Some of you may have heard about the publicity surrounding our recent data concerning the use of neural stem cells in animals with viral induced spinal cord paralysis. We presented this data at the Society for Neuroscience meeting in November, and it was picked up by all of the major news organizations (ABC, CBS, NBC, FOX, Reuters and AP). What we have done is to inject neural stem cells into animals that have previously been paralyzed by a virus (Sindbis virus). The stem cells were administered into the spinal fluid that bathes the spinal cord (essentially we did a lumbar puncture on the animals, but instead of withdrawing fluid, we injected the stem cells). We then observed the animals for functional recovery. To our delight, we observed that the stem cell?treated animals began moving their hind limbs after 8 weeks. Some had only slight recovery while others were able to flex their legs and bear weight on that limb.

So what is the relevance of this to TMA members? Well, this line of experimentation is early, but we certainly hope to advance these studies to ultimately consider the use of stem cells in human patients with TM. What we have to do now is to extend these findings in larger animals (monkeys). We also have to carry out long term experiments to show that the recovery is permanent and that the stem cells don't ultimately cause harm. This will take several years, so please be patient. But also understand that we are working very hard to advance these findings as rapidly as possible!

We also are continuing to investigate the mechanisms of neuronal injury in the spinal cord. We reason that if we better understand why neurons die in the spinal cord, then we can devise ways to halt this death. Dr. Irani and colleagues recently published these findings in the Journal of Virology, while I published two papers with colleagues in the Proceedings of the National Academy of Sciences and in Molecular Cell detailing the important role of the Survival of Motor Neuron (SMN) protein and other proteins in protecting motor neurons from death.

I would like to take this opportunity to provide an update on the Johns Hopkins Transverse Myelopathy Center. We have now been in existence for approximately 15 months. In that time, we have seen 185 TM patients (and counting). So, already we have seen more TM patients than anybody in the world. I certainly hope that for those of you who have come here, you feel that we have provided you with information about your disease, and have given excellent care. Many of you have come from far away and our primary role after the initial visit is to make recommendations to your other doctors. We have often "strongly encouraged" physicians by a letter or phone call to obtain a standing frame or more aggressive PT or bladder medications for a patient, for example. Many of you who have been here have filled out one or more questionnaires regarding your case of TM. The information you have provided has been invaluable in creating a database that is currently being analyzed. From this, we hope to gain information on such questions as what are the clinical features most common in TM both in the acute and convalescent phase, is there a relationship to vaccinations, to trauma or to preceding infections.

The website is soon to undergo renovation. There will be new text added and there will be instructions and recommendations to physicians who may be seeing an acute TM patient for the first time. It is hoped that such a physician may see this while the patient is in the emergency room and would then initiate treatment more quickly than otherwise.

Having said all that, we certainly are having some growing pains, so I respectfully ask that patients have patience. Philis Carbonell (my secretary) and I are involved with most of the TM patients who come here, and we try to do the best we can. But we are sometimes overwhelmed! So, we may not call back right away, and sometimes we drop the ball on certain issues. We ultimately hope to hire additional personnel and we are attempting to procure funding for this, but until then we may have busy periods.

If anybody thinks that Philis has done a great job in setting up the visit to the JHTMC, I would urge people to let her (and her bosses) know. She works very hard and would be very appreciative of kind feedback (or even negative feedback if that be the case). Notes could be sent to Philis Carbonell at Johns Hopkins Hospital, Pathology 627, 600 N. Wolfe St., Baltimore MD 21287-6965. Please cc Jane Hill at Johns Hopkins Hospital, Meyer 8?181, 600 N. Wolfe St., Baltimore MD 21287-6965.