一篇來自 Debra Kain – University of Virginia Health System 發表的論文：中樞神經系統的淋巴管的結構和功能特徵 Structural and functional features of central nervous system lymphatic vessels
The unexpected presence of the lymphatic vessels raises a tremendous number of questions that now need answers, both about the workings of the brain and the diseases that plague it. For example, take Alzheimer’s disease. “In Alzheimer’s, there are accumulations of big protein chunks in the brain,” Kipnis said. “We think they may be accumulating in the brain because they’re not being efficiently removed by these vessels.” He noted that the vessels look different with age, so the role they play in aging is another avenue to explore. And there’s an enormous array of other neurological diseases, from autism to multiple sclerosis, that must be reconsidered in light of the presence of something science insisted did not exist.
麗莎卡普斯（Lisa Capps）一年前生下一名女兒後，被診斷出患了多發性硬化症，由於這種疾病逐漸發展，最終會造成失明、無法行走、大小便失禁、失去平衡感等嚴重問題，令她對未來相當恐懼。
麗莎卡普斯不久之後將在聖安東尼奧神經中心（Neurology Center of San
Antonio）開始接受蘭特拉達療法，該中心的多發性硬化症專家安巴斯醫師（Dr. Ann
Bass）表示，在先前的臨床實驗中，有些病人在接受過兩年的蘭特拉達療程以後，接下來的十年中，症狀不斷減輕，令醫學界非常興奮。
在接受療程的頭兩年，病人每年住院一個星期，每天花七個小時以靜脈注射（intravenous injection）的方式，讓蘭特拉達把身體免疫系統的各種細胞摧毀，然後讓免疫系統重新開機，把免疫系統再一次建立起來。
由於在這段期間病人的免疫功能欠缺，所以需要醫師仔細觀察，特別是要注意腎臟（kidneys）和甲狀腺（thyroid）的功能。頭兩年之後，病人每天需要吃藥，每個星期需要打針。如果新建立的免疫系統不再去攻擊自身的組織與器官，病人可望不會再受多發性硬化症的困擾。
SAN ANTONIO - A groundbreaking new
treatment for multiple sclerosis is now available in the United States
and is being used to treat patients in San Antonio. The
drug Lemtrada was initially denied approval by the U.S. Food and Drug
Administration but the decision was reversed several months ago, after a
big outcry from the MS patient community.
Lisa Capps was excited
to try the new treatment. She'll spend the week hooked up to an
intravenous treatment of Lemtrada for about seven hours a day for five
days.
However, she believes the time spent will be worth it. Other
treatments for MS haven't worked for her and said she believes the new
treatment could give a fighting chance.
"This was the newest thing out there and what they call the closest to a cure that we can get to MS right now," said Capps.
Capps was first diagnosed about a year ago, shortly after he daughter was born.
"I
have to walk with a cane now and I also have cognitive problems, so I
have difficulty thinking, focusing, holding attention," she said.
As
the disease progresses, it could lead to vision loss, complete
inability to walk, urinary and bowel disfunction, the inability to sense
arms and legs, dizziness, loss of balance, and other disabilities.
Treatment with Lemtrada is expected to slow progression of the disease and reduce relapses.
Capp's
physician, Dr. Ann Bass, a neurologist and multiple sclerosis
specialist at Neurology Center of San Antonio, said Lemtrada works by
rebooting the immune system and is similar to rebooting a computer.
She said it wipes out the immune system, then allows it to rebuild over time.
"The immune system kind of rebalance itself and it can last for several years," Bass said.
At
first, patients need close monitoring, especially for kidney and
thyroid function. During the time the immune system is low, patients
require frequent health checks.
However, according to Bass, clinical trials have had ground breaking results
"I
have patients in 10 years remission after two years of treatment," she
said. " It improves their prognosis and really, most importantly, it
just really improves their quality of life."
"It gives me lots of hope because I have a daughter who is 15 months old and I want to be able to keep up with her," said Capps.
Lemtrada is also unique because of the dosing.
According
to Bass, other treatments include daily pills or injections several
times a week, while Lemtrada is given intravenously for a five-day
period the first year and then a three-day period for the second year.
Dancing, walking and running again, the wheelchair-bound MS patients after they were given 'miraculous' stem cell treatment
幹細胞治療後，坐輪椅的MS患者再度跳舞，走路，甚至跑步。
Pioneering treatment has allowed wheelchair-bound patients to run again
Patient given high dose of chemotherapy to wipe out faulty immune system
Therapy then uses person's own stem cells to fight the devastating disease
It may be the first ever treatment to successfully reverse symptoms of MS
是目前完全逆轉回復的首例治療方式
Britons left
wheelchair-bound by multiple sclerosis can walk, run and even dance
again after being given a pioneering stem cell treatment.
Doctors have described the recoveries as ‘miraculous’, while patients say they have been given their lives back.
The treatment uses a patient’s own stem cells – the body’s master cells – to fight the disease.
Professor
Basil Sharrack, of the Royal Hallamshire Hospital in Sheffield, said:
‘Since we started treating patients some three years ago some of the
results have been miraculous. 三年前我們治療的病人中有些真是奇蹟。
WHEELCHAIR-BOUND MOTHER WHO CAN NOW DANCE AGAIN
Today,
Holly Drewery(主角) can run after her daughter Isla. Two years ago she could
take her for a walk only if someone pushed her wheelchair while she held
on to Isla’s pushchair.
2年前Holly Drewery她只能坐著輪椅抱著她女兒
Miss
Drewery, 25, of Sheffield, pictured with Isla, was diagnosed with MS
after suffering numbness and blurred vision. She became wheelchair-bound
after her health worsened on Isla’s birth. She needed help with basic
tasks and couldn’t even wiggle her toes.
Three weeks after the stem cell transplant she was able to walk out of hospital.
Now,
more than 18 months on, she is almost back to normal. She has a
part-time office job and, although she still gets tired, can dance, run
and chase after Isla, two, in the park. 在作完幹細胞治療後3星期，她可以走出醫院，18個月之後，她回復正常，有個兼職的工作。雖然她現在仍舊會覺得累，但至少她可以跳舞，跑步，和小孩在公園追逐。
She said: ‘All I wanted to be able to do is take Isla out. It worked wonders. I am more or less back to normal.’ 我所想要的只是能夠帶她出門，我現在差不多和以前一樣。
Sam Ramsey collapsed when out celebrating her 22nd birthday and six weeks later was paralysed from the neck down by MS. 另一位患者：Sam Ramsey在她22歲生日後6周，因為MS造成她頸部以下癱瘓。
Other
treatments failed but now, after the stem cell treatment, Miss Ramsey,
25, of Newark in Nottinghamshire, can walk on crutches, has passed her
driving test and ordered a car. Sam Ramsey試過很多其它的治療方式，但是也都失敗了，幹細胞治療讓她現在可以藉由助行器行走，也拿到了駕照。
She told the Sunday Times: ‘This treatment has given me my life back.’
'This is not a word I would use lightly but we have seen profound neurological improvements.’
However, more research is needed to prove the patients are not just experiencing a temporary remission, which does happen in MS. 然而，需要更多的研究來證實這不只是緩解的情形。
The
neurological condition, which is more common in women than men, usually
strikes those in their 20s and 30s and affects 2.5million people
worldwide, including 100,000 Britons. It can cause blindness and
paralysis, but current drugs are not suitable for all and there is no
cure. 全球有250萬人，英國就有10萬人深受其苦，目前沒有解藥。
The
disease occurs when ‘friendly fire’ from the body’s immune system
destroys myelin, the fatty protective sheath around nerve fibres in the
brain and spinal cord, disrupting the transmission of vital signals.
The Sheffield treatment uses the stem cells to ‘reboot’ the immune system so that it stops attacking the body and brain. 療程步驟如下：
First, a sample of the patient’s blood is taken and stem cells are removed from it and stored. 第一：抽取病患的血液，並從其中提取出幹細胞進而儲存起來
The patient is then given a high dose of chemotherapy to wipe out their faulty immune system. 第二：病患須經過一個非常高劑量的化療過程，目的是把現在的免疫系統完全摧毀。 Finally, they are given their stem cells back. As master cells, they are able to form a new, healthy immune system.
最後：再把儲存的幹細胞注射回病患自己，重新啟動新的免疫系統。
The transplant has a one-off cost of around £30,000, similar to the amount spent on some patients’ drugs each year. 幹細胞療程費用需要3萬英鎊，約150萬台幣，30萬人民幣，這費用相當於多發性硬化症病人一年的醫療費用。
As
well as stopping the disease in its tracks the treatment, known as
autologous haematopoietic stem cell transplantation, seems to heal
damage that has already been done. 自體造血幹細胞移植療法似乎不僅可以停止疾病的病程，甚至可以修復已經受傷的部位。
以下列出其他MS例證
A man who was blind in one eye has almost normal vision again. 失明的眼睛重現光明
A
woman in Canada who needed 24-hour care appears free of MS more than a
decade after being given a transplant of her own stem cells. 24歲的加拿大女性治療前需要24小時得看護照顧，現在已經有10年沒有再復發。
Despite these dramatic improvements, the treatment is not suitable for all patients. 這種治療並不適用每個病患。
A
US trial on almost 150, reported last month in the Journal of the
American Medical Association, showed it to help roughly half the time. 在美國的實驗性結果報告顯示：150個實驗中，只有半數75人有幫助。
There are also concerns about complications including potentially lethal infections. 過程中也會有致命的危險(一但感染)。
Professor
Sharrack and colleagues are seeking patients with relapsing-remitting
MS, the most common form, for an NHS-funded trial. 目前英國國民保健服務處（NHS）教授Sharrack 團隊正在募集較規模的實驗。
The MS Society described the Sheffield work as ‘very encouraging’ and said it is eagerly awaiting the results of larger trials.
原來MS也有失憶(阿茲海默)或認知困難的副作用(貼此文不是要造成恐懼，而是要讓大家認識)。其實MS造成腦部損傷，有機會會有帕金森氏症以及阿茲海默症的"副作用" 或併發症，但是不一定會發生。我在急性發作的時候也曾經有短期記憶消退，常忘東忘西，必須要依賴紙筆記錄的習慣。腦袋卡卡(BOY GAGA or LADY GAGA)以下三連結探討這部分的實例。
A multiple sclerosis patient from
Saskatchewan who travelled to India to undergo an experimental stem cell
treatment is defending the Winnipeg company that recruited her for the
therapy and study, which some have called into question.
Regenetek Research has been under scrutiny following media reports this week about its CEO, Doug Broeska.
Broeska had recruited MS patients
to take part in the experimental and expensive study, which was
administered in India, involving stem cell injections combined with
so-called liberation therapy, which involves the widening of veins in
the neck.
He was, until recently, also the principal researcher for the study related to the treatment.
However, some patients have questioned Broeska's qualifications as a
researcher. As well, some say the therapy did not work for them, and
they were not receive proper followup.
Other patients, like Linda Friesen of Tisdale, Sask., reported having success with the therapy.
"I am shocked right now. I am surprised in what has been said," she told CBC News when asked about the latest allegations.
Friesen said she used to rely on a wheelchair because of her MS and
injuries from a car accident, but she left that wheelchair behind at the
hospital in India after undergoing the experimental treatment — which
cost her $34,000 US — in 2013.
"It's so amazing to have this opportunity to be part of the research," she said in a promotional video produced by Regenetek.
Friesen told CBC News that the company has paid her to help other MS patients in Saskatchewan with their paperwork.
另一位病患 Linda Friesen 則被報導是一個成功的案例。
"聽到那個質疑讓我很震驚"，她過去需要倚賴輪椅(因為MS和一場車禍)，但是在2013年去了印度花了3萬4千美元做這個手術之後，就不需要輪椅了。能參與這個研究很棒。
Regenetek responds
In a statement issued Thursday, Regenetek Research says its stands
behind its role in the stem cell therapy study, "namely as researchers
tracking participant progress following medical treatment, with such
medical treatment having been provided by third-party medical
practitioners located in India.
"Regenetek Research and its researchers do not provide medical
treatment in connection with the clinical study," the company's
statement reads in part.
"Further, the study was never intended to replace other medical
treatment and individuals were directed to stay in contact with their
treating physicians. We are scientists simply tracking the progress of
participants who have chosen to attempt innovative therapy options and
to have their results noted by us for scientific study."
Winnipeg-based
Regenetek Research issued a statement Thursday in response to media
reports about Doug Broeska, who had recruited MS patients to take part
in the experimental and expensive study involving stem cell injections
combined with so-called liberation therapy. (CBC)
Last
month, the ethics committee with the hospital in India where the
treatment was being performed ordered Broeska to step down as principal
investigator, saying his lack of credentials and medical followup
"violated international ethical standards."
Broeska had stated on a LinkedIn profile that he has a PhD from the
University of Manitoba, but the university confirmed that neither a Doug
Broeska nor a Henry Douglas Broeska graduated from there. The profile
has since been removed from the site.
The International Cellular Medicine Society and the College of
Physicians and Surgeons of Manitoba both said they have no record of
Broeska as a member.
Broeska has not responded to requests from CBC News for an interview.
The company's statement was not signed by him, and it does not directly
address specific questions about his credentials.
Broeska has defended his qualifications to another media outlet and in emails to patients.
In one message, obtained by CBC News, he told a patient that his
credentials are sound and he is "competent to perform research of this
type."
Experts concerned about fallout
Meanwhile, some in the scientific community say they're worried that
the fallout from this and other controversies could result in confusion
about stem cell research as a whole.
Dr. Duncan Stewart of the Ottawa Hospital Research Institute, which
is conducting research on using genetically enhanced stem cells to
repair damaged heart muscle, said the field is in its early days and has
tremendous promise.
"It only takes one high-profile significant problem to make everyone very nervous," he said.
Tim Caulfield, the Canada Research Chair in Health Law and Policy at the University of Alberta, agrees.
"That's a really good example of how the availability of these
treatments, marketing of these treatments, can lead people to believe
stem cell therapy is much further along than it really is," he said.
The Canadian Stem Cell Foundation says it wants the federal
government to invest $50 million in stem-cell research in each of the
next 10 years.
It also wants Ottawa to streamline the process for clinical trials in
this country "so that Canadians that are suffering have access to
treatments that are safe and proven to be effective," said James Price,
the foundation's president and CEO.
Lee Chuckry, 47, of Airdrie, Alta., said he spent $34,000 for the therapy only to find out his MS has worsened.
"I think it's just a big fraudulent scam," he told CBC News on Wednesday.
Chuckry, who has been battling MS for over a decade, said the
treatment involved the widening of the veins in his neck — a practice
advocates call liberation therapy — plus the injection of stem cells
into his veins and spinal column.
Lee
Chuckry of Airdrie, Alta., says he was recruited to undergo
experimental stem cell therapy in India. After travelling there and
spending $34,000 on the treatment, Chuckry says he believes his MS has
worsened. (CBC)
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