Sunday, December 11, 2005

Chinese Surgeon Gives Hope to the Paralysed

When Leo Hallan woke up in a hospital and found out he was paralyzed from his chest down from a motorcycle accident in 1976, he thought his life was over.

The 20 year old American had also lost sensation in both his arms and hands.

Doctors told him he would have to live with the disability for the rest of his life.

Sitting in a wheelchair in Dr. Huang Hongyun's clinic in the Beijing Xishan Hospital recently, Hallan, now 49, told of a miraculous moment when he was able to regain some of his senses for the first time in 29 years.

Shortly after Huang injected Olfactory Ensheathing Cells (OEC) into his spinal cord, he started noticing changes-within a week, he started perspiring below his chest and could feel the chill of the wind for the first time when he went outdoors in his wheelchair.

"When I was outside, I felt cold in my arm, the hair of my arm was moving, I had to look down to believe it," said a cheerful-looking Hallan. "Words cannot express my emotions."

"It was total amazement, just unbelievable," he said.

"Twenty-nine years ago, many doctors said I'd never walk again. At least now I can say there is quite a bit of hope."

Hallan is just one of some 800 patients who have been seen by Huang, whose controversial approach to treating Amyotrophic Lateral Sclerosis (ALS) and spinal cord injuries by injecting cells from aborted fetuses has been skeptically received by many Western medical experts.

"They canĀ“t accept that China is ahead of them." - Dr. Huang

Almost all of his patients are foreigners from Spain, Germany, France, Japan, New Zealand, Singapore and Pakistan, though most are from the United States.

Huang's centre said most of its spinal cord injury patients have regained some sensory and motor function, as well as the control of urine and bowel movement, while most ALS patients had seen indefinite stabilization in their neurological function.

"Most of our patients have obtained significant functional improvement to various degrees and about 70 percent of the patients have obtained some improvement in the quality of their lives," his centre's website said.

It was the first time that the College of Physicians & Surgeons of British Columbia has heard of Huang's practice of using cells from aborted fetuses.

"If this treatment were to be practiced here, it would cause significant ethical concerns," Dr. Morris VanAndel told The Asian Pacific Post.

He is the registrar of the college, the statutory body created to regulate medical practice.

VanAndel said that Huang's practice is "similar to the use of stem cells" from human embryos, a practice banned in the US.

"It is never ethically acceptable to intentionally destroy a human being, no matter how small," said a previous position paper by the Canadian Physicians for Life to the debate on stem cell research.

Western skeptics say the effectiveness of Huang's approach has not gone through rigorous tests and some even accuse him of exploiting desperate patients as laboratory mice.

"I haven't come across anyone in the field who considers his procedures safe and effective," said Professor Geoffrey Raisman at the Institute of Neurology, University College of London, who is pioneering research on OECs.

"He is the only one who claims it works, other people who have examined some of his patients said they saw no improvement," Raisman said.

Moreover, Western doctors say Huang doesn't systematically keep track of his patients so there is no statistical data on how many experience lasting benefits, and he fails to perform controlled studies considered necessary in Western circles.

But that doesn't bother his hopeful patients.

Hallan, who had been told by Western doctors his condition would never improve, swore by Huang's treatment.

He said didn't mind "at all" being a laboratory mouse and that many other patients like him were desperate to try out new treatments, even if they had not undergone enough tests.

"The fact that this has moved on from rat (to human) is one of the most exciting prospects," he said. "There is risk in anything. You have more chance of dying just walking on the street."

From his spartan office decorated with calligraphy extolling his work ("Miracle hands bring back life"), an exasperated Huang argued impassionately and defensively against the criticisms.

He said the placebo-controlled trials that some critics say he should conduct were unethical and not permitted under Chinese law because it would mean effectively deceiving patients into believing they had been treated when they hadn't.

"For someone like Mr Hallan who had been ill for 29 years, it would be cruelty to let him have that done to him," Huang said. "What is the priority here? Science or the patients?"

He also lashed out at the hypocrisy of those who criticize him for his use of nasal linings of aborted fetuses, arguing that Western countries such as the US are already using embryonic cell implants to treat Parkinsons disease.

"So only you are allowed to do this and we are not allowed to do this?" he said.

Another American patient, Doug McGuiness, who had two tiny holes drilled into his skull and then an injection of two million OEC cells, said even if his improvements were only temporary, the US$20,000 (C$23,000) treatment fee would still be worth it.

Eight years after being diagnosed with ALS, the 59-year-old engineer was overjoyed when he could button his own shirt and raise his legs without help just two days after the operation.

"This is a terminal disease, it's worth it even if it is three months, six months, a year," he said, noting that most ALS patients only have three years to live.

Even though it is still unknown exactly how the fetal tissue might work on damaged brains and spinal cords, Huang argued that this shouldn't stop the technique being used when it has been proven to work.

"Why do we need to eat and sleep, do we know? Is that a reason to stop eating?" he challenged.

Huang put the wide skepticism down to discrimination.

"They have a prejudiced attitude. They think it is implausible that a developing country like China can develop something that America and European countries haven't done yet," he said. "They can't accept that China is ahead of them."

With more trials of combinations of different techniques, Huang said it might be a possibility for his patients to walk in the future, but carefully emphasized that this was only one step in a very long process.

"Maybe eventually, but we don't have the solution here right now," Huang said.

But his critics remain unconvinced.

"I would be delighted if he would present evidence his OECs are working in his patients and it would have enormous impact on the field," Raisman said.

But unless he can provide data to convince other experts in the field, it is pointless.
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Researchers Discover Nerve Regeneration May Be Possible After Spinal Cord Injuries

A team of scientists at the University of California San Francisco have made a significant discovery that may help people recover following a spinal cord injury.

For the purpose of the study, scientists stimulated nerve cells in laboratory rats at the time of spinal cord injury and then again one week later. The growth capacity of nerve cells was increased and sustained which can be crucial for nerve regeneration following this type of injury.

An important distinction was made between the properties of nerve fibers of the central nervous system (CNS), which consists of the brain and spinal cord, and those of the peripheral nervous system (PNS), which is the network of nerve fibers that extends throughout the body.

When cells from the CNS experience an injury, they are unable to regenerate by themselves while PNS cells can regrow following an injury.

This regeneration is possible because PNS cell bodies can sense damage to their nerve processes and respond by sending out a signal that triggers the nerve fibers to regenerate.

The team of researchers used a new technique which was able to apply the principles of PNS cell growth to CNS cells by using a type of nerve fiber that has both a PNS and a CNS branch, forging new ground in relation to spinal cord injuries.

The researchers had conducted an animal study and found that an injury made to the peripheral branch preceding a spinal cord injury was able to provide the necessary communication signal which facilitated growth in the CNS branch. This only worked, however, if the PNS injury occurred at least one week before the CNS injury.

According to Allan Basbaum, PhD, senior study author: ?A PNS injury at the time of spinal cord damage will only promote growth of nerve fibers into the spinal cord lesion but not into the tissue beyond it. This is because growth capacity is enhanced, but it is not sustained.?

Basbaum argues that timing is everything in relation to successful nerve regeneration for spinal cord injuries. If too much time lapses after the injury, the cells will revert back to their normal state which inhibits regrowth. In addition, scar tissue begins to form which makes regeneration difficult.

The goal of Basbaum?s team is to achieve regeneration of nerve fibers and to sustain this growth long enough so that spinal cord patients can experience recovery of movement.

Source: Newsinferno News Staff
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Adult Stem Cell Research Can Help Spinal Cord Injury Patients

London, England - Advocates of embryonic stem cell research say more money is needed worldwide for the controversial research to help spinal cord injury patients like deceased Superman star Christopher Reeve. But adult stem cells are already ready to be tried in clinical studies to help such patients.

British researchers say adult stem cells found in the lining of the nose has helped mend paralyzed nerves in rats and could help spinal cord injury patients walk again if they are successful in humans.

Neuroscientist Geoffrey Raisman discovered 20 years ago that the cells responsible for sense of smell are good at renewing themselves and when they were injected into the spines of rates, they were very effective in curing damage to the nervous system.

Raisman hopes they will be as effective with humans and he's working with new clinical trials at the National Hospital for Neurology and Neurosurgery in London early next year.

There have been no clinical trials of embryonic stem cells and spinal cord injury patients.

Raisman heads the spinal repair unit at University College London and he will perform the treatments with the adult stem cells on 10 patients.

The cells avoid one of the biggest problems with embryonic stem cells in that they come from each of the 10 patients and won't be rejected by their immune systems.

The cells from the nose will be injected to create a "bridge" in the spinal cord from cells there to unattached cells in other limbs.

"The injury occurs when a blow to the shoulder pulls nerve fibers out of the spinal cord -- it's like pulling a plug out of a socket. We're trying to make the nerve fibers grow back in," Britain's Press Association reported him as saying.

"It's never been done before. If successful it will open the door to treating all kinds of connective nerve fiber conditions, including spinal injuries, the most severe kinds of stroke, and blindness and deafness caused by nerve fiber injury."

By: Steven Ertelt -
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Friday, December 02, 2005

Nose Stem Cells to Help Spinal Patients

LONDON, England - British surgeons hope a new procedure using stem cells from the lining of the nose will help mend severed nerves of paralyzed patients and may one day allow them to walk again.

Neuroscientist Geoffrey Raisman discovered 20 years ago that the cells responsible for sense of smell are good at renewing themselves.

When these cells were injected into the spines of rats they appeared to help cure damage to the nervous system.

Now Raisman hopes to transfer that technology to humans, working with patients in clinical trials at the National Hospital for Neurology and Neurosurgery in London early next year.

Raisman, who heads the spinal repair unit at University College London (UCL) will perform the procedure on 10 patients. All have suffered a type of injury most often seen in motorcycle accidents where nerves in the arm are pulled out of the spinal cord.

Since the cells come from the patients themselves, there is no risk of them being rejected by the immune system.

The procedure involves taking stem cells from the lining of the nose and using them to create a "bridge" between the severed ends of the nerves.

Raisman said that until now it had not been possible to repair the major nerves running through the spinal cord or branching off from it.

"The injury occurs when a blow to the shoulder pulls nerve fibres out of the spinal cord -- it's like pulling a plug out of a socket. We're trying to make the nerve fibres grow back in," Britain's Press Association reported him as saying.

"It's never been done before. If successful it will open the door to treating all kinds of connective nerve fibre conditions, including spinal injuries, the most severe kinds of stroke, and blindness and deafness caused by nerve fibre injury."

Raisman said the success of the first trial is crucial because harvesting stem cells is such a difficult task.

At present only small numbers can be retrieved, limiting the kinds of injury that can be treated. The new trial is seen as a first step to demonstrating that the technique works in humans.

"If it succeeds it will show that these cells are effective at restoring nerve fibre connections," PA reported Raisman as saying.

"We don't know what's going to happen, but we hope to reverse the effects of the injury and give these patients back the use of their arms."

Raisman was one of the first neuroscientists whose work in stem cell research raised the real possibility that spinal cord injuries, long considered incurable, could be repaired.

If successful, the procedure could also help restore sight to the blind

Spinal cord injuries are caused by disconnection of the nerve fibres -- resulting in numbness, pain, and partial loss of movement -- which never heals.

In severe cases, severing the spinal nerves can lead to permanent paralysis, as happened to "Superman" star Christopher Reeve who was injured in a riding accident in 1995.

Reeve, who died last year aged 52, campaigned for the kind of stem cell research that has led to the pioneering trial taking place in London.

Raisman discussed his research Thursday at a conference on spinal injuries at the Royal College of Physicians in London.
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