Scientists find genetic 'flaw' that makes some patients slow to heal

Published on Monday 11 April 2011 17:31

A GENE that slows the recovery from damage to the nerves in people's limbs has been identified by scientists in Scotland.

The breakthrough discovery will help doctors to make more accurate predictions about recovery after injuries, give clearer information about the effects of drugs and, in the long term, allow treatment to be tailored for individual patients.

It is hoped it will also help in the research and treatment of debilitating conditions such as motor neurone disease (MND) and carpal tunnel syndrome.

Researchers at the University of Edinburgh, who made the discovery, were already aware that the gene - named apolipoprotein E (APOE) - controlled how quickly nerve cells repaired themselves in the brains and spinal cords of people affected by conditions such as stroke or Alzheimer's disease.

The breakthrough came in showing that one form of the gene, APOE4, slows the regrowth of the nerves outside the central nervous system. This includes the nerves that connect to muscles in the arms and legs and those that carry sensory information from the skin.

Professor Tom Gillingwater, who led the study, said having the E4 gene would result in "very poor nerve regrowth" compared with having another form of the gene. "If you get a disease where your nerves are being affected, you have a much, much worse prognosis, your chances of getting better or declining less slowly are reduced, so often you will get a worse form of the disease or your symptom won't recover as well," he said.

He said the discovery had significant clinical outcomes.

"It gives a real insight into why some people will respond well to recovery after nerve injury, while some people don't," Prof Gillingwater said.

"So if a clinician knows the patient's gene type, they will be able to make a much better prediction as to how they are likely to respond to certain types of drugs and how likely they are to get good functional recovery.

"By pinpointing how the gene works, you can start to design therapeutics which are almost patient-specific, so they get the best possible chance of success and recovery."

He said one of diseases that could ultimately benefit from the research would be MND - a debilitating condition that attacks the body's nervous system and motor function.

He said that, initially, it would help to identify how resilient a sufferer would be to the disease and the likely speed of its progression, but it would also help in developing drugs.

A spokesman for MND Scotland welcomed the research."One of the issues that has dogged MND research for many years has been that drugs that appeared to be successful in a particular strain of mice with the disease do not translate to humans," he said.

"It may be that by stratifying people into geno-types, it may be possible to find drugs that work for particular groups of people."

Prof Gillingwater said that, while the gene identification was available now, it would be three to five years before targeted treatments came along, and that individually tailored drugs would be available further down the line.