|EMSB JOINS STE. JUSTINE HOSPITAL FOR GROUNDBREAKING RESEARCH STUDY ON SCOLIOSIS|
MONTREAL, AUGUST 14, 2007- The English Montreal School Board (EMSB) has agreed to work with researchers and medical experts from CHU Sainte-Justine (University Hospital Centre) who are studying musculo-skeletal deformities in adolescence on a groundbreaking study related to adolescent idiopathic scoliosis (AIS).
There was a time when all students in Quebec schools were tested for scoliosis but since 20 years, it is now a thing of the past. While the goal of this study is to collect data from students in Grades 4 through 11, it will also provide parents with a valuable opportunity to get their children screened.
Scoliosis is an abnormal lateral curvature of the spine. It affects four out of every 100 people, mainly girls. For a small number of people, the curve gets worse as they grow and they may need a brace or an operation to correct it.
AIS is the most frequent known disease associated with musculo-skeletal deformities. The most common form of scoliosis is unclear, although AIS is a disease affecting an important number of adolescents (0.2 to 6 percent of the population) and affecting mainly girls in number and severity. Sainte-Justine's orthopaedic clinic sees 2,500 patients every year who need a medical follow-up every three to six months, associated sometimes with bracing and/or surgery. This spinal deformity is called idiopathic because it remains unclear as how it develops. There is no proven method or test available right now to identify children or adolescents at risk of developing AIS or to identify which of the affected individuals are at risk of progression.
With this in mind, the EMSB/Ste. Justine study will work towards finding new treatments and even drugs that might be able to cure, if not prevent these deformities to appear. Dr. Alain Moreau, who is overseeing the research study, explains that what they are working on is a molecular and genetic study of the abnormal signalization of melatonin, a natural hormone, which might cause AIS and explain why the cells of AIS patients cannot response to melatonin.
The Ste. Justine team plans to visit EMSB schools in the fall. All research will compare those children who have already been diagnosed with AIS and others who are completely healthy. Parents are being asked to help this cause and allow their child to participate in this study by asking him or her for a blood sample of 20 ml. in order to compare his or her lymphocytes (white blood cells) with the ones of the clinic's patients.
"All the information collected, hopefully, will lead, in a near future, to new therapies and possibly to new methods of diagnosing sooner adolescent idiopathic scoliosis," says Dr. Moreau.
Dr. Moreau says students who participate have an opportunity to contribute to the advancement of scientific knowledge. As control subjects their blood will be used as a functional test for melatonin and also will permit the hospital to establish paediatric standards for novel biochemical factor levels in blood of children and adolescents. Two blood samples (2X10ml.), only for the purpose of this study, will be taken in order to be able to isolate lymphocytes (blood cells) so that the researchers can extract the DNA used in genetic testing and also dose three different biochemical factors secreted in blood. Following these two blood samples, three other blood samples spaced over six months from each other will be required, meaning a follow-up of 18 months.
These blood samples will be used for research purposes to provide a better understanding of the mechanisms involved in scoliosis. "Therefore, in order to be able to have a better understanding of AIS and possibly develop improved drugs to treat or may be even cure this sickness, need to recruit healthy subjects to compare our results," says Dr. Moreau. "The harvested samples will be identified only by a distinct, non-identifying code number, which will ensure the confidentiality of the sample source. The only information recorded in the laboratory will be the patient's age and sex. We will also collect certain information on your child for our study, such as smoking and drinking habits. The research on the samples taken by the researchers involved in this study, or by their colleagues, may lead to the development of commercial device, new drugs or patentable processes."
While healthy subjects may not derive any immediate or specific benefit from participating in the study, they will, however, have contributed to the advancement of scientific knowledge that might help other children in the future. The research protocol does not present any danger for the patient (other than the risks normally associated with a blood sample). It should also be noted that the research is still at the preliminary and experimental stages and is not aimed at diagnosing any other condition.
Dr. Moreau's group launched the project recently at the Commission scolaire des Affluents (CSA) in Repentigny, where 37 healthy children in five schools were enrolled in the study. During each school visit, an orthopaedic surgeon (Dr. Benoit Poitras) will perform a physical exam using the Adam's forward bending test with a scoliometer; two nurses will collect blood samples (about two teaspoons) and basic demographic data. All data will be codified to remain anonymous. In the event that they detect scoliosis, parents will be informed and a clinical referral will be given for the hospital of their choice for in-depth evaluation and follow-up. At the CSA, some students have been determined to have scoliosis.
One of the benefits of the project is when visiting schools a number of students have been identified as having scoliosis. "Not only will we be doing screening as well," says Dr. Moreau, "but we will also be working with paediatricians to bring more attention to this subject."
The research will be conducted at the Molecular Genetics Laboratory (bone and musculoskeletal deformities) at the Research Center of CHU Sainte-Justine, affiliated to the Université de Montréal. The first phase of the research project will last three years and is subsidized by Paradigm Spine, an Americain Society of New-York and Fondation Yves Cotrel de l'Institut de France.
"This new discovery will significantly change the way orthopaedic surgeons treat scoliosis in the future," says Dr. Moreau. "It will allow doctors to intervene sooner and faster. It brings about possibilities of developing treatments that are less invasive than surgery, such as the effects of nutrition and physiotherapy. This study will provide a more rationale basis for the development of better treatments and the first pharmacotherapies in order to prevent scoliosis and stop its progression."
Michael J. Cohen