New Research Into Healing Nerve Damage

Today's article from neurologywestla.com (see link below) is another interesting piece of research that is years away from being applicable to patients but is nevertheless evidence of the new impetus in nerve damage research that can only be good for the future. It talks about the discovery of a protein (Retinoblastoma) which is present in nerve cells. This protein normally acts as a 'stopper' to nerve growth. It's thought that by inactivating this protein in some way, damaged nerves will be able to regenerate and grow again. That of course is a very simplistic summary and the research is still at an early stage where it's being carried out on animals. However, most people will get the idea and be able to follow the logic. Now we have to wait ten years until it's proved to be a successful process in humans.

Peripheral Neuropathy And Injuries Causing Nerve Damage May Be Healed With New Technique
New Technique for Peripheral Neuropathy
By Susan Scutti | Apr 22, 2014
Posted by npatel on May 1, 2014 

Canadian scientists discovered a crucial molecule, a protein called Retinoblastoma (Rb), that directly regulates nerve cell growth and may be helpful someday in healing peripheral neuropathy.

Many people with diabetes experience neuropathy, a painful form of nerve damage that cannot always be treated effectively with drugs. In their research of the condition, scientists at University of Calgary’s Hotchkiss Brain Institute discovered a mechanism that promotes growth in damaged nerve cells. In fact, the team of researchers discovered a crucial molecule that directly regulates nerve cell growth. “We made the surprising discovery that a protein called Retinoblastoma (Rb) is present in adult neurons,” said Dr. Doug Zochodne, a professor in the Department of Clinical Neurosciences, and author of the study. “This protein appears to normally act as a brake — preventing nerve growth. What we have shown is that by inactivating Rb, we can release the brake and coax nerves to grow much faster.”

Neuropathy, which creates a tingling or burning sensation, is a direct result of nerve damage. Peripheral nerves, which connect the brain and spinal cord to the body, help us feel sensation and also enable movement. Peripheral neuropathy, which causes numbness and pain in your hands and feet, may be the result of any number of factors, including injuries, infections, and even exposure to toxins. Cancer patients, for instance, experience peripheral neuropathy during or following toxic chemotherapy. About 60 to 70 percent of people with diabetes also encounter this condition, with the risk rising with age and duration of their illness. All too common, diabetic neuropathy is more prevalent than multiple sclerosis, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS) combined. Although for some people, the symptoms of peripheral neuropathy may improve over time, this is not the case for all and for this reason, researchers would like to understand how exactly it works.

Based on his understanding of cancer, Zochodne and his research team decided to look for Retinoblastoma in nerve cells. “We know that cancer is characterized by excessive cell growth and we also know that Rb is often functioning abnormally in cancer,” explained Zochodne in a press release. “If cancer is able to release this brake and increase cell growth, we thought we’d try to mimic this same action in nerve cells and encourage growth where we want it,” he said.

In their experiments using cells and animals, the researchers shut down Retinoblastoma in the peripheral nervous system for a short span of time and carefully observed the results. As hypothesized, they saw new growth without any apparent negative effects. Now, they are wanting to advance their experiments to the point of working with humans and in so doing, they hope their work may lead to safe treatments for patients suffering from neuropathy and other forms of nerve damage.

Source: Christie KJ, Krishnan A, Zochodne D, et al. Enhancing adult nerve regeneration through the knockdown of retinoblastoma protein. Nature Communications. 2014.

http://neurologywestla.com/peripheral-neuropathy-and-injuries-causing-nerve-damage-may-be-healed-with-new-technique/

Future Neuropathy Research

Today's post from archneur.jamanetwork.com (see link below), really requires you to follow the link to the original if you want to know more. It discusses the future in the research and development of neuropathy treatments, with special reference to gene cell therapy and the better understanding of the functions of Schwann cell and nerve cell interactions. It's a little complex for the average reader maybe but still gives you a good insight into how things are progressing. Perhaps really effective treatments for nerve damage are not as far away as we thought and we should be thankful that scientists and researchers are now beginning to pay serious attention to nerve problems at a very detailed level.

The Future of Research in Neuropathy ONLINE FIRST 
Takayuki Itoh, MD, PhD1; David Pleasure, MD1,2 JAMA Neurol. Published online November 03, 2014

This viewpoint focuses on the technological advances in nucleotide sequencing and genetic engineering and on our deepening understanding of the molecular processes underlying Schwann cell–axon interactions and axonal degeneration.

The future isn’t what it used to be. How will the technological advances in the analysis and modulation of gene expression, in combination with a deepening understanding of the biology of the peripheral nervous system, alter the diagnosis and management of patients with peripheral neuropathies? This review focuses on the technological advances in nucleotide sequencing and genetic engineering and on our deepening understanding of the molecular processes underlying Schwann cell–axon interactions and axonal degeneration.

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http://archneur.jamanetwork.com/article.aspx?articleID=1919425&utm_source=dlvr.it&utm_medium=twitter&utm_campaign=feed_posts

Feel Like Joining A Neuropathy Clinical Research Study

Today's post from neuropathy.org (see link below) is a call for people who may be interested in taking part in clinical trials and research studies. Without these trials and studies, new treatments and drugs can't be developed and brought onto the market more quickly for neuropathy patients. One of the chief complaints of people living with neuropathy is the amount of time it takes for any promising new development to reach the doctors' prescription pads. One of the ways we can all help to speed up that process is by taking part in studies relevant to our own situation. Maybe something mentioned below will appeal to you, otherwise you could ask your neurologist if there are other appropriate studies going on in your area. It's a commitment certainly but one which may benefit many people in the long run.

Could You Benefit From Potential Treatments Accessible Through Clinical Research Studies? neuropathy.org

You can play an active role in bringing new therapies to the community by participating in clinical research studies. Clinical trials are studies in which researchers test new drugs for safety and effectiveness. Participating in clinical studies gives you a chance to advance and accelerate research, access emerging therapies that are being studied, and help bring new therapies to the community. Talk to your doctor to learn more about clinical trials.
When a pharmaceutical company develops a new drug, it sponsors a clinical trial to test the drug in people with the disease for which it was intended. The process is regulated by the Food and Drug Administration (FDA). The FDA’s approval is required before a drug is allowed to be used. Natural products such as vitamins or food supplements, which are commonly sold in health food stores as alternative medicines, are not regulated by the FDA, and are not required to undergo clinical trials.

Listed below are some neuropathy clinical trials that are currently looking for participants. For a more comprehensive list of neuropathy clinical trials and to locate clinical trials in your vicinity, visit www.clinicaltrials.gov and search using the words "neuropathy" and the name of the city you live in (eg neuropathy, New York City).


Tetrodotoxin (TTX) for Pain Resulting from Chemotherapy Treatment
Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting side effect of many chemotherapeutic agents, including vincristine, paclitaxel, cisplatin, oxaliplatin, bortezomib, and ixabepilone.Chemotherapy-induced peripheral neuropathy occurs in greater than 40% of patients. For this segment of our community, neuropathy and neuropathic pain is the “price of survival” that severely compromises quality of life and daily function. To improve the peripheral neuropathy, the chemotherapy dosing is often either decreased or discontinued potentially affecting tumor responsiveness, prognosis, and survival. There is an unmet medical need for treatment of cancer patients with chemotherapy-induced neuropathic pain (CINP). This clinical research study aims to investigate the efficacy and safety of multiple dose levels of tetrodotoxin (TTX) versus placebo in moderate to severe neuropathic pain caused by chemotherapy. Read more...

Hematopoietic Stem Cell Transplantation in Chronic Inflammatory Demyelinating Polyneuropathy
Chronic inflammatory demyelinating polyneuropathy is disease believed to be due to immune cells, cells which normally protect the body, but are now attacking the nerves in the body. As a result, the affected nerves fail to respond, or respond only weakly, to stimuli causing numbing, tingling, pain, and progressive muscle weakness. The likelihood of progression of the disease is high. This study is designed to examine whether treating patients with high dose cyclophosphamide (a drug which reduces the function of the immune system) and ATG (a protein that kills the immune cells that are thought to be causing your disease), followed by return of the previously collected blood stem cells will stop the progression of CIDP. Stem cells are undeveloped cells that have the capacity to grow into mature blood cells, which normally circulate in the blood stream. The purpose of the high dose cyclophosphamide and ATG is to destroy the cells in the immune system. The purpose of the stem cell infusion is to evaluate whether this treatment will produce a normal immune system that will no longer attack the body. Read more...

Safety and Efficacy of CBX129801 in Patients With Type 1 Diabetes
Currently available treatments for patients with type 1 diabetes focus on replacing insulin, but not C-peptide. In healthy individuals, C-peptide and insulin are co-secreted in equal amounts into circulation.  But in patients with type 1 and some patients with type 2 diabetes, destruction of the beta cells results in deficiency of both insulin and C-peptide. The purpose of this clinical research study is to determine the beneficial effects of CBX129801 (Ersatta™) -- a long-acting synthetic human C-peptide -- following weekly subcutaneous administration for 12 months in type 1 diabetes mellitus patients with mild to moderate diabetic peripheral neuropathy. Read more...

Efficacy and Saftety of ISIS TTR Therapy for Familial Amyloid Polyneuropathy
Familial Amyloid Polyneuropathy is a rare, hereditary disease caused by mutations in the transthyretin (TTR) protein. TTR is made by the liver and secreted into the blood. TTR mutations cause it to misfold and deposit in multiple organs causing FAP. When the nervous system is involved, patients present with progressive sensorimotor and autonomic neuropathy. The purpose of this clinical research study is to determine if ISIS TTR Rx can slow or stop the nerve damage caused by TTR deposits. This study will enroll late Stage 1 and early Stage 2 FAP patients. Patients will receive either ISIS TTR Rx or placebo for 65 weeks. Read more...

A Study Assessing the Safety and Tolerability of Fingolimod as an Oral Therapy for CIDP 
This clinical research study seeks to evaluate the safety and tolerability of fingolimod (FTY720) 0.5 mg -- administered orally once daily -- in the treatment of people with chronic inflammatory demyelinating neuropathy (CIDP). Fingolimod is a sphingosine 1-phosphate receptor (S1PR) modulator. It interacts with S1P receptors located on lymphocytes (a type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue). This interaction causes the lymphocytes to sequester in the lymph nodes, thus preventing them from moving towards, and damaging, targeted parts of the body. In experimental autoimmune neuritis, a T cell-mediated model of CIDP, fingolimod completely suppressed partial paralysis affecting the lower limbs (or paraparesis) and significantly decreased T-cell, B-cell, and macrophage infiltration and demyelination of sciatic nerves. Read more...

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Treatment With Subcutaneous Immunoglobulin (IgPro20)
This clinical study seeks to assess subcutaneous immunoglobulin (IgPro20) for chronic inflammatory demyelinating polyneuropathy (CIDP). Patients on intravenous immunoglobulin (IVIG) maintenance therapy enrolled in this clinical research study will be assessed during three separate study periods. Patients first undergo a period of up to 12 weeks to test for on-going need of immunoglobulin therapy. Those patients will be administered IVIG during an IVIG re-stabilization period. Patients with improved and maintained adjusted inflammatory neuropathy cause and treatment scale (INCAT) in the IVIG Re-stabilization period will continue to the subcutaneous (SC) treatment period of the study. Patients entering the 24 week SC treatment period will be randomized to receive weekly infusions of 1 of 2 IgPro20 doses (0.2 or 0.4 g/kg body weight) or placebo. Read more...

Genetic and Physical Study of Childhood Nerve and Muscle Disorders
The National Institute of Neurological Disorders and Stroke (NINDS) is conducting a clinical research study aimed at diagnosing patients with neuromuscular and neurogenetic disorders with congenital or pediatric onset and to studying the natural history and mechanism of these disorders. Some nerve and muscle disorders that start early in life (before age 25), like some forms of muscular dystrophy, can run in families. However, the genetic causes of these disorders are not known. Also, doctors do not fully understand how symptoms of these disorders change over time. Researchers want to learn more about genetic nerve and muscle disorders that start in childhood by studying affected people and their family members, as well as healthy volunteers. Read more…

Efficacy and Safety of ALN-TTR02 for the Treatment of Transthyretin (TTR)-Mediated Amyloidosis
The purpose of this clinical research study is to evaluate the efficacy and safety of the investigational drug patisiran (ALN-TTR02) in patients with transthyretin (TTR) mediated amyloidosis (also known as Familial Amyloidotic Polyneuropathy or FAP). FAP is an inherited, progressively debilitating, and fatal disease caused by mutations in the TTR gene. TTR protein is produced primarily in the liver and is normally a carrier for retinol binding protein. Mutations in TTR cause abnormal amyloid proteins to accumulate and damage body organs and tissue, such as the peripheral nerves and heart, resulting in intractable peripheral sensory neuropathy, autonomic neuropathy, and/or cardiomyopathy. Read more...

Cognitive Behavioral Therapy for Diabetic Neuropathic Pain
The purpose of this clinical research study is to evaluate the efficacy of cognitive behavioral therapy (CBT) for the management of persistent pain associated with diabetic peripheral neuropathic pain. Study participants will be evaluated pre-treatment (baseline), 12 weeks post-baseline (post-treatment), and at 36 weeks post-baseline (follow-up). Baseline assessment will include a physical examination to confirm the diagnosis of diabetic neuropathy. The primary outcome measure will be pain intensity. Secondary outcome measures will be pain quality, pain-related disability, and physical and emotional functioning. Measures of treatment feasibility will also be examined. CBT plus standard pharmaceutical care (CBT/SC) is compared to an educational intervention plus standard pharmaceutical care (ED/SC) treatment condition.CBT and ED will be provided in 10 weekly, individual treatment sessions of 60 minutes. Read more...

Milnacipran for the Treatment of Idiopathic Neuropathy Pain
Many clinical trials for neuropathic pain are done in patients with diabetic neuropathy. Idiopathic neuropathy, however, is a common diagnosis and accounts for 25% of all neuropathies, and over 50% of small fiber neuropathies. The information in the clinical research study on milnacipran—an experimental medication that helps serotonin and noradrenaline work more effectively on the central nervous system—being conducted at Columbia University in New York—will provide information on whether the drug provides benefit as a medication for idiopathic neuropathic pain. Read more...

Improving Neuropathy and Mobility In Early Diabetes
 Neuropathy is the most common complication of diabetes mellitus. Impaired glucose regulation (IGR) is associated with development of peripheral neuropathy coupled with gait and mobility impairment that may be disabling for the patient.. Investigators at the VA Maryland Health Care System and University of Maryland (Dr. James Russell), and Ann Arbor VAMC and University of Michigan (Drs. Neil Alexander and Kim Gretebeck) are conducting a study on patients with impaired glucose tolerance or who have recently been diagnosed with type II diabetes and also have peripheral neuropathy. The purpose of this study is to determine if an individually tailored diet and physical enhancement program can improve mobility, physical activity, and neuropathy in people with early diabetes. Read more...

Study of Efficacy of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms of Subjects With Sarcoidosis
 Sarcoidosis is an inflammatory disease that affects multiple organs in the body. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body that may alter the normal structure and possibly the function of the affected organ(s). Small-fiber neuropathy is one of the disabling and often chronic manifestations of the disease. The purpose of this clinical research study is to determine whether ARA 290 is effective in the treatment of the neuropathic symptoms of sarcoidosis. In this study, subjects with sarcoidosis and symptoms of small fiber neuropathy will be administered ARA 290 or placebo by subcutaneous injection daily for 28 days. In addition to monitoring the safety of the treatment, the symptoms of the subjects will be assessed with several questionnaires, function tests, and measurement of nerve fibers in their cornea and skin (via a non-invasive test and a biopsy, respectively). Read more... 

http://www.neuropathy.org/site/PageServer?pagename=Benefits_Of_Trials

Cannabis And HIV What Does The Research Say

 Today's post  from  gaynz.com (see link below) is a short article adding to the information we already have about the various medical uses for cannabis, especially for people living with HIV. Of course this blog is most interested in any concrete information relating to HIV and neuropathic pain. The article takes a dispassionate look at the proven pro's and cons' of the issue.

 

Cannabis and HIV/AIDS: What the Research Says

October 15, 2012


In 2010, there was a useful summary of the role of cannabinoids in HIV/AIDS treatment, mostly in North America. In 2004, the Canadian AIDS Society became the first such NGO to back wider access to cannabinoids for People Living With HIV/AIDS, given their benefits in combatting problems like pain, nausea and appetite loss. According to North American studies, between a quarter to one third of all PLWHAs have used cannabis or cannabinoids for these purposes (c23-37 percent). In Canada, ninety percent of those sampled used it as an appetite stimulant, while seventy percent used it as a painkiller and to combat nausea or vomiting.

Pain is probably the best -researched area of medicinal cannabis derivatives useful effects for PLWHAs. It may originate from headache, both forms of herpes, back pain, throat pain, athralagia, lymphoma, anorectal carcinomas or ancillary side-effects of other preventative techniques like chemotherapy or radiation therapy. Its use against peripheral neuropathy ranges from thirty to fifty-five percent. Used for this purpose, cannabis/cannabinoids have no adverse effects on metabolism of antiretroviral medication such as indinavir and ritonovir. In the case of nausea, cannabinoids may be useful if patients do not respond to antiemetics in other contexts. However, there is little specific research data available on these particular effects other than anecdotal references to their benefits. When it comes to weight gain and appetite stimulation, the research indicates that administration of cannabinoids improves appetite and can reverse weight loss, assist food intake and assist sleep. Moreover, it also seems to assist antiretroviral drug compliance.

However, the study’s author cautions that there is lack of standardised measurement of delivery methods within amenable research, whether through cannabis cigarettes, pipes, tobacco/cannabis admixtures, or standardised levels of THC content. There are also difficulties with the small scale of such research samples. However, the research consensus also indicates no negative effects on viral load, CD4/CD8 T-cell levels, or ARV blood plasma levels.

http://www.gaynz.com/blogs/redqueen/?p=1924