Stem Cell Treatment For Children With Eye Nerve Disease
Called 'Medical Hoax'
Article Date: 12 Jul 2008 - 1:00 PDT
Two pediatric eye surgeons at Washington University School of
Medicine in St. Louis expressed alarm over what they label a "21st
century snake oil" scam.
Recent newspaper stories including several from Missouri -- have
reported parents flying their children to main land China for
umbilical cord stem cell (CSC) infusions. The cost of these
treatments, paid for entirely out-of-pocket by the parents, can be
$50,000 or more. CSCs are extracted from the umbilical cords of
Chinese mothers and their newborns and injected into the fluid around
the spinal cord of the American children. The parents are led to
believe by Chinese doctors that these CSCs are an effective treatment
for optic nerve hypoplasia (ONH), a disease causing partial blindness
at birth.
ONH is growth failure of one or both optic nerves during the first
trimesters of pregnancy. The nerve is the "cable" connecting the eye
to the brain and each nerve should have one million fibers; in ONH
the number of fibers ranges from 200,000-800,
about 1 in 5,000 newborns, is not hereditary and the exact cause is
unknown.
Lawrence Tychsen, M.D., and Gregg Lueder, M.D., professors of
ophthalmology and visual sciences at Washington University School of
Medicine and pediatric ophthalmologists at St Louis Children's
Hospital, diagnose and treat dozens of children each year with ONH.
They are concerned that the CSC reports will mislead many parents of
children with ONH, who may bankrupt savings, go deeply into debt or
organize fundraisers to pay for sham treatment.
Although some parents claim improvement in their child's vision after
returning from China, Tychsen and Lueder caution that no objective
visual gains after CSC treatment have been demonstrated in any child
with ONH. They can measure visual improvements objectively in infants
and toddlers using non-invasive nerve and brain imaging and
electronic measures of visual brain activity. They add that one would
expect "a powerful placebo effect after these purported treatments.
The temptation to believe vision had improved, after the expenditure
of so much time and money, would be difficult to resist." Aside from
grave ethical concerns, they say that the injections could be
dangerous, introducing infection or toxic matter into the brain
fluids.
Tychsen, who is also a neurobiologist studying visual brain
development in infant monkeys, listed a number of reasons to
disbelieve reports of improvement. First, CSCs placed in human spinal
fluid would not be transported into the fibers of the optic nerve.
Second, CSCs have never been shown to transform into optic fibers,
even in fish or rodent experiments. In a monkey or human, the task
would be "several orders of magnitude more complex," Tychsen said.
Third, to improve vision, 100,000 or so fibers would need to grow,
not just a few, and each of the fibers would need to connect
precisely in the brain.
"CSCs are used legitimately throughout the United States to treat
blood diseases (such as leukemia) when the donor and recipient are
genetically matched," Tychsen said. "But CSCs from an unrelated
person are rejected and destroyed. Even if an unmatched CSC survived,
found its way inside the optic nerve and transformed itself into a
new fiber, the fiber would need to find the correct connection among
more than 500,000 connections in the visual brain.
Such a series of events would be so improbable as to qualify as
miraculous, the equivalent of a chimpanzee typing the five acts of
King Lear at one sitting," Tychsen said. He said he believes that
experiments by neuroscientists devoted to the discovery of nerve
growth molecules may hold the best hope for future cures.
Lueder pointed out that parents of ONH children should not despair.
"Many babies born with ONH will have some improvement as they mature,
because they learn to exploit more effectively the optic fibers that
remain," he said. Children with ONH can also achieve some
improvements with surgery for eye crossing and nystagmus (roving
movements of the eyes). He added that many ONH children function
reasonably well in school using enlarged print, magnifiers and other
aids for the visually impaired.
Washington University School of Medicine's 2,100 employed and
volunteer faculty physicians also are the medical staff of Barnes-
Jewish and St. Louis Children's hospitals. The School of Medicine is
one of the leading medical research, teaching and patient care
institutions in the nation, currently ranked third in the nation by
U.S. News & World Report. Through its affiliations with Barnes-Jewish
and St. Louis Children's hospitals, the School of Medicine is linked
to BJC HealthCare.
Washington University in St. Louis
One Brookings Dr., Campus Box 1070
St. Louis, MO 63130
United States
http://www.wustl.
http://www.medicaln
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StemCells subscribers may also be interested in these sites:
Children's Neurobiological Solutions
http://www.CNSfoundation.org/
Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123
The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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