Research Synopsis Dr. Stephen G. Waxman’s research focuses on a single and very important theme: preservation and restoration of function in patients with multiple sclerosis (MS) and related disorders. The goal of his research is to restore vital functions such as the ability to walk, the ability to see and the ability to feel sensations in people with MS. His research is unique in that it uses state-of-the-art, highly sophisticated methods of biomedical research and moves back and forth between the clinic and the laboratory, thus greatly accelerating the translation of basic research to the clinical realm. Dr. Waxman’s early work on the characteristics of impulse conduction in normal and demyelinated nerve fibers within the brain and spinal cord has provided a basis for much of what we know today about the pathophysiology of demyelination in MS. His research in the laboratory and clinic has opened up the opportunity to induce remissions in MS. His team is now focussing on the induction of remissions. Dr. Waxman also carried out the first studies on molecular mechanisms of axonal degeneration within the spinal cord and brain. This is of great clinical importance because degeneration of axons produces permanent (non-remitting) deficits in MS. By elucidating the molecular mechanisms responsible for axonal degeneration in the spinal cord and brain, these studies have opened up new approaches to therapies of neuroprotection that can preserve axons and thus restore function in people with MS. Dr. Waxman’s research is also directly relevant to neuropathic pain (pain after injury to nerve cells). Pain and other distressing sensory symptoms occurs in more that 50% of patients with MS. In many cases, it does not respond to currently available treatments. Dr. Waxman’s seminal studies using molecular biological and biophysical methods are beginning to unravel the events that produce pain in MS, opening up the door to the development of new treatments. Dr. Waxman has published more than 400 scientific papers dealing with these topics. The most important include: Waxman, S. G.: Demyelination in spinal cord injury and multiple sclerosis: What can we do to enhance functional recovery? J. Neurotrauma, 9:S105-S117, 1992. Stys, P.K., Waxman, S.G. and Ransom, B.R.: Ionic mechanisms of anoxic injury in mammalian CNS white matter: Role of Na+ channels and Na+-Ca2+ exchanger. J. Neurosci., 12:430-439, 1992. Waxman, S.G. Demyelinating diseases: New pathological insights, new therapeutic targets. New England Journal of Medicine. 338:323-325, 1998. Waxman S.G., Dib-Hajj S., Cummins T.R., Black J.A. Sodium channels and pain. Proc. Natl. Acad. Sci., 96: 7635-7639, 1999. Black, J. A., Dib-Hajj, S., Baker, D., Newcombe, J., Cuzner, M. L., Waxman, S. G. Sensory neuron specific sodium channel SNS is abnormally expressed in the brains of mice with experimental allergic encephalomyelitis and humans with multiple sclerosis. Proc. Natl. Acad. Sci., 97: 11598-11602, 2000. Waxman, S. G. Transcriptional channelopathies: an emerging class of disorders. Nature Reviews Neuroscience, 2: 652-659, 2001. Dr. Waxman has also edited or co-authored several texts which have had very significant impact. These include: The Axon (edited by Waxman, Kocsis, and Stys, Oxford University Press, 1995) is unique in providing the only contemporary text which covers both normal and pathological axons. It spans from the molecular to the clinical, and has helped to push axonal diseases, such as MS, into the mainstream of contemporary biomedical research. Diseases of the Spine and Spinal Cord (Byrne, Benzel, and Waxman, Oxford University Press, 2000) and its predecessor Spinal Cord Compression (Byrne and Waxman, F.A. Davis, 1990) are the definitive clinical texts on spinal cord compression and related disorders. Dr. Waxman has served as supervisor/mentor for more than 100 neurologists- and neuroscientists-in-training with interests in CNS plasticity and recovery of function in disorders such as MS, including many who have now developed their own independent laboratories and gone on to leadership positions around the world. Finally, as the founding Director of the PVA/EPVA Center for Neuroscience and Regeneration Research, Dr. Waxman has brought together the Department of Veterans Affairs, Yale University, and the PVA/EPVA in a uniquely productive collaboration that provides a model of inter-institutional cooperation. Via the Yale-London Collaboration on Neural Repair, which Dr. Waxman established and co-directs, there is now an active, ongoing collaboration between researchers within the Department of Veterans Affairs, Yale University, and several institutions in London, all focused on MS and related disorders and on the search for new therapies that will restore function in people with MS. Dr. Waxman has organized and chaired numerous scientific symposia and workshops, including the 2000 NMSS workshop on Neuronal Injury in MS, and the 2000 Novartis Foundation Symposium on Sodium Channels, Neuronal Hyperexcitability, and Neuropathic Pain. |