New Hope for Paralyzed Patients?
If you have a spinal cord injury, recent reports on stem cell therapy look like a dream come true. Like wire spliced into a severed cable, stem cells could restore communication between your body and your brain.
After endless numbness, you might once again feel the grass between your toes or the caress of a lover. After an eternity of motionlessness, you might rise from your chair or hoist a glass of wine to your lips.
"This is very exciting for patients," says Jeffrey C. Wang, MD, chief of the Orthopaedic Spine Service at the University of Southern California in Los Angeles. "Whenever they hear about stem cells, their eyes light up."
Clinics around the world are already offering such treatments. But the science is still in its infancy. As research progresses, it is heading in so many different directions that it has become more difficult to know which technique might eventually fulfill the promise.
"It's hard to get these studies done," Dr Wang says.
In many ways, spinal cord repair looks like the killer app for a technology that has been kicking around for decades. When an accident damages your spinal cord, you lose some or all of the ability to move or feel below the site of the injury. Some patients can't control much below their necks; it's hard to think of a more debilitating condition. And despite the dramatic progress in so many other areas, medicine and surgery can't do much to help.
The problem is that the spinal cord doesn't heal. In the aftermath of the injury, the inflammatory response includes the release of inhibitory factors in a chain reaction ending in retraction of the nerve cells' axons. The damaged area expands into a cavity, and scar tissue blocks healthy cells from bridging it.[1]
Treatments using growth factors or blocking inhibitory factors, along with physical therapy, help a little bit but generally can't restore much function.[2]
Fewer than 1% of patients who can't move their legs and feet a month after a spinal cord injury ever walk again.[3]
Encouraging Study Results From Abroad
Researchers have been looking for ways to transplant new cells into the gap. Stem cells look like good candidates. These immature cells can grow into many, if not all, of the tissues in the human body—including nerve cells. Not only could they form a bridge across the lesion, but they also may excrete factors that decrease the harmful inflammation.
"A lot of people would agree that getting at what's causing the problem is the way to treat it," says Dr Wang. And recent reports are tantalizing.
In one recent study, researchers from two centers in Salvador, Brazil, transplanted stem cells into the spines of 14 people whose spinal cord injuries had left them with no motor or sensory function below the waist. All of the patients regained the ability to feel light touch, and some recovered some movement in their legs.[4]
At the Trivedi Institute of Transplantation Sciences in Ahmedabad, India, researchers treated 10 similarly disabled patients. "They were desperate for any other therapeutic modality available," the researchers write. After 8 months, eight patients could walk for an hour or more while leaning on walkers. Bladder and bowel function improved.[3]
More such studies keep popping up from around the world. And on their websites, clinics dangle the promise of these treatments to an international audience. A Web page of the Stem Cell Institute in Panama City, Panama, for example, tells prospective patients that a patient's own bone marrow or human umbilical cord tissue (donated by mothers after normal, healthy births) can be used to treat spinal cord injuries and that "a number of published papers and case studies support the feasibility of treating spinal cord injury with allogeneic human umbilical cord tissue-derived stem cells and autologous bone marrow-derived stem cells."[5]
And NeuroGen Brain & Spine Institute in Navi Mumbai, India, will consult with you over the phone, help you arrange your visa, pick you up at the airport, and whisk you to its operating room.[6]
Medscape Orthopedics © 2016 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Stem Cell Therapy for Spinal Cord Injury: A Status Report - Medscape - May 06, 2016.
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