Pioneering cell transplantation therapy helps paralysed man recover function

Written by Elena Conroy

Surgical breakthrough – paralysed man walks again after cell transplantation treatment developed by scientists at UCL and applied by surgeons at Wroclaw University Hospital, Poland.

Following a pioneering cell transplantation treatment, a man who was paralysed from the waist down following a knife attack is now able to walk using a frame. The treatment was developed by scientists at University College London (UCL), and applied by surgeons at Wroclaw University Hospital, Poland. The research, recently published in Cell Transplantation, was funded by the UK Stem Cell Foundation and the Nicholls Spinal Injury Foundation.

The technique involved placing olfactory ensheathing cells (OECs), which allow the nerve cells that give us the sense of smell to grow back when they are damaged, into the spinal cord.

“It’s amazing to see how regeneration of the spinal cord, something that was thought impossible for many years, is becoming a reality,” said Dr Pawel Tabakow, consultant neurosurgeon, Wroclaw University Hospital, and leader of the Polish research team.

Professor Raisman, Chair of Neural Regeneration at the UCL Institute of Neurology, who led the UK research team, first discovered OECs in 1985. He successfully demonstrated that they can be used to treat spinal injuries in rats in 1997 and has been developing OEC spinal repair techniques since 2004. His research has now helped a paralysed man to walk again.

“It is immensely gratifying to see that years of research have now led to the development of a safe technique for transplanting cells into the spinal cord,” explained Raisman. “I believe we stand on the threshold of a historic advance and that the continuation of our work will be of major benefit to mankind. I believe we have now opened the door to a treatment of spinal cord injury that will get patients out of wheel chairs. Our goal now is to develop this first procedure to a point where it can be rolled out as a worldwide general approach.”

The 38-year-old patient, Darek Fidyka, was paralysed after suffering stab wounds which left an 8mm gap in his spinal cord. For the treatment, Darek had to undergo brain surgery to remove one of his olfactory bulbs, which help distinguish smells and are the main source of OECs.

The olfactory bulb was subsequently placed in a cell culture for two weeks to produce OECs. The cells were then injected into the spinal cord above and below the injury and four strips of nerve tissue were taken from the ankle of the patient — these were patched across the 8mm gap forming ‘bridges’ for the spinal nerve fibres to grow across with aid of OECs.

Three months after the surgery, Darek’s left thigh muscle started growing and after six months he started walking within the rehabilitation centre with the help of a physiotherapist and leg braces. Now, two years on, he is able to walk using a frame.

Sir Richard Sykes, chair of the UK Stem Cell Foundation, commented: “We are proud to be the major funders of this work. Our aim is to see potential treatments of this type get into the clinic faster. The first patient is an inspirational and important step, which brings years of laboratory research towards the clinical test bed. To fully develop future treatments that benefit the 3 million paralysed globally will need continued investment for wide scale clinical trials.”

Sources:

Tabakow P, Raisman G, Fortuna W et al., Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging. Cell Transplantation, doi: http://dx.doi.org/10.3727/096368914X685131 (2014) [Epub ahead of print]; University College London press release: https://www.ucl.ac.uk/news/news-articles/1014/211014-UCL-research-helps-paralysed-man-recover-function