Monday, November 27, 2006

Treatment for Spinal Cord Injury Pain

Researchers discover treatment for spinal cord injury pain

Spinal cord injury patients with moderate to severe nerve pain experienced less pain and in some cases no pain while taking the drug pregabalin, according to a study published in the November 28, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology.

'The findings are promising as spinal cord injury pain is a condition which generally responds poorly to currently available treatments,' said study author Philip J. Siddall, MBBS, PhD, with Royal North Shore Hospital in Sydney, Australia.

The study, considered to be the largest randomized controlled trial of spinal cord injury patients with nerve pain, involved 137 adults in Australia over a 12-week period. Half of the group received pregabalin; the other half received a placebo.

Researchers found at the end of 12 weeks, fewer than 16 percent of patients taking pregabalin had severe pain compared with 43 percent in the placebo group. And over one-third of patients in the pregabalin group had no or mild pain.

The study also found pregabalin reduced sleep and anxiety problems compared to the placebo group.

'Pregabalin was significantly more effective in relieving pain, improving sleep, anxiety, and overall well-being in patients with spinal"
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Thursday, November 16, 2006

REMEDI to Conduct Stem Cell Based Spinal Cord Injury Trials

Stem cell-based spinal cord injury treatment in Ireland has moved a step closer after the country's first pre-clinical trials were confirmed.

The trials, which were announced by the Minister for Enterprise and Employment Mr Micheál Martin, are to take place on the NUI Galway campus as part of a collaborative effort between the Regenerative Medicine Institute (REMEDI) and Edinburgh-based global biotechnology company Stem Cell Sciences.

The first of the collaborative studies is expected to examine the ability of neural stem cells from mice to provide functional improvements in spinal cord injury in rats, with a new 'distinct' type of neural stem cell used during the process.

However, while the development is a further step towards stem cell-based treatment in patients, Dr Tim Allsop, Chief Scientific Officer of Stem Cell Sciences, emphasized that procedures involving humans were likely to be 'some time' off.

Spinal cord injury affects more than 25 million people worldwide, with 130,000 new cases reported each year. "
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Monday, November 13, 2006

Injured Man Sees New Hope in Russia

He was left paralyzed in a 2003 accident; now, a treatment holds promise.

Raymond Krolikowski just wants to hug his wife and daughters again.

Krolikowski, 31, has been paralyzed from the shoulders down since a bull-riding accident at a Jacksonville bar in 2003. Now he's hoping a pioneering clinic in Russia will help him regain the use of more of his body.

"I'd do anything to hold my wife and kids," Krolikowski said. "That's the light at the end of the tunnel. To hold my wife and kids and to do things with them. And I miss fishing. I used to love fishing."

Krolikowski is an avid outdoorsman who loves hunting, fishing and boating, but the fateful ride on a bull at Eight Seconds on Sept. 13, 2003, left him unable to do the things he loves. Bull riding wasn't new to him, he said. The Middleburg native had been riding them competitively since he was 13, he said.

"I fell wrong in the arena that night and compressed my spinal cord by 50 percent," Krolikowski said.

The fall also fractured one of his vertebra, he said.

At the time of the accident, Krolikowski was in the U.S. Navy, stationed at Kings Bay Naval Submarine Base in St. Marys, Ga. After the accident he was taken to a Veterans Affairs hospital in Tampa, his paralysis nearly total. He needed a ventilator to breathe.

"They told me I would never get off the ventilator," he said. "The compression is just as bad as severing the spinal cord. It left me paralyzed. It took 41/2 months, but now I'm considered one of their miracle children."

Jacksonville's Eight Seconds bar is now gone, but after Krolikowski's injury, the owners held a bull-riding benefit in his name and raised $3,500. He said he used most of the money so his wife, Jenni, and his daughters, Chelsea, 11, and Constance, 6, could visit him in the hospital.

In subsequent therapy, he was able to straighten his arms, but his progress stalled there. And living with his injury has not always been easy. He's in a spinal injury support group and is being treated for depression, he said.

"I've got problems with my temper because I'm unable to do anything," Krolikowski said.

Now he says he's determined to pursue the promise of more progress offered by stem cell therapy and willing to travel halfway around the world to get it.

NeuroVita, a Moscow-based clinic, is a pioneer in stem cell treatments for spinal cord injuries, but does not use stem cells harvested from embryos, a process that's controversial in the United States. NeuroVita claims on its Web site that the clinic's stem cells treatment takes cells only from the patient.

Krolikowski said he and his wife discovered the Russian clinic on the Internet as they did research on treatment options. NeuroVita's doctors gave him an 80 percent chance of regaining the use of his arms and hands after they reviewed laboratory results from his American doctors, he said.

The hope it's given Krolikowski has made him determined to get the money to go.

"I need at least $30,000. That includes the surgery and the rehabilitation and therapy afterward. It will take about $5,000 to pay to get me over there and back."

He said he'll need two people to help get him on and off the plane and to help him get through the long plane flight. His said he expects that his friend Bruce Tubman and his brother Carl Krolikowski will come along to assist him.

Krolikowski said it's not a question of whether he will go to Russia, but when.

To help send him there, friends are sponsoring a poker run today in Boulogne that they hope will attract around 300 riders, said organizer Gene Cobb who first met Krolikowski in a Hilliard grocery store following his accident.

"He was pulling around his little ones on his wheelchair," Cobb said.

Now Cobb is hoping today's fundraiser will help Krolikowski in his quest for recovery.

"There are people who actually walk afterward," Cobb said. "He stands more of a chance of using his arms than using his legs. He told me he wants to to use his arms so he can give the 'thumbs up' to boats going by on the [St. Marys] river."

Krolikowski frequents Scotts Landing on the St. Marys River. He hopes to someday swim in the river again, using his own arms.

"I got to float this past summer," Krolikowski said. "It was awesome. The water was chilly, but it was nice to be in it again."

By KEVIN TURNER
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Thursday, November 09, 2006

Researchers Find a Reaction to Spinal Cord Injury that Speeds Recovery

Neuroscientists had long believed that the only way to repair a spinal cord injury was to grow new neural connections, but researchers at Georgetown University Medical Center have found that, especially in young rats, powerful cells near the injury site also work overtime to restrict nerve damage and restore movement and sensation.

The same process does not work as efficiently in adult rats and thus recovery time is much longer, the researchers also discovered. But they say that now that they know such a mechanism exists, it may be possible one day to "switch" these cells on therapeutically ? and possibly help humans function better following serious spinal cord injuries.

"No one knew cells in the spinal cord acted to protect nerves in this way, so it gives us some hope that in the future we could stimulate this process in the clinic to enhance recovery and ensure the best outcome possible for patients," said the senior author, Jean R. Wrathall, Ph.D., professor in the Department of Neuroscience.

"This is an animal study, however, and there is much work to do to understand more about this process and how it might be altered," Wrathall said. The study, whose first author is graduate student Philberta Y. Leung, is published in the November 2006 issue of the journal Experimental Neurology.

At the least, Wrathall said, the study reveals surprising new information about nerve cell recovery that neuroscientists can now explore.

In vertebrates, the nervous system uses a two-way transmission system to communicate the electrical impulses that lead to muscle movement and the perception of sensation. In humans, hundreds of thousands of nerve fibers (axons), which can be several feet in length, run through the spinal cord like a two-lane road. Half of these axons connect the brain to distant muscles, and the other half links the body to the brain.

Axons cannot regenerate when they are completely severed, but researchers believe that in a partial injury, surviving nearby axons that serve the same general body area and function can "sprout" new connections to those injured nerve cells that have lost some of their axons. In studying spinal cord injury in rats ? the usual model for this kind of investigation ? researchers had thought that younger rats ("pups") regain function faster because this sprouting occurs more quickly and proficiently than in older rats. "Just as young trees grow more quickly if you prune them than do older trees, we thought than in young animals, surviving axons would sprout new, and longer, axonal connections more readily," Wrathall said.

But their findings surprised them. "We didn't see that sprouting was faster or better in younger than in adult rats after a partial spinal cord injury," she said. Instead, they saw distinctions in what occurred in cells within the spinal cord at the site of injury. Leung and Wrathall specifically discovered that in the pups, specialized neural stem cells grew vigorously after injury and within one week, many oligodendrocytes, cells whose function is to provide a protective myelin sheath to axons, were produced..

The researchers believe that these activated cells wrap nearby surviving axons with extra myelin sheathing in order to protect them and support their function after injury.

"The ability of axons to transmit their signals is greatly dependent on the insulation provided by their myelin sheaths, and we know that axons near the site of injury eventually can die due to loss of this myelin," Wrathall said. "So we believe these stem cells work to protect healthy axons against toxic factors in the microevironment."

Adult rats do not activate these specialized cells to the same extent as the pups do after injury, for reasons that are not understood, she added.

"We hadn't expected these results, but they are exciting for the field of spinal cord injury and recovery," Wrathall said. "Now that we know that the difference in the local cell response to injury means a quicker recovery, we might be able to eventually exploit that innate healing ability in humans."

She added that these new findings might also be relevant to multiple sclerosis, a disease caused by loss of an axon's protective myelin sheath.
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Wednesday, November 08, 2006

Motor Neuron Disease Research Breakthrough

Scientists have reported a breakthrough in their development of a group of neurons which govern motor activity. The research may lead to treatments for motor neuron disease and spinal cord injury.

Researchers have found that the insulin-like growth factor 1 (IGF-1) dramatically increases the in vitro growth of corticospinal motor neuron (CSMN) axons ? projections that carry nerve impulses to the spinal motor neurons that connect to muscles. Additionally, blocking IGF-1 activity reduces that growth in both cultured cells and in living mice.

Jeffrey Macklis, director of the MGH-Harvard Medical School Center for Nervous System Repair, said: "Our findings that IGF-1 specifically enhances both the speed and extent of axon outgrowth of corticospinal motor neurons are the first direct evidence of growth factor control over the differentiation of these neurons.

"In addition to providing insight into the development and circuit formation of this critical population of neurons, these results might lead to the future ability to treat motor neuron disorders and spinal cord injuries."

Although their cell bodies are located in the brain, CSMN axons extend down to the neurons they control in the spinal cord ? extending as far as three feet in adult humans. These neurons degenerate in motor neuron diseases, and their damage contributes to loss of motor function in spinal cord injuries.

Since they are embedded among hundreds of other types of neurons in the cerebral cortex, it has been difficult to study CSMN, and little has been known about cellular and molecular factors that control their growth and development. In order to study growth factor controls over these cells, the researchers developed a new way of isolating pure populations of CSMN in culture and found that IGF-1 was a prime candidate for control over CSMN development.

By Sarah Routledge
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Monday, November 06, 2006

Stem Cell Sciences' NS Cells to begin Preclinical Trials for Spinal Cord Injury

Stem Cell Sciences, a global biotechnology company focused on the commercialization of stem cells and stem cell technologies in research and novel cell-based therapies, is pleased to announce that the Group's Neural Stem Cells (NS cells) will enter pre-clinical testing for spinal cord injury in a groundbreaking collaboration with the world-renowned Regenerative Medicine Institute (REMEDI) at the National University of Ireland, Galway ('NUI Galway').

The initial study will examine the ability of the NS cells to provide functional improvements in models of spinal cord injury at REMEDI.

Spinal cord injury affects more than 25 million people worldwide, with 130,000 new cases reported each year. It represents a considerable social and economic cost to both families and countries.

'It's a really exciting opportunity for us to test our NS cells in pre-clinical models of spinal cord injury' said SCS's Chief Scientific Officer, Dr Tim Allsopp. 'We will examine how the cells remain viable, engraft and support natural repair processes. We are really pleased to be collaborating with NUI Galway's Regenerative Medicine Institute'.

Stem Cell Sciences' NS cells are unique in that they can be grown in serum-free and feeder-free cell culture conditions. Potentially, this makes them very effective when used in a variety of cell-based therapeutics.

Professor Frank Barry, REMEDI's Scientific Director and a world-leading scientist in stem cell therapy, said: 'For REMEDI to be able to evaluate a 'best in class' neural stem cell in conjunction with a world-leading company is a great opportunity for us, and underscores the efforts we are making in Ireland in finding novel therapeutic solutions for currently incurable conditions.'

Initial study results are expected in the first quarter of 2007. If this study proves successful, Stem Cell Sciences and REMEDI plan to expand the collaboration with more extensive testing.

'It would be a great step forward if we demonstrate efficacy for our NS cells in this model' said Dr Peter Mountford, Chief Executive Officer of SCS. 'With our capabilities in novel cell culture media development and stem cell uses in drug discovery, our next step was always to move into pre-clinical trials of illness and disease, using the NS cells.'

Dr Daniel O'Mahony, Director of Technology Transfer at NUI Galway said, 'We are bringing together two technology leaders in their respective fields in the development of new treatments for spinal cord injury. This collaboration between REMEDI and SCS reinforces our commitment to industrial collaborations and to progressing technologies from the laboratory to the market place.'
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Wednesday, November 01, 2006

Marijuana Treatment for Spinal Cord Injury?

THC reduces spasticity in patients with spinal cord injury

According to a clinical study conducted at the REHAB in Basel, Switzerland, THC was effective in reducing spasticity in 25 patients with spinal cord injury. In three study phases patients received oral THC, rectal THC-hemisuccinate (THC-HS) and/or placebo, each for six weeks. Originally, it was planned to start with an open phase with oral THC followed by an open phase with rectal THC-HS and then a three-way crossover placebo-controlled phase with oral THC and rectal THC-HS. Due to logistical problems with the import of THC- HS Phase 2 had to be stopped after inclusion of seven patients. Phase 3 was changed to a parallel study with oral THC and placebo.
Medical Marijuana

Phase 1 was completed by 15 patients with a reduction in the mean spasticity sum score from 16.7 at baseline to 8.9 on day 43. Mean maximal daily doses were 31 mg oral THC. Reductions with rectal THC-HS were similar (Phase 2) as with oral THC. However, doses were higher with mean maximal doses of 43 mg THC-HS. It was possible to compare seven subjects who received oral THC in Phase 1 and placebo in Phase 3 demonstrating a significant improvement following the cannabinoid.

Major reasons for drop out were increase of pain and psychological side effects. Authors concluded that "THC is an effective and safe drug in the treatment of spasticity. At least 15- 20 mg per day were needed to achieve a therapeutic effect."
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