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Thread: Under one roof: the Miami Project to Cure Paralysis model for spinal cord injury research

  1. #1

    Under one roof: the Miami Project to Cure Paralysis model for spinal cord injury research

    • Kleitman N (2001). Under one roof: the Miami Project to Cure Paralysis model for spinal cord injury research. Neuroscientist. 7 (3): 192-201. Summary: Concentrating a wide range of spinal cord injury (SCI) research laboratories in a single location to accelerate progress and draw attention to the promise of SCI research has made The Miami Project to Cure Paralysis one of the most publicly recognized and often controversial research groups in the neurosciences. A "Center of Excellence" at the University of Miami School of Medicine, the Miami Project also serves as a model for SCI research programs being developed nationally and internationally. Founded in 1985, the Miami Project set out on an unprecedented path-to develop a research center dedicated to improving treatments for SCI by bridging basic and clinical science. In doing so, neurosurgeon Barth Green, M.D., enlisted not only a multidisciplinary team of scientists but also a devoted following of financial donors and volunteer research subjects, and support from the University of Miami and Florida legislature. Highly visible spokespersons, including cofounder ex-Miami Dolphin Nick Buoniconti and his son Marc, brought the issue of SCI paralysis and the promise of research before the public, the media, and sports communities. As progress in the neurosciences has raced ahead, public attention to medical research, and SCI research in particular, has grown exponentially. This review will assess the Miami Project as a model for disease-based research that unites academic, philanthropic, and patient communities in a common cause. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11499398> Department of Neurological Surgery, University of Miami School of Medicine, Florida 33101, USA. nkleitman@miami.edu

  2. #2
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    Orlando!

    Just don't forget to stop by Orlando when you visit...with mouse ears on, you'll get MUCH better treatment

    Eric Texley

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    Senior Member bilby's Avatar
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    Good! now the researchers are in close proximity with each other, they can hold hands while they discuss ways to squander money.

    bill

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    The Miami Project is a really important experiment for the field. It was the first attempt to get a group of researchers together under one roof. It was based on the concept that one Center can solve the problem of spinal cord injury. Nick and Marc Buonocanti worked their hearts out to fund this Center and make it work. They and others are beginning to understand is that while such a Center approach is very important, they cannot do it alone. Most of the people now understand that there is too much going on in the field and that it is critical that many Centers all over the world collaborated to make progress in the field. Our current state of optimism concerning the possibility of regenerating the spinal cord really stemmed from the work of many dozens of centers. Wise.W

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    Senior Member Max's Avatar
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    I dont think so....

    Too much funding, not many results....

  6. #6
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    miami projected

    i HATE TO SOUND NEGATIVE but The Miami Project is in the stone age compared to the cellular possibilities today. It was a effort to explain and contact someone over there about harness-treadmill therapy. The ethical route, following the government's guidlines, is their schedule, and that will not get us out of these chairs anytime soon.

  7. #7
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    Dr. Young:

    Earlier you commented...

    "It was based on the concept that one Center can solve the problem of spinal cord injury. They and others are beginning to understand that while such a Center approach is very important, they cannot do it alone."

    ...which I believe is a total distortion of the truth! There is absolutely no reason why a single, well-funded center cannot address all the regenerative obstacles related to spinal cord injury PROVIDED its researchers are advancing the proper avenues AND they're willing to cooperate. Other labs can certainly improve on or eclipse such a center's results. But there's no reason why the Miami Project or Rutgers CAN'T bring an effective regenerative treatment to clinical trial.

    You yourself have repeatedly claimed in this and other forums that ten percent of the spinal cord is all that is needed to realize an almost total functional return. Are you for one second suggestion that such an improvement might not be reaped if a multifaceted center were able to effectively develop (and possibly combine) a cell replacement therapy (stem cells or OEGs), axonal regeneration (from neurotrophic upregulation, enhanced Integrin receptor expression, or Inosine) substrate matrix scaffolding (in combination with CSPG suppression or the glial scar's removal), and local metabolic enhancement? Of course it would!

    As I said above, there's no reason why the Miami Project or Rutgers CAN'T bring an effective regenerative treatment to clinical trial. But exchanging "can't" with "won't" truly hits the nail on the head!

    James Kelly

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    Jim, you have been on these forums for a long time and I had hoped to convince you that the problem of spinal cord injury is too big for a single center. Miami has been accused unfairly, in my opinion. I can understand that they raised expectations to high with their title and claims. On the other hand, I believe that they have truly contributed to the field. The statement that you made about Miami not wanting to cure spinal cord injury is wrong. Let me start the discussion with a short defense and add to it.



    Miami did, as many of us did, invest in a particular approach towards regenerating the spinal cord injury... a Schwann cell embedded synthetic bridge coupled with neurotrophins. It took them over 4 years to get optimize the bridge, develop the surgical techniques, put the Schwann cells into the bridge, and show that many axons indeed grew into the bridge. They have now tried for over six years to get the axons to grow out of the bridge. They have shown beyond doubt that axons will grow in transected spinal cords into artificial bridges, that Schwann cells will support growth, and that the problem is to get the axons to grow out of the bridge into the distal spinal cord. Please remember that this is a problem that nobody has been able to solve. For a while, it looked as if Henreich Cheng might have done so but nobody has been able to replicate the work to date.

    Miami has also made a significant contribution to the development of rehabilitation techniques, including FES-exercise. The now widespread acceptance of FES-exercise is in large part due to the efforts of Miami. Without their early work showing that FES combined with bicycling type devices will improve muscle and systemic performance, there would not be as thriving an industry that is currently making devices for such an approach to spinal cord injury rehabilitation. In the early 1990's, they were already walking patients in harnesses and have made that an integral part of their rehabilitation program. Their voice, along with others, made the rapid acceptance of Reggie Edgarton's work on treadmill training of locomotion clinically feasible.

    Miami has made very significant contributions towards our understanding of the mechanisms of neuropathic pain and techniques to improve fertility. Finally, they are one of the best, if not the best, spinal cord surgery centers in the United States. Barth Green has significantly advanced treatment of syringomyelia. Most neurosurgeons now recognize that when they operate on syrinxes, they must reconstruct the dura around the spinal cord to allow cerebrospinal fluid passage around the cord.

    Everybody thinks that the Miami Project has spent HUGE amounts of money. Maybe from the perspective of an individual, this may be true. However, from the perspective of institutional investments into research, it is not true. I don't know their budget precisely but it is on the order of several million dollars per year. This is just about enough to support about 100 people and staff.

    They have a group of about 100 people working on about 7 major areas. All these efforts were scattered all over the University of Miami. A significant portion o the organization has to be devoted to fundraising. People were not working together and it was very time consuming trying to get everybody together even for a meeting. It was also very difficult for them to recruit and retain good researchers without having the space or facilities. They were finally able to get a building of their own to centralize these operations, after 10 years of fund-raising. This building is absolutely essential to their ability to recruit and retain the best scientists. They have already lost some of their best people because there is now tremendous competition for good researchers in spinal cord injury.

    Wise.

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    Thanks Dr. Young

    90-99% of us here consider you a father or brother like figure.

    Just wanted to remind you most of us really appreciate what you do for sci.

  10. #10
    I agree with cannon ball. Thanks Dr. Young. I thought Jim was done with his conspiricies. My mom has warned me about all the nuts I might run into on the internet. I guess that is part of having a free speaking forum. sigh....

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