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  • Stem Cell treatment for C5inc

    dear all i am woundering if anyone knows is if stem cell treatment will help or work on C5 inc after 3 years knowing that i do walk on crutches but my right hand is not getting any better

  • #2
    Originally posted by zq783 View Post
    dear all i am woundering if anyone knows is if stem cell treatment will help or work on C5 inc after 3 years knowing that i do walk on crutches but my right hand is not getting any better
    zq783,

    I am not sure that anybody knows but, to date, the evidence is not convincing that any stem cell therapy alone (without other regenerative therapies) will restore function that is due to motoneuronal injury. Let me explain further.

    Injury to the spinal cord causes two types of damage. One is damage to the ascending and descending axons (nerve fibers) that go from the brain to the spinal cord. This causes loss of sensation and control of the spinal cord below the injury site. However, the spinal cord below the injury often remains alive and active, manifesting in spasticity and sometimes in neuropathic pain.

    The second is damage to the neurons that at the level of injury. For example, if your injury site is at C8, this damages the neurons that innervate your hand and you will see atrophy of the muscles of your forearm and your had. Likewise, if your injury is at spinal level T10, you may damage the motoneurons that innervate your upper leg (i.e. your hip flexors and quadriceps).

    To fix the former, what one needs to get axonal regeneration and sprouting
    • by implanting cells to bridge the injury site and allow axons to grow across,
    • by providing a continuing source of growth factors (such as the neurotrophins) to stimulate axonal growth, and
    • by blocking growth inhibitors that are present in the spinal cord (including Nogo and chondroitin-6-sulfate proteoglycans).

    This is what we are trying to do with HLA-matched umbilical cord blood mononuclear cells (UCBMC) and lithium in clinical trial. The UCBMC should bridge the injury site and provide a bridge. The lithium stimulates the cells to produce neurotrophins that would stimulate the axons to grow. We are planning to add growth inhibitor blockers.

    The second problem, i.e. local damage to neurons at the injury site, will require a different solution. We will probably need to implant neural stem or progenitor cells (stem cells that produce neurons) that have been treated with sonic hedgehog and other factors that will push the cells to produce motoneurons. After the cells have been implanted, we must treat the cells with growth factors and other treatments that will stimulate the motoneurons to send their axons out of the ventral roots to reinnervate muscle. Doug Kerr has shown that this is possible in animals where he used a virus to destroy motoneurons, implanted embryonic stem cells that had been converted to motoneurons with factors such as retinoic acid and sonic hedgehog, and then treated with regenerative therapies (such as dibutyryl cAMP and rollipram) to stimulate the cells to extend neurons into the ventral roots.

    It is likely that both types of treatment will also cause surviving axons to sprout. In your case, you have incomplete spinal cord injury. This means that you have surviving axons that are allowing you to walk. Treatments with neurotrophin or drugs that increase neurotrophin production should simulate the surviving axons to sprout and innervate more neurons below the injury site. This may result in better control of movement, less fatigue, and greater strength.

    Wise.

    Comment


    • #3
      Dr.Wise,

      According to my reports what kind of damage I seem to have ? And in which kind of these two therapies I need to focus on ?

      Thank You very much

      Comment


      • #4
        Originally posted by ValonOsmani View Post
        Dr.Wise,

        According to my reports what kind of damage I seem to have ? And in which kind of these two therapies I need to focus on ?

        Thank You very much
        Most people have both kinds of injuries. I suspect that you do, too. It is entirely possible that regenerative therapies such as umbilical cord blood and lithium would restore you to a stage that is similar to what zq783 has. At that point, we have to address the segmental neuronal loss. Wise.

        Comment


        • #5
          Dr.Wise,

          Thank you very much ... You encourage me to train even harder...

          Comment


          • #6
            If we could only get these regenerative therapies containing umbilical cord and lithium crackin faster, we just might be able to get back some kind of real life...

            Comment


            • #7
              So the nerve roots leaving the spinal cord also don't regenerate?
              Alan

              Proofread carefully to see if you any words out.

              Comment


              • #8
                Good ting you are so positive Dr. Young. But the brain/cord connections for example, as I understand it, are not so simple, not the cord either like you tend to explain. I asked here some time ago about the cord (couple of years ago), and then the answers was it was difficult, but now suddenly it seams not to be. What has happened?

                Comment


                • #9
                  Originally posted by alan View Post
                  So the nerve roots leaving the spinal cord also don't regenerate?
                  Mine didn't.

                  Comment


                  • #10
                    Originally posted by Leif View Post
                    Good ting you are so positive Dr. Young. But the brain/cord connections for example, as I understand it, are not so simple, not the cord either like you tend to explain. I asked here some time ago about the cord (couple of years ago), and then the answers was it was difficult, but now suddenly it seams not to be. What has happened?
                    Finally science realized that some neurological damages actually only needs gentle pushing in the right direction for the human body to start cooperating with good results as outcome?
                    @Leif - if you are keen on knowing everything about the complexity of the spinalcord before we try anything - you can rest assured that you and me wont be walking in this life.
                    Lets get to work - then discover for what reasons things went good/bad
                    (and the reason I use 'bad' in that sentence, and not 'worse' - is because it can't get any worse - and you should know that).

                    Let's get moving- shall we?
                    "It's not the despair, I can handle the despair! It's the hope!" - John Cleese

                    Don't ask what clinical trials can do for you, ask what you can do for clinical trials. (Ox)
                    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

                    Comment


                    • #11
                      Originally posted by Leif View Post
                      Good ting you are so positive Dr. Young. But the brain/cord connections for example, as I understand it, are not so simple, not the cord either like you tend to explain. I asked here some time ago about the cord (couple of years ago), and then the answers was it was difficult, but now suddenly it seams not to be. What has happened?
                      Leif,

                      Brain and spinal cord connections are complicated. On the other hand, we know from direct observations of animals and people who have recovered walking from spinal cord that remarkably few axons are necessary and sufficient to restore locomotion. So, the question is how animals and people recover function with so little spinal cord. The answer is that many animals and people recover movements that are programmed in the spinal cord.

                      Walking is one of these functions that recover in people with incomplete spinal cord injuries. Many people with as little as 10% of the descending tracts of their spinal cords recover unassisted walking. The central pattern generator is located at about the L2 segment of the spinal cord. The brain does not need a great deal of complex interactions with the central pattern generator in order to activate walking behavior. In fact, you don't need the brain at all for walking. Anybody who has seen a decapitated chicken run understands this.

                      In the 1980's, Barbeau, et al. reported that cats can be trained to walk
                      Barbeau, H. and S. Rossignol (1987). "Recovery of locomotion after chronic spinalization in the adult cat." Brain Res 412(1): 84-95. Abstract: Cats were spinalized (T13) as adults and were trained to walk with the hindlimbs on a treadmill. After 3 weeks to 3 months and up to 1 year depending on the animal, all were capable of walking on the plantar surface of the feet and support the weight of the hindquarters. Interactive training appeared to accelerate the recovery of locomotion and maintain smooth locomotor movements. Despite the obvious loss of voluntary control and equilibrium which the experimenter partially compensated for by maintaining the thorax and/or the tail, the cats could walk with a regular rhythm and a well-coordinated hindlimb alternation at speeds of 0.1-1.2 m/s. Cycle duration as well as stance and swing duration resembled those of normal cats at comparable speeds. The range of angular motion was also similar to that observed in intact cats as was the coupling between different joints. The EMG activity of the hindlimb and lumbar axial muscles also retained the characteristics observed in the intact animal. Some deficits such as a dragging of the foot in early swing and diminution of the angular excursion in the knee were seen at later stages. Thus, the adult spinal cat preparation is considered as a useful model to study the influence of different types of training and of different drugs or other treatments in the process of locomotor recovery after injury to the spinal cord.
                      Another function that appears to recover frequently is micturition (the act of urination). This is a complex function that involves coordination between the central, autonomic and somatic nervous systems, with brain centers including the pontine micturition center, periaqueductal gray, and the cerebral cortex [source]http://en.wikipedia.org/wiki/Urination[/source]. Yet, spontaneous and coordinated micturition frequently recovers in animals and people with spinal cord injuries that damage >90% of their ascending and descending tracts.

                      Much of micturition must programmed in the spinal cord and the peripheral ganglia that control the bladder and sphincters. The presence of peripheral ganglia coordinating the bladder and sphincters must be the reason why Dr. Xiao has been able to restore micturition in people by bridging a lumbar ventral root to the pudendal nerve. These people can micturate by scratching the dermatome of the ventral root that is connected to the pudendal nerve. Interestingly, according to Dr. Xiao, in children with spina bifida and retention of some connectivity between their brains and lower spinal cords, such bridging procedures can lead to restoration of voluntary micturition.

                      Decapitated chickens not only can run around after their heads are cut off. They micturate and defecate. Therefore, the programs for such functions must reside in the spinal cord and even in peripheral ganglia. Animals and people with less than 10% of their spinal cord crossing the injury site can walk voluntarily and often so well that an untrained observer cannot tell the difference between such recovered people and normal. While it is true that the connections between the brain and spinal cord are complex and extensive, this does not mean that recovery of function requires recreation of all the complex connections.

                      Our goal therefore must be to develop therapies that can make people with so-called "complete" spinal cord injuries incomplete and people with incomplete spinal cord injury more incomplete. For people who have damage of their spinal cord gray matter, we must find ways of restoring that involve replacing motoneurons and neuronal circuitry. We have the tools to do so now with neural stem cells and methods to stimulate regeneration by these cells. For example, we are starting experiments in which we are genetically modifying neural stem cells to grow axons after they are transplanted.

                      I want to urge you to avoid joining the ranks of naysayers. Yes, based on history, spinal cord injury has not been cured. If you want to believe that history recapitulates itself, yes, we will not have a cure. However, I think that there is progress. A century ago, people thought that flying was impossible. Fifty years ago, talking on a cell phone was considered science fiction but how many of us are without a cell phone today? Transplantation of organs was considered to be impossible when I went to medical school. Now, it is routinely done. Yes, we can and will cure spinal cord injury.

                      Wise.

                      Comment


                      • #12
                        Amazing........

                        I dont know why people are afraid to believe this ?! I just believe it with all my body,mind and spirit...

                        You know sometimes I feel like this too, wondering that I'm blind or to much optimistic

                        Hope that I dont get dissapointed..

                        Comment


                        • #13
                          I think some people just dont believe it because they cant see it with all the lost time and patience so far gone ...hopefully it could be felt with all the HOPE!!

                          Comment


                          • #14
                            Dr wise

                            so you think that there some kind of treatment yet for me? by the way i walked yest 5 km in 2h 45 min ,
                            wish everyone the best recovery and many thanks Dr wise

                            Originally posted by Wise Young View Post
                            zq783,

                            I am not sure that anybody knows but, to date, the evidence is not convincing that any stem cell therapy alone (without other regenerative therapies) will restore function that is due to motoneuronal injury. Let me explain further.

                            Injury to the spinal cord causes two types of damage. One is damage to the ascending and descending axons (nerve fibers) that go from the brain to the spinal cord. This causes loss of sensation and control of the spinal cord below the injury site. However, the spinal cord below the injury often remains alive and active, manifesting in spasticity and sometimes in neuropathic pain.

                            The second is damage to the neurons that at the level of injury. For example, if your injury site is at C8, this damages the neurons that innervate your hand and you will see atrophy of the muscles of your forearm and your had. Likewise, if your injury is at spinal level T10, you may damage the motoneurons that innervate your upper leg (i.e. your hip flexors and quadriceps).

                            To fix the former, what one needs to get axonal regeneration and sprouting
                            • by implanting cells to bridge the injury site and allow axons to grow across,
                            • by providing a continuing source of growth factors (such as the neurotrophins) to stimulate axonal growth, and
                            • by blocking growth inhibitors that are present in the spinal cord (including Nogo and chondroitin-6-sulfate proteoglycans).

                            This is what we are trying to do with HLA-matched umbilical cord blood mononuclear cells (UCBMC) and lithium in clinical trial. The UCBMC should bridge the injury site and provide a bridge. The lithium stimulates the cells to produce neurotrophins that would stimulate the axons to grow. We are planning to add growth inhibitor blockers.

                            The second problem, i.e. local damage to neurons at the injury site, will require a different solution. We will probably need to implant neural stem or progenitor cells (stem cells that produce neurons) that have been treated with sonic hedgehog and other factors that will push the cells to produce motoneurons. After the cells have been implanted, we must treat the cells with growth factors and other treatments that will stimulate the motoneurons to send their axons out of the ventral roots to reinnervate muscle. Doug Kerr has shown that this is possible in animals where he used a virus to destroy motoneurons, implanted embryonic stem cells that had been converted to motoneurons with factors such as retinoic acid and sonic hedgehog, and then treated with regenerative therapies (such as dibutyryl cAMP and rollipram) to stimulate the cells to extend neurons into the ventral roots.

                            It is likely that both types of treatment will also cause surviving axons to sprout. In your case, you have incomplete spinal cord injury. This means that you have surviving axons that are allowing you to walk. Treatments with neurotrophin or drugs that increase neurotrophin production should simulate the surviving axons to sprout and innervate more neurons below the injury site. This may result in better control of movement, less fatigue, and greater strength.

                            Wise.

                            Comment


                            • #15
                              Originally posted by zq783 View Post
                              so you think that there some kind of treatment yet for me? by the way i walked yest 5 km in 2h 45 min ,
                              wish everyone the best recovery and many thanks Dr wise
                              zq, yes, I believe that there will be treatments that will restore more function for you.

                              From your description, you have an incomplete C5 injury with residual neurological deficits in your right hand. The therapies won't be, in my opinion, just transplants of stem cells alone but cell transplants plus other therapies that stimulate axons to grow.

                              Probably the first generation therapies should strengthen what you have already, including walking faster and for longer distances. By the way, electrical stimulation of the L2 spinal cord already can do this.

                              The second generation therapies should be transplantation of neural stem cells combined with growth stimuli and inhibitors of axonal transplant, to replace neurons in the cervical spinal cord.

                              Wise.

                              Comment

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