Advances in spinal cord rehabilitation
About 5.6 million Americans have some degree of paralysis, far more than previously thought, according to the findings of a survey by the Christopher & Dana Reeve Foundation.
Previously, the highest estimate of paralyzed Americans was 4 million.
Stem cell research has taken off since President Obama signed an executive order freeing federal funds for work on any type of stem cells. There is promising research being done, and a number of clinical trials are underway. The first clinical trial in the U.S., using embryonic stem cells, was approved by the FDA for the treatment of paralysis. Embryonic stem cells are coaxed into forming spinal cord cells. Successful studies have been done in rats that were paralyzed. India also will also start human clinical trials for therapies using umbilical blood cord (UBC) stem cell, and China has a number of trials underway as well. Another research team has pinpointed stem cells within the spinal cord that, if persuaded to differentiate into more healing cells, will result in fewer scarring cells following an injury and may lead to a new, non-surgical treatment for debilitating spinal-cord injuries. Their results could lead to drugs that might restore some degree of mobility.
The tiny number of stem cells in the adult spinal cord grow slowly or rarely, and fail to promote regeneration on their own. But recent experiments show that these same cells, grown in the lab and returned to the injury site, can restore some function in paralyzed rodents and primates. Another research team uses olfactory (scent receptor) cells from the patient’s nose, injecting them into damaged spinal cord. The olfactory tissue in the nose is unique because it is the only place in the body where there is constant replacement of nerve cells throughout life. These cells can help overcome the blocks that prevent nerve cell regeneration after damage to the spinal cord and provide growth factor hormone, enabling them to make connections. Trials on patients showed positive benefits for patients including return of some muscle function and sensation in parts of the body which previously had no feeling. Another team of scientists is tackling the problem from a different angle: through microscopic messenger molecules that can tell the disconnected nerve cells to re-grow using molecules are called nanofibers. These have to be constructed outside the body and implanted. Another approach involves spontaneously generated nanofibers which create themselves from smaller molecules and can be inserted with a simple liquid injection. Nanofibers carry the protein building blocks to the injured area promoting the growth of nerve cells and inhibiting the growth of scar tissue. Rats with severed spines, five weeks after the injury, injected with nanofibers regained significantly more motion in their hind legs.
Spinal cord injuries present a two-fold problem: First, the nerve cells are disconnected, cutting off messages from the brain that tell the body how to move and second, shortly after the injury a scar tissue begins to form, blocking nerve cells from growing back. When nerve cells in the brain or spine are damaged, they often release a spurt of chemicals that cause nearby cells to die, so stopping this process is key to preventing the damage that continues to build after spinal cord injury. A number of promising studies address these problems including using a common and safe blue food dye. Tests in rats showed the dye, called brilliant blue G, crossed into the spinal fluid and helped block inflammation. These studies may lead to a practical, safe agent that can be given to patients shortly after injury, for the purpose of decreasing the secondary damage. Also, Cholesterol-lowering drugs called statins have shown promise. After spinal cord injury, inflammation cuts off blood flow to the spine, making the injury that much worse. When researchers gave newly paralyzed rats statins, they not only improved, they actually started walking again. Human trials on the use of statins to treat spinal cord injuries are expected to start soon. Statins are already FDA approved for lowering cholesterol.
Recently our slopes and town have been graced by some amazing athletes representing the Hartford Ski Spectacular. I had the opportunity to talk to a paralyzed mono ski instructor as he rode the chair with me. This has inspired me to write about some of the current advances in spinal cord rehabilitation. My former department chair at Rutgers has been in the forefront of this research, and I know Christopher Reeves’ mother, so this has been an area I’ve always been interested in. Frisco Rowing Center is looking to sponsor an athlete interested in competing in rowing in the Paralympics. Contact us if you, or you know of someone interested. Our e-mail is email@example.com.
Breckenridge resident Dr. Joanne Stolen is a former professor of microbiology from Rutgers now teaching classes at CMC. Her scientific interests are in emerging infectious diseases and environmental pollution.
By Dr. Joanne Stolen
special to the daily