IDAHO FALLS, Idaho--An injection and a few minutes in a gentle beam of neutrons may someday ease the pain of severe rheumatoid arthritis for thousands of Americans.
In collaboration with the Department of Energy's Idaho National Engineering and Environmental Laboratory, physicist Jacquelyn Yanch of the Massachusetts Institute of Technology has devised a new way to kill the synovium, the lining that overgrows and ruins a joint afflicted with rheumatoid arthritis. She is testing the technique on rabbits and hopes to test it on humans in a few years.
Yanch injects a boron compound into an arthritic joint and exposes the joint to a beam of subatomic particles called neutrons. The boron absorbs some of the neutrons and forms a radioactive substance that quickly decays. Radiation from the decay kills the synovium and vanishes as soon as the neutron beam is turned off, since boron itself is not radioactive.
In helping develop the new arthritis treatment, INEEL, the DOE's leading nuclear technology laboratory, is applying and expanding its nuclear expertise. Advancing nuclear technologies is one of INEEL's assigned missions. For more than 10 years INEEL has conducted research on boron neutron capture therapy, a treatment for brain tumors that exploits the same interaction between boron and neutrons.
"This is an application for certain key technologies we've developed from the cancer program," said INEEL physicist David Nigg, who is collaborating with Yanch. "We're excited about it."
INEEL is studying the speeds and trajectories of the neutrons in the beam so Yanch and her coworkers can better estimate how much radiation they are administering.
The new technique should be more effective than surgery, which often fails to remove all the diseased tissue. It should be safer than an injection of a radioactive material, which kills the synovium, but leaves radioactivity in the body.
No one knows what initiates or how to cure rheumatoid arthritis, a potentially crippling disease that afflicts more than two million Americans. The disease arises when the immune system mistakenly targets the synovium, the membrane that surrounds a joint and holds in the lubricating synovial fluid. The synovium grows abnormally and invades cartilage and bone, causing them to soften and crumble.
Drugs can often hold the immune system in check. But even after drug therapy, between 10 and 20 percent of patients continue to suffer in at least one joint. Then, the only way to slow the progress of the disease is to get rid of the synovium.
Yanch and her collaborators from MIT, Brigham and Women's Hospital, and Newton Scientific, Inc., are trying their technique on the knees of rabbits with induced rheumatoid arthritis. Early results are promising. "We have very clear evidence that we've killed the synovium," Yanch said, "which is what you want to do."
But more work must be done before Yanch can test the technique on people. For treatment of non-lethal diseases the FDA requires experiments on two different animal species before it will approve experiments with humans, Yanch said.
Yanch thought of the technique in 1992, but the technology began to grow only after she received support from INEEL in 1995. "Most of the development has come with funds we've received through the University Research Consortium," Yanch says. "It's been a big help."
INEEL's University Research Consortium fosters collaboration between laboratory and university researchers to produce valuable new technologies and address national energy or environmental needs. The consortium funds several projects involving nuclear energy and technology.
The INEEL is managed and operated by Bechtel BWXT, Idaho, LLC (BBWI) for the U.S. Department of Energy.
For more information, see a feature story at http://inelext1.inel.gov/science/feature.nsf/ineel/synovectomy
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