A rescue for spinal cord injuries?
Advances in the science of spinal cord injury treatment are newsworthy, and considerable media attention is drawn towards new developments. Aside from the use of methylprednisolone, none of these developments have reached even limited use in the clinical care of human spinal cord injury. Around the world, proprietary centers offering stem cell transplants and treatment with neuroregenerative substances are fueled by glowing testimonial reports of neurological improvement. Independent validation of the results of these treatments is mostly lacking. However, in January 2009, a pharmaceutical company received FDA clearance to begin human safety testing of its stem cell treatment candidate, on newly injured patients with complete thoracic injury. A diverse array of other treatments are being researched, including biomaterial solutions, cell replacement therapies, and electronic stimulative devices. This is where RESCUE comes in. RESCUE is a highly innovative project aiming to pave the way toward clinical trials for stem cell therapy in Spinal Cord Injury (SCI) repair. The project is funded by the European Commission FP6 research programme, and combines the expertise of stem cell biologists as well as experts in spinal cord pathology from 9 European research groups. RESCUE’s objective is to translate experimental studies using human stem cells in preclinical animal models into the clinic. This will be achieved through the elaboration of a series of therapeutic tools for stem cell therapy to be used in a wide variety of clinical paradigms of SCI. Spinal cord lesions represent an ideal model for the development of regenerative therapy for traumatic lesions of the central nervous system (CNS), as they are more prone to precise functional characterization and follow-up than brain injuries. Preclinical results obtained in the context of RESCUE can therefore be used as templates for the elaboration of therapeutic strategies whose application should be broadened to other CNS traumatic damages, such as traumatic brain injuries and stroke. The consortium has been constituted in order to bring together participants whose skills come from two different areas of research, stem cell biology on the one hand, and spinal cord pathology on the other hand. RESCUE focuses on the combination of the most efficient technologies to direct the fate of intrinsic, as well as extrinsic stem cells, and/or their transformation, in order to obtain appropriate cell types at the right time and in the right place, to promote repair of the injured spinal cord. The final aim of the RESCUE project is to be able to propose clinical trial protocols appropriate for the treatment of SCI. To reach this goal, the RESCUE project investigates a number of different approaches that are currently available to try to restore function of the injured spinal cord through the use of human stem cells from bone marrow and the central nervous system. These approaches include: Enhanced regeneration of neurons and axons in the spinal cord through increased availability of axon growth-permissive molecules and/or trophic agents produced by stem cells or their progeny. Such molecules may be produced by unmodified cells or by cells specifically engineered to do so. The regeneration/restoration of function by supporting and monitoring the activation of intrinsic spinal cord stem cells. The restoration of function after replacement of the damaged cells following local grafting. The use of stem cells during the acute phase (within one week of the injury in man) to reduce inflammation and secondary degeneration in the spinal cord. This also reduces the formation of the scar tissue which constitutes a major barrier to axonal regrowth. As Spinal Cord Injuries are extremely complex, it is necessary to investigate a wide source of stem cells, since individual sources might have an application in specific pathological situations. To give an example of results of the RESCUE project, Jean-Philippe Hugnot (teacher-researcher at the University of Montpellier) Alain Privat (Inserm research director) Luc Bauchet (neurosurgeon) and their colleagues at Inserm Research Unit 583 have for the first time demonstrated in 2008 the presence of neural precursor cells in the adult human spinal cord. The use of these stem cells for therapeutic purposes could potentially contribute to repairing the spinal cord of persons suffering from a traumatic injury, as well as in the case of a degenerative disease involving the motor neurons. So RESCUE helps to pave the way to a rescue of spinal cord injury patients and maybe in a near future, help will be at hand.