Research Into Nerve Pain Patience Is A Virtue

 Today's post from foundationforpn.org/ (see link below) tries to remove the feeling that many people living with neuropathy have, that there is very little research and thus very little progress being made in the medical field of neuropathy. This blog agrees and frequently tries to highlight new research studies, however medically complex for the reader, to show that there is a great deal of work being done behind the scenes. The problem is that the time spans between ideas, research, study, tests and evaluations and products on the pharmacists' shelves for patients can be enormous. This is frustrating for current patients but it is surely better to know what's going on and be aware of the fact that much is being done, than be kept in the dark and have the feeling that the medical world is ignoring our plight; even if it means waiting years for concrete results.
 

International Research on Peripheral Neuropathy

foundationforpn.org/ March 7, 2016

It is not unusual for peripheral neuropathy patients, their caregivers and loved ones to be heard wishing for research on PN that may bring hope for better treatments or even a cure. Many people share the perception that little or no research is occurring on peripheral neuropathy leaving them frustrated and sometimes even angry.

In fact, research is happening all over the world. ClinicalTrials.gov is a Web-based resource that provides patients, their family members, health care professionals, researchers, and the public with easy access to information on publicly and privately supported clinical studies on a wide range of diseases and conditions. The Web site is maintained by the National Library of Medicine (NLM) at the National Institutes of Health (NIH). As March 1, 2016, ClinicalTrials.gov identified 1745 studies related to peripheral neuropathy since it first started collecting data in 2007.* 561 studies listed there are still active. The map above shows that 46% of the research is taking place in the U.S. but 29% is also taking place across Europe.

The Foundation for Peripheral Neuropathy uniquely supports PN research through the Peripheral Neuropathy Research Registry (PNRR). Currently, limited data exist to define characteristics of peripheral neuropathy patients with neuropathic pain. In a groundbreaking step to learn more about PN and to find a cure for the debilitating condition, the Foundation for Peripheral Neuropathy launched the first ever national Peripheral Neuropathy Research Registry (PNRR) focused on Diabetic, Chemotherapy-Induced, HIV/AIDS and Idiopathic neuropathies. The data in the PNRR aims to help researchers access detailed genotypic and phenotypic history and neurological examination information about people with painful and non-painful peripheral neuropathies. This Research Registry will facilitate both basic and clinical research studies that are expected to improve understandings of the etiology and pathogenesis of PN. Ultimately, the major goal of the Registry is to improve the ability to diagnose, treat and prevent peripheral neuropathy.

* The ClinicalTrials.gov results database was launched in September 2008 to implement Section 801 of the Food and Drug Administration Amendments Act of 2007 (FDAAA), which requires the submission of “basic results” for certain clinical trials, generally no later than 1 year after their Completion Date. The submission of adverse event information was optional when the results database was first released but was required beginning in September 2009. Results information for registered and completed studies is submitted by the study sponsor or principal investigator in a standard, tabular format without discussions or conclusions. The information is considered summary information and does not include patient-level data.

For more information on how clinical trials work and for featured clinical trials visit the Clinical Trials page on our website

 

 https://www.foundationforpn.org/2016/03/07/5016/

NEW INSIGHTS INTO FACIAL TRANSPLANTATION

In 2009, the first face transplant was performed at Brigham and Women's Hospital (BWH), and lead surgeon, Dr. Bohdan Pomahac has been pioneering the procedure since. However, understanding the technical challenges, particularly around how the recipient accepts or rejects the donated face, is just beginning. Following any transplant, including facial transplant, T cells in the recipient mount an immune response to the donated tissue, threatening rejection. This process is successfully managed through immunosupression medication so that the recipient is able to tolerate the transplanted face

Now, researchers at BWH have made a discovery that provides new insight into the body's rejection process. Researchers have demonstrated that immune cells, or T cells, involved in the rejection process are significantly of donor origin. These findings are published in Modern Pathology on January 17, 2014.

"The conventional belief about face transplant was that rejection is directly related to the recipient T cells attacking the donor T cells of the face, which are perceived as foreign to the recipient's immune system," explained Christine Lian, MD, a skin pathologist at BWH and lead author of this study. "We now need to rethink this process. Based on our findings, it is clear that the donor T cells, which are transferred as part of the new face, play a significant role in the rejection process as well."

The researchers examined 131 face transplant biopsy specimens from a total of five patients who received a face transplant between 2009 and 2013 at BWH. The samples were examined by conventional microscopy for categorizing the level of rejection and guiding immunosuppressant therapy, and additional antibody based biomarkers were also applied. The use of biomarkers allowed the researchers to differentiate between the donor and recipient cells under the microscope. Researchers found that during active rejection episodes, many to most of the immune cells in the face specimens that were involved in the rejection were of donor origin.

"The participation of these donor immune cells in face transplant rejection represents a paradigm shift in the understanding of the rejection process," explained George F. Murphy, MD, director of Dermatopathology at BWH and a senior author of this study. "One intriguing possibility that now exists is that the transplanted faces are not simply passive targets vulnerable to rejection, but carry along with them their own army of immune cells that may defend the face against attacking recipient cells in order to thwart the rejection process," says Murphy.

Researchers note that more studies need to be done to better understand these complex immune cell interactions, but these new findings will help to develop the best diagnostic and therapeutic strategies that, for the first time, will consider include immune cells from the donor as well as the recipient.