Regenerating Nerve Tissue in Spinal Cord Injuries

Severe injuries to the neck during recreational activities such as horseback riding or playing football can permanently alter someone’s life dramatically. With no options for the repair of spinal cord injuries, many are left with little hope for recovery.

New work by researchers at Rush University Medical Center (RUMC) in Chicago is investigating a new therapy that uses stem cells to treat spinal cord injuries within the first 14 to 30 days of injury. Rush is one of only two centers in the country currently studying this new approach.

“There are currently no therapies that successfully reverse the damage seen in the more than 12,000 individuals who suffer a spinal cord injury each year in the United States alone,” says Richard G. Fessler, MD, PhD, professor of neurological surgery at RUMC. An estimated 1.3 million Americans are living with a spinal cord injury.

“These injuries can be devastating, causing both emotional and physical distress, but there is now hope. This is a new era where we are now able to test whether a dose of stem cells delivered directly to the injured site can have an impact on motor or sensory function,” Fessler continued. “If we could generate even modest improvements in motor or sensory function, it would result in significant improvements in quality of life.”

Dr. Fessler is the principal investigator at RUMC of a clinical trial that involves progenitor cells that are likely to develop into a certain cell types. Specifically, this study is studying nerve cells known as oligodendrocyte progenitor cells, which potentially can make poorly functioning nerves function better. A San Francisco Bay-area biotechnology company known as Asterias Biotherapeutics, developed the cells and is sponsoring the trial.

This clinical trial is designed to assess the safety and efficacy of increasing doses of AST-OPC1 to treat individuals with a cervical spinal cord injury that resulted in tetraplegia, the partial or total paralysis of arms, legs and torso. As of mid-August, one individual has been enrolled in the study at Rush and there are high hopes that others will be enrolled as well in the near future.

Three escalating doses of AST-OPC1 will be examined in patients with subacute, neurologically complete injury to the cervical spinal cord (the spinal cord in the neck, specifically, the spinal nerves known as C5 to C7). These individuals essentially have lost all sensation and movement below their injury site and have severe paralysis of the upper and lower limbs.

In order for this therapy to work, the spinal cord must be continuous not severed. Patients must be able to begin treatment within 25 days of their injury.

Fessler and his group will administer AST-OPC1 between 14 to 30 days after sustaining the injury. Following the treatment, patients will receive frequent neurological exams and imaging in order to assess the efficacy of the treatment. Furthermore, patients will be followed for 15 years thereafter.

“If this treatment proves to be safe and effective, in the future, it also might be used for peripheral nerve injury or other conditions that affect the spinal cord, such as multiple sclerosis or ALS,” Fessler says.

The study is recruiting male and female patients ages 18 to 65 who have recently experienced a cervical spinal cord injury at the neck that resulted in partial or total paralysis of arms, legs and torso. All participants must be able to provide consent and commit to a long-term follow-up study.