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Remember the New York Times story by Gina Kolata that was so critical of the fetal cell transplant study - calling it a failure and disasterous? Please read the following for the perspective of an expert in this field : FROM: Nature ONLINE Monday 21 May 2001 www.nature.com "Medicine: Better diagnosis for brain transplants By HELEN PEARSON Media disaster stories about fetal cell transplants for treating Parkinson's disease were excessive, according to a review of recent clinical results1. The prospect such therapy is a positive one, say US experts. Controversy erupted earlier this year with the publication of results from the first controlled clinical trial in which patients suffering from the movement disorder Parkinson's disease received transplants of human embryonic brain cells2 After one year, benefits were limited and 15% of the patients also developed uncontrollable movements - side-effects reported in The New York Times as -"disastrous"3. This interpretation is wrong, says Ole Isacson of Harvard Medical School, Massachusetts, an expert in fetal transplantation - partly because the study's results were only reported over the short term. A second look at the results by Isacson and his colleagues suggests that key outcomes of the trial - the patients' symptoms and dopamine uptake - show initial improvements in line with those found in previous, less rigorous Tri als. "The study was premature," he says. There were problems with the study design, admits Kurt Freed of the University of Colorado School of Medicine, Denver, author of the original research. For one thing, primary criteria for judging the outcome was patients' subjective rating of their symptoms - and they just can't remember. "A patient recollecting how they were simply doesn't work," says Freed, in retrospect. Almost all patients have subsequently shown beneficial effects after additional intervention to balance dopamine levels, Freed adds. Fetal transplants aim to use immature brain cells from human embryos to boost flagging levels of the brain chemical dopamine in Parkinson's patients. Over-production of dopamine by the grafted cells may explain the nasty side-effects, thinks Freed. Isacson offers an alternative explanation: that they result from the way the cells were handled, which was different from other studies. The brain transplants contained a mix of cell types, and some evidence suggests that the key dopamine-containing cells were easily killed. He is optimistic that clinical trials will ultimately prove successful. "It's a very crude but promising beginning to a new medical therapy," says Isacson." 1. Isacson, O., Bjorklund, L. & Pernaute, R.S. Parkinson's disease: interpretations of transplantation study are erroneous. Nature Neuroscience 4,553 (2001). 2. The New York Times, March 2001 3. Freed, C. et al. Transplantation of embryonic dopamine neurons for severe Parkinson's disease. New England Journal of Medicine 344, 710-719 (2001). ------------------------------------------------------------------------- ------------------------------------- One of the problems with media reporting of medical news is that it seeks to provide an instant answer, ( and the most attention-grabbing headline), but medical research does not work like that. It is slow and incremental and results need to be fully analyzed and studied before any conclusions can be made. Success is measured by small steps that increase the scientific knowledge, and negative results can be as important as the positive ones. We owe our thanks and gratitude to all the researchers who are working so hard to bring us closer to a cure, and all the courageous Parkinson's patients who have volunteered to be subjects in studies such as this one. Linda ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn