The Hindu : Tamil Nadu News : `With medical intervention, gene replacement can be avoided'

Online edition of India's National Newspaper
Wednesday, Jun 30, 2004

Tamil Nadu

Tamil Nadu

`With medical intervention, gene replacement can be avoided'

By Ramya Kannan

Veda Vedanarayanan, professor of Neuropsychiatry, University of Jackson, Mississippi, United States. — Photo: R. Ragu

CHENNAI, JUNE 29. Medical interventions to correct gene defects are likely to circumvent the complex procedure of Gene Replacement Therapy (GRT), says Veda Vedanarayanan, professor of neuropsychiatry, University of Jackson, Mississippi, United States.

While the hype surrounding gene replacement has been high, a lot of questions are involved in actually trying to work out the GRT process. "How will the information we have translate into treatment? Replacement is extremely difficult and so far we have not succeeded. We have to examine how to deliver genetic material into the specific area, figure out how it will work and what the side effects are."

Researchers and doctors are trying to examine how other genes respond when one gene is repaired. "Do they hurt the cell, do they help the cell? Studying these dynamics will enable medical professionals to evolve interventions that will help circumvent to GRT. We can use medicines to switch on and off a cell," says Dr. Vedanarayanan.

He was in Chennai recently to deliver the A.Appa Rao oration at the International Neuropsychiatry Symposium, organised by the Neurosciences India Group and hosted by the Deepa Krishnan Child Neurodevelopment Centre at the Voluntary Health Services (VHS) Hospital, Taramani.

Appreciating the VHS centre for providing multiple specialised services under one roof, he emphasised the importance of setting up more such centres of excellence. With orthopaedicians, neurologists, neurosurgeons, speech and occupational therapists, genetics counsellors and social workers collaborating under one roof, the overall requirements of a child with neurological problems could be handled effectively.

Call to policymakers

Policymakers must create enabling facilities for the rounded development of children with neurological disorders, as cost-benefit studies had shown that initial intervention would decrease cost in the long-term and also enhance productivity levels. For instance, many children with severe spasticity might require every year three or four hospitalisation sessions that would be expensive. "We can treat their spasticity and enable them to be more mobile. The advantage of working in paediatrics is that children have the potential to recover and make remarkable progress," says Dr. Vedanarayanan.

"Investing in a child is money well spent. The initial investment might be high, but if you neglect children a society cannot progress. Besides, the long-term benefits are quite substantial. Look at the savings made downstream and invest for the future."

Comfort level

It was also important to look at the comfort levels of the child with neurological problems while treating her/him. It was not only the child but also the family that suffered. Spastic children suffered from frequent night cramps and pain and could not sleep. Even family members had to stay up to take care of the child.

"There are other problems with motor impairment, feeding, hygiene, even posture. We cannot make every child walk. But that is not the ultimate goal. We are looking at how much comfort we can provide the child and the family and every little thing matters," he said. "However, many times, children manage to exceed the goals set by us and walk, even run."

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