Dr. Michael Fehlings from Toronto Western Hospital is studying a new drug to treat spinal cord injuries soon after they happen. The drug, called Cethrin, is applied during surgery to the injury site in a fibrin glue type of material. Cethrin is a recombinant protein that is made through artificial DNA technology. The protein inhibits Rho, a key pathway that triggers cell death and increases damage after a spinal cord injury.
"You apply [Cethrin] directly to the damaged spinal cord and then the medication penetrates the damaged spinal cord," Fehlings said.
Cethrin is still under study, but early results look promising. Results from a one-year study of the drug in 37 patients were presented in April, 2007 at the annual meeting of the American Association of Neurological Surgeons in Washington, D.C. All patients in the study had "A" grade injuries, which are the most serious. Injuries are graded from A to E, with A being the most serious and E being the least serious.
Patients received Cethrin an average of 53 hours after their injury occurred. After six months, 28 percent of patients improved by one or more grades. Five patients improved to a "C" grade, and two improved to a "D" grade.Typically, there is some recovery that occurs after an injury, but the rates of recovery are quite low, in the range of 5 percent to 10 percent.
"In this trial, fully a third of patients showed significant recovery, and almost 20 percent of the patients showed a major degree of recovery. In my own clinical experience, this type of recovery is very unusual," Fehlings said.
Fehlings says the drug is not a cure for spinal cord injuries, but it could have a major impact on patients' lives.
"They might be able to now grip a jar or to drink, or they might be able to transfer themselves, whereas before they might not have had trunk control. In some patients, it might even mean that they could recover the ability to walk," he said.
At least five institutions in the United States and three in Canada are studying Cethrin's role in spinal cord injuries.
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