Cambridge research team close to breakthrough in repairing spinal
21 February 2008
The Cambridge University Centre for Brain Repair is on
the brink of a major potential breakthrough in the repair of spinal cord
Spinal cord injuries are a major cause of disability in the UK, with more
than 40,000 sufferers. Injuries can take the form of anything from loss
of sensation to full paralysis.
Cord injury is incredibly distressing for both the patient and their family
because there is no cure — active lives can be turned upside down
overnight. It is especially tragic because, cruelly, the average age at
the time of injury is just 19.
Until now, despite the attempts of many scientists to find a cure, the
problem facing neurologists has been that the body simply cannot repair
damage to the brain or spinal cord.
Although it is possible for nerves to regenerate, they are blocked by the
scar tissue that forms at the site of the spinal injury.
However the research team headed by Professor James Fawcett's believes it
is close to a clinical treatment that could allow nerve fibres to
regenerate within the spinal cord and also encourage remaining nerve
fibres to work more effectively.
This revolutionary discovery may ultimately result in treatments to improve
the lives of people paralysed through spinal damage. The Action Medical
Research team has found that a bacterial enzyme called chondroitinase is
capable of digesting molecules within scar tissue to allow some nerve
fibres to regrow.
Excitingly it also promotes something called nerve plasticity. This means
that any remaining undamaged nerve fibres have an increased likelihood
of making new connections that could bypass the area of damage.
Recent work by Professor Fawcett's team has found that using chondroitinase
in conjunction with rehabilitation allows greater opportunity for nerve
recovery than by using either technique alone. This is an important
finding, because it shows that the treatment can open up a window of
opportunity during which rehabilitation can be much more effective. The
finding will probably also be important for rehabilitation after stroke
and brain injury.
This ground-breaking discovery will need to be
tested before it can be given to patients, to establish the optimum time for
it to be administered. Professor Fawcett said, "It is rare to find that a
spinal cord is completely severed, generally there are still some nerve
fibres that are undamaged.
"Chondroitinase offers us hope in two ways; firstly it allows some nerve
fibres to regenerate and secondly it enables other nerves to take on the
role of those fibres that cannot be repaired.
"Scientists have worked hard to produce treatments for paralysed patients
with spinal injuries for many years, but it has proven extremely
complicated. Clinical trials have not yet been started, but the
treatment is under pre-clinical development by Acorda Therapeutics, a
biotechnology company in New York.
"Along with rehabilitation we are very hopeful that at last we may be able
to offer paralysed patients a treatment to improve their condition."
Dr Yolande Harley of UK charity Action Medical Research, which funded the
research, said, "The charity is proud to be at the forefront of medical
advance thanks to brilliant researchers like Professor Fawcett.
"His work will give new hope to people with recent spinal injuries. Today
the emphasis is on providing the best possible care and occupational
therapy but eventually we hope to have a clinical treatment that will
help to improve the underlying injury that is causing the patient's loss
of mobility or sensation.
"This is incredibly exciting, ground-breaking work and is truly innovative
research from the very best in the field."