Thursday, February 07, 2008

Could a Spinal "Bypass" Reverse Paralysis?

A breakthrough in spinal surgery yesterday offered hope to victims of paralysis.

The technique, which has been tested on rats, involves bypassing damaged tissue in the spine.

This allows signals to travel across injured areas, New Scientist reports.

Dr John Martin and his colleagues at Columbia University in New York have so far tested the procedure only on rodents. They selected a motor nerve branching from the healthy cord above the injury and cut it away from the abdominal muscle to which it is normally attached.

They then stretched the free end across the injured section of spinal cord and used a protein "glue" to fix it.

Two weeks later the team found that the graft had sprouted new extensions which had begun to form connections - or synapses - with the motor nerves in the isolated lower spine.

Zapping the spinal cord above the injury made the lower limbs of the rats twitch - showing motor signals had started once again to pass along the entire length of the spine.

The researchers say removing the nerve from the abdominal muscle did not appear to cause any major side effects and suggest this is because nearby nerves pick up the slack.

Fellow neuroscientist Dr Reggie Edgerton, of California University, said the approach had considerable clinical potential but added that it was too early to tell whether it would work in humans.

Dr Marie Filbin of the City University of New York cautioned that it may not be possible to "reprogramme" a nerve that normally connects to an abdominal muscle to transmit the sophisticated signals needed to produce fine, controlled movements.

But Dr Martin, who presented his study at the New York State Spinal Cord Injury Research Program Symposium, said: "What we want to do is plug in new connections to bypass the damaged region."

He believes that - with a little surgical assistance - spinal cord nerves above an injury could be capable of making such connections with nerves lower down the spine.

He said: "We know the nerves can make new connections to muscle so we asked whether it's possible for them to also connect with spinal cord neurons isolated through injury."

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Friday, August 24, 2007

Stem-cell therapy: Cure or hoax in China?

'Some get miracles'; others are skeptical

The website for Beike Biotechnology bursts with stories that can only be categorized as medical miracles: a paraplegic can move his legs again; a man with muscular dystrophy can carry a cup of water, a stroke victim can speak.

These tales of ailments treated come from all over the world - England, Hungary, Russia, Canada - and back the healing claims of a controversial Chinese treatment that purports to cure the incurable.

"I saw miracles every day I was there," says Leslie Wells, who flew to China in April, 11 years after a swimming pool accident rendered her arms and legs limp. "It can be a crapshoot. Some people get miracles, some people get nothing."

Doctors at Beike - based in Shenzhen, China - are treating a host of nerve disorders with stem-cell therapy, a procedure still under early clinical trials in much of the Western world. In just two years, doctors at Beike have injected stem cells from umbilical cords into the spines of nearly 1,000 patients from outside the country. Roughly 30 of those patients came from Canada, according to a Beike spokeswoman.

Approval for such treatments in Canada is years away, and the medical community here stands firmly opposed to people seeking them in China, citing possible health risks. In a research paper published in Neurorehabilitation and Neural Repair last year, several doctors in Canada and the United States followed up with patients of Hongyun Huang, who has been offering stem-cell treatments in China for several years. Few of the patients had improved since returning from China.

"If it sounds too good to be true, it's too good to be true," says Michael Rudnicki, Canada Research chair in molecular genetics at the University of Ottawa.

But increasing numbers of Canadians are sidestepping domestic regulations and venturing to China in hopes of a cure.

Ms. Wells, of Milton, Ont., first heard about Beike in a news story she read about two Ontario women who had suffered spinal-cord injuries in a car accident and then received the stem-cell treatments in China with some success.

As she flipped through the beaming testimonials on the company's website, it crossed her mind that the whole thing might be a scam. She just wanted a cure to nerve pain so crippling that "no painkiller known to man would help."

Her spine specialists warned her against it.

Eventually, she decided. "I was like, all right, what do I have to lose? Just a little money."

Ms. Wells paid $23,000 for the procedure and travelled to Nanshan Hospital in China, where she received six injections teeming with stem cells into her spinal fluid. Beike says the stem cells repair damaged nerves.

After her second injection, the pain that had made jobs and school seem impossible, was nearly gone.

"On a scale of one to 10, it went from like a nine down to a two. I haven't taken a single painkiller since."

She's not alone in her praise of the injections. With his speech and balance failing, George Arruda, an Ancaster, Ont., landscaper with ataxia, flew to Nanshan for four spine injections and two IV drips.

Ataxia is a progressive disorder that prematurely kills the nerve cells responsible for balance and co-ordination, and is one of the long list of neural conditions that Beike will treat. That list also includes epilepsy, ALS, cerebral palsy, spinal-cord injury and strokes,

Mr. Arruda knew it was an uncertain therapy, but his wife had recently given birth to a daughter. "I just wanted to be a healthy strong dad for her."

Before the trip, he could get around only with the aid of a walker. One night, about midway through his treatment, he was surprised to find himself walking to the bathroom unassisted.

"Immediately, I was about 20 per cent better," he says.

Since returning to Canada in February, he's had a relapse of symptoms. But he says that was probable considering the degenerative nature of ataxia. He's now looking at other stem-cell treatments.

Western medical experts chalk up the positive testimonials to the placebo effect. "We can give people a sugar pill and tell them it will get rid of all their pain and they'll insist that it works," Dr. Rudnicki says, "so I'm highly doubtful of testimonials. If I just spent $30,000 on a procedure, I would want to say it worked too."

Researchers at the University of Alberta are in the midst of studying the proliferating number of companies offering stem-cell cures. So far, they've discovered more than 30 based all over the world.

"The term stem cell has so much currency around the world right now," says Tim Caulfield, Canada Research chair in health law at the University of Alberta and member of a Canadian network of stem-cell researchers. "Even though the scientific community is deeply skeptical, people just associate the term with hope. It's a perfect area for quackery."

Eventually, Dr. Caulfield expects that researchers can use the University of Alberta study to make policy recommendations. "If there is fraud, we want to find it. The people going in for this are often tremendously sick and desperate. We want to ensure they are not being exploited."

Beike is open to the scrutiny. Patients are encouraged to post pictures and blog entries online documenting their time in China. Most depict a pristine hospital with cheery medical staff.

"Most of the doctors who work for us have been trained in Europe or the U.S.," says Kirshner Ross-Vaden, lead medical consultant with Beike's North American operations. "These are people who are leading the entire medical field. We have the nicest hospitals in China. The North American medical establishment is simply behind the times."

Beike says that 86 per cent of their clients show some measure of improvement.

Researchers in Canada say that while clinical trials have begun to look at the possibilities of stem-cell treatments, the therapies won't be available to the public for years - if they actually work.

Until that day comes, researchers here continue to advise against a stem-cell trip to China.

"They are ... putting patients at risk," Dr. Rudnicki says.

By: PATRICK WHITE

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Thursday, July 26, 2007

Spinal Cord Injury Therapy Developed

U.S. medical scientists have developed a new spinal cord therapy that helps the body permanently recover from such injuries.

Researchers at the Sloan-Kettering Institute for Cancer Research studied rats with crushed spinal cords. The scientists found treatment soon after injury, combining radiation therapy to destroy harmful cells and microsurgery to drain excess fluids, significantly helped the body repair the injured cord.

The scientists, led by Nurit Kalderon, said their findings demonstrate conventional clinical procedures hold promise for preventing paralysis due to spinal cord injuries. Currently there is no cure for human spinal cord injury.

"This research opens the door to developing a clinical protocol for curing human spinal cord injuries using conventional therapies," said Kalderon.

The study, supported by a grant from the National Institute of Neurological Disorders and Stroke, appears in the online journal PLoS One.

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