Israeli Medical Advances

 Healing the World

By Shmuel Shapira, Israel 21C, October 29, 2006

Shmuel Shapira  is a professor, Hadassah University Hospital Deputy Director General and Director of Hebrew University-Hadassah School of Public Health

Israel has been always in the front of world clinical medicine, medical sciences and biotechnology. And in the last five years major promising scientific contributions have originated from different Israeli hospitals and faculties of medicine which are having worldwide implications. Here are just a few of the highlights which my medical and scientific colleagues at Israeli hospitals and research centers have been part of:

Ovarian tissue transplant
In a breakthrough that provides hope for woman undergoing chemotherapy during their fertile years, for the first time in the world, a cancer patient who had become sterile due to anti cancer chemotherapy treatment gave birth after undergoing a transplant of ovarian tissue. The ovarian slices had been taken from her body prior to initiation of chemotherapy treatment and preserved by freezing them.

Behind the stunning medical advance were Dr. Dror Meirow, Prof. Jehoshua Dor, and Dr. Jacob Levron of the IVF Fertility Unit at Sheba Medical Center. The global breakthrough was reported in The New England Journal of Medicine in 2005.

Human embryonic stem cells
Research in human embryonic stem cells is a rapidly developing and promising scientific field. These cells are in high demand because of their ability to reproduce almost infinitely and to differentiate into diverse tissues. The demand for cardiac and nerve cells production is crucial because damaged nerve and muscle cells do not regenerate following disease or injury.

In 2001, Drs Benjamin Reubinoff, Tamir Ben-Hur and their group from Hadassah Hebrew University Medical Center described in Nature Biotechnology Journal the derivation of neural progenitor cells from human embryonic stem cells. This is a significant stage in the study of early human development of neurons (nerve cells) and in the creation of an unlimited source of donor cells for neural transplantation therapy.

When human early nerve cells were transplanted into the brains of newborn mice, they had demonstrated wide distribution and differentiation in the recipient mice brain. These observations set the stage for future developments that may allow the use of human embryonic stem cells for the treatment of different neurological disorders and central nervous system trauma.

Umbilical cord stem cells
Israeli researchers are also at the forefront of research which could one day make heart transplants obsolete. Using stem cell technology, they’re developing a way to use the blood of a newborn baby’s discarded umbilical cord as an unlimited source of stem/progenitor cells that could be injected into the injured heart in order to regenerate damaged heart tissue.

Stem-cell based therapy has also emerged as a novel strategy to repair myocardial damage. In a breakthrough approach for regeneration of dead heart cells, Professors Jonathan Leor and Arnon Nagler at the Sheba Medical Center performed a pilot study to demonstrate the safety and feasibility of intracoronary delivery of umbilical cord blood ‘ progenitor cells into the infarcted myocardium of pigs, and to track cell migration and colonization.

Another group at Sheba led by Dr Sarah Ferber successfully modified liver cells to produce insulin. This may be a future method to cope with the so common and devastating disease; insulin dependent diabetes.

Stroke treatment
A collaboration between Hadassah University Hospital and the University of Pennsylvania found a safer way to benefit from the use of the potent drug -tissue-type plasminogen activator (tPA) for stroke while abolishing its serious side effects. This drug?s desired effect is fibrinolysis (liquefying blood clots) in the brain blood vessels and enabling better blood flow. These clots are the most common cause of stroke which is associated with high mortality and morbidity.

Until now, severe side effects brought on by tPA have limited its use. The research group found certain protein decreasea the neurotoxic effects of tPA while preserving its fibrinolytic qualities. This promising study for the management of patients suffering from ischemic stroke was published this year in the prestigious journal Nature Neuroscience.

Fetal well-being
Another pioneering work from Hadassah-Hebrew University Medical School offers a promise for the well being of pregnant woman and theirs fetuses and an optional remedy for other common gynecological disorders. A group led by Drs. Hanna, Yagel and Mandelbaum demonstrated the role played by decidual (part of the placenta) Natural Killers (dNK) at the human fetal maternal interface.

These unique cells play a role in the penetration of the early fetal cells into the uterine bed, and for the proliferation of blood vessels in the placenta. These DNK cells may also play an important role in the delicate fetal-maternal immunologic interaction. Advances based on the Hadassah study may enhance the understanding of preeclampsia (early toxicity of pregnancy), gynecological breakthrough bleeding, endometriosis (uterine tissues implanted in abnormal locations) and recurrent miscarriages. This pioneering study was published in Nature Medicine this year.

Hepatitis C prevention
An important contribution to preventive medicine was developed by a group lead by Dr Arieh Yaari at Soroka University Medical Center in Beersheva. This group described in the Journal of Medical Virology a novel saliva test for the early detection of hepatitis C.

The hepatitis C virus infects more than 170 million people around the world; 70% of these will develop severe side effects such as cirrhosis, liver failure and cancer of the liver.

This new saliva test will gradually replace the traditional blood test, and the much simpler and less resource demanding method will enhance mass screening resulting in improved containment of the disease and early treatment to prevent life threatening complications.

While years of war and terror have made Israel a world center of excellence for terror medicine and war surgery, they are fields that originated from critical necessities. That at the same time, the Israel medical community has developed the capabilities of being at the cutting edge of international biomedical research is indeed a great achievement.


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