Man on Fire - the disease, not the film!

Tweet My train of thought was distracted recently whilst reading about a very distressing condition called Peripheral Neuropathy. What caught my attention was the phrase "Man on Fire", which, if my memory serves me well was an action-thriller staring Denzil Washington, and what a very fine actor he is!

Firstly, more on peripheral neuropathy: this is a descriptive term that means damage to the nerves out in the "periphery" - usually the legs, and is often found as a complication of long standing Diabetes, alcoholism and exposure to toxins. However, in many cases there is no known cause, and consequently it is sometimes described as idiopathic (unknown) peripheral neuropathy. Despite all the medical jargon, what the sufferer experiences is unrelieved, excruciating burning pain in the affected areas, that may eventually lead on to complete loss of sensation. Now the loss of sensation may seem like a relief, but the problem then is that the patient can cut or graze themselves without knowing it, and this will often  lead on to infection and ulceration: and in the case of a Diabetic or an alcoholic, these two things are not conducive to improving ones health!

In the case of Diabetes, the damage to the peripheral nerves is thought to be due to damage to the tiny blood vessels that provide nutrition to the nerves themselves. In the case of Idiopathic peripheral nerve damage, we obviously don't know what the cause is. But Professor Stepehn Waxman MD PhD and his colleagues at the Yale School of Medicine have found that in about 30% of these cases there may be a defective gene involved: and this is where Denzil Washington comes in! There is a very rare medical condition called "Man on Fire" syndrome, where those afflicted sufferer life long, excruciating pain that so far has only been numbed by a cocktail of strong narcotic painkillers and antidepressants. Patients with Man on Fire syndrome have a defect in a single Gene , SCNA9 – which is expressed in sensory nerve fibers, and this is the same Gene defect identified in Dr Waxman's peripheral neuropathy patients.

The work they are doing with this damaged gene will lead to better understanding of peripheral neuropathy and holds out hope for far better management for those who suffer from it. What makes my occasionally cynical mind think that there must be a light at the end of the tunnel for those with this condition, is a press release from May 2011 which said:

" Yale School of Medicine has entered into a collaboration with Icagen, Inc. and Pfizer to explore the potential efficacy of investigational compounds as novel treatments for pain. These compounds, which were identified from an existing collaboration between Icagen and Pfizer may be useful in treating pain in people with a rare genetic disorder called ......... the “man on fire syndrome.”