Did Nose Cells Help Paralyzed Man Walk?

By Peter Russell
WebMD Health News

Reviewed by Keith Barnard, MD

Oct. 21, 2014 – A group of doctors and scientists say a paralyzed man has been able to walk again after surgery in which nerve cells from his nasal cavity were transplanted into his spinal cord.

Darek Fidyka, a 38-year-old Bulgarian who was left paralyzed from the chest down when he was stabbed in an attack in 2010, is now able to walk again using a frame, and he's regained feeling in his legs, doctors say.

But some experts warn that the medical evidence is far from conclusive, and it would be wrong to give false hope to people expecting a cure for paralysis.

Reported Details

The surgery was done in Poland in partnership with scientists led by Dr. Geoffrey Raisman, a professor at the Spinal Repair Unit at UCL Institute of Neurology in London.

Treating people with a complete spinal cord injury has generally been unsuccessful, because no methods exist to regenerate severed spinal nerves across the injured area.

Now doctors and scientists say they've been able to restore some lower limb function and some sensation by transplanting what are known as olfactory ensheathing cells (OECs) from the patient's nose. These cells send the sense of smell from the nasal lining to the brain. The patient's own OECs were transplanted into his spinal cord, and a "nerve bridge" using some lower limb nerves was built between two stumps of the damaged spinal column.

Prior studies with animals suggest OECs have good regeneration powers, while constructing nerve bridges is a time-honored surgical procedure. But the two techniques hadn't been used together before.

Details of the treatment have been published in the journal Cell Transplantation and will be featured in a BBC Panorama program.

A Breakthrough?

Dr. Pawel Tabakow of the Wroclaw Medical University in Poland says in a statement: "Prior to the transplantation, we estimated that without this treatment, our patient's recovery chances were less than 1%. However, we observed a gradual recovery of both sensory and motor function that began 4 months after the surgery."

Raisman says in a statement: "We believe that this procedure is the breakthrough which -- as it is further developed -- will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury.

"We are currently raising the funds to mount an Anglo-Polish initiative to verify the benefits of this approach with further patients."

Second Opinion

Still, the findings have not convinced some experts that this is a major breakthrough for people with paralysis.

Commenting in a statement, Dr. Simone Di Giovanni, chair in Restorative Neuroscience for Imperial College London, says that one case of improvement "cannot represent any solid scientific evidence to elaborate upon. In fact, there is no evidence that the transplant is responsible for the reported neurological improvement.

"The use of these cells for spinal cord injury repair have been implemented for 30 years now with very controversial results in rodents, non-human primates, and patients. Extreme caution should be used when communicating these findings to the public in order not to elicit false expectations on people who already suffer because of their highly invalidating medical condition."

The surgery was part-funded by the U.K.'s Nicholls Spinal Injury Foundation, whose founder, David Nicholls, is upbeat about the results. "Paralysis is something that most of us don't know very much about, because we are not affected by it," he says in a statement.

"One of the most devastating moments a parent will ever experience is the sight of their son or daughter lying motionless in a bed and facing the reality that they may never walk again," he says.

Nicholls was inspired to found the charity after his 18--year--old son was paralyzed from the neck down after diving into shallow water in Australia in 2003.



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SOURCES: Tabakow, P. Cell Transplantation, 2014.Press release, Nicholls Spinal Injuries Foundation.Dr Simone Di Giovanni, chair in restorative neuroscience, Imperial College London.Science Media Centre.

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