APOLOGIES FOR the lurid yet fiendishly-clever-as-usual title, but trust me–it’s no less appropriate than was last week’s POODLEs reference. Not only is today All Hallows’ Eve, a time for all things sanguinary, but it just happens to be the 2nd anniversary of my stem cell transplant, undergone whilst witnessing the devastation of Hurricane Sandy from my hospital room window.
Plus, I’m way overdue for a medical update, and what with all the security breaches and new operating systems with which we’ve been inundated recently, I figured you could use a break from the geeky computer stuff. So let’s jump right into some geeky medical stuff instead.
As I noted right around this time last year, the sheer volume of blood moved in and out of one’s body prior to said transplant is about as sanguinary as it gets. Yet through it all, the docs and I remained sanguine and thus, here I prattle to report on my current condition re: chronic graft vs host disease and an innovative but, ah, sanguinary new treatment for that most vexing of conditions afflicting much of the cGVHD population–keratitis sicca, a.k.a. dry eye.
BECAUSE OF the way cGVHD causes a stubborn and severe inflammation of the tear ducts, we transplant patients end up with a pretty high-octane version of dry eye–the kind that is virtually debilitating at times, and doesn’t respond to artificial tears, lubricants or even the vaunted Restasis–although that does seem to work quite well for the attractive eye doctor in the TV commercial.
So what have the best and brightest researchers recently conjured for us keratitis sickies? As you’ve probably deduced from all of the above, it has everything to do with… blood.
Seems that the only area of our body that is not threaded through and through with blood vessels is the cornea–the clear outer covering of the eye over the pupil. Clear being the operative term here–if the cornea were intertwined with blood vessels, it would no longer be clear, and we’d have only four senses with which to work.
SO HOW DOES the cornea receive the nutrients that blood transports to all the rest of our cells, if the blood has no way to get there? Why, tears of course. Seems they’re not just for keeping your eyes lubricated (courtesy of the tear film that covers and protects the cornea); they also carry the same nutrients that your blood supplies to all other parts of your body.
These researchers therefore theorized that if they mingled the blood from an individual suffering from severe dry eye with artificial tears, in just the perfect proportion, they could create an autologous serum in the form of eye drops that would work as well as the real McCoy. Tears of renown, if you will.
Sounds simple, perhaps, but the early returns have been promising. Here’s an excerpt from a recent study published at the Wiley Online Library:
Theoretically, autologous serum eye drops (AS) have a potential advantage over traditional therapies based on the assumption that AS serve not only as a lacrimal substitute to provide lubrication, but also contain other biochemical components mimicking natural tears more closely. The application of AS in dry eye treatment has gained popularity as a second-line therapy in the treatment of dry eye. Published studies on the subject indicate that autologous serum could be an effective treatment for dry eye.
THE REST, as they say, is history. To wit: In a most happy coincidence, AS happened to be exactly what Manuel B. Datiles, M.D., the ophthalmologist with whom I was fortunate enough to meet at last year’s NIH trial, was–and still is–experimenting with.
This smidgen of information I gleaned at the trial led me to broach the subject of AS with one Leonard Bielory, M.D., he of the STARx Allergy & Asthma Center in Springfield, NJ and the immuno-ophthalmologist I’ve been visiting recently. In an even happier coincidence, he’s already been preparing AS for some of his patients, and has offered to whip up a batch for yours truly in the very near future–but only if I agree to just a little more bloodletting, of course.
TO WHICH I say: Why not? It is Halloween, after all. And what’s Halloween without a little, er… blood let for tears.
Next: Back to computer/technology stuff that I’ll pretend you’re actually interested in