Birde
08-07-2001, 10:47 AM
The Reeve-Irvine Research Center will be starting a clinical trial in the next 18-24 months, and there are several new trials that will be starting within that time frame around the world. With the help of friends, I am compiling a list of human clinical trials with expected start dates and will be sending it out shortly. I also have a database for those interested in participating in trials and would be happy to include you. Below I have outlined some of the work underway here at the Center and around the world.
Ten years ago, it did not seem likely that there would be a cure for paralysis, but major recent developments have shown that there is good reason to hope. Indeed, Five Nobel laureates working with a distinguished alliance of fellow scientists in 1993 identified ten achievable goals, one of which was "regenerate the spinal cord." They added the proviso that reaching the goal was dependent on gathering research funds sufficient to provide the scientists, equipment and facilities necessary to pursue promising areas of research.
While a cure may still be in the future, our understanding of how the body reacts after an injury and what we can do to help repair the damage is growing at a fantastic pace. We now know that the natural ability of the brain and spinal cord to recover from injury, while very limited, does exist and, in some cases, can be significantly enhanced resulting in recovery of function. Scientists have found that even rudimentary manipulations of these processes can result in improved function. There are many new technologies that will facilitate interventions in the spinal cord at the molecular and cellular levels and new, reliable and reproducible animal models now more closely approximate the human condition.
The cure for spinal cord injury and paralysis will come through the concerted efforts of many scientists. Scientist from different backgrounds, different fields of study, and different perspectives all working together. The goal of the Reeve-Irvine Research Center is to become the central hub for spinal cord injury research in California and across the globe, allowing this multidisciplinary vision to give birth to cures.
The Reeve-Irvine Research Center was established to study injuries to and diseases of the spinal cord, which result in paralysis or other loss of neurologic function, with the goal of finding a cure. The Center is devoted to studies of basic cellular and molecular mechanisms that underlie the response of the nervous system to injury. Rich in basic science, the Center is also connected through collaborators to clinical issues related to spinal cord injury. All current work in the Center utilizes animal models for exploring regeneration of the spinal cord following injury. The Associates of the Reeve-Irvine Research Center include basic scientists and physician scientists carrying out research on nervous system injury, stroke, and neurodegenerative disorders and on basic processes that underlie nervous system development, regeneration and plasticity.
Research on spinal repair and recovery from disease and injury generally falls into 3 categories: containing the damage that follows the initial injury; inducing nerve regeneration and repair; and advancing therapies that enhance remaining functioning. Currently, research in the Center focuses on the first two of these categories.
Containing Secondary Damage
Important new and unique animal models, which show a dramatic delay in the onset of degenerative changes in damaged neurons, are demonstrating progress in understanding the processes that cause nerve cell death. Cell death sometimes extends for days after the initial trauma, literally leaving a hole in the middle of the spinal cord that must be transversed for recovery of function. To the spinal cord injured individual this can mean a tremendous difference in residual ability, for example the being able to control your hands or not. If we understand why cells continue to die after the trauma, we can look for ways to prevent cell death and keep the damaged area to a minimum, and an individual's capabilities to a maximum.
Dr. Steward's research program in the Center uses a forward genetic approach to define the cellular processes that occur after injury that lead either to progressive degeneration on the one hand or cellular repair on the other. Work has focused on a unique mutation that causes a dramatic delay in the onset of degenerative changes in damaged neurons. This delay leads to an equally dramatic delay in the activation of macrophages and microglia, and in the development of reactive changes in astrocytes.
These studies are providing clues on how to manipulate early responses to injury and so prevent progressive necrosis (cell death) and cavitation (the creation of a cyst or hole in the spinal cord). Looking forward, it may be possible to develop treatment strategies that mimic the effects of certain genes that delay onset of degenerative processes so as to enhance repair.
Enhancing the growth and regeneration of damaged nerve cells
There is now strong evidence that the spinal cord can regenerate, if the environment is suitable. Recent studies have found that myelin creates a cellular environment that inhibits regeneration. Myelin is the insulation around an axon that allows electrical messages to be sent. Without myelin, neurons cannot communicate and signals from the brain will not reach their destinations. However, for reasons that are not well understood, the presence of myelin causes neurons to stop growing, and so limits regenerative growth following injury.
Dr. Hans Keirstead has developed a novel immunological technique for temporarily removing myelin from discrete areas of the spinal cord. He has used his innovative technology, on which he holds a patent, to show that it is possible to promote axon regeneration in the spinal cord of experimental animals by temporarily removing myelin. Once the axon has grown through the injury to its pre-trauma site, the myelin can be regenerated allowing restoration of function.
Other scientists out side the Center are working on other ways to promote spinal cord repair. For example, researchers at the Robert Wood Johnson Medical School, in New Jersey, have just discovered a way to take bone stem cells from an animal or a human and force these bone cells to become nerve cells. They are now trying to see if they can promote recovery of function when these new nerve cells are transplanted into the damaged spinal cord of an animal. If they find recovery of function in animal models, then they will be able to try this technique in humans. There is a considerable amount of work that needs to take place before human trials, but this is an important step in the right direction.
Another study that has just begun is a human clinical trial. Dr. Michal Schwartz of the Weizmann Institute of Science in Rehovot, Israel, performed the first macrophage transplantation into a human, marking the beginning of her clinical trial. Macrophages are part of the immune response. They do clean up work, picking up foreign materials and ingesting them. There is controversy over the role of macrophages following SCI with some believing they are beneficial and others believing they may cause more damage. Dr. Schwartz feels that macrophages can be good depending on their concentrations. Time will tell if this technique can promote recovery of function, but again the more we understand the closer we are to cures.
Rehabilitation
The Center is currently not working in this area, however, it is becoming very clear that rehabilitation following injury is important. Researchers at UCLA have found that the spinal cord below an injury can remember how to walk or stand, but it must be retrained to do so. Animals with spinal cord injuries can learn to walk on a treadmill, and humans can also. while injured individuals can not walk on their own, with body support and therapists or robots moving their legs, they can begin to retrain their muscles and nerves to produce walking movements. The UCLA group thinks that this may be very important for keeping an injured individuals body ready for when treatments or cures become available.
The field is currently on the threshold of major discoveries that will lead to new treatments for neurological dysfunction brought about by injury, stroke, degenerative diseases, and developmental and genetic disorders. Scientific discoveries that lead to new treatments will lead to fundamental improvements in quality of life for disabled individuals. Please let me know if you would like to be in the Center's clinical trial database and contact me any time.
Sincerely,
Maura Hofstadter, Ph.D.
Director of Education and Scientific Liaison
Reeve-Irvine Research Center
University of California, Irvine
2109 GNRF
Irvine, CA 92697-4292
(949)824-3993
(949)824-2625 fax
Ten years ago, it did not seem likely that there would be a cure for paralysis, but major recent developments have shown that there is good reason to hope. Indeed, Five Nobel laureates working with a distinguished alliance of fellow scientists in 1993 identified ten achievable goals, one of which was "regenerate the spinal cord." They added the proviso that reaching the goal was dependent on gathering research funds sufficient to provide the scientists, equipment and facilities necessary to pursue promising areas of research.
While a cure may still be in the future, our understanding of how the body reacts after an injury and what we can do to help repair the damage is growing at a fantastic pace. We now know that the natural ability of the brain and spinal cord to recover from injury, while very limited, does exist and, in some cases, can be significantly enhanced resulting in recovery of function. Scientists have found that even rudimentary manipulations of these processes can result in improved function. There are many new technologies that will facilitate interventions in the spinal cord at the molecular and cellular levels and new, reliable and reproducible animal models now more closely approximate the human condition.
The cure for spinal cord injury and paralysis will come through the concerted efforts of many scientists. Scientist from different backgrounds, different fields of study, and different perspectives all working together. The goal of the Reeve-Irvine Research Center is to become the central hub for spinal cord injury research in California and across the globe, allowing this multidisciplinary vision to give birth to cures.
The Reeve-Irvine Research Center was established to study injuries to and diseases of the spinal cord, which result in paralysis or other loss of neurologic function, with the goal of finding a cure. The Center is devoted to studies of basic cellular and molecular mechanisms that underlie the response of the nervous system to injury. Rich in basic science, the Center is also connected through collaborators to clinical issues related to spinal cord injury. All current work in the Center utilizes animal models for exploring regeneration of the spinal cord following injury. The Associates of the Reeve-Irvine Research Center include basic scientists and physician scientists carrying out research on nervous system injury, stroke, and neurodegenerative disorders and on basic processes that underlie nervous system development, regeneration and plasticity.
Research on spinal repair and recovery from disease and injury generally falls into 3 categories: containing the damage that follows the initial injury; inducing nerve regeneration and repair; and advancing therapies that enhance remaining functioning. Currently, research in the Center focuses on the first two of these categories.
Containing Secondary Damage
Important new and unique animal models, which show a dramatic delay in the onset of degenerative changes in damaged neurons, are demonstrating progress in understanding the processes that cause nerve cell death. Cell death sometimes extends for days after the initial trauma, literally leaving a hole in the middle of the spinal cord that must be transversed for recovery of function. To the spinal cord injured individual this can mean a tremendous difference in residual ability, for example the being able to control your hands or not. If we understand why cells continue to die after the trauma, we can look for ways to prevent cell death and keep the damaged area to a minimum, and an individual's capabilities to a maximum.
Dr. Steward's research program in the Center uses a forward genetic approach to define the cellular processes that occur after injury that lead either to progressive degeneration on the one hand or cellular repair on the other. Work has focused on a unique mutation that causes a dramatic delay in the onset of degenerative changes in damaged neurons. This delay leads to an equally dramatic delay in the activation of macrophages and microglia, and in the development of reactive changes in astrocytes.
These studies are providing clues on how to manipulate early responses to injury and so prevent progressive necrosis (cell death) and cavitation (the creation of a cyst or hole in the spinal cord). Looking forward, it may be possible to develop treatment strategies that mimic the effects of certain genes that delay onset of degenerative processes so as to enhance repair.
Enhancing the growth and regeneration of damaged nerve cells
There is now strong evidence that the spinal cord can regenerate, if the environment is suitable. Recent studies have found that myelin creates a cellular environment that inhibits regeneration. Myelin is the insulation around an axon that allows electrical messages to be sent. Without myelin, neurons cannot communicate and signals from the brain will not reach their destinations. However, for reasons that are not well understood, the presence of myelin causes neurons to stop growing, and so limits regenerative growth following injury.
Dr. Hans Keirstead has developed a novel immunological technique for temporarily removing myelin from discrete areas of the spinal cord. He has used his innovative technology, on which he holds a patent, to show that it is possible to promote axon regeneration in the spinal cord of experimental animals by temporarily removing myelin. Once the axon has grown through the injury to its pre-trauma site, the myelin can be regenerated allowing restoration of function.
Other scientists out side the Center are working on other ways to promote spinal cord repair. For example, researchers at the Robert Wood Johnson Medical School, in New Jersey, have just discovered a way to take bone stem cells from an animal or a human and force these bone cells to become nerve cells. They are now trying to see if they can promote recovery of function when these new nerve cells are transplanted into the damaged spinal cord of an animal. If they find recovery of function in animal models, then they will be able to try this technique in humans. There is a considerable amount of work that needs to take place before human trials, but this is an important step in the right direction.
Another study that has just begun is a human clinical trial. Dr. Michal Schwartz of the Weizmann Institute of Science in Rehovot, Israel, performed the first macrophage transplantation into a human, marking the beginning of her clinical trial. Macrophages are part of the immune response. They do clean up work, picking up foreign materials and ingesting them. There is controversy over the role of macrophages following SCI with some believing they are beneficial and others believing they may cause more damage. Dr. Schwartz feels that macrophages can be good depending on their concentrations. Time will tell if this technique can promote recovery of function, but again the more we understand the closer we are to cures.
Rehabilitation
The Center is currently not working in this area, however, it is becoming very clear that rehabilitation following injury is important. Researchers at UCLA have found that the spinal cord below an injury can remember how to walk or stand, but it must be retrained to do so. Animals with spinal cord injuries can learn to walk on a treadmill, and humans can also. while injured individuals can not walk on their own, with body support and therapists or robots moving their legs, they can begin to retrain their muscles and nerves to produce walking movements. The UCLA group thinks that this may be very important for keeping an injured individuals body ready for when treatments or cures become available.
The field is currently on the threshold of major discoveries that will lead to new treatments for neurological dysfunction brought about by injury, stroke, degenerative diseases, and developmental and genetic disorders. Scientific discoveries that lead to new treatments will lead to fundamental improvements in quality of life for disabled individuals. Please let me know if you would like to be in the Center's clinical trial database and contact me any time.
Sincerely,
Maura Hofstadter, Ph.D.
Director of Education and Scientific Liaison
Reeve-Irvine Research Center
University of California, Irvine
2109 GNRF
Irvine, CA 92697-4292
(949)824-3993
(949)824-2625 fax