Wirth, et al (2002). Feasibility and safety of neural tissue transplantation in patients with syringomyelia

[Wise Young]

• Wirth ED, 3rd, Reier PJ, Fessler RG, Thompson FJ, Uthman B, Behrman A, Beard J, Vierck CJ and Anderson DK (2001). Feasibility and safety of neural tissue transplantation in patients with syringomyelia. J Neurotrauma. 18 (9): 911-29. Summary: Transplantation of fetal spinal cord (FSC) tissue has demonstrated significant potential in animal models for achieving partial anatomical and functional restoration following spinal cord injury (SCI). To determine whether this strategy can eventually be translated to humans with SCI, a pilot safety and feasibility study was initiated in patients with progressive posttraumatic syringomyelia (PPTS). A total of eight patients with PPTS have been enrolled to date, and this report presents findings for the first two patients through 18 months postoperative. The study design included detailed assessments of each subject at multiple pre- and postoperative time points. Outcome data were then compared with each subject's own baseline. The surgical protocol included detethering, cyst drainage, and implantation of 6-9-week postconception human FSC tissue. Immunosuppression with cyclosporine was initiated a few days prior to surgery and continued for 6 months postoperatively. Key outcome measures included: serial magnetic resonance imaging (MRI) exams, standardized measures of neurological impairment and functional disability, detailed pain assessment, and extensive neurophysiological testing. Through 18 months, the first two patients have been stable neurologically and the MRIs have shown evidence of solid tissue at the graft sites, without evidence of donor tissue overgrowth. Although it is still too soon to draw any firm conclusions, the findings from the initial two patients in this study suggest that intraspinal grafting of human FSC tissue is both feasible and safe. Department of Neuroscience, University of Florida College of Medicine, Gainesville, USA. wirth@ufbi.ufl.edu.
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11565603>

[paulsask]

Greetings

Dr. Young - This is not current is it ?
I believe it mentions the first 2 patients, 18 months post op.
The summary did not state any type of functional recovery of the 8 people.
Do you know if any had substantial return of movement or sensation ?
About Dr. Vacanti's work, he thought immature nerve cells found in csf would be a good source of autologus cells, of course to avoid immunosuppression drugs.
Could you please explain to me, what exactly immature nerve cells are, and the benefits of using them.
Are they more closely related in function as say fetal cells ?
I'm asking you because some time ago, Dr. Vacanti never did return my email with any explanation.

Paul

[Wise Young]

Paul, I am not sure what Dr. Vacanti is referring to. Normally, the cerebrospinal fluid does not contain an immature nerve cells or stem cells, that I know of.

The abstract above is the first and most recent report of the clinical trial that had been going on in Florida with fetal cell transplants to people with progressive syringomyelia. It provides the 18 month followup on the two first patients in the trial. The trial was not supposed to establish efficacy, just feasibility and safety of the procedure.

Wise.

[paulsask]

Dr. Young

In the Cure forum, the title "Undergrad Probes regeneration........".
That particular article also describes using immature cells.
This is where I lose track. You don't seem to know what these people are talking about, and if you don't know, then I would be lead to believe such a thing doesn't exist.
Is there such a cell in our bodies ? A type that can be harvested before fully maturing, besides OEG which regenerate all our lives.

Paul

[Wise Young]

Paul,

I hope that I did not imply that there are no immature cells in the central nervous system... there are plenty of those. The formal and more accepted scientific term is "progenitor" or "precursor" cells... These are cells the give rise to other cells. Although they are often considered to be more "immature", that is a vague word that is not used very much any more, especially since the discovery of stem cells in the central nervous system of adults. What I thought you (or Vacanti) were referring to, however, was the presence of cells in the cerebrospinal fluid. This is the fluid that surrounds the brain and the spinal cord. There should normally be no cells in the cerebrospinal fluid. After injury, there may be some cells that are released in the cerebrospinal fluid. Likewise, in people with multiple sclerosis, there are frequently inflammatory cells (lymphocytes, neutrophils) in the cerebrospinal fluid. This is abnormal.

I am puzzled by your fixation on Vacanti. In my opinion, there is simply not enough information to know what is going on and I am taking in most of the information with a grain of salt until I get more definitive information concerning what was done and what the results were. These breathless journalistic reports do not do anybody any favors.

Wise.

[paulsask]

Dr. Young

Thank you for your explanation.
You are quite right that the media often mixes facts, and even hypes some articles.
Vacanti is just one of several researchers that seem to be going in the right direction (?).

Paul