New University College London Unit Holds Out Hope Of Repair Of Spinal Cord Injuries

Spinal cord injuries have long been considered incurable, but the work of the team holds out significant hope that spinal cord patients will eventually be able to regain much of the ability to move that they have lost. For paraplegic patients this could lead to a return of sensation and movement to some leg muscles, potentially allowing them to stand and making movement easier, while tetraplegics (patients with spinal injury high in the neck region), could recover touch sensation and movement of the hands, and regain the ability to dress, feed and clean independently.

Professor Raisman’s team at the NIMR has demonstrated that it is possible for severed spinal cord nerve fibres to grow back and restore lost functions, and has now moved to UCL with a view to transferring the technology from rats to humans, working with patients at the new Spinal Repair Unit within UCL.

Professor Raisman was one of the first neuroscientists whose work raised the real possibility that spinal cord injuries, long considered incurable, could be repaired. His key discovery was that there is one part of the nervous system, a region in the nasal cavity concerned with the sense of smell, in which nerve fibres are in a state of continuous growth throughout adult life.

Raisman’s team transplanted cells from this region into the injured spinal cord of laboratory rats, and found that the cells had a remarkable capacity to integrate into the damaged pathways, laying a ‘bridge’ over the gap in the nerve fibres caused by injury.

The team has found that the same ‘pathway repairing’ cells that are found in rats can be obtained from the nasal cavity of human adults. If this technique can be transferred to humans, the patient can be his or her own cell donor, avoiding the need to find donor individuals, foreign stem cells or powerful designer drugs with unknown side-effects. A promising feature of the transplants is that samples of the reparative cells can be obtained from the adult nasal lining by a technique which does no permanent damage, since this system, like the skin, is in continuous self-renewal.

The establishment of the Spinal Repair Unit at UCL is the first step in bringing this potentially groundbreaking discovery to the stage of clinical trials on patients, collaborating with scientists within the Institute of Neurology, and the neurosurgical teams of Professor Alan Crockard and Professor Thomas Carlstedt at the National Hospital for Neurology and Neurosurgery. It is anticipated that the background work needed to begin the first clinical trial could be complete within the next two to three years. It is hoped that the first trials will confirm the safety of the approach and demonstrate modest but significant improvements in sensory, motor and other functions lost after spinal injury.

The Unit will be supported by funds from the British Neurological Research Trust (BNRT), and funding for the Unit will also be pursued through Advancing London’s Global University – the Campaign for UCL, a £300 million development campaign launched by UCL.

“I have spent my research career in trying to find a treatment for spinal cord injury, and I never anticipated that we would get this far when I started out,” said Professor Raisman, who is to be the first Director of the Spinal Repair Unit.”

“We have been able to persuade the medical profession that a cure was possible, and the fact that we have now joined UCL, and will be able to collaborate with the UK’s major neurosurgical team to develop human trials, represents a major step forward.

“The mission of the new combined laboratory and clinical team is to demonstrate the efficacy and safety of human ‘pathway repairing’ cells and to work out ways of obtaining sufficient cells to repair human spinal cord injuries. We also have to devise appropriate surgical procedures for their transplantation, establish the criteria for patient selection for the first trials, and apply sophisticated methods of assessing any recovery in the patient after treatment.

“It goes without saying that we do not wish to raise false hopes in patients who are living with spinal cord injury. However, our work to date has indicated that, contrary to what was previously thought, the spinal cord does have the potential to repair itself. That is why the UCL Institute of Neurology believes that human trials are a logical next step.”

“Geoff Raisman and his team have shown that the repair of the injured spinal cord is now a real possibility,” said Roger Lemon, Director of the Institute of Neurology. “However, in order to translate the very exciting findings in the rat into benefits for patients it is essential to have scientists and clinicians working together, and this move means that we can now start preparing for the day when the first trials will begin.

“Spinal cord-injured patients have been at the heart of organising, funding and leading the fundamental research that made the startling discovery that repair was possible. The Institute of Neurology is now working with a number of spinal research charities, including the International Spinal Research Trust (Spinal Research). They, like us, all look forward to seeing this promising research translated into successful clinical trials at the earliest possible stage.”

"In all the years I have been in spinal cord research there has never been a more positive or more encouraging development" said John Cavanagh, Head of Research at Spinal Research. The establishment of the new Unit has also been welcomed by the Christopher Reeve Paralysis Foundation, another leading charity supporting spinal injury research.

Notes:

1. The new Spinal Repair Unit will be located at the Institute of Neurology, Queen Square which has an international reputation for its work in understanding the brain. Research scientists at the Institute work closely with its associated National Hospital for Neurology and Neurosurgery (part of the UCL Hospitals NHS Foundation Trust). The Unit is supported by a grant from the British Neurological Research Trust (BNRT).

2. The development of spinal repair research is one of the key projects UCL is seeking support for through Advancing London’s Global University – the Campaign for UCL, a £300 million fundraising campaign launched today in central London.

3. The work of Professor Raisman’s team at the National Institute for Medical Research was funded by the Medical Research Council, the BNRT and the Norman and Sadie Lee Foundation.

4. An estimated 40,000 people in the UK live with a spinal cord injury, which can cause varying degrees of disability.