Actual SCI surgeries around the world

[filbert2]

HEALING THERAPIES NEWSLETTER
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This is the 18th email newsletter© associated with www.healingtherapies.info.
The purpose of this website is to expand the healing spectrum of people with
physical disabilities, especially spinal cord dysfunction. Newsletter size
(~3,200) precludes responses to individual inquiries. [To unsubscribe, respond
with "delete."].

In contrast to the previous newsletter that focused on a consciousness-based
approach to healing, this newsletter swings to the opposite end of the healing
spectrum and summarize various function-restoring procedures involving the
transplantation of stem or olfactory cells.

Please support those who have made this newsletter possible, including
"PN/Paraplegia News" (subscribe 602-224-0500 or www.pn-magazine.com), and
Paralyzed Veterans of America (www.pva.org).
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CUTTING-EDGE SURGERIES
(adapted from April 2005 "Paraplegia News" articles)

When I directed PVA's Spinal Cord Research Foundation a decade ago,
function-restoring interventions for spinal cord injury (SCI) were rare and
usually off the radar screen in this pre-Internet era. In contrast, today, so
many promising surgeries are in the developmental pipeline, it is difficult to
keep track of them; at this ever-accelerating rate, the next decade's progress
is anticipated with great excitement. This article's purpose is to provide
brief synopses of some of these surgeries involving the transplantation of
various stem or olfactory cells.

Improvements accruing from these surgeries can vary from the negligible to
dramatic. Furthermore, results often depend upon the patient's commitment to
aggressive, post-surgical physical rehabilitation designed to maximize restored
function, which scientific purists consider a confounding factor. Although
impressive success stories receive great visibility, the disappointments do
not.

OLFACTORY & STEM CELLS
Because olfactory tissue is exposed to the air we breathe, it contains cells
with considerable turnover potential, including renewable neurons, progenitor
stem cells, and olfactory ensheathing cells (OECs) (insert link).

When transplanted into the injured spinal cord, OECs promote axonal regeneration
by producing insulating myelin sheaths around both growing and damaged axons,
secreting growth factors, and generating structural and matrix macromolecules
that lay the tracks for axonal elongation.

Stem cells can differentiate into cells that can potentially treat many
neurological disorders. Although a complex subject that cannot be adequately
discussed in this article, transplantable stem cells are often categorized as
either embryonic, a contentious issue in this country, or adult
(non-controversial).

As the name implies, the former are derived from embryonic tissue and possess
the greatest potential to differentiate into a wide range of cell types,
although it has proven difficult to direct their differentiation pathway.

Adult stem cells are found in numerous tissues, including bone marrow (which
produces, for example, hematopoietic stem cells that give rise to blood cells),
and nervous tissue (whose stem cells can evolve into neurons and neuronal
support cells). Although adult stem cells usually differentiate into the
specialized cells associated with the originating tissue, when certain cues are
provided, they can differentiate into cells associated with other tissue. For
example, under appropriate circumstances, bone-marrow-derived stem cells have
the potential to become nerve cells.

Transplantable cells can be obtained from the patient (autologous), different
individuals or embryos (allogeneic), or different species (xenogeneic). All
three types have been transplanted into the injured spinal cord. Because
autologous tissue is from the patient, there is no immunological rejection.
Embryonic cells' undifferentiated nature also minimizes, to some degree,
rejection.

In addition to different cells being transplanted, there are differences in how
they are re-introduced into the patient. All of the procedural differences help
explain why some methods appear so promising and others less so.

SURGICAL PROCEDURES:
1) Portugal: Dr. Carlos Lima implants whole olfactory tissue obtained from the
patient (i.e., no immunological rejection) back into the injury site (insert
link). Lima believes that more than one cell type is needed to maximize
regeneration, including not only OECs but also olfactory neurons in different
developmental stages, and precursor stem cells. To date, he has treated over 40
patients, most of whom have accrued benefit. An adult stem-cell advocate, Lima
believes "Mother Nature made embryonic stem cells to proliferate and adult stem
cells to replace and repair."

2) China: In contrast, Dr. Hongyun Huang transplants OECs isolated from fetal
olfactory bulbs (insert link). The isolated OECs are grown and expanded in
culture, and then about a million are injected around the injury site exposed
through a limited laminectomy. Huang has transplanted OECs into hundreds of
patients, often many years after injury, and there is a long waiting list for
his procedures. Because many patients regain some function soon after surgery,
improvement is not due to relatively slow neuronal regeneration or
remyelination. Huang speculates that OECs wakeup quiescent neurons that still
transverse the injury site, perhaps by altering the injury site's environment
through secreting growth factors and producing adhesion and matrix molecules.

3) Australia: In a phase-1 clinical trial, Dr. Alan MacKay-Sim's team has
implanted autologous OECs back into the patient's injured cord. The OECs were
isolated from the patient's nasal tissue and amplified in culture to yield up
to 20-million cells over six weeks. These cells were injected into 40 sites
surrounding the injury site. The progress of three subjects who received OEC
transplants is being compared to three individuals who did not have the
transplants. These comparative assessments are blinded, i.e.,
progress-monitoring assessors do not know which patients had the procedure.

4) Brazil: Dr. Tarcisio Barros et al. have infused bone-marrow-derived stem
cells into the spinal artery closest to the injury site in 32 subjects with
clinically complete injuries (2-12 years post injury). The stems cells were
isolated from the patient's own blood after treatment with a drug that
stimulates the bone-marrow production of these cells and, in turn, their
spillover into the blood. After one-year follow-up, 18 patients have shown
improvement in electrophysiological neuronal conduction, which, in some cases,
has been translated into functional improvement.

5) Russia (Moscow): Dr. Andrey Bryukhovetskiy has transplanted embryonic and
autologous (i.e., from the patient) adult stem cells into patients with chronic
SCI. From extensive experience using both cell types, Bryukhovetskiy has
concluded that autologous stem cells are much more effective than the embryonic
stem cells in restoring function. With his most recent work, either olfactory or
hematopoietic-derived, autologous stem cells are implanted within a gel-polymer
matrix for patients who need reconstructive surgeries. In patients who did not
need such surgeries, hematopoietic stem cells are transfused intrathecally into
the spinal fluid. Although results are preliminary, some of Bryukhovetskiy's
patients (average 5-years post injury) have had dramatic functional
improvements in relatively short time periods, many improving two grades using
the commonly used ASIA classification scale.

6) Russia (Novosibirsk): Dr. Samuil Rabinovich's team has transplanted various
combinations of fetal OECs, cells from nervous and hematopoietic tissues, and
spinal cord fragments into the injury site of 15 patients. Ranging in age from
18 to 52, patients were one-month to six years post injury and had complete,
Frankel grade-A injuries (Frankel classification evolved into today's ASIA
scale). Each patient received one to four cell transplantations at various
times, and was followed at least 1.5 years. Improvements were noted in 11 of 15
patients. Six improved to grade-C, incomplete level, and five were able to walk
with crutches. In general, patients who had the transplantations sooner after
injury accrued the most benefit.

7) South Korea: Dr. Song Chang-Hoon et al. injected stems cells isolated from
umbilical cord blood into a 37-year old woman's injury site. Injured for 19
years, she regained significant function relatively soon after surgery,
including some walker-assisted ambulation. Chang-Hoon believes that injecting
the cells directly into the spinal cord is more effective than infusing them
into spinal fluid surrounding the cord. Unlike embryonic stem-cells, umbilical
stem-cells are not controversial. They also have less rejection potential than
most other donor tissue except embryonic tissue; i.e., some, but not strict,
matching between donor and recipient is needed.

8) Czech Republic: Dr. Eva Sykova and colleagues have harvested autologous,
bone-marrow stem cells from the iliac bone (i.e., hip) of 17 patients. Within
five hours of harvesting, cells were re-introduced into the patient through the
vertebral artery (7 cases), intravenously (10 cases), or underneath the cord's
dura membrane (1 case). Eight and nine patients were treated 11-30 days and
2-17½ months after injury, respectively; one patient was treated twice. Four
had improved ASIA scores, seven had enhanced neuronal conduction, and the
lesions of three were reduced in size as measured by MRI. In general, more
benefits accrued when the treatment was done closer to the time of injury.
Sykova is now experimenting with stem cells incorporated within a gel matrix,
and treating patients with bone-marrow-derived stem cells that have spilled
over into blood after drug stimulation.

9) Mexico: Starting in the early 1990's Dr. Fernando Ramirez' team has
transplanted blue-shark, embryonic neuronal cells (i.e., xenogeneic
transplantation) into the injured spinal cord of 89 patients with SCI. His
approach evolved from live-cell therapies developed by European scientists
starting in the 1930s long before stem cells emerged as a hot scientific
topic.

CONCLUSION
For a variety of scientific, regulatory, and societal reasons, most SCI surgical
breakthroughs are happening elsewhere in the world. Although our conservative
approach to developing new treatments ensures safety and efficacy using
scientifically pure methodology, it hinders the development of real-world
treatments. There is always a tradeoff between the risk of new therapies and
the risk of not having any therapies at all. In contrast, for many foreign
scientists, there are fewer hurdles to overcome to move beyond animal research
to human interventions. To help benefit Americans with SCI, we need to
open-mindedly form bridge-building collaborations throughout the world.

© 2005 www.healingtherapies.info ALL Rights Reserved

http://filbs.friendpages.com

I want it all, I want the fairytale~Pretty Woman

[antiquity]

Good synopsis. Thank you Filbs.

[Stephan28]

filbs0602 (sorry I don't know your name),but
hey, there is also another dr. performing surgery in Mexico. I just had stem cell surgery on 06/05/05. The Dr. went in and removed all of my scar tissue and injected umbilical cord cells in my back. I will go back every two months to get re injeceted w/ the stem cells for better results...he also prescribed 4ap for maximum results. I will let this forum know of my progress when I start working out and stuff. I have pictures of my surgery if any one wants to see...

"Always do sober what you said you'd do drunk. That will teach you to keep your mouth shut" -Ernest Hemingway

[Shwetarose]

Stephan.
U underwent surgery but whats the doctor name? U must be knowing the name of the doctor