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Thread: Mayo Clinic Changes Treatment for Spinal Cord Injury

  1. #11
    The Future of Spinal Cord Research at Mayo Clinic

    Mayo provides important base support for SCI research projects by funding necessities not funded by external grants such as space, infrastructure, microscopes, centrifuges, electrophysiological and other critical equipment.

    Dr. Windebank has devoted most of his research career to understanding the mechanisms of peripheral nerve disease. He has extensive knowledge in how peripheral system Schwann cells stimulate regeneration after injury and was well aware that spinal cord nerve fibers also have the capacity to regenerate, but that many efforts have been thwarted by a cellular process that inhibits regeneration and promotes scarring.
    Dr. Yaszemski is an expert in engineering a variety of polymers that are used as scaffolds to support new bone growth. He is also a firm believer in research that is initiated by patients who have a problem that needs to be solved. As a spine surgeon, he is frustrated that the best he can currently offer a person who comes in with an acute spinal injury, is stabilization of the bony spine that will allow the person to function with paralysis.
    In casual discussions the two physicians wondered how they could synthesize their combined clinical skills with their cellular biology and engineering expertise and launch an effort to help patients with SCI. Just two years later, they began seeing promising results in studies that evolved from their collaboration.

    "Thus far we've successfully implanted a scaffold in animals, shown that it supports and directs growth, and that it functions as a delivery system for drugs." Michael Yaszemski, M.D., Ph.D.

    Orthopedic surgeon, Bradford Currier, M.D., and neurosurgeons Richard Marsh, M.D., and Robert Spinner, M.D., help plan experiments and keep the team focused on translating the science to humans.
    To simulate spinal cord injury a small section of a spine is surgically excised from an anesthetized rat. It is replaced with a trellis-like, biodegradable, polymer scaffold designed to anchor nerve cells, deliver drugs that promote nerve regeneration, and dissolve after a predetermined time to make room for more nerve growth. "We're using polymer chemistry to find the ideal combination of plastics," says Dr. Yaszemski. "And we have designed and constructed a variety of these mini scaffolds. Now we're ready to test them to find the architecture that produces maximal nerve growth."
    Another variable is sorting out which compounds do the best job of promoting nerve growth.
    "We know that Schwann cells promote nerve growth so we harvest them from the peripheral nervous system and load them into the polymer scaffold," explains Dr. Windebank. "We also introduce neurotrophins - protein growth factors that promote nerve growth by blocking natural cell death. And we are experimenting with compounds that inhibit scar formation."
    Three months after they injected Schwann cells into rat spinal cords, the research team observed as many as 5,000 nerve fibers growing throughout the length of the polymer scaffolds. There are hundreds of thousands of nerves in a normal spinal cord but Dr. Windebank estimates that it will be possible to restore function with ten percent of the normal number.
    Collaboration with the Spinal Nerve Regeneration Project
    Mayo researchers devote much of their time to educating future leaders in science and educational duties frequently lead to further scientific collaboration. For example, Drs. Windebank, Sieck and Yaszemski are all members of the thesis committee of a graduate student who is working on the polymer scaffolds an activity that keeps them abreast of each other's projects.
    "Neuron target cell interactions have been best characterized in the motoneuron muscle area," says Dr. Sieck. "Potentially, motoneurons can pick any muscle fiber they want to innervate but they choose very specific types of muscle fibers that express the same contractile and metabolic proteins. The same problem exists for nerve axons in the spinal cord as they regrow following SCI. As we increase our understanding of the mechanisms by which neurotrophins mediate neuron-target cell interaction, we can apply that knowledge to developing therapies that will help Drs. Windebank and Yaszemski to steer a newly regenerated nerve in the right direction."
    While encouraged by their progress, Dr. Windebank cautions that they must find a way to guide nerve terminals to make contact with the correct nerve ending before function can be restored.
    "Thus far we've successfully implanted a scaffold in animals, shown that it supports and directs growth, and functions as a delivery system for drugs," says Dr. Yaszemski. "That says nothing about the nerve fibers actually functioning."
    Slobodan Macura, Ph.D., a biochemist and an expert in nuclear magnetic resonance microscopy and spectroscopy, helps investigators judge their progress by producing images of the tiny polymer scaffold. Together with spectroscopy studies, he is able to provide information on the composition and concentration of metabolites in body fluids, cells, tissues, and organs. Other basic scientists at Mayo are conducting research that may help when the team is ready to begin the complex process of restoring function.

    http://discoverysedge.mayo.edu/spina...jury/index.cfm


    (This is investigative research being worked on. It is not a current registered human clinical trial.)


    Last edited by GRAMMY; 01-04-2012 at 03:17 AM.

  2. #12
    Thanks Grammy!

    Looks like we can see acceleration in SCI Cure Research field!

    More & more teams , labs and doctors, more and more king's horses and king's men trying to put us, Humpty Dumpties, together again!

    By 2015 we can see real, proven hope ...

    Living in a dream
    www.MiracleofWalk.com

    Miracles are not contrary to nature, but only contrary
    to what we know about nature
    Saint Augustine

  3. #13
    I think we have lots of fine researchers that are working in the field. Their advancements will be critical for good outcomes for us. I like reading about their progress as they put the pieces back together.

  4. #14
    I would like to know the clinical evidence Dr. Huddleston has to back up his opinion that Methylprednisolone is not effective.

    I received it after a severe fall and am ASIA C.

  5. #15
    Quote Originally Posted by GRAMMY View Post
    I think we have lots of fine researchers that are working in the field. Their advancements will be critical for good outcomes for us. I like reading about their progress as they put the pieces back together.
    exactly... me too...
    I like that expression - "they put the pieces back together" ...
    In opposite dimension world we are connected than broken than connected than born than finish in big bang ...
    www.MiracleofWalk.com

    Miracles are not contrary to nature, but only contrary
    to what we know about nature
    Saint Augustine

  6. #16
    Quote Originally Posted by comad View Post
    I like that expression - "they put the pieces back together" ...
    I knew you'd like that one since you used the Humpty Dumpty reference!

  7. #17
    Quote Originally Posted by Jim View Post
    I would like to know the clinical evidence Dr. Huddleston has to back up his opinion that Methylprednisolone is not effective.

    I received it after a severe fall and am ASIA C.
    I received it after a severe fall and am ASIA A.

  8. #18
    Quote Originally Posted by Fly_Pelican_Fly View Post
    Now, I wonder if Drs Yaszemski and Windebank could execute a clinical trial within DoD grounds where the FDA has no jurisdiction
    Pelican,

    It is not true that the FDA does not have jurisdiction over Department of Defense (DoD) trials. DoD clinical trials are required to get IND (initial new drug/device application) for clinical trials. I have been sitting in various meetings involving clinical trials for the DoD and they work closely with the FDA to get permission for trials.

    Wise.

  9. #19
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    Quote Originally Posted by GRAMMY View Post
    I found the video valuable from a few days ago when the Mayo Clinic announced that steriods are no longer automatically in the treatment of trauma protocol for their patients...
    How did you find it valuable?

  10. #20
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    Quote Originally Posted by GRAMMY View Post
    I found the video valuable from a few days ago when the Mayo Clinic announced that steriods are no longer automatically in the treatment of trauma protocol for their patients or when other doctors call the center for advice on their trauma cases.
    If some of the biggest trauma centers in Scandinavia - I mean not necessarily from the country I’m from - but a neurosurgical team, which is regarded some of the best, on SCI, use these steroids whilst a neighboring university don’t use it. I will not use names on these universities, but I can say so much that the professor and the head of this trauma SCI surgical department, is considered some of the best, and they use these steroids because they believe by practice it will help patients. And that is known, if one bothers to do a search.

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