The first British attempt to treat paralysed spinal cord injury patients with their own nasal stem cells was announced by Prof Geoffrey Raisman, the director of the Spinal Repair Unit at University College London. While this is not the first time that such a transplant has been attempted, the research is remarkable because, unlike earlier efforts, it rests on a 40-year programme of research on animals and has an established scientific pedigree.
The new hope rests on the discovery that there is only one part of the nervous system in which nerve fibres are in a state of continuous growth throughout adult life. The nerves are at the top of the nose and are concerned with the sense of smell.
Prof Raisman’s team will harvest nasal cells to treat at least 10 patients in a pilot study early next year at the National Hospital for Neurology and Neurosurgery in Queen Square, central London.
“I have spent my research career in trying to find a treatment for spinal cord injury, and I never anticipated that we would get this far when I started out,” he said.
He believes that one day transplants will enable patients to regain much of the ability to move that they have lost.
For paraplegic patients this could lead to a return of sensation and movement to some leg muscles, potentially allowing them to stand and make movement easier, while tetraplegics (with spinal injury high in the neck region), could recover touch sensation and movement of the hands, and regain the ability to dress, feed and clean themselves.
“For many years these injuries were considered incurable, and they are still are incurable,” said Prof Raisman, although he pointed out that around half of patients can make a recovery to some extent. For those who do not “this opens the door to the repair of these injuries.”
In the first human trial he will focus on patients - mostly teenagers - who have had an injury typical of motorcycle accidents where nerves in the arm have been pulled out of the spinal cord, leading to complete paralysis and loss of sensation in the arm as well as intractactable pain in most cases.
Depending on where the spine was severed in laboratory animals these transplants resulted in the ability to reach with a paw or to climb. “We were the first, and still the only, team to show that this repair resulted in a restoration of the ability to breathe,” he added. The principle could be used to restore bladder, bowel and sexual functions.
Making a patient his own donor “will avoid the need to use embryonic tissue, to find donor individuals, foreign stem cells, the immune response or to use powerful designer drugs with unknown side-effects.”
“Success will open the door to a number of other conditions where nerve fibres are damaged,” he said. “These include some major forms of stroke, as well as blindness and deafness caused by nerve injuries.
“We do not wish to raise false hopes in patients who are living with spinal cord injury. However, our work to date clearly indicates that, contrary to received wisdom, the spinal cord does have the potential to repair itself.”
First results are expected within the year.
I am looking forward to hear positive news from this trial.