Category Archives: Stem Cells for Spinal Cord Injury

Stem Cells in the Olfactory Bulb for Certain Neurological Conditions Including Spinal Cord Injury

Dear Pain Matters blog readers,

It is worth adding more to Friday’s blog post dated 21 November 2014.

https://painmatters.wordpress.com/2014/11/21/stem-cell-treatment-of-spinal-cord-injury-one-case/

A QUESTION WHETHER STEM CELL TREATMENT COULD ALSO REDUCE NERVE PAIN IN SOME SPINAL CORD INJURY PATIENTS?

Many patients with spinal cord injury also suffer severe nerve pain.  Could stem cell treatment for spinal cord injury (potentially) result in:

(1) enhanced motor and sensory function; and

(2) reduced nerve pain

in some patients?

A recent Review Paper suggested that stem cells may have the following 2 beneficial effects:

(1) regenerative effects that may enhance motor and sensory functions (eg in spinal cord injury patients); and

(2) decreased pro-inflammatory response that may lead to reduced nerve pain.

It is possible that a reduced pro-inflammatory response (consequently, reduced nerve pain) may be a prerequisite before the stem cells’ regenerative effects can take place.  Thus, the mechanisms that underlie the stem cells’ beneficial effects on nerve pain may be different from those that underlie their regenerative effects (Franchi et al, 2014).

It would be useful to include spinal cord injury patients that also have spinal cord injury pain in upcoming stem cell trials.

If research can show that stem cell treatment can, at times, result in BOTH: 

(1) enhanced motor/sensory function; as well as

(2) reduced nerve pain,

this would be a immense breakthrough for medical science.

MORE ON STEM CELLS IN THE OLFACTORY BULB

Stem cells are available in different parts of your body.  Recently, it was shown that the olfactory bulb (in the upper nasal cavity, used in the sense of smell) can be a rich source of olfactory ensheathing cells and olfactory nerve fibroblasts.

Specifically, researchers reported that olfactory ensheathing cells and olfactory nerve fibroblasts were taken from the olfactory bulb, placed in a culture for 2 weeks, and subsequently transplanted into an injured spinal cord of a paralysed patient named Darek Fidyka, a 38-year old man who suffered paralysis from the chest down following a stabbing in 2010.

https://painmatters.wordpress.com/2014/11/21/stem-cell-treatment-of-spinal-cord-injury-one-case/

Given the amazing regenerative capacity of these olfactory bulb stem cells, ongoing research into the transplantation of these stem cells into injured or diseased body/brain regions is warranted.

One day, perhaps, the ‘miracle of stem cells’ may be a standard medical treatment option, and the transplantation of stem cells will be as normal as ‘planting seeds in a garden’.

WHERE TO FROM HERE?

Other questions arise.  For example, can the regenerative stem cells from the olfactory bulb also be transplanted (via autologous stem cell transplant) into different parts of the body including spinal cord and brain?

If yes, could autologous stem cell transplant (using stem cells from one’s own olfactory bulb) be used one day to treat people with:

Diabetes (Kuwabara & Asashima, 2012);

Spinal cord injury; and/or

– Other neuronal diseases including Amyotrophic Lateral Sclerosis (aka Lou Gehrig’s Disease, or Motor Neurone Disease), Parkinson’s Disease, and some Post-Stroke conditions (eg Locked-In-Syndrome)?

Research into non-embryonic sources of stem cells is warranted (Franchi et al, 2014).  Permanent damage does not occur when stem cells are removed from the olfactory bulb (that is also relatively accessible via surgery).

The possibilities of stem cell research are endless.

I hope that stem cell research offers hope and inspiration to all people suffering from pain, limited mobility, and reduced sensory function.

Sabina Walker

“Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.” 

Einstein

REFERENCES

(1) Kuwabara, Asashima (Research Center for Stem Cell Engineering, National Institute of Advanced Industrial Science and Technology (AIST), Japan)

Regenerative medicine using adult neural stem cells: the potential for diabetes therapy and other pharmaceutical applications; J Mol Cell Biol (2012):4(3):133-139.

doi: 10.1093/jmcb/mjs016

http://jmcb.oxfordjournals.org/content/4/3/133.full.pdf+html

(2) Olfactory Bulb Stem Cells And Lou Gehrig’s Disease
Johns Hopkins Medical Institutions
27 October, 2004

http://www.sciencedaily.com/releases/2004/10/041025121323.htm

(3) Franchi et al; Adult Stem Cell as New Advanced Therapy for Experimental Neuropathic Pain Treatment; BioMed Research International (2014); Article ID 470983, Pages 1-10 (10 pages).

doi: 10.1155/2014/470983

PMCID: PMC4147203

http://www.hindawi.com/journals/bmri/2014/470983/

MORE REFERENCES

(FOR READERS WHO WANT TO LEARN MORE ABOUT STEM CELLS IN THE OLFACTORY BULB….OTHERWISE JUST IGNORE THE FOLLOWING PAPERS)

(4) Pagano et al; Isolation and characterization of neural stem cells from the adult human olfactory bulb. Stem Cells. 2000;18(4):295-300.

http://www.ncbi.nlm.nih.gov/pubmed/10924096

(5) MacKay-Sim; Stem cells and their niche in the adult olfactory mucosa. Archives Italiennes de Biologie (2010):148:47-58.

http://www98.griffith.edu.au/dspace/bitstream/handle/10072/35444/64019_1.pdf?sequence=1&isAllowed=y

(6) Moreno-Estellés et al; Symmetric expansion of neural stem cells from the adult olfactory bulb is driven by astrocytes via WNT7A. Stem Cells (Dec 2012);30(12):2796-2809.

doi: 10.1002/stem.1243.

http://www.ncbi.nlm.nih.gov/pubmed/22987443

(7) Gritti et al; Multipotent neural stem cells reside into the rostral extension and olfactory bulb of adult rodents. J Neurosci (Jan 2002);22(2):437-445.

http://www.jneurosci.org/content/22/2/437.full.pdf

(8) Liu & Martin; Olfactory bulb core is a rich source of neural progenitor and stem cells in adult rodent and human. J Comp Neurol (May 2003);459(4):368-91.

http://www.ncbi.nlm.nih.gov/pubmed/12687705

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Partial Recovery from Paralysis Following Stem Cell Treatment – A Case Study

Dear Pain Matters blog readers,

Here’s some positive news for patients with spinal cord injury!  It was recently reported that stem cell treatment in a patient with spinal cord injury resulted in partial recovery.  

While more studies are needed, a 3-minute video (see BBC News link) introduces Darek Fidyka, a 38-year old man who suffered paralysis from his chest down after being repeatedly stabbed in his back in 2010.  The knife attack left Darek with a completely severed spinal cord, leaving him with a mere thin strip of scar tissue on the right side of his spinal cord, and unable to walk.

Pre-stem cell treatment, Darek was paralysed for almost 2 years after the knife attack, with virtually no hope for recovery despite intensive physiotherapy.

Post-stem cell therapy, and in collaboration with UK scientists, Polish surgeons removed 1 of Darek’s 2 olfactory bulbs (used in the sense of smell) from his upper nasal cavity to make a culture of olfactory ensheathing cells and olfactory nerve fibroblasts.  After 2 weeks, the cells in this culture were directly transferred into his spinal cord (via 100 micro-injections, both above and below the injured site).

The olfactory bulb offers the greatest source of olfactory ensheathing cells.  Importantly, these olfactory ensheathing cells provide a pathway for the continual regeneration of the olfactory nerve fibres throughout adult life.

Nerve tissue was removed from Darek’s ankle (4 thin strips) and grafted into an 8mm gap on the left side of his spinal cord (to ‘bridge the gap‘ between the top and bottom of his severed spinal cord).

The researchers hypothesized that the transplanted (and regenerative) olfactory ensheathing cells can help nerve fibres to reconnect.  In other words, these olfactory ensheathing cells stimulated the spinal cord cells to regenerate/repair.  The ankle nerve tissue was auto-grafted into the 8 mm gap of the spinal cord, like a ‘bridge’.

There was nil risk of rejection of the ankle nerve tissue, olfactory ensheathing cells, nor olfactory nerve fibroblasts (as they were his own), hence no need for immunosuppressive drugs.

Darek took his first assisted steps 6 months after stem cell therapy.  Two years post-therapy, Darek is now able to walk with a walking frame.  He has improved trunk stability, partial recovery of voluntary leg movements, partial recovery of sensation, as well as increased muscle mass in, and improved vascular function of, the left leg (consistent with left-sided stem cell treatment).

MRI scans confirmed that the 8mm gap in the spinal cord was closed, post-stem cell therapy.

While moderately successful, walking with a walking frame is (quoting Darek) “an incredible feeling.  When you can’t feel almost half your body, you are helpless, but when it starts coming back it’s like you were born again.

Quoting Dr Tabakow, consultant neurosurgeon, It’s amazing to see how regeneration of the spinal cord, something that was thought impossible for many years, is becoming a reality.” 

Prof Geoff Raisman stated that this is “more impressive than man walking on the moon“.

Follow-up studies are needed before any final conclusions can be made.  It is hoped that 10 patients with comparable injuries can be similarly treated in the next year(s).

http://www.bbc.co.uk/news/health-29645760

The patient, Darek Fidyka, offers a small glimmer of hope and inspiration to many patients with spinal cord injury including Daniel Nicholls.  His father, David Nicholls, contributed generously to this ground-breaking research (via The Nicholls Spinal Injury Foundation), together with the UK Stem Cell Foundation.

Daniel Nicholls was only 18 on 30 December 2003 when he broke his neck and became paralysed from the neck down after diving into a wave and hitting a sandbank on Bondi Beach in Sydney, Australia (where I regularly swim and snorkel).

http://www.bbc.co.uk/news/health-29686709

QUESTION:

Many patients with spinal cord injury also suffer from nerve pain.  It would be interesting to find out if targeted stem cell therapy for spinal cord injury could also lead to reduced nerve pain in these patients.   

Until next week,

Sabina Walker, Blogger of Pain Matters blog

A journey of a thousand miles begins with a single step…..
(Lao-tzu, Chinese philosopher)

REFERENCES

(1) Tabakow et al. Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging. Cell Transplantation (21 Oct 2014).

doi: http://dx.doi.org/10.3727/096368914X685131

http://www.ncbi.nlm.nih.gov/pubmed/25338642

(2) Fergus Walsh. Paralysed man walks again after cell transplant.

BBC News Health (21 October 2014).

http://www.bbc.co.uk/news/health-29645760

http://www.bbc.co.uk/news/health-29686709

(3) Callaghan, Greg. Australian of the Year Alan Mackay-Sim on the advantage of being ‘an interested scientist’.

Sydney Morning Herald (Good Weekend) (8 April 2017): 18-21.

http://www.theage.com.au/good-weekend/australian-of-the-year-alan-mackaysim-on-the-advantage-of-being-an-interested-scientist-20170404-gvdcqe.html