Spinal cord regeneration. There is a casuistry in each patient who suffers a spinal cord injury, because a combined therapy that is successful in one patient is not transferrable to the rest.
This week, both the national and international press have reported on an article in medical journal Cell Transplantation (CT-1239 Cell Transplantation Early Epub), which published the outcome of a clinical trial where it was shown that a 38-year-old Bulgarian man whose spinal cord was severed after being stabbed in the back could now walk again with the aid of a walker only.
While this is undoubtedly encouraging news, we must be cautious in its regarding.
Spinal cord injury is a condition that very dramatically disrupts not only the life of the person, whether suffered congenitally or suddenly, but that of his or her family and friends who witness firsthand the difficulties experienced by the person not only in the physical environment, but also psychological and even social difficulties. For this reason, any news related with spinal cord injury always generates great social impact that can lead us to prematurely think that “it’s cured at last”.
We must be cautious and investigate a little further. When a spinal injury occurs, it causes an interruption in the communication pathway between the muscles and the brain, so that the information sent by the brain to produce a movement is interrupted as if it were an electrical connection. This particular case reported the results of a treatment applied to a single patient, combining transplant of nerve tissue from the ankle with cells from the olfactory ensheathing glia. The olfactory pathway, as an exception in the central nervous system, is characterised by having the capacity to continually regenerate the olfactory sensory neurones (which are those that allow us to perceive smells). In the last 20 years, these cells have been the object of investigation, due to their ability to promote growth of the broken connections in spinal cord injuries, as well as covering them in myelin (a substance that is necessary for them to function).
In this way, the nerve tissue from the ankle acted as a “bridge” between the healthy ends of the spinal cord so that the cells could perform their function more efficiently.
This treatment was complemented with five hours of neurorehabilitation daily, between 3 and 5 days per week.
As this is a licit and valid therapy, there are other publications with similarly positive results using different cell types (mainly stem cells from bone marrow), drug therapy and even electrostimulation.
We should also add that there is certainly a casuistry in each patient who suffers a spinal cord injury, so that a therapy that is successful in one patient is not transferrable to the rest.
For this reason, the future recovery from spinal cord injuries involves the in-depth study of each person individually, and treatment with combined therapy (cell, electrostimulation, physiotherapy, drugs, biomaterials, etc.).
It is thus necessary to rely on the professional ethics of the investigators, who must publish their results with impeccable scientific rigor and work together to combine techniques that make it possible in the future for today’s news to be extendable to anyone with spinal cord injuries.