Hope for Paraplegics

Spinal cord regeneration trials begin in Australia

BRISBANE, Australia

Doctors in Brisbane have begun the world's first clinical trial of spinal cord regeneration, using cells from the nose of a paraplegic in a bid to repair his damaged spinal cord.

    They said the first transplant of the regenerating nasal olfactory cells into a spinal cord was conducted last June by a surgical team at Brisbane's Princess Alexandra Hospital.

    The clinical trial followed experiments at Brisbane's Griffith University and other laboratories around the world in which rats with severed spinal cords were able to move their legs weeks after being transplanted with nasal cells called olfactory ensheathing cells.

    The cells connect the lining of the nose with the brain to provide our sense of smell. Unlike most nerve cells, they continue to regenerate throughout life, a property that probably evolved because they can be destroyed by infections. An obstacle to human trials had been that not enough of the cells could be collected from a single individual to patch up a human spinal cord.

    The team at Griffith University led by Alan Mackay-Sim solved the problem by developing a method of removing the nasal cells from a patient under local anesthetic and growing a large number of the cells in culture.

    "There are only a few microns (millionths of a meter) of mucus between the air and the nerve endings," points out Mackay-Sim. The idea is that the transplanted cells will provide a bridge to allow spinal nerves to grow through the damaged area, the scientists say.

    For the trial operation, surgeons injected 14 million of the olfactory cells into several damaged regions of the volunteer's spinal cord. It is hoped the transplanted cells would provide a bridge to allow spinal nerves to grow through the damaged area.

    Gary Evans, head of the Princess Alexandra Hospital Foundation, said the eight-hour operation was an outstanding success. "There were actually six or seven sections of the nerves in the cord that they were able to identify as being severed and put the cells directly into that area," he said.

    Three other volunteers are due to undergo similar surgery later in the trial, doctors said. All the volunteers' identities were kept secret. Each patient in the trial will undergo a battery of tests to see if there is any improvement in their condition.

    However, members of the Queens-land Spinal Cord Regeneration Project cautioned the trials were only in their initial stages and involved primarily testing the safety of the surgical procedures.

    "We're not expecting too much at all," said Tim Geraghty, director of the spinal injuries unit at Princess Alexandra. He added: "This is to try to prove that we are not going to do any harm, which is the whole purpose of a phase one trial. If we get some positive outcomes, even better--like feeling coming back in the legs or an improvement in bodily control functions. Even if people could get back some sensation around their bottom and legs, that would be extremely helpful in preventing bedsores. A step up would be an improvement in bladder or bowel or sexual function." AFP