Aa
Individualized Medicine
Someone explain where I've got this wrong.
It seems like a lot of painful, baffling things about HCV treatment with Interferon alpha have a fairly simple explanation - most of us use the wrong IFN-a.
Why do 20% of those infected clear the virus on their own? They're using their bodies own version of IFN.
Why do 50% fail to clear with the lab-produced product? Bad match of product with the individual genome.
Why do even a larger % of African-Americans fail to clear? An even worse match of product to individual.
Why do many end up with auto-immune disease post-tx? Bad match.
Why do people destroy their thyroid, end up with metabolic problems, psych problems, etc, etc, etc? Bad match
Why does Consensus IFN work where other IFNs don't? Slightly better match.
Is gene sequencing cheap? No.
Would producing a different IFN for each patient be even remotely, financeally plausible? Hell no. (But that may not be necessary. Maybe as few as a dozen or two dozen 'basic models' could accomodate most patients, leaving the major cost the gene sequencing.)
No need for Alinia.
No need for PIs.
Maybe even no riba.
Will any of us ever see individualized treatment for this disease? Doubt it. Just some ideas I've had for awhile.
"Engine just ain't stong enough
to get you 'round the turn.
Lie on your back in the middle of a field
and watch you body burn."
Jorma Kaukonen 'Trial By Fire'
It seems like a lot of painful, baffling things about HCV treatment with Interferon alpha have a fairly simple explanation - most of us use the wrong IFN-a.
Why do 20% of those infected clear the virus on their own? They're using their bodies own version of IFN.
Why do 50% fail to clear with the lab-produced product? Bad match of product with the individual genome.
Why do even a larger % of African-Americans fail to clear? An even worse match of product to individual.
Why do many end up with auto-immune disease post-tx? Bad match.
Why do people destroy their thyroid, end up with metabolic problems, psych problems, etc, etc, etc? Bad match
Why does Consensus IFN work where other IFNs don't? Slightly better match.
Is gene sequencing cheap? No.
Would producing a different IFN for each patient be even remotely, financeally plausible? Hell no. (But that may not be necessary. Maybe as few as a dozen or two dozen 'basic models' could accomodate most patients, leaving the major cost the gene sequencing.)
No need for Alinia.
No need for PIs.
Maybe even no riba.
Will any of us ever see individualized treatment for this disease? Doubt it. Just some ideas I've had for awhile.
"Engine just ain't stong enough
to get you 'round the turn.
Lie on your back in the middle of a field
and watch you body burn."
Jorma Kaukonen 'Trial By Fire'
Since the subject is a very old book I have a question? This is a very old photo of 3 different bird dogs stamped on the back of the matting M.T. Sheahan. I know he did postcards around 1907-1911 but I can't find anything about even a postcard of this photo. Someone suggested maybe this is a photo that he used to create a postcard?. It is in a very old plain black frame. I can post a picture. This photot is driving me nuts along with waiting for that 1 year post tx bloodwork LOL
Denise
Denise
You are so right. My apologies. One of those "for hire" publisher situations that goes waaaaay back, it seems. At any rate, love the story but I think our copy did vanish at some point. (We still have all of Thomas though.)
Can't see the videos on the computer I'm using right now. But, I can see what I think I'm going to see later. Duh, on my part.
I actually did a little research before posting that. The authorship, from my point of view, is not really undisputedly clear. Therefore the 'unknown'. We still have a copy at home. Geez, we need a spring cleaning!
SOC is the best we have for now and it works better than previous treatments. That is why we are where we are for now. Look at the old stats for SVR with interferon monotherapy. We have come a long way. Yes, we have a long way to go, but progress is being made at a rapid pace.
As Jim said interferon doesn't attack the virus directly. But the new PIs (protease and polymerase inhibitors) do. Using the knowledge gained from what has been learned from HIV (how viruses work and reproduce) a new treatment type will be available in the next few years. PIs such as Telaprevir, which is re-enginnered from Vertex's 1994 HIV/AIDS drug, prevents viral replication by inhibiting the protease (i.e. protease inhibitor) used by the virus to replicate. Since it is a new approach, and is attacking the virus directly, we see that patients who were non-responders to SOC do respond to PI therapy.
These new meds are the results of the new biotechnology industry which is beginning to understand the underlining mechanisms that cause disease. It is a revolutionary approach to the past drug discovery processes used by big pharma.
We will soon have new medicines that for the first time will directly act on the HCV virus in the liver. This is a welcomed event for all of us in this community.
Hectorsf
As Jim said interferon doesn't attack the virus directly. But the new PIs (protease and polymerase inhibitors) do. Using the knowledge gained from what has been learned from HIV (how viruses work and reproduce) a new treatment type will be available in the next few years. PIs such as Telaprevir, which is re-enginnered from Vertex's 1994 HIV/AIDS drug, prevents viral replication by inhibiting the protease (i.e. protease inhibitor) used by the virus to replicate. Since it is a new approach, and is attacking the virus directly, we see that patients who were non-responders to SOC do respond to PI therapy.
These new meds are the results of the new biotechnology industry which is beginning to understand the underlining mechanisms that cause disease. It is a revolutionary approach to the past drug discovery processes used by big pharma.
We will soon have new medicines that for the first time will directly act on the HCV virus in the liver. This is a welcomed event for all of us in this community.
Hectorsf
Author not at all unknown. That was written by Watty Piper. (As a writer, I like to see credit given where credit is due.)
"I think I can. I think I can"
Author Unknown.'The Little Engine That Could'
By the way, didn't Jorma play piano for the Dead?
did anyone ever consider blood type maybe all bloodtype O's clear or A's or B's Or negatives or positives there are too many complex variables from what I can understand in each human body make up to consider when a doctor puts you on the meds he does not know really only going with what is popular at the time no real individual testing is done that I have heard of we are all lumped together with my limited mental capabilities from HCV it gets harder and harder to understand something that I doubt in my life time anyone will truly understand or know of an instant real cure
I asked HR if there would ever be a vaccine to cure HCV he highly doubted it as their would have to be a individual vaccine for every person with HCV not a possibility
we are all too complex once we get the virus it is an individual disease some are luckier than others and live longer or respond to treatment and go on to live happy healthy lives those percentages are more documented than the failures but the long term problems one may suffer from treatment may be worse than the virus all depends on the individual
There are definate factors we do know going in to maybe increase our chances of success with treatment but still no guarantees
So we are in the hands of the big drug companies and at their mercy they influence our doctors who guide us having a forum to discuss these decisions one has to make with their own life is invaluable not to mention the help it is to just be able to communicate ideas and thoughts to one another
will there ever be a vaccine in my opinion NO Will there ever be a cure in my life time it is debatable for me I do not see interferon and riba as a cure but a nightmare that could leave me worse off will I do it who knows I may but I do not like failure nor my percentages not much of a gambler these days
I asked HR if there would ever be a vaccine to cure HCV he highly doubted it as their would have to be a individual vaccine for every person with HCV not a possibility
we are all too complex once we get the virus it is an individual disease some are luckier than others and live longer or respond to treatment and go on to live happy healthy lives those percentages are more documented than the failures but the long term problems one may suffer from treatment may be worse than the virus all depends on the individual
There are definate factors we do know going in to maybe increase our chances of success with treatment but still no guarantees
So we are in the hands of the big drug companies and at their mercy they influence our doctors who guide us having a forum to discuss these decisions one has to make with their own life is invaluable not to mention the help it is to just be able to communicate ideas and thoughts to one another
will there ever be a vaccine in my opinion NO Will there ever be a cure in my life time it is debatable for me I do not see interferon and riba as a cure but a nightmare that could leave me worse off will I do it who knows I may but I do not like failure nor my percentages not much of a gambler these days
Ive always wondered why some SVR and some dont,and why 10% have no sides at all...only thing i can see is its all genetic...
Genetically engineering and/or a vaccine will hopefully put a complete end to HCV which the interferons are struglling with as you suggest. Unfortunatly, we may have to wait many years for these newer treatments to be developed. (See current post on week 2 test).
The problem with the interferons is that they don't really target the virus, they target the immune system which then targets the virus and unfortunately sometimes everything else in it's path potentially causing all sorts of immune issues. That's why the next generation treatments -- already here in trial -- the PIs are so promising, because they actually target the virus.
For this reason, I doubt much work will go into individualizing interferons but rather in coming up with generic and perhaps individualized anti-viral cocktails to fight the virus similar to how they fight HIV. And hopefully without interferon down the road. At least this is the thought of many leading hepatologist including Dr. E. Shiff of Miami.
If you want to read some pretty interesting stuff on individualizing tx using current interferons, check out some of the work by Dr. Gerond Lake-Bakaar (collegue of Dr. Ira Jacobsen) on "pulse therapy". Not yet ready for prime time but about as individual approach as possible since he uses an indivdual's unique viral response to time the interferon pulses as opposed to using a pre-set formula.
-- Jim
The problem with the interferons is that they don't really target the virus, they target the immune system which then targets the virus and unfortunately sometimes everything else in it's path potentially causing all sorts of immune issues. That's why the next generation treatments -- already here in trial -- the PIs are so promising, because they actually target the virus.
For this reason, I doubt much work will go into individualizing interferons but rather in coming up with generic and perhaps individualized anti-viral cocktails to fight the virus similar to how they fight HIV. And hopefully without interferon down the road. At least this is the thought of many leading hepatologist including Dr. E. Shiff of Miami.
If you want to read some pretty interesting stuff on individualizing tx using current interferons, check out some of the work by Dr. Gerond Lake-Bakaar (collegue of Dr. Ira Jacobsen) on "pulse therapy". Not yet ready for prime time but about as individual approach as possible since he uses an indivdual's unique viral response to time the interferon pulses as opposed to using a pre-set formula.
-- Jim
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