Spinal Cord Treatment

Spinal Cord Treatment

There are a couple of news stories today about paralyzed people and the stem cell treatment using stem cells from the nose that is being done in Portugal. One story, in the Fort Wayne Journal Gazette, is about a young man who is raising money for the treatment. In the procedure, stem cells from the nasal cavity are inserted into the spine in the hope that they will generate new stem cells and re-connect the spinal cord. The prospective patient’s mother reports that 7 of the 8 treatments have been somewhat successful (in the 8th, there was an unknown other problem). The Detroit Medical Center will be providing follow-up care.

The second story, in the Belleville News Democrat, is about a young woman who has had the procedure. This story reports that 46 people have had the surgery since 2002. The woman in this story has some feeling in her legs again and has received new braces to help her stand, instead of being confined to a wheelchair; she also has two hours of rehabilitation every day.

The Spinal Cord Injuries Recovery Center has the following on its website:

The surgery is experimental and the Lisbon team has not yet published articles describing its findings. However, the physicians have indicated that while there have been no dramatic cures, there has been improvement with many, but not all, patients. Improvement ranges from increased sensation or decreased pain to improved motor abilities or bowel and bladder function. Dr. Lima’s team is collaborating with the Detroit Medical Center in treating American spinal cord injury survivors. Because the FDA has not yet approved the procedure, Dr. Lima’s team operates on patients in Portugal and the Detroit Medical Center performs follow-up rehabilitation. The cost of surgery is around $50,000 (not including travel costs). The cost of rehabilitation is between $3,000 and $4,000. The Detroit Medical Center has a website describing the program at the following address:
http://www.rimrehab.org/news/index.pl?action=view&id=1132750110.>

And, for something else to think about, here’s a letter that appeared this week in the New Scientist about animal studies of spinal cord injury:

As a researcher and a neurologist who has cared for patients with spinal cord injuries, I applaud most scientific efforts that help us better understand these injuries, but I do not expect that data from animal experiments will translate into effective treatments for humans (11 February, p 11).

Despite more than 40 years of spinal cord injury research on animals and numerous "breakthroughs" in laboratory animals, spinal cord treatments, including Naloxone, Nimodipine, interleukin-10, and even the controversial methylprednisolone, fail when applied to human patients. Precisely controlled animal experiments simply do not mimic the complexity of human spinal cord injury, which often includes organ failure, shock, multiple fractures and infections.

The numerous differences between humans and animals in spinal cord neuroanatomy, physiology and reaction to injury - even at the cellular level - can manifest as profound differences in disease physiology and treatment effectiveness. For example, many animals possess a "central pattern generator" that allows spinal cord function independent of input from higher brain centres, but this has not been shown to exist in humans.

Rather than continue with disappointing and wasteful animal experiments, scientists who want to help patients with spinal cord injuries should concentrate on clinically relevant human-based research.

Aysha Akhtar
Washington DC, US Physicians Committee for Responsible Medicine
Physicians Committee for Responsible Medicine
From issue 2540 of New Scientist magazine, 25 February 2006, page 25

This is probably something to keep in mind when reading about animals regaining mobility when treated with stem cells. I grant that I am to some extent taking Dr. Akhtar as an authority here and don’t know if this position is disputed by other scientists. I expect it is, or there would have been no reason to write the letter.