Active lives turned upside down forever

Each year in the UK and Ireland, around 600 people injure their spinal cord.¹ Many are young, in their late teens, 20s or 30s. Their injuries tend to come without warning, through falls, or accidents on our roads or when playing sports.

Spinal cord injuries cause paralysis and loss of sensation, commonly from the waist or neck down. Sufferers must suddenly face up to the devastating news that their life has been changed forever. They can experience chronic pain and profound disturbances of bowel, bladder and sexual function. Complications include infections, severe cardiovascular problems, broken bones and depression.

Mechanical aids, nursing care, physiotherapy and electrical stimulation can make a considerable difference to people’s lives, improve their overall health and bring small improvements in their condition. Complications such as infections and broken bones can be treated.

However, sufferers must come to terms with the fact that, currently, nothing can cure their underlying injury. Sadly, there is no way to repair a damaged spinal cord. Many sufferers therefore remain paralysed and dependent on others for the rest of their lives.

Repairing damaged nerves

The spinal cord contains thousands of nerve fibres, which allow the brain to communicate with other parts of the body. Injuries to the spinal cord cause problems if those nerve fibres are damaged or torn.

The body cannot repair damage to nerve fibres within the spinal cord. Recently however, several exciting, experimental treatments, which aim to stimulate repair of the spinal cord, have shown promise in laboratory models and a few trials are beginning in people.

In this project, the researchers aim to find out how two of these new treatments work using a laboratory model. They are forming a ‘nerve bridge’ across a damaged area of spinal cord, using a nerve from outside the central nervous system, and transplanting special cells from the nose, called olfactory ensheathing cells, which seem to encourage severed nerve fibres to re-grow.

The researchers are investigating whether this combined treatment encourages severed nerve fibres to make appropriate – or near normal – connections with other nerve cells within the spinal cord after an injury.

The Project Leader, Dr Peter Kirkwood, is a leading expert in understanding and assessing the complex network of connections formed by the thousands of different nerve fibres within the spinal cord.

Dr Kirwood is collaborating with Professor Geoffrey Raisman, who is a world leader in understanding the properties of olfactory ensheathing cells and in developing their use in spinal cord repair.

By working together, these two researchers can draw on a unique combination of expertise, meaning the project team is especially well placed to succeed. Daily interactions with clinicians mean the researchers are acutely aware of the needs of people who have suffered a spinal cord injury.

Both researchers are based at University College London (UCL), which has excellent facilities. UCL is widely regarded as the leading institution for neuroscience in the UK and very highly ranked in the world.

Essential understanding

The researchers believe it will eventually be possible to find a treatment that can repair spinal cord injuries and free people from disability. Their work will help by contributing vital information about how two particular experimental treatments work. This information is essential if we are to make experimental treatments more effective and develop them for use in people.

At present, 40,000 people are believed to be suffering the devastating effects of a spinal cord injury in the UK.¹ Because people are most commonly injured in early adulthood, and their life expectancy is near normal, the lifetime costs to the community can be enormous.

Many people are living in hope of new treatments. People who are paralysed from the waist down, for example, would love to walk again, of course, but equally they would be very happy if they could simply regain control of their bowels, bladder or sexual function. The researchers believe their work will bring increased understanding that is essential if we are to develop the kind of effective new treatments that are so eagerly awaited.