Thursday, November 14, 2013

Loose ends: Welcome back Louis Gifford: David Butler, please, glia are NOT "immune" cells.

It's a beautiful day here in the deep south of the Canadian prairies - the sun is blazing, glinting off wet streets. Yes, wet!
It's mid November, but bits of snow that fell last month disappeared; this month's temp has hovered at zero-ish, with almost no precipitation. Last night it must have rained a little bit. 

Not bad for mid November! No seasonal affective disorder at all! Not a trace. And in only short 5 weeks, daylight will turn around and lengthen yet again.  

Lately I had been all wound up spending hours and hours a day doing new images for yet another draft of my nerve book, also the manual I use for teaching, when the big screen computer died. It's currently in the Mount Saint Apples hospital, an hour to the north, for a dead hard drive ectomy. It will be there for a few more days probably. So I'm at loose ends, kind of.

I'm going to have to get a dolly for trips to the computer hospital. I can carry that beast for short periods of time, but jeepers, the distance between the mall parkade and the Apple service store is very long, involving a short flight of stairs to boot. I had to rest frequently. This time I was offered help by a lady using a wheeled walker: She suggested I put the box on top of the walker somehow, and she would give it a ride to the Apple store. I didn't see this as a good idea, worried the box might fall off or something. Just then along came another woman, a few inches taller, a few pounds lighter, and quite a few years younger than I, who offered to carry it for me. So I let woman number 2 help me. I mean, I would have made it, maybe with one more rest, but hey, she looked capable and acted like she needed to acquire service points for some imaginary merit badge or something, so... what the hey, OK.

Still, a little fold up dolly would do the trick, then I wouldn't be so besieged by helpful strangers. Not that I don't appreciate the offers to help, but just this: You can spend your life thinking you're completely invisible, when really you are totally visible, which is a little disconcerting. And it doesn't take much social ripple for strangers to appear out of the shadows if they see something that bothers them, but isn't a threat, and think they might be able to help restore peaceful calm to the mall.
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When I'm at such loose ends, I blog. 

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In the last few days some exciting news from the UK: Louis Gifford has relaunched his wonderful series from a decade ago, Topical Issues in Pain. Maybe this time round, the kindling will catch fire, and his brilliance will not only revitalize, but deepen the profession.
Seriously, my profession has lots of 'splainin' to do: The first time I ever even heard of the neuromatrix model of pain was from Topical Issues in Pain book #3, where Melzack had written a very nice long foreword. Why did I have to stumble across it in Louis Gifford's book in 2003? It had already been out for years! Why had no one presented it or written about it yet in any of our professional publications here in Canada? 

Better late than never, I suppose. But I can't help but think the profession in Canada was still so mesmerized by pushing around mesoderm that it couldn't quite make the leap to considering the effects we have on way more sensitive ectoderm. It was only about a year later that Nick Matheson put a bug in my ear, and a few months later that I contacted Neil Pearson, and the Canadian Physiotherapy Pain Sciences Group  (which eventually became Pain Science Division of CPA) was launched.

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Today I found the latest edition of noinotes in my inbox. I love David Butler, the therapist, the teacher, the author... and I love this little professional confessional, but: 
Excerpt: 
"I thought I may have reached nirvana with the brain, but now I realise that neurones are only 10% of the brain and as the rest is immune cells, so there is long way to go."


David, David, David... 
A little bit of me dies every time you say that. It's misleading.
I realize you picked that up from Mick Thacker; I do not know why he continues to assert that, because if he closely read developmental biology, he would see how that statement is not correct.
Immune cells are from way far back in development, before, the body has even started to be built. They come from the yolk sac or something. Microglia are immune cells; hard long rigorous argumentative and painstaking lab bench gruelling research over decades has finally established this.  

There was no controversy as far as I am aware about the origin of all the other glia: glial origin seems to have been recognized quite straightforwardly, early on: no arguments arose. They come from neural tube stem cells, i.e., ectoderm; neural stem cells differentiate into either neuronal cells or non-neuronal cells. If they turn into a neuron, then they do neuron stuff. If they turn into an astrocyte, an oligodendrocyte, etc. (i.e., any other cell termed "glia"), then they can do all kinds of stuff, including (but not restricted to) immune-like stuff. 
I think, therefore, it's misleading to call glial cells immune cells as if the two categories were completely equivalent. I saw it in your latest edition of Explain Pain, too. 
Please, please stop.