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A team of surgeons at Yale Medical School has just performed a pioneering nerve transplant that -- if it works -- may someday offer hope to millions of victims of multiple sclerosis (MS) and similar diseases.

Timothy Vollmer, M.D., an associate professor of neurology at Yale, said the procedure was part of a Phase I clinical trial to find out whether it is safe to transplant nerve cells from another part of the body into a patient’s brain, whether they will survive, and if they do, whether they will begin to repair the damaged cells in the brain that cause disorders like MS.

He said it will be six months before he and the other researchers know the answers to those questions.

MS is caused when the immune system attacks nerve fibers in the brain and strips away their protective sheath of myelin, making it difficult for them to transmit messages. It is very much like stripping the insulation from an electric wire, making it short out.

On July 17 and 18, 2001 a group of Yale surgeons led by Dennis Spencer, M.D. removed nerve cells called Schwann cells from a nerve in the patient’s ankle, and implanted them in the patient’s brain. The team used MRI (magnetic resonance imagery) to guide a needle through the frontal lobe to a spot where the nerve fibers were damaged.

It was the first time the operation had ever been done.

The cells in the brain and spinal cord that are supposed to form myelin around nerve fibers are a different type, called oligodendrocytes, but in animal experiments Schwann cells were found to be able to replace them and start making myelin around damaged nerve cells.

What’s Next?
Vollmer said they’ll study the patient intensively for six months, by imaging the neurons in the area involved, and testing the nerve and muscle function. At the end of that time, the researchers will do a small biopsy to see whether the cells survived, and whether they made any myelin.

If both answers are yes, much more research would still have to be done to find out whether the procedure is not only safe and effective, but whether it might eventually help the 1.4 million people worldwide with MS and others affected by other diseases that also strip myelin from their nerve cells, such as the hereditary diseases called leukodystrophies.
 
 

drkoop.com
Date Published: 7/24/01
Date Reviewed: 7/24/01