Transplantation of human chromaffin cells for control of intractable cancer pain

Adrenal medullary chromaffin cells produce high levels of endogenous opioid peptides. Recent data suggest that transplantation injected locally into the spinal subarachnoid space reduced intractable malignant pain. In order to determine the feasibility, the efficacy and the risks of using adrenal medullary tissue for control of irreducible pain, we have developed a transplantation protocol on cancer pain patients selected when they required chronic intrathecal injection of morphine and progressively increasing doses to maintain the level of analgesic effects. At the present time, our clinical trial involves 8 patients. We report here our initial results (mean follow-up: 5 months). The various data collected before and after the intrathecal administration of chromaffin cells included: 1) Pain evaluation over time, with concomitant narcotic intake, 2) CSF sampling through an implanted access port to determine the following biological parameters: biochemical assay for opioid peptides, cell count and phenotyping of lymphocytes, 3) peripheral blood samples for lymphocyte typing. The results confirm the efficacy of adrenal medullary transplantation into spinal CSF for controlling irreducible cancer pain. Complementary intrathecal and oral morphine were totally stopped in 2 cases and stabilized in 5 others. It seems essential to have an important volume of grafted tissue to achieve analgesia with high levels of metenkephalin in CSF. A progressive decrease in metenkephalin release was observed from 2 to 4 months after the transplantation. Two patients with a long-term follow-up (8 and 12 months) needed another intrathecal chromaffin cell graft

Lifespan Versus Healthspan

International audienceLifespan is a measure of duration, not of content, and it does not provide the same information as biological markers of ageing. Therefore, one cannot rely on lifespan to infer conclusions about ageing. For example, two centenarians can die in very contrasted physiological states: as bedridden for years or during jogging. Healthspan can be measured in animal models by relying on behaviour, resistance to stress, and so on. Biogerontologists working with animal models tend to privilege the measurement of lifespan rather than that of healthspan when the animal lives for a short time (e.g. Caenorhabditis elegans, Drosophila melanogaster) because measuring lifespan is easy and studying, say, behaviour, is more difficult. Conversely, biogerontologists privilege healthspan when the animal model lives for years (e.g. rodents, non-human primates), because measuring lifespan can be out of reach. In any case, biogerontologists should try to observe both lifespan and indicators of health, whenever it is possible, and not conclude that ageing is delayed when they have simply observed longer lifespans