NOTE: This Message was originally addressed to Tom Mckeever
      from Epwoll@execpc.com and was forwarded to you by Tom Mckeever
                           --------------------
Date:         Wed, 5 Apr 1995 14:56:49 -0500
From:         Ernie Wollering 
Organization: Exec-PC
Subject:      Interesting Research
To:           Multiple recipients of list POLIO 
  There are a number of interesting areas of research these days,
 focusing on the mechanisms that allow muscle and nerve cells to remain
 healthy and viable. I thought I'd put down the little I know about it
 with respect to PPS and ask for comments, clarifications and
 expansions.
  I guess we've all noticed that after the initial attack of Polio,
 there was a recovery period during which we regained some of our
 muscle strength and functionality. This is generally attributed
 to sprouting and reinnervation by the remaining nerve cells. For
 a period of years after that, we were able to build and maintain
 our muscles through exercise. With the onset of post-polio syndrome
 and specifically post-polio muscular atrophy, that same exercise now
 seems to overload the nerve cells causing neuropathy, and with no
 nerve cells to drive the muscles, muscular atrophy.
  For some period of time then, there was a mechanism which allowed the
 nerves to stay healthy, and allowed the reinnervation process to keep
 ahead of the denervation process. After some point in time, that
 mechanism seems to have failed. Research into some of the substances
 involved in that mechanism includes the work on neurotrophins. I
 believe that a substance called ciliary neurotrophic factor (CNTF)
 has been shown to promote motor neuron 'health' and that a trial
 is currently underway (has finished?) with folks that have ALS.
  Insulin-like growth factor I (IGF-I) is another substance being
 investigated. It stimulates protein synthesis and growth in muscles.
 It was found that polio survivors had significantly lower
 concentrations of IGF-I than a control group. I believe trials are
 being conducted to determine if bringing IGF-I levels back up to
 a 'normal' range will improve muscle growth and strength.
  These research areas are fairly recent and may or may not prove
 beneficial in the future. Still they are interesting and I was
 wondering if anyone had any additional information on them.
 Ernie
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