Thread: ChinaSCINet Update

  1. #1201
    Thats great optimism on ur part !

  2. #1202
    I'm not talking about a conclusion about if the fundament for a "cure" has been found or even coming within our lifetimes but more in the vain of that there is even a slight amount of effect to be measured that can be related to the use of UCBMC.

  3. #1203
    Thanks for the train analogy Wise. I admit to thinking we had gone backward not forward after watching the video.


    Quote Originally Posted by Wise Young View Post
    Lunasicc,

    I would not conclude that the UCBMC "doesn't really do anything" based on the data to date. In Hong Kong, we saw no white matter crossing the injury site in any subject before treatment. In one subject who did not have treatment, we saw no white matter growth across the injury site over a 2 year period. In 3 of 5 subjects who were treated with UCBMC and had reasonable MRI-DTI images, we saw white matter tracts crossing the injury site. In Kunming, some subjects that have been treated with UCBMC show early locomotor improvement though they did not show changes in motor scores in the legs at 6 weeks. We did not do MRI/DTI in the Kunming subjects but all received the intensive locomotor training.

    Long tract regrowth is a very slow and the axons have a long ways to grow. Axons grow very slowly, no faster than hair growth and that is assuming that they know exactly where to go and have no impediments. A mm per day would be very fast. In order to activate muscles directly, the axons must grow all the way to the lumbosacral spinal cord located at T12 and L1 spine, a distance of over 500 mm from the neck to the bottom of the rib cage.

    So, let me give an analogy. We are waiting in Miami Florida for a train to come from Boston. The train tracks have been disrupted in Connecticut (cervical spinal cord injury). No trains have come from Boston for a long time. We hear on the news that an effort has been made to repair the train tracks. After waiting a day, no train appears. The news, however, tells us that some trains have been sighted in Washington DC and we are seeing increased activity in Atlanta and Alabama. Should we be concluding that the repairs of the train track have been unsuccessful?

    Wise.
    And the truth shall set you free.

  4. #1204

    Unhappy Dr wise

    Sorry i just had to ask
    and we know you are a busy man
    What i think Looking at the videos and what the Doctors seem to be saying . Is Well we know this dose not work and that dose work ? But give us time and we will come up with some thing . I am afraid to say looking at it must of us will see nothing For a while . Like most of us we where hoping This was the real deal . I am very disappointed but will have to see what the rest of paper says .
    Can you tell us where you go from here ? If you can would you try to break it down to lay man terms .
    So must of us will understand
    unfortunately i think must of us do ?

    once again thanks for work and effort that you have put into it
    Last edited by skeaman; 11-13-2012 at 06:33 PM.
    AS I SIT HERE IN MY CHAIR . I LOOK OUT UPON THE GROUND .I WONDER WILL I EVER GET UP AND WALK A ROUND ??


    http://justadollarplease.org

  5. #1205
    Quote Originally Posted by ay2012 View Post
    Sorry Dr. Young but just to clarify: the observation that some patient are walking is from seeing patients six months into the trial whereas the lack of improvement in motor and sensory scores is for six week data. Yet you seem to indicate that people are walking without improvement in these scores...
    We are not the first to report that people are walking without changes in motor or even sensory scores. As I have pointed out, many "walking quads" can walk well with relatively poor voluntary control of individual muscles and poor sensation from the legs below the knees. This is because there is a central pattern generator (CPG) in the lower spinal cord that contains the programs for walking. If you activate the CPG, it tells the rest of the muscles of both legs to walk. Actually, the CPG contains many other locomotor programs including skipping, hopping, trotting, galloping, and cantering.

    We are talking about very early results in the trial, i.e. 6 weeks after transplantation. The axons have not had the time to grow far and connect with structures below the injury site. In fact, our images of the spinal cord in Hong Kong suggest that none of the people have tracts that grow across the injury site before 6 months and some did not until 12 months. So, I have been cautioning people to stop jumping to conclusions. We don't have all the 6 month data yet from Kunming where they have undergone the locomotor training and therefore I am talking only about a quarter of the patients who have shown early locomotor improvement at 6 weeks without changes in motor or sensory scores. This may change by 6 month and 12 months.

    Wise.

  6. #1206
    Quote Originally Posted by Tachtig View Post
    I'm not talking about a conclusion about if the fundament for a "cure" has been found or even coming within our lifetimes but more in the vain of that there is even a slight amount of effect to be measured that can be related to the use of UCBMC.
    Tachtig,

    Our phase II trials have shown that the transplants appear to be safe, at least at 6 weeks after the transplants in terms of "severe adverse events". We are seeing white matter growth in 2 of 5 patients who have adequate MR-DTI and have received the two lower doses of cell injections without lithium. There may be growth of white matter than is below the threshold of resolution of MRI. In 8 subjects in Hong Kong, we are seeing some sensory improvements but little motor score differences so far. We are still awaiting the 6 month data from Kunming.

    It is still very early in the studies. We did not see anybody showing MR-DTI images of white matter growth before 6 months after transplantation. We do not expect substantial recovery of function so early. If such recovery did occur, it would argue strongly against regeneration as the cause of such recovery. The fact that the recovery is coming late and very slowly is consistent with the recovery being due to regenerated axons.

    I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything. This is precisely why I have been so reluctant to release any data to the public. People are expecting miracles, misinterpreting the results, and being unduly pessimistic. In fact, some people are prematurely predicting the demise of the trials and therapy without thinking about the consequences of what they are saying and the fact that they have no basis for saying so.

    Wise.

  7. #1207
    Quote Originally Posted by skeaman View Post
    Sorry i just had to ask
    and we know you are a busy man
    What i think Looking at the videos and what the Doctors seem to be saying . Is Well we know this dose not work and that dose work ? But give us time and we will come up with some thing . I am afraid to say looking at it must of us will see nothing For a while . Like most of us we where hoping This was the real deal . I am very disappointed but will have to see what the rest of paper says .
    Can you tell us where you go from here ? If you can would you try to break it down to lay man terms .
    So must of us will understand
    unfortunately i think must of us do ?

    once again thanks for work and effort that you have put into it
    Skeaman,

    I am sorry but I am not sure that I see any reason for you or others to be "disappointed". We should be celebrating for the following reasons:
    1. Transplantation of cells into chronically injured spinal cord is safe.
    2. The cells appear to encourage white matter growth and at least 2 of 5 subjects are showing remarkable white matter growth across the injury site and both up and down the spinal cord. The growth is substantial enough to be detectable on MR-DTI. MR-DTI, on 3T MRI machines, cannot detect structures that are less than a mm in size. We didn't expect see such growth and I am amazed. We need to confirm the presence of these regrowing tracts electrophysiologically. If so, this is the first demonstration of spinal cord regeneration in humans. It is too early and the tracts may not have connected. Don't you think that this is important and interesting?
    3. Some of the subjects are recovering function. Many have recovered some sensation in the dermatomes close to the injury site. In Hong Kong, none of the subjects are able to walk without assistance and this is not surprising since we anticipated that intensive walking exercise may be required for locomotor recovery. In Kunming, some subjects are recovering locomotor function but, to our surprise, without significant changes in motor and sensory scores of their legs. We don't have the 6 month followup studies on the patients yet and therefore these results are very early.

    Most of the people here know more about spinal cord injury than any scientist and are not "laymen". I hope that my language is clear. If there is anything that you do not understand, please ask. What should be very clear to everybody from my posts is that ChinaSCINet has done an incredible amount of work with very little money to carry out the trials to date. We have now transplanted umbilical cord blood mononuclear cells into 28 chronic subjects and 13 subacute subjects. Every weekend, teams of dedicated nurses are going to the homes of the subjects to do the examinations. The participating doctors are excited about these results and we are doing our best to make sure that all the data is properly collected and rigorously analyzed. The data indicate that the procedure is safe and we are seeing some regeneration and recovery. It puzzles me why people are disappointed.

    Wise.
    Last edited by Wise Young; 11-13-2012 at 10:22 PM.

  8. #1208
    Quote Originally Posted by Wise Young View Post
    Tachtig,

    Our phase II trials have shown that the transplants appear to be safe, at least at 6 weeks after the transplants in terms of "severe adverse events". We are seeing white matter growth in 2 of 5 patients who have adequate MR-DTI and have received the two lower doses of cell injections without lithium. There may be growth of white matter than is below the threshold of resolution of MRI. In 8 subjects in Hong Kong, we are seeing some sensory improvements but little motor score differences so far. We are still awaiting the 6 month data from Kunming.

    It is still very early in the studies. We did not see anybody showing MR-DTI images of white matter growth before 6 months after transplantation. We do not expect substantial recovery of function so early. If such recovery did occur, it would argue strongly against regeneration as the cause of such recovery. The fact that the recovery is coming late and very slowly is consistent with the recovery being due to regenerated axons.

    I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything. This is precisely why I have been so reluctant to release any data to the public. People are expecting miracles, misinterpreting the results, and being unduly pessimistic. In fact, some people are prematurely predicting the demise of the trials and therapy without thinking about the consequences of what they are saying and the fact that they have no basis for saying so.

    Wise.
    Thanks for the clarification Dr. Young and the reminder that what we say, the conclusions we jump to, can have an impact, especially when we don't (nor do many other people) have all the facts at this time.
    At the same time, and I know you understand this, the community is constantly on pins and needles. We want you, anyone really, to succeed and we, or at least I, will follow you and help out in any way possible to get this going as soon as possible so long as we see progress and remain informed. So please don't stop releasing information to the public! Just take a moment to calm us down every once in a while and remind us, as you have, that progress is a slow process...

  9. #1209
    Quote Originally Posted by ay2012 View Post
    Thanks for the clarification Dr. Young and the reminder that what we say, the conclusions we jump to, can have an impact, especially when we don't (nor do many other people) have all the facts at this time.
    At the same time, and I know you understand this, the community is constantly on pins and needles. We want you, anyone really, to succeed and we, or at least I, will follow you and help out in any way possible to get this going as soon as possible so long as we see progress and remain informed. So please don't stop releasing information to the public! Just take a moment to calm us down every once in a while and remind us, as you have, that progress is a slow process...
    You are welcome of course. I hasten to point out that I don't have all the data either and we are doing all of this together. This is science, not magic or religion. The data is what it is. All that we can do is to make sure that the data is reliable and credible. If umbilical cord blood mononuclear cells and the lithium combination do not work, we go on. There are many other therapies waiting in the wings, ready to go. If it restores function in some people, that is great and we can work to improve the therapy and compare it against other therapies.

  10. #1210
    "The data indicate that the procedure is safe and we are seeing some regeneration and recovery"(#1208)
    Dr.Wise, are you sure that you don't confuse the term "regeneration" with the term "plasticity"?

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