Lorenzo's Oil

This article is about the film. For the substance, see Lorenzo's oil.

Lorenzo's Oil is a 1992 drama film directed by George Miller. It is based on the true story of Augusto and Michaela Odone, two parents in a relentless search for a cure for their son Lorenzo's adrenoleukodystrophy (ALD).

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Plot

Failing to find a doctor capable of treating their young son Lorenzo's rare disease, Augusto and Michaela Odone seek their own cure. They set out on a mission to find a treatment and save their child. In their quest for a treatment the Odones clash with doctors, scientists, and support groups, who are skeptical that anything could be done about ALD, much less by laypeople. But they persist, setting up camp in medical libraries, reviewing animal experiments, badgering researchers, questioning top doctors all over the world, and even organizing an international symposium about the disease. Despite dead ends of research, the horror of watching their son's health decline, and being surrounded by skeptics (including the coordinators of the support group they attend), they persist until they finally hit upon a therapy involving adding a certain kind of oil (actually olive oil with two specific long chain fatty acids removed) to their son's diet. They contact over 100 firms around the world until they find an elderly British chemist who is willing to take on the challenge of distilling the proper formula. It proves successful in normalizing the accumulation of the very long chain fatty acids in the brain that have been causing their son's steady decline, thereby halting the progression of the disease. There is still a great deal of neurological damage remaining which cannot be reversed until new treatments are found to regenerate the myelin sheath (a lipid insulator) around the nerves.

The film ends with Lorenzo at the age of 14 showing definite improvement (he can swallow for himself and answer yes or no questions by blinking) but indicating more medical research is still needed. Several healthy children are shown who, having followed a course of treatment with Lorenzo's oil, have remained symptom-free. We learn Lorenzo can communicate again via a modified sign language, and that Augusto Odone later received an honorary Ph.D. for his pioneering work in researching and discovering a significant treatment for ALD.

Cast

• Nick Nolte as Augusto Odone
• Susan Sarandon as Michaela Odone (nominated for Best Actress Oscar)
• Zack O'Malley Greenburg as Lorenzo Odone
• Peter Ustinov as Prof. Gus Nikolais
• Kathleen Wilhoite as Deirdre Murphy
• Gerry Bamman as Dr. Judalon
• Margo Martindale as Wendy Gimble
• James Rebhorn as Ellard Muscatine
• Ann Hearn as Loretta Muscatine
• Maduka Steady as Omuori
• Mary Wakio as Comorian Teacher
• Don Suddaby as himself
• Colin Ward as Jake Gimble
• Latanya Richardson as Nurse Ruth
• Jennifer Dundas as Nurse Nancy Jo
• William Cameron as Pellerman
• Laura Linney as Young Teacher

Developments since the film

The Odones founded the Myelin Project in the hopes of finding a way to restore the myelin sheath, which is destroyed in ALD and a host of other myelin diseases such as multiple sclerosis. If this vital substance can be restored, patients like Lorenzo may regain function and eventually lead a normal life.

For those boys who have elevated long chain fatty acids, but who do not exhibit neurologic symptoms or an abnormal MRI, the treatment of choice is Lorenzo’s Oil (LO; Moser et al, 2003; Moser et al., Arch Neurol. 2005; 62(7):1073-80) together with a very low fat diet and, where appropriate, corticosteroids. LO, which is administered daily, is a mixture of glycerol trierucerin and glycerol triolein, 1:4. It is thought to act by reducing plasma levels of very long chain saturated fatty acids (Moser et al., Ann Neurol. 1987; 21(3):240-9). The clinical studies of LO have been criticized because, for ethical reasons, they did not compare treatment with placebo control groups. Rather, the benchmark was patient compliance, as measured by control of plasma very long chain fatty acids. That is, the outcome for patients whose very long chain fatty acids remained poorly controlled was compared to that for patients who were well controlled. While LO appears to be effective in preventing the onset of neuroinflammation, it is not able to reverse it, once initiated (van Geel et al., J Neurol Neurosurg Psychiatry. 1999; 67(3):290-9). Patients on LO therapy must be carefully monitored, as trieucerin has been reported to reduce platelet counts (platelets are needed to make blood clot properly; Konijnenberg et al., Platelets. 1998; 9:41-8).

For those boys with an abnormal MRI or who exhibit minor neurologic symptoms, the only effective treatment currently available is heterologous bone marrow transplant (Mahmood et al., Lancet Neurol. 2007; 6(8):687-92). This procedure was initiated in an attempt to arrest the inflammation characteristic of childhood ALD, and prevent further destruction of brain myelin. While it meets with mixed results (Peters et al, Blood. 2004; 104(3):881-8), bone marrow transplant has been reported to lead to restoration of neurologic function in some ALD patients (Shapiro et al., Lancet. 2000; 356(9231):713-8). Most recently, Aubourg has reported success with transplant of the ALD gene, using HIV virus as the vector.

The Myelin Project

In April 2007 The Myelin Project international headquarters moved to Amarillo, Texas. Margaret Weis, Ph.D. was elected as the new President of The Myelin Project and Candace Root was named Executive Director. Dr. Weis is a research scientist at the Texas Tech University Health Sciences Center School of Pharmacy. The Myelin Project offices are located in the Laura Bush Institute for Women's Research on the campus of the Texas Tech University Health Sciences Center, 1400 Wallace Blvd., Suite 258, Amarillo, Texas 79106 800-869-3546.

The real-life Odone family

Augusto Odone worked at the Myelin Project until April of 2007 when he retired as President of The Myelin Project. Lorenzo's doctor, Hugo Moser, died on January 20th 2007 of pancreatic cancer. Michaela Odone died of lung cancer in June 2000. Lorenzo Odone is still alive, having lived far longer than his doctors predicted. He celebrated his 29th birthday on May 29 2007 [1], and is still living in Virginia with his father. He can no longer see, speak, or move on his own, but can communicate by wiggling his fingers and blinking his eyes. Lorenzo is not on any type of life support. He continues to be cared for by his friend Oumouri Hassane from the Comoros Islands. [2]

References

• Lorenzo's Oil at the Internet Movie Database
• The Myelin Project
• Lorenzo's Oil Lives Up to Its Billing Atlanta Journal Constitution – July 12, 2005
• Lorenzo Article from The Philadelphia INQUIRER. August 11, 2005