Team close to repair treatment for spinal injuries
15 February 2008
An Action Medical Research funded project, based at the Cambridge University Centre for Brain Repair, is on the brink of a major potential breakthrough in the repair of spinal cord injuries.
The charity, which only funds the very best in cutting edge research, has said that the ground-breaking work may bring new hope to sufferers.
Spinal cord injuries are a major cause of disability – in the UK there are more than 40,000(1) people suffering from injuries to their spine, which can take the form of anything from loss of sensation to full paralysis.
Cord injury is incredibly distressing for both the patient and their family because there is no cure – active lives can be turned upside down overnight. It is especially tragic because, cruelly, the average age at the time of injury is just 19.
Until now, despite the attempts of many scientists to find a cure, the problem facing neurologists has been that the body simply cannot repair damage to the brain or spinal cord.
Although it is possible for nerves to regenerate, they are blocked by the scar tissue that forms at the site of the spinal injury.
However, Professor James Fawcett’s Cambridge based team believes it is close to a clinical treatment that could allow nerve fibres to regenerate within the spinal cord and also encourage remaining nerve fibres to work more effectively.
This revolutionary discovery may ultimately mean treatments to improve the lives of people paralysed through spinal damage.
The Action Medical Research team has found that a bacterial enzyme called chondroitinase is capable of digesting molecules within scar tissue to allow some nerve fibres to regrow.
Excitingly it also promotes something called nerve plasticity. This means that any remaining undamaged nerve fibres have an increased likelihood of making new connections that could bypass the area of damage.
Recent work by Professor Fawcett’s team has found that using chondroitinase in conjunction with rehabilitation allows greater opportunity for nerve recovery than by using either technique alone. This is an important finding, because it shows that the treatment can open up a window of opportunity during which rehabilitation can be much more effective. The finding will probably also be important for rehabilitation after stroke and brain injury.
This ground-breaking discovery will need to be tested before it can be given to patients, to establish the optimum time for it to be administered.
Professor Fawcett said, “It is rare to find that a spinal cord is completely severed, generally there are still some nerve fibres that are undamaged.
“Chondroitinase offers us hope in two ways; firstly it allows some nerve fibres to regenerate and secondly it enables other nerves to take on the role of those fibres that cannot be repaired.
“Scientists have worked hard to produce treatments for paralysed patients with spinal injuries for many years, but it has proven extremely complicated.
Clinical trials have not yet been started, but the treatment is under pre-clinical development by Acorda Therapeutics, a biotechnology company in New York.
“Along with rehabilitation we are very hopeful that at last we may be able to offer paralysed patients a treatment to improve their condition.”
Dr Yolande Harley of Action Medical Research said, “The charity is proud to be at the forefront of medical advance thanks to brilliant researchers like Professor Fawcett.
“His work will give new hope to people with recent spinal injuries.
“Today the emphasis is on providing the best possible care and occupational therapy but eventually we hope to have a clinical treatment that will help to improve the underlying injury that is causing the patient’s loss of mobility or sensation.
“This is incredibly exciting, ground-breaking work and is truly innovative research from the very best in the field.”
1. The Spinal Injuries Association Annual Report 2003/4 states an estimation of 40,000 UK sufferers
Professor Fawcett’s paper Therapeutic time window for the application of chondroitinase ABC after spinal cord injury has been published online by Experimental Neurology.
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