Stem cell research and the treatment of spinal injury

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Stem cell research and the treatment of spinal injury

27th April 2010

The challenge faced by doctors hoping to treat patients with spinal cord injuries has been, at the very least, a frustrating one and sometimes, seemingly hopeless. In recent years stem cell research has opened up a new world of possibilities and optimism for the medical community and patients alike.

Animal testing has become an intrinsic part of stem cell research and scientists have been encouraged by results seen after replacing ruined nerve cells in animals with transplants of foetal cells. This procedure has, however, only ever been successful when undertaken within a few days of an injury.

More recently, researchers at Washington University believed that they had restored leg movement in rats with severe spinal trauma using the transplant technique up to nine days after the rats were injured. The cells used in this instance were mouse-embryo stem cells modified to ensure they would grow into basic nerve cells and other associated cells.

"When the spine is severely bruised, some nerve cells die off immediately," said John McDonald, a physician and neuroscientist at Washington University, in a recent report. "A second wave of programmed cell death called apoptosis follows. Most of this carnage occurs within 24 hours, shutting off nerve signals travelling the spine."

Following severe spinal trauma the centre of the spine fills with fluid which becomes a cyst, scar tissue then forms, preventing recovery. Neurons and axons at the injury site stop functioning and even if a neuron remains intact, it often dies quickly if the trauma has stripped the protective myelin sheath off the axon.

McDonald and his colleagues studied the outcome of 62 rats whose spines were bruised and as such could not support weight on their back legs. On the ninth day following the injury 28 of the rats received injections of embryonic stem cells pre-treated with retinoic acid to induce their growth into nervous system cells. 100% of the rats given cell transplant and anti-rejection drugs were able to stand on all four legs and, to varied extents, walk within another 14 days. The other 34 rats that were not injected showed no change.

Several weeks after the transplant most of the stem cells had died off but those that had survived were enough to produce a growing supply of new central nervous system cells.

It was not until January 2009 that the U.S. Food & Drug Administration gave permission for doctors to test the cell transplant treatment on individuals with thoracic spinal cord injuries. However, testing on those with cervical damage was not approved because preclinical testing with rats hadn't been completed.

Dr Keirstead, of University California, undertook further testing, similar to that of McDonald, using rats with cervical spinal trauma - approximately 52% of spinal cord injuries are cervical while the other 48% are thoracic.

"People with cervical damage often have lost or impaired limb movement and bowel, bladder or sexual function, and currently there's no effective treatment," said Keirstead, a primary author of the study. "It is a challenging existence."

Rats with 100% walking ability that had suffered neck spinal cord injuries were resorted to 97% following the cell transplant treatment which uses human embryonic stem cells destined to become spinal cord cells. The walking ability of those that underwent no treatment reduced to 38%. Keirstead and his colleagues discovered that the stem cells not only rebuilt myelin, the biological insulation for nerve fibres, but prevented tissue death and triggered nerve fibre re-growth.

Polly Fletcher, a serious injury specialist at Fentons Solicitors LLP, said that whilst stem cell technology is a controversial area of medicine, and it remains unclear exactly how the technique is able to produce such dramatic results, it does provide some hope to those who have suffered a spinal cord injury.

"The effects of such an injury are devastating with almost every aspect of day to day life being affected," said Polly, a partner at the firm. "At Fentons we work with spinal cord injured clients and help to rebuild their lives considering all aspects of treatment and rehabilitation. I am sure that as research continues our clients will wish to monitor progress in the hope that the technological advances may one day provide new possible treatments for spinal injured patients."

March 2010 saw the first anniversary of President Obama's decision to lift restrictions on human embryonic stem cell research in America. Although some have predicted stem cells to be a panacea for human illness, the development of effective techniques is still at a very early stage. The research faces strong opposition but an increase in funding worldwide is imperative if we are to seriously delve into its possibilities.

How can Fentons help?
Fentons have specialist spinal injury claim solicitors experienced in handling claims for most forms of spinal injury.

If you think that you have a case or require further information contact Fentons on 0800 0191 297 or fill in the online claims questionnaire.

Sources:
- Hans S. Keirstead, (2009) "Human Embryonic Stem Cell-Derived Oligodendrocyte Progenitor Cell Transplants Improve Recovery after Cervical Spinal Cord Injury", Stem Cells, Vol 28.1, pp 152 - 163

- N. Seppa (2000) "Stem cells repair rat spinal cord damage - Brief Article" Science News, pp 1-2

- Science Daily

- World Intellectual Property Organisation