can help the handicapped, protect us from bombs, save us from drowning or from the rubble of an earthquake, they are super fun alarm clocks and self-protection weapons, etc.

'Wild' HIV-1 can kill you, and domesticated HIV-1 can cure your cancer.

I want that to stop being a weird concept.

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I love it when a research paper makes me laugh. This paper makes me laugh. It is AWESOME!! Continuous Quinacrine Treatment Results in the Formation of Drug-Resistant Prions Okay, heres the deal: Prions cause disease by making 'normal' proteins fold wrong. When they fold wrong, they clump up…
A lot of folks have been forwarding me this story from the New York Times--  In Girl’s Last Hope, Altered Immune Cells Beat Leukemia It is a FANTASTIC story about a little girl who had been sick from leukemia for two years, wasnt responding to conventional therapies, and her parents chose to try…
One of the reasons I started writing ERV was to help demystify viruses for the general public. To Average Joes/Janes, viruses are scary-ass little buggars-- alien creatures that make you sick, kill you overnight in horrible scary ways, and you never see them coming. I hope long-time readers of ERV…
Vpu has kinda been my accessory protein of choice here at ERV, but its not the only one with a super cool evolutionary history and super cool evolutionary implications. Another particularly fun one is Nef. This eeeeeeeety bitty HIV-1 protein (27 kDa) has a lot on its plate. Contrary to the 'expert…

You've made inroads. I for one didn't find it a weird concept at all, to the point that I was surprised that the xkcd cartoon was implying that it was.

Excellent analogy, btw.

I was reading this at my doctor's office this morning. He thought the comic was amusing; he thought the article was fantabulous.

Abbie, thank you for writing about this; I would have been otherwise uninformed about this. I hope that you'll write more on this topic to help the biologically naive (like me!) understand this whole mess.

Oh, and when you're not doing that, can you work on curing HIV/AIDS? Also, work on a cure for unwanted freckles too!

If you aren't already familiar with it, Red Dwarf featured "positive viruses" in shows in their fifth and eighth season. Identified strains included "reverse flu", "inspiration", "charisma", "sexual magnetism" and "luck".

http://reddwarf.wikia.com/wiki/Positive_Viruses

So as not to dump this comment into spam, I won't link to episodes on youtube, but they are
"Quarantine" (season 5, ep. 4) and the "Back in the Red" trilogy (season 8, ep. 1-3).

Abbie, I'm confused about the e-mail your site just sent me . . .it's pretty lame as far as a come-on is concerned. You simply do not start off with, "I'm not a doctor" as an invite to role-playing. I'm not a doctor, do you want to play not a nurse?

Well, what if I am a doctor?

It's all so confusing.

Anyway, jokes aside, I meant what I said at #2 above. I'm also a bit chagrined that this post of yours hasn't seen more commentary. This is really egg-sighting gnus eyed thank the sheeples wood wont two reed.

You know, when small pox was killing children and there were no cures for it and someone said, "let me put some cow pox or small pox in you and that will prevent your getting it" people thought that was madness. Why? Because injecting yourself with something incurable to make you healthier is not logical. Of course, now that small pox is basically eradicated and only the nutjobs think vaccines are bad, the concept is easy for people to understand.

This sort of thing will need to go the same course. People have viewed HIV as a horrible scourge so they'll need to see that it can be harnessed for our betterment, and honestly, it's totally reasonable for people to be skeptical at first, as they should be. But they also need to be willing to consider good evidence when it is offered.

So... possibly a dumb question, but I'll ask anyway.

Would this work properly if the person was already infected with HIV, or would that cause problems with the treatment? I mean, both the "wild" strain and the therapeutic strain would be trying to alter the same types of cells, right? So they would be competing, and I would think that it would therefore reduce the effectiveness of the treatment... right?

Just wanted to de-lurk to say thanks for such an interesting blog. The science is a bit over my head, but I plan to drop in and learn some things. If not for a certain controversy which I shall not here name, I might not have become familiar with ERV. No cloud without a silver lining, etc. Carry on. (re-lurking)

Maybe we should call them vogs. After all, we don't call domesticated wolves "wolves" still. It would help if they were furry and had big eyes though.

Firstly, curse you for causing me to go on an hour long youtube-Simpsons clip binge.

Secondly, that's awesome. I've heard of genetically engineering viruses to do stuff, but I never thought of it as domestication before.

Aren't virus by definition parasitic though? They have to kill cells to reproduce.

VRt: in some ways they're parasitic (hijacking your cells to copy themselves), but that doesn't have to lead to cell death, especially with any virus that has the ability to establish latency. Eg Epstein-Barr virus has an initial big round of replication following initial infection that leads to some cell death, because your immune system kicks in and kills EBV+ B cells. But after a while, the EBV quietens down (latency) and only copies itself when your cells do, and for the vast majority of the population its a harmless passenger all your life.

I think you're going to have a pretty long wait before that stops being weird to most people.

Probably the best the generation raised to be terrified of AIDS will manage is HOLYSHITTHATSFRIGGINAMAZING!! which is still good progress.

But eventually, for teh kidz learning about it, it will be "meh" (also their music will make us depressed and angry).

...and so it goes.

'Wild' HIV-1 can kill you, and domesticated HIV-1 can cure your cancer.

Justicar: you do have to be prepared for the possibility that Abbie actually DOES find the cure for HIV-1 disease, but that the cure entails giving the patient inoperable brain cancer. Shiva's a twatcuntbitch.

By sasqwatch (not verified) on 16 Aug 2011 #permalink

Frankly, this XKCD has done a better job of explaining the research than most news organizations (including NPR). (You, of course, make everthing clear.)

The NPR Shots blog did a piece that was pretty good, but clearly some people missed the point. One comment said "This is awesome. Could you use this approach to cure HIV? Nanotechnology is awesome." *Facepalm* Yes, science is hard.

By JustaTech (not verified) on 16 Aug 2011 #permalink

So, this is the flipside to Ricky Gervais' "Dr. Ben" in Louie?

"No, um, you've got AIDS. Like I thought. But don't worry, the cancer will kill the AIDS before it kills you rather slowly and painfully..."

We could like name the various critters different things and then have a celebrity virus death match where they bust open a can whoopass . . . inside someone's ass.

Abbie, suddenly your line of work scares me.

Sasqwatch, screw all of that - I just want to be the first kid on the block with a pet HIV. It'd be like being the first one with a Furby!

"This is awesome. Could you use this approach to cure HIV? Nanotechnology is awesome." *Facepalm* Yes, science is hard.

Even harder when those who know the answers (or think they do) are too busy laughing at others for admitting ignorance instead of pretending to know shit to save face, instead of explaining to someone why something does/doesn't work thereby improving ever so slightly the cumulative knowledge of the world.

We laugh at creationists for claiming to know shit they don't. And you laugh at someone for asking how something works instead of just making shit up.

Welcome to the elite atheist/skeptic/science/asshole community - where not knowing exactly the same thing as any single other person is the very reason we'll hate you.

What a dick.

Abbie, thank you for writing a blog that tries to spread information instead of pointing at laughing at all the kids who were just too stupid to go into JustaTech's precisely chosen field.

Justicar, I was going to give you HIV as a donation to your blog! This is the very one I was going to give you:

http://www.thinkgeek.com/geektoys/plush/6708/images/1128/

After that, I was going to give you herpes, gonorrhea, bad breath and anthrax. I thought E.coli was pretty cute, too, looks just like the flying spaghetti monster! I wonder if it is one of the "good" strains or a "bad" strain?

As anyone here might or might not know, chemotherapy is a brutal regime. It asks a great deal of the patient, and demands much from the family in terms of support. It pretty much reduces a patient to near immunological death. The bone marrow transplant is not a great option either. This is truly a new horizon of sophisticated medicine that cannot come soon enough.

As for viruses - I have been in love with them ever since I saw diagrams of the lunar module-like bacteria phage in texbooks as a kid in school. They are a great aid to science, offering as they do a chance to break down completely a life-form. Not just the genome, but how proteins and self-assmebly can come about.

As for god - what was he thinking? After all that work creating complex multi-cellular organisms? I'll leave behind these little starter creatures that can bring down my greatest works...he he he - look at their noses run!

Sick.

Abbie,

In concert with your past discussions I think instead of a pack of wolves a better analogy would be fire.

*shoves biscuit in Arnie's Kong toy*

I think genetic modification and your field have the greatest potential, in this century at least, for elevating the human condition.

You are to be applauded for your commitment to difficult and egregiously under compensated work.

Of course if you chuck it all to write a best selling coffee table book about the science of kissing I will be forced to hate you like poison.

By Prometheus (not verified) on 17 Aug 2011 #permalink

Of course convincing people that although viruses are responsible for a great deal of human suffering they will one day be used to benefit health would be easier if an engineered adenovirus wasnât responsible for the death of an experimental gene therapy subject.

For therapeutic viral delivery the FDA prefers RNA viruses over DNA viruses and they would really frown on a virus that can integrate. Is the idea an engineered HIV would target cd4 cells? For cancer I like activating the immune system with the humanized anti-ctla4 antibody; an inhibitor of an inhibitor is an activator. This therapy has shown some efficacy against melanoma and has also been tried to treat HIV (and anti-PD1) along with other chronic viral infections.

By Kevin Crawford (not verified) on 17 Aug 2011 #permalink

Of course convincing people that although viruses are responsible for a great deal of human suffering they will one day be used to benefit health would be easier if an engineered adenovirus wasnât responsible for the death of an experimental gene therapy subject.

For therapeutic viral delivery the FDA prefers RNA viruses over DNA viruses and they would really frown on a virus that can integrate. Is the idea an engineered HIV would target cd4 cells? For cancer I like activating the immune system with the humanized anti-ctla4 antibody; an inhibitor of an inhibitor is an activator. This therapy has shown some efficacy against melanoma and has also been tried to treat HIV (and anti-PD1) along with other chronic viral infections.

By Kevin Crawford (not verified) on 17 Aug 2011 #permalink

Justicar @16: I'm sorry, my original comment was unclear. What I was trying to say was that *beause* the reporting on this trial has been tremendously over-simplified (partly in order to reach an audience with little knowledge of a very complicated field), and in some cases just plain bad, a person who seemed interested in the report (The commenter I quoted) seemed to have mis-understood the methods used in the trail.

Now I see that my comment came across as castigating the commenter. I was simply trying to express my frustration at finding a way to convey very exciting science to a public that generally lacks the knowledge base to understand that science.

I did not correct that commenter because 1) I didn't have the time, and 2) I do not feel I understand this science well enough to explain it. (After all, I am just a tech.)

TL;DR: Sorry, that wasn't what I meant, I didn't tell that person they were wrong.

By JustaTech (not verified) on 17 Aug 2011 #permalink

Abbie: In your talk at the oklahoma freethought meeting you talked at length about the incredibly high mutation rate of (some?) viruses; how can it be ensured that domesticated viruses will not mutate quickly to a genotype that is neither helpful nor harmless, and is it in principle possible to prevent virus mutation?

regards, N.

The term 'domesticated virus' in this context means a virus in which some genes essential for replication have been removed. You can do this if you have those genes already integrated into the 'packaging' cell line - all the gene products necessary replication for are expressed but the virus particles that are produced will not have the full set of genetic information that is necessary for replication in the subsequent cells it infects.
The standard process of viral genome point mutation will not result in the domesticated virus regaining replication ability. The danger remains, however, in the case of a cell that already has a related virus infection. In that case genetic recombination, rather than point mutation, may result in the domesticated virus regaining the necessary genes to function in the wild.

A. Safety considerations:
1) Potential of replication competent lentivirus (RCL) being generated during production of the vector
2) Potential of productive infection of animals injected with a RCL in a vector preparation
3) Potential of viral vector mobilization
4) Vector / Virus shedding for animals
5) Accidental injection of vector preparation into personnel
6) The importance of the gene in the vector.

It would be incorrect to assume that you cannot cause harm with gene therapy vectors.

"Over the past decade, a variety of researchers have developed gene therapy vectors based on human immunodeficiency virus (HIV). But while HIV-derived vectors are promising, they also pose a risk. These vectors might insert the therapeutic genes into chromosomes at sites that behave like "on switches" that activate cancer-causing genes. This problem occurred previously during a study in France, triggering leukemia in children being treated with gene therapy for an inherited disease of the immune system.

Our goal is to improve the safety of HIV-based vectors so they can be used in the future to treat patients without these risks. Therefore, we are trying to engineer such vectors so they insert genes directly into well-defined sites on human chromosomes that lack cancer-causing on-switches."

http://www.fda.gov/biologicsbloodvaccines/scienceresearch/biologicsrese…

@Sigmund: Whether or not you posted that in answer to the question I directed at Abbie, thanks. I now see that the question was rather stupid and not thought through.

@Bon: What does "vector mobilisation" mean in this context?

@N, your question was not stupid in any way. If the loss of virulence is due to a point mutation then a virus can revert to full virulence with a back mutation, as you suggest. If the virus is replication incompetent because it is made with a packaging cell line this still doesnât rule revertants. In this case the mechanism would be recombination instead of a mutation.

By Kevin Crawford (not verified) on 19 Aug 2011 #permalink

@KevinCrawford: What I meant was not that the question was stupid, but rather, unnecessary. I should have worded that better. I know in principle what evolution is, which implies that I have a very basic understanding of genes. Given that, and with some thought, I could have arrived at all these conclusions and then would have been able to corroborate them with what has been said in this thread and in Abbie's posts. As such, the question was a sign of intellectual laziness, that is all. Thank you for your answer regardless.