A 40-year-old teacher who was critically ill 21/2 years ago because of the damage that AIDS had done to her brain says she is doing well today because of treatment linked to fetal-cell research at the University of Nebraska Medical Center. "If it weren't for that research, I wouldn't be alive," said the teacher, who agreed to be interviewed on the condition that she not be identified. The elementary school teacher said she was grateful for her treatment, even though she personally is opposed to abortion. She is the first person treated at the Medical Center whose condition was reversed after AIDS had done so much damage to the brain. She was described as in a "walking coma" before treatment began. She was given a standard combination of three AIDS drugs plus other drugs to knock down the inflammation of her brain, Dr. Howard Gendelman, one of her doctors, said in 1997 in a World-Herald interview describing her case. It was not disclosed at the time that some of the research that led to the addition of ibuprofen, a commonly used anti-inflammatory, to the woman's treatment was based on use of cells from aborted fetuses. The teacher said she was "so out of it" at the time that she was unaware of most things around her and did not know the basis of her treatment. The World-Herald's disclosure of the human fetal-cell research at the Medical Center two weeks ago led to an outpouring of reaction from the public and elected officials and to changes in university policy and practices regarding research based on fetal tissue. NU's Center for Neurovirology and Neurodegenerative Disorders, headed by Gendelman, does research on AIDS dementia and Alzheimer's. The AIDS research is what has helped the teacher. "I know abortion is wrong, and I do feel maybe doing research on aborted fetuses is inappropriate," said the teacher, who is Catholic. "But I know the research at the center is huge and that the fetal-tissue research is only a small part of it. "The fetal-tissue research has cast a shadow over all of the other research," said the teacher, who decided to speak out after consulting with her family and a priest. "I feel that, without revealing myself, I am a face" on this issue, she said. "I am walking, talking, breathing, leading a normal life." Now teaching second grade, she said she has made steady progress in the last two years. She continues to take a combination of three AIDS drugs. "Life is good," said the teacher, who also was interviewed by The World-Herald in 1997. She said she hopes that politicians will look at the research and not just at the fetal-tissue question. Medical Center officials said that from now on they will, whenever possible, seek sources of fetal tissue other than elective abortions. The teacher applauded that move. University and Medical Center officials also decided this week to form an outside ethics advisory panel and to put all research involving human fetal tissue through a full internal review. Gendelman has declined requests for interviews. But information was provided this week by Dr. Jenae Limoges, a physician-researcher at the neurovirology center who is familiar with the teacher's case. Limoges uses animal research to test HIV-related drugs and studies neuro regeneration by using animal cells and human cells from autopsies. Research at the center done in 1994-95 had shown that HIV infects microglia, a type of brain cell, that then secret inflammatory substances that kill neurons, the "thinking" cells of the brain, Limoges said. Ibuprofen, which is known to decrease secretions from inflammatory cells, was tried as part of the teacher's therapy. Limoges, who spends about a quarter of her time caring for patients, said some other NU Medical Center AIDS patients with dementia also have had good treatment results but none as striking as that of the teacher. Dr. Eugene Major, a researcher and laboratory chief at the National Institute of Neurological Disorders and Stroke, said the work of Gendelman and his center is on the "cutting edge" of AIDS research. Gendelman's group was among the first to report the role of an inflammatory process in damaging the brain's neurons, he said. Understanding how the neural damage occurs is critical to targeting treatments, Major said. Use of triple-drug therapy has reduced the level of virus circulating in the bloodstream of AIDS patients who undergo this treatment and improved their health, Major said. But despite this advance, there is concern about the brain continuing to harbor the AIDS-associated virus.
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