In a world first, a paralyzed man with severed spinal cord walks again after nerve cell transplant

Night_Hawk

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[h=1]In a world first, a paralyzed man with severed spinal cord walks again after nerve cell transplant[/h] By Terrence McCoy October 21
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This 38-year-old Bulgarian patient, who suffered his injury in 2010, is believed to be the first person in the world to recover from the complete severing of the spinal nerves. (BBC/PA Wire)


In 2010, an assailant attacked Darek Fidyka with a knife, repeatedly stabbing the bald, broad firefighter in the back, and altered his life forever. One of the strikes cleanly sliced through Fidykas mid-spine. Doctors at the time told the Bulgarian there was only a 1 percent chance he would recover. He had lost all motor and sensory control over his legs.

Fidyka went into intensive physiotherapy, but nothing worked. He showed no signs of recovery.


But now, following a surgery scientists hail as a breakthrough and a world first, life has changed for the 38-year-old Fidyka. He can walk with a frame, drive and live with greater independence.


As described by the BBC, which was granted special access to the project and to the rehabilitation over the course of a year, Polish surgeons put into practice a technique developed at University College London. There, research by Geoffrey Raisman revealed damaged nerve cells can form new connections with a little help from special cells in the nasal cavity called olfactory ensheathing cells.


The surgeons took nerve cells from Fidykas nose, used them to culture new ensheathing cells, and transplanted them into the spinal cord stumps above and below his injury. The hope was they would connect and form a bridge or pathway across the gap caused by the injury. And thats exactly what happened.


Within months after the procedure, Fidyka developed feeling in one of his legs and today can move around on his own. In an interview with the BBC, he described it as an incredible feeling. When you cant feel almost half your body, you are helpless, but when it starts coming back its like you were born again.
Scientists were cautious about the promising procedure, stressing only one patient has so far been treated. Determination of the precise mechanisms of action, repetition in more patients and more long-term follow up are all necessary to help validate whether this promising procedure is of clinical relevance, John Sladek of the University of Colorado told the Independent.


Still, if just for Fidyka, the scientists are rejoicing at what the BBC calls a world first in medicine, the full narrative of which is published in the journal Cell Transplantation. Prior to the transplantation, we estimated that without this treatment, our patients recovery chances were less than one percent, Pawel Tabakow of the Wroclaw Medical University said in a statement. However, we observed a gradual recovery of both sensory and motor function that began four months after the surgery.
He can get around with a walker and hes been able to resume much of his original life, including driving a car, Raisman, one of the studys authors, told the Guardian. Hes not dancing, but hes absolutely delighted.


He added to the Independent: I believe this is the first time that a patient has been able to regenerate severed long spinal nerve fibers across an injury and resume movement and feeling. I believe we have now opened the door to a treatment of spinal cord injury which will get patients out of wheelchairs. Our goal is to develop the first procedure to a point where it can be rolled out as a worldwide general approach.


That goal, however, is clearly a long way off. Right now, hes working to raise funds to treat several more patients in Poland in the next five years. Those tests may help show whether this treatment can help an estimated 3 million people paralyzed across the world.
Paralysis is something that most of us dont know very much about, because we are not affected by it, the founder of the Nicholls Spinal Injury Foundation told the Guardian. But the scientific information relating to this significant advancement will be made available to other researchers around the world so that together we can fight to finally find a cure for this condition which robs people of their lives.
http://www.washingtonpost.com/news/...cord-walks-again-after-nerve-cell-transplant/
 

Night_Hawk

Siasat.pk - Blogger
[h=1]پہلی اسپائنل کارڈ سرجری کے بدولت مکمل طور پر مفلوج شخص اپنے پیروں پر کھڑا ہوگیا
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ویب ڈیسک منگل 21 اکتوبر 2014
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آپریشن کے نتائج تاریخی ہیں تاہم اس تیکنیک میں مزید بہتری لائی جاسکتی ہے، ڈاکٹرز۔

وارسا: جدید ٹیکنالوجی نے جہاں زندگی کو پر آسائش بنادیا ہے تو وہیں میڈیکل کی دنیا میں ایک بھر پور انقلاب برپا کردیا ہے جس کی بدولت زندگی کی خوشیوں اور تازگی سے محروم لوگوں میں دوبارہ زندگی کی امید کے چراغ روش کردیئے ہیں اور ایسا ہی کچھ ہوا پولینڈ میں جہاں مایوسی کے بسترپر لیٹا معذورشخص اسی ٹیکنالوچی کی وجہ سے اپنے پیروں پر کھڑ ا ہوگیا۔
بلغاریہ کا 38 سالہ شخص ڈیرک فیڈیکا 4 سال قبل ایک قاتلانہ حملے میں چاقو کےوار سے زخمی ہوگیا اور یہ زخم اس کی ریڑھ کی ہڈی کی معذوری کا باعث بن گیا اور یوں وہ بستر پر لیٹ گیا اور مایوسی نے اس کی زندگی تاریک کردی، اس کے جسم کے معذور حصے کے خلیوں نے کام کرنا چھوڑدیا۔ ڈاکٹروں نے ڈیرک کی سرجری یعنی سیل ٹرانسپلانٹ کا فیصلہ کیا جو کہ اس طرح کی معذوری کا دنیا کا پہلا انسانی آپریشن تھا اوریہ آپریشن پولینڈ میں برطانوی سائنسدانوں کے تعاون سے کیا گیا، اس طرح اس وقت اسپائنل کارڈ نروز کی سرجری میں ایک نئی تاریخ رقم ہوگئی جب ڈیرک نے آپریشن کے بعد فریم کی مدد سے پہلا قدم اٹھایا۔
اس آپریشن کے لیے نروز اسپورٹنگ سیل کو ڈیرک کی ناک سے حاصل کیا گیا جس کی بدولت اس کے ٹوٹے ٹشوز دوبارہ کام کرنے لگے، پولینڈ میں دنیا کےممتاز ترین اسپائنل کارڈ کے ماہرین نے آپریشن میں حصہ لیا جس میں ناک سے حاصل کئے گئے آل فیکٹری این شیتھینگ سیلز (او ای سیز) کو ریڑھ کی ہڈی میں منتقل کیا گیا، اس طریقہ کار کی بدولت ٹوٹے ہوئے سیل کو دوبارہ کام کے قابل بنا دیا گیا، جس سے سونگھنے والے پیغامات آل فیکٹری بلب سے ہوتے ہوئے فوربرین تک پہنچے جنہوں نے اسپائنل کارڈ کو تلاش کیا جس کی بدولت نروز فائبر میں پھر سے بڑھنے اور جڑنے کا عمل شروع ہوگیا، یہ وہ عمل تھا جو اس سے قبل ناممکن سمھجا جاتا تھا لیکن اب نہ صرف ممکن ہوگیا بلکہ اس کی کامیابی بھی عمل میں آگئی۔
آپریشن کے بعد ڈاکٹرز کا کہنا تھا کہ اگرچہ ڈیرک کا قدم اٹھانا طبی دنیا میں ایک بڑا بریک تھرو ہے جب کہ اس تیکنیک کے بانی لندن کالج آف نیورولوجی کے پروفیسر جعفری ریس مین کا کہنا تھا کہ آپریشن کے نتائج تاریخی ہیں تاہم اس تیکنیک میں مزید بہتری لائی جاسکتی ہے اور یوں ریڈھ کی ہڈی کی معذوری سے مایوس لوگوں کے لیے امید کی کرن پیدا ہوگئی ہے۔

http://www.express.pk/story/297075/
 

Night_Hawk

Siasat.pk - Blogger
[h=1]Paralysed man walks again after cell transplant[/h] Comments (608)
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By Fergus Walsh Medical correspondent

A paralysed man has been able to walk again after a pioneering therapy that involved transplanting cells from his nasal cavity into his spinal cord.
Darek Fidyka, who was paralysed from the chest down in a knife attack in 2010, can now walk using a frame.
The treatment, a world first, was carried out by surgeons in Poland in collaboration with scientists in London.
Continue reading the main story [h=2]“Start Quote[/h]
I have waited 40 years for something like this”
Prof Wagih El Masri Consultant spinal injuries surgeon
Details of the research are published in the journal Cell Transplantation.
BBC One's Panorama programme had unique access to the project and spent a year charting the patient's rehabilitation.
Darek Fidyka, 40, from Poland, was paralysed after being stabbed repeatedly in the back in the 2010 attack.
He said walking again - with the support of a frame - was "an incredible feeling", adding: "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."
Prof Geoff Raisman, chair of neural regeneration at University College London's Institute of Neurology, led the UK research team.
He said what had been achieved was "more impressive than man walking on the moon".
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Out of media player. Press enter to return or tab to continueUK research team leader Prof Geoff Raisman: Paralysis treatment "has vast potential"




The treatment used olfactory ensheathing cells (OECs) - specialist cells that form part of the sense of smell.
OECs act as pathway cells that enable nerve fibres in the olfactory system to be continually renewed.
In the first of two operations, surgeons removed one of the patient's olfactory bulbs and grew the cells in culture.
Two weeks later they transplanted the OECs into the spinal cord, which had been cut through in the knife attack apart from a thin strip of scar tissue on the right. They had just a drop of material to work with - about 500,000 cells.
About 100 micro-injections of OECs were made above and below the injury.
Four thin strips of nerve tissue were taken from the patient's ankle and placed across an 8mm (0.3in) gap on the left side of the cord.
The scientists believe the OECs provided a pathway to enable fibres above and below the injury to reconnect, using the nerve grafts to bridge the gap in the cord.
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How the injury was treated
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1) One of the patient's two olfactory bulbs was removed and the olfactory ensheathing cells (OECs) were grown in culture
2) 100 micro injections of OECs were made above and below the damaged area of the spinal cord
3) Four strips of nerve tissue were placed across an 8mm gap in the spinal cord. The scientists believe the OECs acted as a pathway to stimulate the spinal cord cells to regenerate, using the nerve grafts as a bridge to cross the severed cord
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Before the treatment, Mr Fidyka had been paralysed for nearly two years and had shown no sign of recovery despite many months of intensive physiotherapy.
This programme of exercise - five hours per day, five days a week - has continued after the transplant at the Akson Neuro-Rehabilitation Center in Wroclaw.
Mr Fidyka first noticed that the treatment had been successful after about three months, when his left thigh began putting on muscle.
Six months after surgery, Mr Fidyka was able to take his first tentative steps along parallel bars, using leg braces and the support of a physiotherapist.
Two years after the treatment, he can now walk outside the rehabilitation centre using a frame.
He has also recovered some bladder and bowel sensation and sexual function.
Dr Pawel Tabakow, consultant neurosurgeon at Wroclaw University Hospital, who led the Polish research team, said: "It's amazing to see how regeneration of the spinal cord, something that was thought impossible for many years, is becoming a reality."
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Mr Fidyka undergoes five hours of physiotherapy a day

Mr Fidyka still tires quickly when walking, but said: "I think it's realistic that one day I will become independent.
"What I have learned is that you must never give up but keep fighting, because some door will open in life."
The groundbreaking research was supported by the Nicholls Spinal Injury Foundation (NSIF) and the UK Stem Cell Foundation (UKSCF)
UKSCF was set up in 2007 to speed up progress of promising stem cell research - the charity has to date contributed £2.5m
NSIF was set up by chef David Nicholls after his son Daniel was paralysed from the arms down in a swimming accident in 2003.
To date the charity has given 1m to fund the research in London and a further 240,000 for the work in Poland.
The breakthrough A key difference with Mr Fidyka was that the scientists were able use the patient's olfactory bulb, which is the richest source of olfactory ensheathing cells.
This meant there was no danger of rejection, so no need for immunosuppressive drugs used in conventional transplants.
Most of the repair of Mr Fidyka's spinal cord was done on the left side, where there was an 8mm gap.
He has since regained muscle mass and movement mostly on that side.
Scientists believe this is evidence that the recovery is due to regeneration, as signals from the brain controlling muscles in the left leg travel down the left side of the spinal cord.
MRI scans suggest that the gap in the cord has closed up following the treatment.
None of those involved in the research want to profit from it.
Prof Geoff Raisman said: "It would be my proudest boast if I could say that no patient had had to pay one penny for any of the information we have found."
NSIF said if there were any patents arising, it would acquire them so as to make the technique freely available.
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The sense of smell and spinal repair
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The complex neural circuitry responsible for our sense of smell is the only part of the nervous system that regenerates throughout adult life.
It is this ability that scientists have tried to exploit in stimulating repair in the spinal cord.
Every time we breathe, molecules carrying different odours in the air come into contact with nerve cells in the nose.
These transmit messages to our olfactory bulbs - at the very top of the nasal cavity, sitting at the base of the brain.
The nerve cells are being continually damaged and must be replaced.
This process of regeneration is made possible by olfactory ensheathing cells (OECs), which provide a pathway for the fibres to grow back.
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Mr Nicholls said: "When Dan had his accident I made him a promise that, one day, he would walk again. I set up the charity to raise funds purely for research into repairing the spinal cord. The results with Darek show we are making significant progress towards that goal."
Prof Wagih El Masri said: "Although the clinical neurological recovery is to date modest, this intervention has resulted in findings of compelling scientific significance."
The consultant spinal injuries surgeon, who has treated thousands of patients in the UK, added: "I have waited 40 years for something like this."
All those involved in the research are keen not to raise false hopes in patients and stress that the success will need to be repeated to show definitively whether it can stimulate spinal cord regeneration.
The scientists hope to treat another 10 patients, in Poland and Britain over the coming years, although that will depend on the research receiving funding.
Dr Tabakow said: "Our team in Poland would be prepared to consider patients from anywhere in the world who are suitable for this therapy. They are likely to have had a knife wound injury where the spinal cord has been cleanly severed.
Sir Richard Sykes, chair of the UK Stem Cell Foundation, said: "The first patient is an inspirational and important step, which brings years of laboratory research towards the clinical testbed."
"To fully develop future treatments that benefit the 3 million paralysed globally will need continued investment for wide scale clinical trials,"
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The researchers
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Prof Raisman

Prof Raisman has spent more than 40 years studying how to repair the spinal cord.
In animal studies he showed that OECs injected into the rat spinal cord could reverse paralysis.
In 2005, Prof Raisman was approached by a Polish neurosurgeon who had begun researching how to apply the technique in humans.
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Dr Tabakow
Dr Tabakow carried out an initial trial involving three paralysed patients who each had a small amount of OECs injected in their damaged spinal cords.
While none showed any significant improvement, the main purpose of the study was achieved, showing that the treatment was safe.
 

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