Revolutionary new X-ray treatment that could save the sight of thousands

By Sophie Borland

UK's Daily Mail

An X-ray treatment that could save the sight of thousands is being trialled on the NHS.

The 15-minute procedure has been shown to halt wet age-related macular degeneration, one of the most common forms of blindness in the elderly.

Around 250,000 suffer from this debilitating condition which, if not treated, can cause loss of sight in just three months.

Currently sufferers have to undergo monthly injections in their eye for the rest of their lives to prevent them from going blind, and they are often unable to read, drive or live independently.

But early trials of the new procedure have shown that it could halt the progression of the condition immediately, saving the NHS £300million a year.

The trials on 60 people in Mexico showed that half did not need any more treatment while the remainder needed infrequent injections – only a few each year.

Wet AMD is caused when blood vessels grow over an area in the middle of the retina called the macular, which is at the back of the eye.

It is currently treated with several drugs, including Lucentis and Avastin, which temporarily stop the vessels from growing.

But the powerful new procedure, called iRay, can destroy the blood vessels completely. Patients sit at the front of a machine and place their chin on a rest while X-rays are beamed into the back of their eye.

The procedure lasts between 15 and 20 minutes and is estimated to cost around £4,000 a time. A year’s worth of the monthly injections costs £12,000.

The procedure, developed by U.S. firm Oraya Therapeutics, is being tested at London’s Kings College Hospital and doctors are hoping to recruit 50 more patients to take part in the trials.

If successful, it could be rolled out in hospitals nationwide and researchers believe it could save the NHS up to £300million a year.

Consultant ophthalmic surgeon Tim Jackson, who is leading the trial, said: ‘This is an exciting new technology that targets one of the most common causes of blindness in the UK.

‘If the initial results are borne out in these important larger studies then a majority of patients will have something to look forward to – an easily administered, one-off treatment that maintains or improves vision, and fewer injections into their eye.’

There are around 20,000 new cases of wet AMD in Britain every year, mostly Occurring in the over-60s.

The condition is more common among women, and is thought to be linked to smoking and heavy drinking.

PAINLESS PROCEDURE

Jonny Gathorne-Hardy, 77, is one of the first British patients to undergo the treatment.

He was diagnosed with wet AMD in his right eye last June and had been receiving injections of Lucentis almost every month.

But since undergoing the treatment at the beginning of December he has not needed a single injection. Mr Gathorne-

Hardy, an author of children’s books, described the procedure as ‘painless’.

He lives in Binham, near Fakenham in Norfolk, and had to travel more than 20 miles every month to Norwich for the injections.

Mr Gathorne-Hardy said: ‘The Lucentis injections are fairly frightening. I’ll be delighted if I never need any more.’

Researchers Devise Process To Create Ready-Made Blood Vessels For Kidney, Heart Patients.

Ready-made and easily stored, bioengineered transplants did well in animal trials

By Maureen Salamon
HealthDay Reporter

WEDNESDAY, Feb. 2 (HealthDay News) -- Scientists say they have devised a process to create ready-made, easily stored blood vessels that may potentially be used for patients undergoing heart surgery or kidney dialysis.

Using donor tissue cultured on biodegradable tube-shaped frames called scaffolds, researchers spent more than five years engineering the "off-the-shelf" blood vessels, which cannot be rejected by patients' immune systems and are resistant to infection or clotting. The bioengineered vessels can be refrigerated long-term in a saline solution.

The study was conducted in baboons and dogs by scientists from Duke, East Carolina and Yale universities, along with Humacyte Inc., a private company based in Durham, N.C. that develops products for vascular disease and soft-tissue repair.

"We're very encouraged by the results," said study author Shannon Dahl, who is co-founder and director of scientific operations at Humacyte. "This type of technology has the potential to help more than 500,000 patients each year. The next step is to lay the groundwork . . . that can bring this to the clinic."

While engineered blood vessels can be grown using patients' own cells, the process can take nine months or longer, making it unfeasible for those needing more immediate heart bypass surgery, which is performed in the United States about 400,000 times each year. Doctors can also graft veins from other body areas, particularly the legs, but the ready-made vessels can help those whose veins are unsuitable, Dahl said.

Additionally, the bioengineered veins can be made in sizes large enough to use in kidney dialysis patients, half of whom lack the healthy vessels needed for bloodstream access to dialysis machines and receive grafts made of infection- and obstruction-prone synthetic material, according to the study, reported in the Feb. 2 issue of Science Translational Medicine.

According to the National Kidney Foundation, about 320,000 Americans depend on regular dialysis treatments to remove waste products from their blood because of kidney failure.

"I think this is a very nice example of translating a scientific advance into a clinical application in an area in which we have a very large patient population," said Gordana Vunjak-Novakovic, a professor of biomedical engineering at Columbia University in New York City and director of its Laboratory for Stem Cells and Tissue Engineering.

"What they offer now is essentially making a piece of native vessel without adverse effects on the patient," Vunjak-Novakovic said. "It's almost like a medical device, providing a really native-looking and native-functioning vessel."

Dahl and her team produced 37 vascular grafts using smooth muscle cells of 19 human donors. Once the blood vessels were fully formed, detergent was used to strip the muscle cells away, ensuring they would not cause an immune response in transplant recipients.

The vessels were then implanted in baboons and dogs during coronary artery and carotid artery bypass surgeries, where they experienced low rates of complications and became similar to the animals' natural arteries over several months. When the vessels were removed for examination, there was no evidence of fibrosis or thickening of the vessel walls.

Dahl said the ability to create large supplies of ready-made vessels from a cell bank will someday lead to lower production costs for each vein segment. She said she could not speculate on what those costs might be, however, or when the veins will be tested in humans.

"But the approach we're using is quite unique," Dahl said. "We use large banks of cells, where many approaches to tissue engineering are focused on one patient at a time. So, the approach we use offers an economy of scale."

Vunjak-Novakovic said she believes it might be only several years before the vessels could be available to patients.

"Now they need to do the next step -- study them in humans," she said. "But I don't think any major, critical problems are left. It's very promising."

More information

For more about tissue engineering, visit the National Institute of Standards and Technology.

SOURCES: Shannon Dahl, Ph.D., director, scientific operations, and co-founder, Humacyte, Durham, N.C.; Gordana Vunjak-Novakovic, Ph.D., professor, biomedical engineering, Columbia University, and director, Laboratory for Stem Cells and Tissue Engineering; Feb. 2, 2011, Science Translational Medicine

Last Updated: Feb. 02, 2011

Copyright © 2011 HealthDay. All rights reserved.

People With Type 1 Diabetes May Eventually Be Able To Grow Their Own Insulin-Producing Cells, Research Indicates.

Researchers Say Advancement May Lead to Cure for Type 1 Diabetes

By Denise Mann
WebMD Health News

Dec. 13, 2010 -- New research suggests it may be possible for people with type 1 diabetes to grow their own insulin-producing cells -- an advancement that could lead to a cure for this form of diabetes.

The preliminary findings are slated to be presented at the American Society of Cell Biology 50th annual meeting in Philadelphia.

“The goal here is to cure diabetes, not to treat it,” says study author G. Ian Gallicano, PhD, an associate professor in the department of biochemistry and molecular and cellular biology and the director of the Transgenic Core Facility at Georgetown University Medical Center in Washington, D.C.

Islet cells in the pancreas are responsible for producing insulin, but these cells are destroyed in people with type 1 diabetes.

Of Mice and Men

In the new study, however, researchers were able to take cells from men’s testicular tissue, isolate stem cells, and turn them into insulin-secreting islet cells. These islet cells were then re-injected into mice with diabetes.

And it worked. “These cells behave a lot like beta-islet cells,” Gallicano says. “They secrete insulin in response to glucose, and we were able to secrete insulin in mouse models to reduce high blood sugar or glucose levels.” The effects lasted for one week.

The next step is to see if these cells can produce enough insulin to cure diabetes in people. If this occurs, clinical trials in humans can begin, he says.

Today, islet cells can be transplanted from donors into people with diabetes, but there is the risk of rejection. This risk is eliminated when the islet cells are derived from the recipient. There is also a shortage of available islet cell donors.

Gallicano says there are many unanswered questions, such as how to best deliver these bioengineered cells back into the body, and whether it will work in women.