More MS news articles for Oct 2001

Embryonic Spinal Cord Transplant a Feasible Treatment for Spinal Cord Injuries

http://www.medscape.com/reuters/prof/2001/10/10.09/20011008clin007.html

WESTPORT, CT (Reuters Health) Oct 08 - Two patients who underwent transplantation of embryonic spinal cord have remained stable during 18 months of followup, researchers in Florida report. These findings suggest that intraspinal grafting of cells is feasible and safe, they conclude.

"People for years have described procedures that were not documented well for spinal cord injury patients. Here we present that documentation, loud and clear," Dr. Paul J. Reier told Reuters Health.

In 1997, Dr. Reier, of the University of Florida College of Medicine in Gainesville, and associates performed the normal surgical protocol for progressive posttraumatic syringomyelia on two patients. At the same time, they implanted 6- to 9-week postconception human fetal spinal cord tissue. The investigators report the 18-month results in the Journal of Neurotrauma for September.

"Cyst collapse was confined to regions where the donor tissue was implanted, even though detethering and decompression were performed over the entire syrinx," supporting the notion that the grafts had survived, the investigators write.

They also observed progressive closure of the cysts between 6 weeks and 18 months after surgery. However, MRI lacked the spatial resolution and tissue contrast to define donor-host boundaries and unequivocally confirm survival of the grafts.

The authors observed no indication of adverse consequences, such as inflammation or overproliferation of the donor tissue.

After previous decompression surgeries, both patients had worsened within 1 year. "The fact that the graft sites and neurological status have been stable in both patients through 18 months in the current study suggests that their outcomes are at least no worse than after their previous operations," the investigators point out.

Neurophysiological measures such as cortical- and spinal cord-evoked potentials, H-reflex excitability, and peripheral nerve conduction did not worsen after the surgery or during followup. One patient actually showed a decrease in spasticity as demonstrated by a rate potentiation of tibial H-reflexes on the right side and an increase in the response probability of left tibial H-reflexes.

"Now [my colleagues and I] are continuing research at a preclinical level to address questions of how to put a nervous system back together, and then to get good measures of functional benefit," Dr. Reier said.

He noted that more work needs to be done in the areas of precise graft placement and minimally invasive surgical approaches so that placebo-controlled trials can be conducted. "We learned enough from this experience to begin to see how to do this on a stable population with minimal risk," Dr. Reier concluded.

J Neurotrauma 2001;18:911-929,931-945.
 

Copyright © 2001 Reuters Ltd