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July 1, 1998 · by TNN Medical Reporter Virginia
Baskerville
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The recovery of damaged heart tissue, infection in young children with
transplanted hearts, and the potential use of a kidney rejection drug to
eradicate the human immunodeficiency virus were discussed in the medical
literature in mid June.
- In contrast with long-held opinion that damaged heart tissue does not
recover, investigators at Temple University School of Medicine in Philadelphia
reported that damaged tissue showed signs of recovery in patients on a left
ventricular assist device (LVAD). The study "shows that LVAD support of
the failing human heart causes significant improvement in myocyte contractility
and ß-adrenergic responsiveness … [and] that LVAD support could be
useful as a potential means of promoting myocardial recovery," Konstantina
Dipla, PhD, and colleagues said on June 16 in Circulation
(1998;97:2316-2322). In an accompanying editorial, William H. Barry, MD, wrote
that the clinical implications of the study may be "of considerable
importance" if the improvement in myocyte function is due at least in part
to the reduction in ventricular wall stress.
- Immunosuppression following heart transplantation may prevent children
younger than 4 from developing certain antibody responses and leave them at
risk of sinopulmonary infections, according to the June 13 issue of The
Lancet (1998;351:1778-1781). British investigators Andrew R. Gennery and
colleagues found "a long-lasting association between early age at
transplantation and failure to produce antibodies to pneumococcal
polysaccharide antigen," leading to recurrent and damaging sinopulmonary
infection in some children. Older children responded normally despite receiving
long-term immunosuppression.
- OKT3, the mouse monoclonal antibody used to prevent kidney rejection, may
hold promise for eliminating HIV from the body, David Ho wrote on June 19 in
Science (1998;280:1866-1867) in a commentary exploring
possibilities for eradicating and controlling HIV. "Low-dose OKT3 should
be judiciously tested not only to define its safety profile in this context,
but also to determine the magnitude of T cell activation achievable without
prohibitive toxicity," he wrote. Ho projected that many courses of OKT3
would be required to accomplish the goal of flushing HIV-infected cells from
the body.
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