
Paralysed man walks again after cell transplant - pierre-renaux
http://www.bbc.com/news/health-29645760
======
bhousel
Completely shameless plug follows, but this is an area of research that
matters a lot to me personally. My mother has neuropathy and is in a
wheelchair. It's been rough watching her lose function, and now encouraging to
see her regain some of her nerve function with immunotherapy and exercise.

I'm running the NYC Marathon to raise money for the Christopher and Dana Reeve
Foundation, a nonprofit organization dedicated to improving the lives of those
with paralysis, mobility impairment, and spinal cord injury.

The Reeve Foundation has funded over $80 million for paralysis and spinal cord
injury research. Scientists are learning more every year about how the spinal
cord works, how nerve cells die and can be regenerated, and how new therapies
can promote nerve regrowth. As a direct result of this research, there are
people today who can breathe, control their bladder, and walk, after receiving
treatment for severe spinal injury.

If this is an issue that you are interested in, please consider a donation:
[http://www.christopherreeve.org/nyc2014/bhousel](http://www.christopherreeve.org/nyc2014/bhousel)

Thanks for listening..

~~~
surfy
I ran this for the Reeve Foundation a few years ago. The NYC Marathon is an
incredible event - so much energy all along the route. It's like a 26 mile
party. Envious!

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tokenadult
The article notes, "This process of regeneration is made possible by olfactory
ensheathing cells (OECs), which provide a pathway for the fibres to grow
back." In other words, this was not an experimental treatment with stem cells
(pluripotent cells). The story details here are interesting to me, as my late
dad spent the last six years of his life paralyzed from the chin down from a
spinal cord injury (a slip and fall on ice on a parking lot). His spinal cord
was not completely severed, so he had quite a lot of sensation from the parts
of his body that were immobilized, but he was not able to learn to walk with a
walking frame even as well as the patient reported on here. (My dad's injury
was much higher up on the spinal cord, which makes a big difference. His
bruising of his spinal cord was at the second cervical vertebra.)

The article continues, "All those involved in the research are keen not to
raise false hopes in patients and stress that the success will need to be
repeated to show definitively whether it can stimulate spinal cord
regeneration." Yes. This is a very early result, but there seems to be
something here that has achieved results never before achieved, and if those
results can be replicated in other patients, this will be great news.

The article mentions what kind of patients the experimental team is looking
for. "Dr Tabakow said: "Our team in Poland would be prepared to consider
patients from anywhere in the world who are suitable for this therapy. They
are likely to have had a knife wound injury where the spinal cord has been
cleanly severed." Many spinal cord injuries are bruises or tears rather than
cuts, and may not heal as well with the technique described in the article.
But this is a start, and may open up investigation of other approaches to
repairing injuries to the spinal cord.

~~~
fredkingham
He's been doing this since the 70s. When I broke my back 10 years ago there
was another panarama in which he'd shown dramatic improvement in rats.

He's only got round to spinal injury's now because its something occasionally
improves without aid and is therefore unreliably for scientific tests. He was
looking at other types of injury (I can't remember the name) where the nerves
to the arm are torn out, as this never shows any signs of recovery.

He's now moved on to knife wounds as these offer the cleanest types of
complete break ie very unlikely to improve later.

Raisman has been thorough and methodical about this. Its his life's work and I
have no doubt he'll succeed

(I was actually in hospital with Dan Nicholls, whose father has been funding
Reiman's research [http://www.nsif.org.uk/](http://www.nsif.org.uk/))

~~~
jtheory
It's easy to be confused about the time scale on this kind of work; it's
hidden from public view until there's an appropriately newsworthy milestone.

As you point out, this is not a "Eureka!" moment at all; it's a waypoint on an
arduous path that has taken decades of work, and will continue on (largely
equally slowly) for a long time to come.

The operation discussed in the article was two years ago; it's taken that much
time (with intense physical therapy the entire time!) before he has gotten the
mobility he has now.

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espinchi
_Prof Raisman has spent more than 40 years studying how to repair the spinal
cord._

This type of perseverance is admirable.

~~~
zwischenzug
I just heard this guy on Radio 4. The presenter gave him an opportunity to
downplay the significance of this, and he didn't take it. He really believes
he's onto something big.

When the presenter asked him about the 40-year wait, he went quiet; then said
something about having a duty to help these sufferers by continuing the work.
Pretty inspiring.

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philbarr
Counterpoint on the TV on SKY News from Dr. Mark Bacon from "Spinal Research"
who says that this is nothing new, that it is not as significant as a "man
walking on the moon" as has been claimed.

He says that this is essentially a feasibility study showing safety, and that
it was the unique situation of the patient where the cut was very narrow and
clean that allowed this to happen; most other spinal injuries damage much more
of the spinal column. He said he also wants to quantify exactly how much of
the shown result was directly a result of the surgery. The patient had lots of
different treatments and they don't know how much those had an effect.

However, when the interviewer said, "although you've added a note of caution
there, should people with these kinds of injuries have a bit more hope now
that this news has come out?" the response was, "absolutely, it shows that we
are making inroads into this. This area, even just a few years ago was thought
to be dead, but now we are making clinical trials."

Edit: Changed it from BBC News to SKY News. Oops.

~~~
dazonic
I'm dubious of the "walking again" claims though. Sure it's awesome he's
regained feeling - that's the story here. But his so-called walking is between
parallel bars or with a walker, both with full calipers. Complete paraplegics
can do this by just swinging their legs, and it looks like what this guy was
doing. They showed him lying on a bed, I wish they'd show just what leg
movement - if any - he's regained.

------
quotient
That's amazing. I really hope that more research is done in (stem) cells. It
shows outstanding promise, and it seems safe to assume that this is just the
start for a technique of treatments that revolutionizes the way we view and
treat illness.

Edit: The article did not mention stem cells, but I think stem cells will
inevitably be discussed in this thread as they're a very closely related
topic, hence the mention.

~~~
ajuc
Re stem cells - my sister is a vet, she says currently animals get much better
treatment than people because stem cells are experimental for people, but
routinely used on animals, and the effects are astonishing.

She also have this conspiracy theory about sport stars returning to sport 3
months after especially bad injuries - they must get stem cells, it's
impossible otherways.

I don't know if it's true, I hope it is because it means it will eventually be
used on regular people as well.

~~~
tim333
I think it's a shame that this kind of experimentation is not done in a way
that maximises the well being of mankind. Paralysed rats were sucessfully got
to walk again at least as early as 2003
([http://www.youtube.com/watch?v=5x8e2qsAVGc](http://www.youtube.com/watch?v=5x8e2qsAVGc))
and it would seem to make sense to experiment on the odd human but instead we
have to wait decades I think at least partly to cover the regulators arses in
case there are any problems. But it would be better for society to have the
odd experimental problem than thousands people suffer for years while they
muck about with paperwork and the like.

I see from Wikipedia that Geron Corporation have recently submitted 28,000
pages of documents to the FDA for a stem cell related trial so maybe in 2023
or some such we'll be able to do for people what we could do for rats in 2003.

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pontifier
I've heard about the remarkable ability of nasal nerves to regrow, and it's
fantastic that they seem to be able to translate this to the spine. I wonder
about other nerve bundles. My mother lost her vision due to optic nerve
damage, and this seems like a very promising technology. I hope they can
repeat the result.

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joeyo
As far as I can tell, this is the paper [1]. It was published a little over
twelve months ago, so that's a pretty big lag before the news article. Was
there perhaps a follow-up that I missed?

1\.
[http://www.ncbi.nlm.nih.gov/pubmed/24007776](http://www.ncbi.nlm.nih.gov/pubmed/24007776)

~~~
alexbate
Yeah - kind of. The BBC's Panorama show (kind of linked to BBC News, but long
documentaries) has had special access to his rehabilitation over the last
year, that special airs tonight.

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adhambadr
amazing two thoughts pop onto my head

do you think the same technique can be used to reproduce damaged optical
nerves ? this could be a huge step towards curing a huge percentage of
blindness, something Ive been very personally interested in lately.

am I the only one who wonders why the slow pace of such crucial medical
discoveries ? after a successful attempt, the future plan is treating only 10
more patients over the next 'years'. In Silicon valley timezone thats
centuries, my non-medical tech corrupt mind is screaming pump money, replicate
this to 100 patients in the next 60 days and scale, scale, scale!!!

~~~
maccard
> replicate this to 100 patients in the next 60 days and scale, scale,
> scale!!!

Most likely the fear of any unknown side effects that haven't manifested just
yet, and the ability to refine whatever procedure was performed to try and
minimise any of the long term downsides to this approach?

~~~
innguest
I doubt what is keeping this from scaling is fear of unknown side-effects. I
bet people would be lining up to be a guinea-pig to this if regulation
allowed.

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tsenkov
40 years without turning your back on a project... probably "heroic" is one of
the words describing it.

I suppose the biggest "bottleneck" in the progress of such work is testing.

What is the current state of computer simulations of bio systems? Is OpenWorm
the biggest project in this direction? If I remember correctly, they weren't
exactly simulating completely down to the cellular organelle (or atomic)
level, but instead simulated starting from higher level of abstraction (muscle
contraction etc.).

~~~
thewillcole
upvote for the casual "turning your back" pun!

~~~
tsenkov
Ha.Ha. :) Pun (not) intended.

~~~
thewillcole
That comment cost me 1/12 of my hard-earned 12 points. So this is what
_martyrpun_ feels like.

------
lotsofmangos
This is amazing. Hopefully he won't grow a bit of snotty nose on his back like
the woman who had a similar treatment in Portugal -
[http://www.stemcellsportal.com/content/nasal-mass-grows-
pati...](http://www.stemcellsportal.com/content/nasal-mass-grows-
patient%E2%80%99s-spine-following-stem-cell-transplantation) \- though I dare
say the risk is more than worth it.

------
refurb
I'm assuming that a treatment like this will likely be much more successful
with a more recent injury?

From what I understand once a nerve is injured processes continue that result
in less and less activity. When you're treating an injury as old as his, you
not only have to "make the connections", but also reverse any nerve atrophy
(for lack of a better word).

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vijaygirija
That's so nice. Cell transplantation has increased rapidly in western
countries. And saved many lives.

------
quattrofan
A friend of mine commented on Facebook using the word "merely" as in merely
transplanted some cells. I've got the feeling a lot more complex science and
medicine went into this, can anyone provide some more detail in layman's
terms?

------
ladytron
Human cloning + surrogacy + suspended animation ( theraputic hypothermia ) +
nerve regeneration + microsurgery = immortality. Theoretically this now seems
possible.

~~~
jeffreyrogers
What about the brain?

~~~
ladytron
What about it? Scientists are doing a trial run in Pennsylvania now where they
put people with multiple gunshot wounds in suspended animation for up to two
hours. They expect little brain damage. Get it up to a few more hours, and I
think successful transplants can happen. Also, as other posters had noted,
this man had been paralyzed for 2 years. If you fixed the cut immediately I
assume there would be less functional degeneration and scar tissue.

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ioddly
This is amazing. How was the olfactory bulb removed?

~~~
ape4
I assume they unscrewed it (joke attempt)

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squozzer
Congrats. This deserves a beer. Sorry I can't share.

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kathrinekennley
Astonishing breakthrough that offers great hope to millions of people. When
one considers the great complexity of nerves in the spinal column, makes this
news even more remarkable.

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toblender
Time to go do some extreme sports.

