Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

SCID kids leading healthy, normal lives 25 years after 'Bubble Boy'

15.10.2009
Mention the words "bubble boy" and many will recall David Vetter, the kid with big eyes and a thick thatch of dark hair who died 25 years ago after spending almost the entire 12 years of his life in a germ-free, plastic bubble. David was born with severe combined immune deficiency, or SCID, a condition that robbed him of an immune system.

Since David's death however, researchers have refined treatment options for children with SCID, and today, as scientists at Duke University Medical Center report in The Journal of Pediatrics, most of them who undergo related donor bone marrow transplants manage to grow up, go to school, and for the most part, lead pretty normal lives.

That conclusion comes from the longest and largest study to date of children with SCID treated at a single center. Led by Rebecca H. Buckley, M.D., professor of pediatrics and immunology at Duke, researchers followed for up to 26 years 110 of the 124 surviving SCID children out of the 161 who had come to Duke for bone marrow transplants. The study involved periodic questionnaires and visits to Duke for reassessment of various aspects of their lives, including immune function, growth, behavior, nutritional needs, mental, physical, and emotional well-being and any trouble with recurrent infections.

Buckley says the data clearly show that SCID infants who receive a related donor bone marrow transplant within the first 14 weeks of life are significantly more likely to survive and have fewer problems over time than those who receive transplants later in infancy or who have already developed an infection.

Buckley says the findings underscore the need for SCID testing at birth. "If we can identify children with SCID at birth, we can save more lives. When we transplant these babies prior to the onset of infections, 94 percent survive. But if they are older or if they have already developed an infection, only 71 percent will live."

There are at least 13 subtypes of SCID, but all arise from genetic mutations that are either inherited or arise in the infant. SCID is described as a rare disorder, but Buckley points out that no one really knows how often it occurs because testing for the condition at birth is not done. "Babies frequently die from infections, but no one thinks about SCID," Buckley says, "and autopsies are rarely done any more, so the death certificate simply lists 'infection' as the cause." Buckley believes SCID may actually be as prevalent as PKU, an inherited metabolic disorder that is routinely identified and treated through newborn screening.

Buckley has been advocating for over a decade about the need for routine screening for SCID in newborns. So far, the only states to perform it are Wisconsin and Massachusetts, which are conducting pilot studies.

In the Duke study, 77 percent of the children survived and 86 percent of those were considered healthy by their parents, says Buckley. Still, growing up with a corrected immune system is not always a sunny experience. Investigators found that 58 percent of the children needed periodic antibody therapy because of inadequate B cell function, and about one-third required antibiotics. In addition, about 10 percent had some sort of developmental delay and about 20 percent had attention deficit disorder, often due to the lack of an enzyme called adenosine deaminase, one of the causes of SCID. Other conditions appearing in a minority of the patients include diarrhea, rashes and HPV infection. Some of the conditions appeared more frequently in certain SCID subtypes than others.

At least two other centers specializing in SCID have recently published long-term outcome data on their patients, but more of Buckley's patients survived and the survivors are healthier, in general, than their counterparts elsewhere. Buckley, director of Duke's Immune Deficiency Foundation Center of Excellence for Primary Immunodeficiency Diseases and a member of the Institute of Medicine, says the difference may lie in Duke's therapeutic approach.

Unlike other centers, Duke does not use chemotherapy before performing a bone marrow transplant in a SCID infant. "SCID babies do not have any T cells, so they cannot reject a graft. Chemotherapy can harm the lungs, liver and other organs and those who receive it may be sterile as adults."

Even though a tissue-matched related donor - the ideal donor - is rarely available for these infants (only 16 had them in her series), Buckley was able to use half-matched parental donors in the other 145 by using a process to strip away the donor's T cells from the marrow graft to prevent potentially fatal graft-versus-host disease. If T cells are not removed from half-matched marrow, the SCID infant would die of graft-versus-host disease—a reaction of donor T cells against the infant. Removing the T cells from the donor bone marrow also allows omission of immunosuppressive drugs after the transplant, a practice routinely used in many centers. "Giving a SCID infant drugs to suppress the immune system is counterproductive if you are trying to build a new immune system," she says.

In the future, other therapies may be possible. "Gene therapy is likely to be the best option -- if the problems encountered to date can be worked out," says Buckley. Gene therapy trials were halted in 2003 after some patients developed cancer following the therapy, but new trials that may be safer may start soon.

The research was funded by the National Institutes of Allergy, Immunology and Infectious Diseases.

Duke coauthors of the study include Mary D. Railey, M.D. and Yuliya Lokhnygina, Ph.D.

Michelle Gailiun | EurekAlert!
Further information:
http://www.duke.edu

More articles from Health and Medicine:

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

nachricht Better equipped in the fight against lung cancer
16.05.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

Im Focus: Dozens of binaries from Milky Way's globular clusters could be detectable by LISA

Next-generation gravitational wave detector in space will complement LIGO on Earth

The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...

Im Focus: Entangled atoms shine in unison

A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.

The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...

Im Focus: Computer-Designed Customized Regenerative Heart Valves

Cardiovascular tissue engineering aims to treat heart disease with prostheses that grow and regenerate. Now, researchers from the University of Zurich, the Technical University Eindhoven and the Charité Berlin have successfully implanted regenerative heart valves, designed with the aid of computer simulations, into sheep for the first time.

Producing living tissue or organs based on human cells is one of the main research fields in regenerative medicine. Tissue engineering, which involves growing...

Im Focus: Light-induced superconductivity under high pressure

A team of scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg investigated optically-induced superconductivity in the alkali-doped fulleride K3C60under high external pressures. This study allowed, on one hand, to uniquely assess the nature of the transient state as a superconducting phase. In addition, it unveiled the possibility to induce superconductivity in K3C60 at temperatures far above the -170 degrees Celsius hypothesized previously, and rather all the way to room temperature. The paper by Cantaluppi et al has been published in Nature Physics.

Unlike ordinary metals, superconductors have the unique capability of transporting electrical currents without any loss. Nowadays, their technological...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

 
Latest News

Supersonic waves may help electronics beat the heat

18.05.2018 | Power and Electrical Engineering

Keeping a Close Eye on Ice Loss

18.05.2018 | Information Technology

CrowdWater: An App for Flood Research

18.05.2018 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>