Sometime within the next six weeks, Dr. Ivar Méndez and his surgical team at the Victoria General Hospital in Halifax will pool nerve cells from two, three or perhaps four aborted fetuses and implant them in the brain of a patient with Parkinson’s disease. The controversial operation will mark phase two of the team’s study of the incurable neurodegenerative disorder. At least nine more patients will follow, with a report expected in late 1997. The theory behind the implants—first tried in Sweden in 1988—is to substitute fetal nerve cells that are capable of growing for damaged adult cells that cannot regenerate. It is, says Méndez, “like replacing a faulty chip in your computer.”
Perhaps, but brain surgery has proved nowhere near as simple. Gone is the optimism that greeted fetal-tissue implants in the late 1980s. Inconsistent results have led doctors to believe the implanted neurons—which secrete dopamine, a chemical messenger lacking in Parkinson’s patients—will have to be supplemented with other treatments. And no one knows whether the grafts can survive the undiscovered brain-cell killer behind the illness. On top of that, abortion opponents continue to denounce the operations as yet another indignity against the unborn.
Halifax surgeons performed the first fetal-tissue implant in Canada in 1991, followed by four more to complete phase one of their study.
In December, 1994, Méndez and company—still the sole Canadian team in the field—announced they would expand their research after all patients showed a lessening in the severity of their symptoms and their deterioration slowed. They all still require medication, however. Unlike phase one, phase two involves implanting cells in two locations of the brain instead of one.
A major stumbling block continues to be cell survivability. “If you don’t know how many cells survive, you don’t know how much you have to put in,” Méndez says. To date, doctors have relied on indirect evidence from brain scans. But last April, The New England Journal of Medicine reported on an autopsy that showed implanted fetal cells had survived and grown in the brain of a 59-year-old male Parkinson’s patient
If such surgery proves beneficial to Parkinson’s patients, it could eventually be used to treat epilepsy, Huntington’s disease or brain and spinal cord injuries. Meanwhile, studies are under way in the United States, Sweden and France that may defuse the controversy over using fetal cells. Scientists are now growing genetically engineered cells in culture, hoping they can provide a limitless supply—and new hope—for victims of brain disease.
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