PostPolio

Mesotherapy PostPolio Treatments

MIT The Mesotherapy Institute of Technology Research Division

Post Polio Syndrome (PPS): The Mesotherapy Approach in Evidence Based Research and Anti-Aging Treatment

Press Release. November 14, 2005.

Post Polio Syndrome is a disorder of the neuromuscular system which appears in survivors of acute poliomyelitis (partial or complete functional recovery) at least fifteen or more years after the initial illness. Its symptoms include new onset of progressive muscle weakness, decreased muscle endurance during activities, joint and muscle pain, and severe fatigue. The triad of new muscle weakness, overwhelming fatigue and pain are most common complaints.  The diagnosis is made with triad duration exceeding 12 months in the recovered polio patient.
There are approximately 12 to 20 million people living worldwide who have had polio and are polio survivors. Polio continues to occur in under-vaccinated children of third world countries. In the United States, there is 1.2 to 1.6 million people who are polio survivors and may have Post Polio Syndrome.

Poliomyelitis is caused by any of three serotypes of poliovirus, an RNA virus. The initial illness may be paralytic or non-paralytic in its clinical course. The poliovirus attacks the anterior horn motor neuron and damages the nerve axons extending to muscle tissue. The muscles involved may be temporarily or permanently paralyzed. Paralytic poliomyelitis is classified as spinal, bulbar or spino-bulbar. Bulbar paralysis may be life-threatening, since it affects the brain centers for the vital functions of breathing and swallowing. It is now recognized that the silent GI form of poliovirus infection was perhaps more prevalent with flu-like symptoms and non-paralytic. This latter type may represent a silent-CNS involvement which will make this sub-group of aging boomers subject to PPS in the future.

In the pathophysiology of the poliovirus infection, the anterior horn motor neurons are the site of sustained damage. Those less damaged motor neurons would attempt to restore new axon growth by sprouting new nerve endings into the muscle fibers occupied with severely damaged nerve endings. Whereas a normal person may innervate up to 500 individual muscle myofibrils, the sprouting axons attempted to innervate 800-2000 fibers. For the recovered polio survivor, this compensatory network restored either partial or complete muscle function and physiology. Current research reveals through electromyography (EMG) studies that normal activities of adult daily living require these muscle groups to work about twice as hard. Further age-related studies of patient groups reveals that normal patients will lose about 1 percent per year of motor neuron volume and axonal nerve endings as a so-called natural process of aging. Further, it is demonstrated that healthy adults begin losing about 1 percent of muscle mass per year after age 50. Combine this with an American turning 50 years of age approximately every eight seconds and 1.6 million potential PPS survivors, time is marching faster than research!

MIT, the Mesotherapy Institute of Technology, has undertaken a broadly evidence-based research project addressing the clinical efficacy aspects of mesotherapy as a discipline in delivering vital micro-nutrients, medications, and hormones with anti-aging potential to the site of pathology, namely the deteriorating neuromuscular system and skeletal muscle in particular.

Whereas we recognize the significance of multi-center, double-blind, crossover clinical trials as the definitive manner of approaching treatment modalities and therapeutic combinations, quite frankly, a significant number of people will die or suffer irreversible paralytic progression of disease in the years requisite to publish such classically designed and executed studies.

Recent published research by Sullivan et. al. (October 2005) has yielded significant data to support the potential for bio identical hormone replacement therapy in muscle strength and muscle mass regeneration of elderly males. Progressive resistance muscle strength training (PRMST) has been demonstrated to be a safe and effective process for increasing muscle mass (hypertrophy), strength, and functional status in elderly men known to have decreased overall muscle mass through the natural aging process. Whereas high intensity has been proven safe in this patient group, a more moderate intensity must be used for PPS patients with more limited regimens. Radom-Aizik et. al. at the University of Pittsburgh Genomics Unit have published an intriguing report (October 2005) revealing modified expression of 397 genes out of 14,500 tested corresponding to skeletal muscle metabolism of elderly men during aerobic exercise. These investigators identified upregulated cellular energy pathways and downregulated protein catabolism pathways during exercise. These genomics studies give rise to insights on the importance of delivering optimal microcellular and intracellular energy support and micronutrients to the PPS patient through a mesotherapy delivery system. The MIT MesoJect VariDepth delivery system capitalizes on multiple levels of nutrient delivery in the mesoderm, known to metabolize and absorb into skeletal muscle effectively. (Both research papers published in Medicine & Science in Sports & Exercise, Vol. 37, No. 10, Oct. 2005).

Our clinical goal is to establish a multi-disciplinary approach to achieve the highest quality of daily living available to PPS patients and polio survivors in general. Over the next several months, we will post our data and reveal the outcomes of this research.
The following gives some insights as to our approach:

Category 1. Since most recovered polio survivors have compensated through their adult lives with a key baseline level of muscle mass, tone, and motor nerve axon sprouting, it is our goal to approach anti-aging concepts which may stabilize the motor nerve axon function. For example, a patient at the age of 69 would be expected to have a 9 percent loss (from age 60) of motor neurons from the natural aging process. We will implement regular replacement therapy with human growth hormone at a dosage regimen of one unit HGH per day for four out of seven days, giving sufficient time for systemic hepatic metabolism and target activation. Our clinical question will be to assess the neurological function of the patient through ten different subjective and objective parameters, which may be expanded as the data is accumulated.

Category 2. Second priority is muscle mass. Again, most recovered polio survivors have compensated muscle mass levels, however, the new PPS patient may well be an individual who falls between, for example ages 50 and 69, and has lost from 1 percent to 19 percent muscle mass. Such muscle mass loss may be significant enough to cause PPS weakness and severe fatigue with loss of endurance, including gait stability. The clinical approach will be to implement bio-identical testosterone replacement therapy to physiological levels that would support the daily efforts of an individual ages 40-45 years. Muscle mass testing will be accomplished by (1) manual muscle testing, (2) electromyography, (3) Cybex mechanical assessment, (4) objective clinical circumference measurement, and (5) physical therapy-rehabilitation specialist assessment. Gait, freedom of tasks of adult daily living (ADL's), and appliance requirement will be measured.

Category 3. Mesotherapy injections. Medications include, but are not limited to, one of the most prevalent neuron metabolic precursors, phosphatidyl serine. Its activity may be enhanced with cyclic-AMP, co-enzyme A, Multiple Trace Elements, Ginkgo Biloba, and Traumeel®, a homeopathic anti-inflammatory formula manufactured by Heel Corporation (Germany). All of these constituents are supportive to electrochemical energy and neuron metabolism. Immune system support will include astragalus, reishi extract, germanium susquioxide, and gak. All of these are standardized extracts. The MIT Mesoject VariDepth System™ will be employed to disperse these medications to the mesoderm overlying the skeletal musculature and areas where the patient may experience weakness, fatigue, or loss of endurance. The matrix distribution is symmetrical and the focal treatment is site specific. Worldwide research in mesotherapy for the past fifty years has established the efficacy of administration of key medications to the targeted tissue and organ site. (There are over 15,000 practitioners of mesotherapy worldwide, who potentially could provide treatment for PPS patients throughout the world). The assessment parameters of both Category I and Category II will be applied to further investigate aspects of endurance in successfully performing ADL's.

Category 4. We will embark upon measurement of the poliovirus virion nucleic acid (vRNA) and capsid protein by established measurement techniques utilized in clinical virology today. Although no biological marker for PPS has been identified, the role of an integrated defective poliovirogene and potential reverse transcriptase synthesis of poliovirus proteins has not been exhaustively studied or ruled out. Current technologies may give rise to new detection methods not presently in use. Our research team at MIT will collaborate with HealtheUniverse researchers using fat-derived stem cells for innovative approaches of monoclonal antibody-specific treatment of transgenic mice, potentially applicable to human PPS survivors. HealtheUniverse holds patents for technologies in stem cell culture and low beam laser application of monoclonal antibody engineering. The Salk Research Institute, La Jolla, CA, University of California, Los Angeles, University of Southern California, and other interested university research centers will be invited to participate in this collaborative research. Of vital importance to so many, this clinical area warrants further research, including a multi-national, multi-center clinical trial.

Category 5. Rehabilitative medicine assessment will be performed at St. Judes Hospital and Rehabilitation Center in Fullerton, CA. Personnel there are highly skilled in assessment of PPS patients and in their individualized rehab programs. Their regular assessments will be an integral part of this research reporting effort. Whereas there is discussion of post-polio muscular atrophy (PPMA) subgroups, we hope to demonstrate post-polio muscle regeneration ("PPMR") subgroups. This data will be based on an objective measurement of muscle group hypertrophy size by circumference measurements and Cybex strength measurement in combination with St. Jude's Rehab standardized measurements.
Interval electromyography will be documented for clinical correlation by consulting neurologists. Cybex measurements will be conducted at Pro Sport Physical Therapy, Newport Beach, CA.

The Mesotherapy Institute of Technology's research program has focused on the development of medication formulas and treatment procedures for mesotherapy. Considerable effort has been given in the past to mesotherapy pain management of both nocioceptive and enteropathic pain syndromes. MIT is the first mesotherapy research institution to pursue an evidence-based clinical trial in Post Polio Syndrome and neuromuscular treatments, addressing the regenerative medicine benefits of human growth hormone, bio identical testosterone replacement therapy, and mesotherapy treatments of medications and micronutrients to the neuromuscular system. Irrespective of this evidence-based outcome, further clinical research in regenerative medicine treatments will be required, including government support for PPS research and the vital importance of these 1.6 million human lives.

R. Stephen Jennings, MD, MS, FAAFP, DABM

Principal Investigator Vipul Dev, MD, Research Director

For further information please contact:

The MIT Post Polio Syndrome Longevity Center Clinical Trial.
The Mesotherapy Institute of Technology, MesoSphere Medical Centers, and The MesoSphere are all subsidiaries of Mesogen Corporation. All Rights Reserved. 2005.