New Spinal Treatment Shows Promise

A study has found that injecting a patient's own immune cells into a damaged spinal cord enabled some patients with spinal cord injury to recover a degree of sensation and movement.

In the study, involving 10 patients, immune cells were extracted from each patient's blood, "activated” by incubating them with skin cells, and then injected directly into the damaged spinal cord. This all must be done within 14 days of the injury, so even if larger trials confirm its benefits, the method will not help all the people with existing injuries. The 10 patients were all in the most severe category of spinal injury, called ASIA-A, defined as having no sensation or ability to move below the site of injury.

Three of the patients treated so far have recovered some weak muscle function and are now classed as ASIA-C. One has regained bladder control, while another can stand and walk with assistance. Fewer than 4% of patients normally recover from ASIA-A to C. Two other patients have regained some sensation and are now classed as ASIA-B. Four other patients show signs that nerve signals can pass through the injury site. There were no signs of any ill effects.

The controversial technique is being developed by ProNeuron Biotechnologies (Los Angeles, CA, USA; www.proneuron.com). It is based on the work of Michal Schwarz, of the Weizmann Institute of Science (Rehovet, Israel). Her theory is that one of the reasons for the poor healing of spinal injuries is that the central nervous system is partly isolated from the immune system. It takes months for macrophages, which clean up damaged tissue and promote healing by releasing growth factors, to accumulate at a spinal injury site. However, many researchers remain unconvinced, and some doctors think the new treatment might actually make things worse for patients with spinal injury.

"Whether macrophages are damaging or beneficial is very controversial,” noted Geoff Raisman, who works on spinal cord injury at the National Institute for Medical Research in London (UK).




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