Who Plans to Attend Working 2 Walk 2011 ?

[lynnifer]

The two approaches are completely different. I think it's unfair to ask another physician's opinion on another approach.

Just my opinion .. but Dr Silver's work looks like something that could help now with body functions, etc. Could it lead to walking again? Not normally in my opinion because like he said, too many things have to work in concert.

Dr Young's leading up to something at the root of the problem .. but it won't be here in our lifetimes (just my opinion).

[jsilver]

Dear Kivi,

I took a look at the links you provided. Both pertain to the original work by Henrich Cheng and Lars Olson, who used nerve grafting +FGF to promote walking restoration in adult rats with complete thoracic cord transection. In the original work, which uses a complicated arrangement of multiple grafts, these researchers claimed robust functional recovery of walking. However, this was only minimally confirmed by other labs in the years following its publication. And when it was confirmed the results were published in low profile journals. (By the way, when someone (and that includes me) claims robust recovery after SCI in any publication it is important to be highly critical and ask tough questions). Our technique published in 2006 and 2011 used a long graft around the lesion plus chondroitinase (We did not include FGF). For our work aimed at restoring a measure of bladder function after complete transection I have teamed up with Yu-Shang Lee who is now at the Cleveland Clinic and was trained in Cheng's lab. We are , indeed, using a modification of the original Cheng technique to bridge the cord directly across the original lesion. We have added the chondroitinase enzyme as well as FGF and that has made a considerable improvement over the original method. We have learned that the FGF especially helps cells integrate better at the ends of the graft. I can now understand why it was so difficult to reproduce the original data. Not only is the surgery remarkably difficult but without the enzyme ( just the graft +FGF) very few axons actually regenerate completely across the lesion and back into the spinal cord on the other side. Importantly, even with the enzyme added to the full treatment, the return of walking is extremely minimal. However, if one waits for at least 6 months after surgery there occurs a very significant improvement in bladder function and that is what I will present at W2W. So I think that the original work over emphasized walking and completely missed the effect on micturition.

Jerry

[kivi66]

lynnifer, sorry, but what is unfair is spinal cord injury. Just my opinion ..

[lynnifer]

kivi - no need to apologize. I agree that what is unfair is spinal cord injury.

The two approaches are apples and oranges though. Trust me I am always critical of Dr Young (sorry if he's reading this!), but not in this case.

Thanks for the explanation Dr Silver. You're one to watch on the paralysis hope radar!

[Isildur]

Originally Posted by lynnifer

The two approaches are completely different. I think it's unfair to ask another physician's opinion on another approach.

Just my opinion .. but Dr Silver's work looks like something that could help now with body functions, etc. Could it lead to walking again? Not normally in my opinion because like he said, too many things have to work in concert.

Dr Young's leading up to something at the root of the problem .. but it won't be here in our lifetimes (just my opinion).

How could be possible that something that is not even in trials will be better and faster that something that will be soon in phase II? Can you elaborate your theory?

[lynnifer]

Isilder,

If you take a cell phone whose battery has run out and plug it into the wall, it might take a bit of time, but it will recharge and make the connections. That is something concrete.

With CHINASCINET, they are trying to recharge the battery to make connections with an abstract idea.

That is how I'm thinking of this. Nerve grafts have a long history and why no one has put them to use before this is beyond me. I say 'now' because I believe this is something that could help me if I were sixty years old even - how blessed it would be to have my bladder back at any age. I'll never walk again.

I realize there will be trials with Silver's work too, but I hope they progress fast and have more faith in that idea, than any other I've heard in all my years of paralysis.

[Isildur]

I know, but every trial must follow the same steps, and even in the best case scenario, there isn´t another research right now that can end trials before ChinaSCInetwork.
For example, Dr.Vaquero will start trials this year, and even with all the animal (rats and pigs) and pre-clinical data, he can´t reach phase III before Dr.Young.

[Christopher Paddon]

So that's any hope of walking again shot down in flames........

I'm afraid I can't get very excited about being able to control peeing again

[kivi66]

jsilver, I would be very grateful if you share your thoughts concerning research works on pten-mtor manipulation: "Robust Regeneration of Injured Nerves Achieved for First Time in Adult Mammalian Spinal Cord"(http://www.healthyaging.net/articlel...rd-/Page1.html) in liaison with this: "In addition, the researchers investigated how these RGLs were activated on a molecular level, focusing, in particular, on the regulatory role of an autism-associated gene called PTEN. Conventional wisdom was that deleting this gene led to an increase in stem-cell activation. However, the scientists demonstrated that was a transient effect in the mouse brains, and that, ultimately, PTEN deletion leads to stem-cell depletion." (http://www.medicalnewstoday.com/releases/230001.php)
and about this recent discovery: "Connection Discovered Between the Nervous System and the Vascular System" (http://www.sciencedaily.com/releases...0608131330.htm).

[rjames]

Dr. Silver, thank you for taking the time to come on this forum and share your thoughts about your work and your thoughts on SCI research in general. I just hope that the members on here treat you with the respect you deserve.... My wife and I had the pleasure of meeting you and talking a little about your area of research at the Reeve Irvine "Meet the Scientist" function this past spring.

It seems to me that the type of work you are doing would be faster to the clinic than say a Stem Cell therapy. looking forward to hearing about future developments with your work.

Originally Posted by jsilver

Dear Kivi,

I took a look at the links you provided. Both pertain to the original work by Henrich Cheng and Lars Olson, who used nerve grafting +FGF to promote walking restoration in adult rats with complete thoracic cord transection. In the original work, which uses a complicated arrangement of multiple grafts, these researchers claimed robust functional recovery of walking. However, this was only minimally confirmed by other labs in the years following its publication. And when it was confirmed the results were published in low profile journals. (By the way, when someone (and that includes me) claims robust recovery after SCI in any publication it is important to be highly critical and ask tough questions). Our technique published in 2006 and 2011 used a long graft around the lesion plus chondroitinase (We did not include FGF). For our work aimed at restoring a measure of bladder function after complete transection I have teamed up with Yu-Shang Lee who is now at the Cleveland Clinic and was trained in Cheng's lab. We are , indeed, using a modification of the original Cheng technique to bridge the cord directly across the original lesion. We have added the chondroitinase enzyme as well as FGF and that has made a considerable improvement over the original method. We have learned that the FGF especially helps cells integrate better at the ends of the graft. I can now understand why it was so difficult to reproduce the original data. Not only is the surgery remarkably difficult but without the enzyme ( just the graft +FGF) very few axons actually regenerate completely across the lesion and back into the spinal cord on the other side. Importantly, even with the enzyme added to the full treatment, the return of walking is extremely minimal. However, if one waits for at least 6 months after surgery there occurs a very significant improvement in bladder function and that is what I will present at W2W. So I think that the original work over emphasized walking and completely missed the effect on micturition.

Jerry