
Paralyzed man regains use of arms and hands after experimental stem cell therapy - jpgvm
https://stemcell.usc.edu/2016/09/07/paralyzed-man-regains-use-of-arms-and-hands-after-experimental-stem-cell-therapy-at-keck-hospital-of-usc/
======
martyvis
The Australian of the Year (just announced yesterday, January 26th being our
national day), was Emeritus Professor Alan Mackay-Sim
[http://www.abc.net.au/news/2017-01-26/the-amazing-work-of-
pr...](http://www.abc.net.au/news/2017-01-26/the-amazing-work-of-professor-
alan-mackay-sim/8214882)

He performed pioneering work taking a type of adult stem cell from the nose
and showing how it can be be used for spinal repair. A polish paraplegic,
Darek Fidyka, regained the ability to walk following surgery in 2014 using
this research findings.
[https://en.wikipedia.org/wiki/Darek_Fidyka](https://en.wikipedia.org/wiki/Darek_Fidyka)

~~~
akandiah
The paraplegic in question can now ride a bike!
[http://www.bbc.com/news/health-35660621](http://www.bbc.com/news/health-35660621)

~~~
drcross
The former paraplegic in question can now ride a bike!
[http://www.bbc.com/news/health-35660621](http://www.bbc.com/news/health-35660621)

FIFY

------
Xcelerate
This is very exciting. This type of work can even benefit people who aren't
paralyzed — damaged cartilage can also be repaired this way.

When I ran track in college, I somehow developed focal cartilage defects in
both knees. This brought my running career to a halt and made walking
extremely painful for about a year. In an attempt to fix this, I had a type of
surgery known as the OATS procedure performed. This is where the surgeon takes
a plug of undamaged articular cartilage from a low load bearing region of the
knee and swaps it with the damaged cartilage. Walking is mostly pain-free for
me now, but it still hurts too much if I attempt to run.

As though one cartilage injury weren't enough, I somewhat stupidly decided to
take up weight lifting after I couldn't run anymore and attempted to set down
a barbell that was way too heavy for me. In doing so, I triggered a mild lower
lumbar disc herniation. So now I have two permanent injuries. Luckily, neither
injury is very severe, so some days I don't even notice the pain while other
days it approaches mildly annoying "background noise".

These types of cartilage injuries are common, and arthritis is even more
common. But the issue with cartilage is that once it's damaged, it doesn't
heal on its own because cartilage has no vascular system. You can break all
the bones you want and eventually they will heal, but damaged hyaline
cartilage will not. The best that your body can do is to produce "low-quality"
fibrocartilage in place of the damaged hyaline cartilage.

Fortunately, there's been a lot of research over the last decade on using
mesenchymal stem cells (taken from your own bone marrow) to regrow true
hyaline cartilage as opposed to fibrocartilage. The stem cells have actually
been shown to differentiate into hyaline cartilage. For me, this has the
potential to permanently alleviate both knee and back pain. Moving this
research away from clinical trials seems to be taking forever for some reason
though...

~~~
lee
I started getting into weightlifting this past year, and doing deadlifts has
always scared me.

I still do them, and try to do them with proper form, but it's always in the
back of my mind that I might hurt my back due to the load.

Could you give me more detail on how you hurt your back? How heavy of a load
was it? Was it during a deadlift?

~~~
Xcelerate
It actually had nothing to do with deadlifts or bad form. I was working on my
bench press and couldn't get the fifth rep up. I set the bar down on my chest
and instead of calling out for help (to any of the fifty people standing
nearby), I thought it would be less embarrassing to just roll it down to my
knees and then stand up and set the weight down. Stupid decision. Once I got
the weight to my knees, I severely underestimated my back-to-chest strength
ratio and the weight plummeted to the ground, pulling my (arched) back down
with it. I think it was about 215 lbs (97 kg).

The key to deadlifts is good form and not letting your back arch at all. I
would recommend getting an expert trainer or an advanced lifter to help you
practice your form if you are worried about it. It's worth the time to prevent
an injury.

~~~
robbiemitchell
I was taught not to use a clamp on the bar when doing bench, so you can lean
to one side and let the weights drop off if you get stuck.

~~~
ropable
Seems like questionable advice - sounds like a great way to accidentally drop
a bunch of weights to the floor if you're at all uneven with your bar path
(not at all unusual when fatigued).

~~~
FrancoDiaz
Not only that, but even a little shift in the weights can cause problems with
your lifts. Warmups (135 or so) I'll leave them off, but anything over 200
I'll put them on.

------
neuronexmachina
Given that their methodology uses embryonic stem cells, it'll be interesting
to see how this plays out in the US with opponent Tom Price as head of Health
& Human Services.

> The stem cell procedure Kris received is part of a Phase 1/2a clinical trial
> that is evaluating the safety and efficacy of escalating doses of AST-OPC1
> cells developed by Fremont, California-based Asterias Biotherapeutics. AST-
> OPC1 cells are made from embryonic stem cells by carefully converting them
> into oligodendrocyte progenitor cells (OPCs), which are cells found in the
> brain and spinal cord that support the healthy functioning of nerve cells.
> In previous laboratory studies, AST-OPC1 was shown to produce neurotrophic
> factors, stimulate vascularization and induce remyelination of denuded
> axons. All are critical factors in the survival, regrowth and conduction of
> nerve impulses through axons at the injury site, according to Edward D.
> Wirth III, MD, PhD, chief medical director of Asterias and lead investigator
> of the study, dubbed “SCiStar.”

~~~
downandout
It's interesting that this article is months old (from September 2016) and is
only now on the front page of HN. I suspect that it has something to do with
our desire to argue the benefits of stem cell research to the new
administration.

I certainly hope they listen, but I fear they won't. People opposed to
embryonic stem cell research based upon religious beliefs aren't going to
suddenly ignore what they believe to be instructions from their particular
God, even if it has enormous benefits for society. I hope that Trump is more
reasonable than that, but the hard-line pro-life stance he recently took
through executive order doesn't make me optimistic that this kind of research
will continue in the US during the next four years.

~~~
19guid
You don't have to believe in God to make the argument that an embryo is a
developing human being who is therefore worthy of legal protection. There are
plenty of secular pro-lifers. [1]

[1] [http://www.secularprolife.org/](http://www.secularprolife.org/)

~~~
StavrosK
I don't think anyone disagrees with that. The question is at which point the
embryo becomes enough of a human where its needs outweigh the needs of the
parents.

~~~
gnaritas
That's really not relevant, it can be stipulated that life begins at
conception and it simply doesn't matter, no persons right to life trumps
another persons right to bodily autonomy. It's not murder to let someone die
if you're the only bone marrow donor that could save their life and you refuse
to donate and it's not murder to get an abortion; not all killing is murder,
nor is all killing wrong. As long as the baby requires use of the mothers body
to survive, it's right to life is secondary to her consent to carry it and
that's true even if you give a fetus the full rights any other grown person
would have. No grown person could demand their right to life is more important
than your consent to your control your own body, even if your refusal kills
them.

~~~
refurb
_It 's not murder to let someone die if you're the only bone marrow donor that
could save their life and you refuse to donate and it's not murder to get an
abortion_

"One of those things is not like the other, one of those things..."

Not donating bone marrow requires doing _nothing_. Having an abortion require
an active procedure.

~~~
gnaritas
> Not donating bone marrow requires doing nothing. Having an abortion require
> an active procedure.

True, but simply not relevant to any point I made. No metaphor is perfect, but
the point here is that your control over your own body trumps another right to
life. You wouldn't allow the government to forcibly take your bone marrow to
save a life, and that's no different than being forced to carry a pregnancy to
term against your will in regards to the point of bodily autonomy. Another
persons right to life ends when it depends on someone else's body to live. The
other person has a right to not consent to use their body against their will.

~~~
refurb
_but the point here is that your control over your own body trumps another
right to life_

I think you need to refine that stance.

As a parent, I certainly don't have control over my own body. If I fail to
provide the necessities of life for my child, I will go to jail and my kid
will be taken from me. The gov't can (and will) force me to do certain things
with my body.

~~~
gnaritas
Child neglect has nothing to do with your body. You are free to give up your
child for adoption if you don't want to take care of them. Abusing a child and
being punished for it isn't remotely similar to anything being discussed here.
You're yet again deflecting from the point and attempting to setup a strawman.

------
startupdiscuss
Despite all the cynicism, there are still wonderful things about good old
medicine and science.

90 days! Paralysis to utility!

Is someone going to tell me something like: oh, the nerve wasn't completely
severed so recovery might have happened anyway?

Well, go ahead, but in the meantime I am enjoying this news.

~~~
jpgvm
There has been a lot of uplifting news coming out of stem cell and gene
therapy the last couple of days. :)

~~~
gtaylor
Even if this is but one small step towards wider treatment, this is worth
taking a moment to be happy and thankful for. You know that this patient is!

------
obeone
Here is the December 14 2016 update to that story: [http://keck.usc.edu/stem-
cell-therapy-gives-paralyzed-man-se...](http://keck.usc.edu/stem-cell-therapy-
gives-paralyzed-man-second-chance-at-independence/)

~~~
justinclift
And further information from a few days ago:

[https://blog.cirm.ca.gov/2017/01/25/good-news-from-
asterias-...](https://blog.cirm.ca.gov/2017/01/25/good-news-from-asterias-
cirm-funded-spinal-cord-injury-trial/)

Looks like a second group of people is getting treatment with a higher dosage.
The results of that will definitely be of interest to many. :)

------
willholloway
Stem cells are showing more and more promise. One thing we know about them is
that young stem cells are better than old ones. I think there is a lot of
promise in stem cell banking.

I haven't pulled the trigger yet, but do plan on banking my own stem cells
while I'm in my early 30's because parts of me will inevitably start to break
down in the coming decades, and I really like the idea of tapping my own young
cells when I am old to heal some of that.

The only company I know of that is doing this is Forever Labs,
[https://www.foreverlabs.co/](https://www.foreverlabs.co/), I am not
associated with them, I just think they are on the right track with stem-cell
banking and have spoken to one of the founders and was pretty excited about
what they were doing and think its something worth supporting, which is why
I'm writing this comment.

~~~
ahallock
Thanks for this. I had no idea that young cells were better, even if that may
seem obvious. I had to dig, but the price is $7000 for the procedure and
lifetime storage or $3500 and then $250 per year for storage. Maybe
competition in this could reduce the storage costs.

~~~
tempestn
Ya, it is a bit steep. I'd love to see more options for this as well
(especially here in Canada, where I don't believe there are any yet...)

------
tokenadult
The patient's age being twenty-one may have made a difference in this happy
news story. My dad had a slip and fall on ice at age seventy-two that left him
paralyzed from the chin down until he died six years later. He had had a
similar injury from a car crash (back when cars didn't have seat belts) at age
eighteen, from which he recovered fully (although he wasn't so paralyzed from
the first injury). So when he had his second injury, he at first thought he
would also recover from that injury. Maybe because the second injury
aggravated damage to his spine still remaining from his first injury, or maybe
just because he was a lot older when injured the second time, he never
recovered much at all from the second injury. His experience reminds me how
many other people in a family are affected by spinal cord injuries, and thus
how important it is to find better treatments for them.

So it's hard to say how wide a range of patients will be treatable with the
new technique, but that's what medical research is for: to find out what helps
for which patients. I hope further research continues on this and other
treatments for spinal cord injuries.

------
pdimitar
Can somebody explain the stem cell therapy to a complete laic like myself? I
don't mean links to science articles, I mean a description you would attempt
projecting at me if we were having a beer.

For me the stem cells are some sort of a magical Wolverine regeneration sauce.
Never understood why they even work.

~~~
anigbrowl
They are some sort of magical wolverine regeneration source. When you have a
fertilized egg the first thing it does is start multiplying. But once you have
a little cluster of cells they start making decisions (using bits of DNA to
communicate) about what they should turn into - a skin cell, a bone cell, a
brain cell or whatever. The trick with stem cells is to harvest them and keep
them on ice just before they start making decisions. Then you transplant them
into an injured body and they're all like 'hey ho, looks like I'm surrounded
by nerve cells here so I'm gonna be a nerve cell too' (if you injected them
into a spinal column) or 'woot, looks like I'm in a community of liver cells,
I'm gonna turn myself into a liver cell' etc. etc.

The biggest problem is that you'd like a whole tank of stem cells that you
could dip some injured person into and have them come out fully repaired, but
getting stem cells to multiply without turning into anything in particular is
a challenge so we have to cultivate them in very small quantities and it's
relatively slow and expensive to do that.

I'll have a pilsener, please.

~~~
toyg
The trick is also making sure they don't get too excited and build a tumor,
which would make things really bad.

But yeah, they're almost magic, except we understand it. Which is probably why
large sectors of the religious public finds them so abhorrent: they take away
yet another arrow from the inscrutable Fate they worship, they lift another
bit of veil from the mystery of our existence. And it's a shame, because the
objective need for strict regulation will be hampered by constant calls for
pointless bans.

~~~
zeveb
> But yeah, they're almost magic, except we understand it. Which is probably
> why large sectors of the religious public finds them so abhorrent: they take
> away yet another arrow from the inscrutable Fate they worship, they lift
> another bit of veil from the mystery of our existence.

No, that's completely and totally not it. Folks oppose embryonic stem cell
research because they believe both that embryos are human beings and that
innocent human beings should not be killed. That's it.

Note that Mr. Bush continued to fund adult stem cell research, and continued
to fund research on existing stem cell lines; what he didn't do was continue
to fund the destruction of more embryos.

You may disagree with the idea that an embryo is a human being, and you may
disagree that innocent human beings should not be killed, but you mayn't be
uncharitable to your opponents.

------
overcast
It's exciting to know that paralysis will be a thing of the past in
potentially our near future. Deafness/Blindness/Cancer/etc all benefits from
these studies.

------
cpncrunch
It says it is a clinical trial, but I can't find the actual study, only
another press release:

[https://www.sciencedaily.com/releases/2016/09/160914095610.h...](https://www.sciencedaily.com/releases/2016/09/160914095610.htm)

We really need to wait until the clinical trial publishes its results to know
whether or not the treatment works. This person might have recovered naturally
without any treatment.

~~~
Brakenshire
It looks like a randomized trial hasn't started yet.

~~~
cpncrunch
Are you sure? It says "The first early data results from a group of patients
in this study will become available on September 14, 2016."

------
warcher
One _really important_ caveat here-- nature abhors a vacuum, and spinal cord
injuries are no exception. A chronic injury to the spinal column will result
in scar tissue coming in over the wound, which is a totally separate issue
from the initial injury. If your spinal cord injury is over a month old, you
have a completely separate problem, ie, how to clear out the scar tissue so
that nerve regeneration is even possible.

------
MR4D
Odd comment - what's neat to me about this article on HN is that nobody has
said "clickbait" or misleading title. That this kind of title can represent
reality shows what amazing times we live in.

The level of medical awesomeness is off the charts - so many people can now
start to hope for not just a better life, but a radically better life.

------
aphextron
I know that directly correlating a recovery with a specific therapy is really
hard to do. There have been many stem cell studies like this in the past which
have shown similar seemingly miraculous results, even though it's not entirely
certain whether the patient would have recovered otherwise or if something
else was responsible. Paralyzed people inexplicably regain motor control all
the time. I'd be curious to know how rigorous the study was in regards to
control.

------
narrator
Meanwhile, 9 years ago in China, people were already receiving this kind of
therapy, but nobody believed them[1]. As Gibson has said, "The future is
already here, it's just not evenly distributed."

[1][https://www.reddit.com/r/IAmA/comments/k1hts/i_am_a_28yr_old...](https://www.reddit.com/r/IAmA/comments/k1hts/i_am_a_28yr_old_american_who_went_to_china_to/)

~~~
anjc
It's crazy how arrogant a little knowledge can make some people, as seen in
that Reddit thread.

~~~
chc
I don't think wanting reasonable evidence before believing that a medical
procedure works and works safely is the same thing as arrogance.

~~~
anjc
Yeah, wanting reasonable evidence before believing in the casual relationship
between two events is fair.

But in this case, the Redditor can't provide scientific proof, because he's a
layman. What he can provide is evidence that he couldn't walk, received stem
cell treatment, and then could walk.

90% of the top level comments effectively said "No, impossible, there must be
some other reason that you can now walk". That is to say, they feel that
because there's no evidence that it's possible, it's impossible until
scientists prove that it is possible. Well no, that doesn't make sense and it
isn't usually how things work. These people's small amount of knowledge of the
scientific method has caused them to arrogantly discredit potentially real
phenomenon.

What's interesting is that one of the main top level comments which says "wow,
I had a feeling this would be possible" is from an actual stem cell
researcher.

~~~
chc
I looked at that thread, and the non-negative-score comments seem to range
from credulous to reasonably skeptical, with none that are fairly
characterized as "No, impossible!"

In fact, given how sketchy the poster of that thread was being (e.g. linking
to his non-medical blog when asked for medical details and saying he's too
embarrassed to talk about it when asked again), I'd say people were pretty
generous.

------
rce123
After an accident such as this, is there a point at which it's too late to
perform this type of injection? Asking for someone in a similar situation.

~~~
givinguflac
The article says that this study requires the patient to be stable enough for
an injection 13-14 days post-injury. That's not to say we know it wouldn't
help, but that's what this study is looking for.

------
avenoir
I believe the same article was already posted here a few months back.
Regardless, it would be interesting to know how much functionality this young
man will gain after his rehabilitation. Stuff like this is hard to believe to
be 100% effective, at least at this stage of our understanding and use of stem
cells. But man this is absolutely astounding if it helps him regain even like
30% of his limbs.

------
keeganjw
Congrats! I feel so happy for this guy. Awesome news!

------
mercurialshark
I remember an earlier article highlighting the potential benefits of olfactory
stem cells for damaged brain tissue repair.

Engraftment of human nasal olfactory stem cells restores neuroplasticity in
mice with hippocampal lesions

[https://www.jci.org/articles/view/44489](https://www.jci.org/articles/view/44489)

------
thomyorkie
Could this possibly lead to a cure for neuro-degenerative diseases like
parkinson's and ALS?

------
rudolf0
Could stem cell therapy be used to potentially improve existing muscular or
neurological connections in normally functioning individuals? Kind of like a
whole-body neurotropic.

~~~
alextheparrot
I think that's not currently clear, I'd expect technologies such as CRISPR to
have a far greater impact on enhancement of "normal" honestly. Some brain
diseases are caused by the overriding of nuerons, so more is not necessararily
better, for example.

------
DamnInteresting
Note that this was published several months ago, in September 2016. So if this
news sounds familiar, that's probably why.

------
uptownfunk
Is there a greatly increased risk for cancer from stem cell use given these
are cells that have a high rate of proliferation?

~~~
anigbrowl
Maybe, but for most people cancer in the future vs being dead or paralyzed now
is an easy decision. I'm not _aware_ of such an elevated risk, just saying
that it would be an acceptable trade-off in many circumstances.

~~~
sambe
The follow-up article mentioned by another poster
([https://news.ycombinator.com/item?id=13494463](https://news.ycombinator.com/item?id=13494463))
mentions cancer as a risk of the treatment.

------
toodlebunions
Amazing, stem cell therapy has so much potential.

