Spinal Cord Injury- No longer terminal???

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It is not atypical with spinal cord injury that the patient cannot survive without ventilator assist. The problem is complicated by the difficulty in repairing the damaged spinal cord.

In the past, limited success has been developed by nerve grafts, which restored some functionality to the arms and legs of affected patients.  But, when the cervical portion of the spine is damaged, messages to the diaphragm are interrupted, and that muscle is critical to breathing on one’s own. More to the point, it is not atypical for respiratory infections to develop- and they lead to the death of the subject.

When the spinal cord is damaged, nerve scarring occurs.  More importantly, a structural component of cartilage (chondroitin sulphate proteoglycans) precludes nerve (axon) repair and the development of new neural connections. For years, Dr. Silver (lead researcher for this project, Case Western Unviersity) has been playing with sciatic nerve grafts, since it was known that this procedure could restore function to the arms and legs.  But, getting those grafts to work on the spinal cord is a whole different matter.

The big leap- the introduction of chondroitinase ABC (an enzyme recovered from Proteus vulgaris), which snips the sugar ends of the proteoglycans away, is his innovation.  This process seems to allow the nerves to grow through the graft, restoring nerve functionality.

As they reported in Nature, the researchers were able to restore breathing functionality to mice.  They employed a nerve graft across the spinal cord scar formation, while simultaneously injecting the chondroitinase (the enzyme which destroys the inhibitory proteoglycans, mentioned above).  The graft yields structural support and protection; some 3000 nerves entered the bridge and almost 500 grew out the other side of the graft.  This technique restored at least 80% and as much as 100% (full restitution) of the breathing function in the mice, after a three month recovery period.   The recovery persisted through six months post graft surgery (which was the termination point of this study).

Human studies are in the works.  And, additional work has begun for lower spinal cord injuries, an injury which precludes normal bladder function.   It is doubtful this technique will be able to restore more complicated body functions, such as the ability to walk, to patients.  And, there is the question as to how long this recovery will persist; after all, once the injected enzyme dissipates,  the body may not be able to resist the effect of the proteoglycans.

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12 thoughts on “Spinal Cord Injury- No longer terminal???”

  1. Roy,

    WOW! If we could restore spinal cord injuries that would be amazing! As I was reading this I was wondering if this would restore many other functions as well as how long and you gave me my answer!

    One day!

    1. Yes, Leona!
      Each day, we get one step closer. While Dr. Silver made a great leap forward, we don’t know if the nerves will be broken when the enzyme decays. And, what would happen if we link this with a stem cell concoction, which may stop the release of the chondroitin…
      One day- from your mouth, via researcher’s actions- to G0d’s ears…
      Roy

  2. I never realized how common it was for spinal cord injuries to affect breathing on one’s own. Of course, I knew about paralysis. I can’t even imagine being completely dependent on a machine in order to breathe. And it’s mind boggling to think that they might be able to restore that function, if only for a relatively short time. Fascinating! Thanks for another eye-opening post! ~ Suerae

    1. Thanks for your comments, Suerae.
      Every time I study and learn about these advances, I am amazed how lucky I really am. Not only can I walk, move my arms, and generally be a PITA, it’s these other possibilities that remind me of the difference of a 100 microns or so…
      Thanks for dropping in. I really appreciate your visit.
      Roy.

  3. Amazing news, Roy. I look forward to hearing more about the advances. Improving basics functions such as bladder control would give the patient some of his or her dignity back. Thanks for this promising update.

    Sherrie

    1. Sherrie- absolutely correct about these advances.
      But, I am not sure about the patient’s dignity. The spinal cord is already damaged, so mobility is virtually gone. This is more of an issue that deals with comfort- and the prevention of urinary tract infections.
      Roy

  4. Thanks so much for sharing this post! Blows my mind… and am praying that someday they could some how reverse the effects of all spinal cord injurys! It’s so heart breaking, as I had a friend that fell 50 ft down a cliff in the dark and now has to spend her life in assisted living and a wheelchair… so we need to praise GOD and give him the glory to give our scientists the knowledge they need to HELP others!

    1. Christina:
      Science/Technology is making progress. Unfortunately, a great deal of the impetus is deriving to care for our injured troops. May your friend receive the benefits as soon as possible.
      Thanks for dropping in!
      Roy

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