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Working2Walk 2011 features Dr. Jerry Silver!

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    Working2Walk 2011 features Dr. Jerry Silver!

    Dr. Jerry Silver from Case Western Reserve University talks to us about his nerve grafts for restored breathing and bladder function using Chondroitinase (chABC) commonly known as the Ch'ase enzyme.

    This new strategy shows clearly, for the first time, that long distance regeneration, with appropriate re-formation of functional connections, can be achieved in the adult after spinal cord injury! ROBUST FUNCTIONAL REGENERATION BEYOND THE GLIAL SCAR



    http://www.unite2fightparalysis.org/video_library

    Last edited by GRAMMY; 27 Oct 2011, 9:33 PM.
    http://spinalcordresearchandadvocacy.wordpress.com/

    #2
    Interesting....
    Han: "We are all ready to win, just as we are born knowing only life. It is defeat that you must learn to prepare for"

    Comment


      #3
      very good presentation.

      Comment


        #4
        We have to rely on Acorda to release this enzyme

        Comment


          #5
          Here are 2 of the articles that were published about it this past summer.

          http://www.cleveland.com/science/ind..._use_expe.html

          http://www.bbc.co.uk/news/health-14139204

          I still kinda feel bad about the rats having to be paralyzed 2 times. Their breathing is restored with the nerve graft and shot of Chase, but then the perfectly working graft had to be cut in two in order to prove that the graft had indeed been working, so they end up paralyzed a second time. Ewwww!
          Last edited by GRAMMY; 27 Oct 2011, 10:43 PM.
          http://spinalcordresearchandadvocacy.wordpress.com/

          Comment


            #6
            "Silver speculates the months-long delay between treatment and the return of regular breathing may be because the regenerating axons need time to build up the necessary insulation. Or it might take a while for the nerve fibers to make proper connections." (http://www.cleveland.com/science/ind..._use_expe.html)

            jsilver, does it mean that remyelinetion occurs spontaneously, without any additional "tricks"? If so, it's just amazing.

            Comment


              #7
              Originally posted by kivi66 View Post
              "Silver speculates the months-long delay between treatment and the return of regular breathing may be because the regenerating axons need time to build up the necessary insulation. Or it might take a while for the nerve fibers to make proper connections." (http://www.cleveland.com/science/ind..._use_expe.html)

              jsilver, does it mean that remyelinetion occurs spontaneously, without any additional "tricks"? If so, it's just amazing.
              The nerve bridge contains Schwann cells which can re-myelinate spontaneously, although this undoubtedly takes some time. Re-myelination is critical to proper function of regenerated axons and this property of Schwann cells is one of the major reasons (among others) we chose the peripheral nerve autograft strategy. Np additional tricks are needed.

              Comment


                #8
                Dr. Silver your work and progress is very exciting and promising...Keep up the good work

                This question has probably already been asked and I maybe jumping the gun but what is the next step to get the translational work done and get this therapy to the clinic?

                Comment


                  #9
                  Originally posted by rjames View Post
                  Dr. Silver your work and progress is very exciting and promising...Keep up the good work

                  This question has probably already been asked and I maybe jumping the gun but what is the next step to get the translational work done and get this therapy to the clinic?


                  I second that question
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                  "what???? , you don't 'all' wear a poop sac?.... DAMNIT BONNIE, YOU LIED TO ME ABOUT THE POOP SAC!!!! "


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                  Comment


                    #10
                    Originally posted by rjames View Post
                    Dr. Silver your work and progress is very exciting and promising...Keep up the good work

                    This question has probably already been asked and I maybe jumping the gun but what is the next step to get the translational work done and get this therapy to the clinic?

                    If you watched the video, you saw and heard 2 more important pieces of the puzzle. the most important is the very last bit where we show a strong return of function in the respiratory system in animals that had sustaing a cord lesion 1 year earlier. Recovery occurs rapidly (within 1 week) with a single injection of enzyme. Importantly the return of function at chronic time points is even stronger than the effect we see at acute stages. If you're interested we can begin to discuss various experiments that we have done which have helped us to begin to understand why this should be. the results are very exciting and are relevant to all treatments (including the use of stem cells) that target chronic injury. Hopefully , this new work will strongly stimulate Acorda to get going with a chondroitinase clinical trial. Secondly, I showed new work where we completely transected the cord and built a bridge across the gap. here we focused on the return of bladder function that continued to improve nicely at around 6 months following treatment. In the case of complete transection injuries we need to build a bridge and our new work shows that for the urinary system, at least, we can surely restore a good measure of function. By the way If you look carefully at one of the slides you may notice that I also describe a nice improvement in locomotor function in these same animals from a BBB score of 2 to a score of 7, a 5 point increase. However, I need to stress that a score of 7 is far from normal walking but there is improvement (I didn't stress walking in my talk) Thus, if we wait long enough regenerating axons can travel relatively long distances in the spinal cord and hook up synaptically to restore certain critical functions. I'm hoping that a courageous team of neurosurgeons in our country joins me in attempting a clinical trial in people with cord injuries below the respiratory nuclei. They have been hesitant to move forward with a bridge building + ch'ase clinical trial in people with very high injuries for fear of doing more damage. There's is not much left working is high quads. By the way Henrich Cheng in Taiwan has already attempted many such surgeries in humans so this procedure is certainly feasible in humans. He has yet to combine bridging +ch'ase.

                    Comment


                      #11
                      Originally posted by jsilver View Post
                      They have been hesitant to move forward with a bridge building + ch'ase clinical trial in people with very high injuries for fear of doing more damage.
                      I understand the caution, but I know I for one would risk it. 12 suctions today and counting. Just surviving takes a toll.
                      Last edited by Scaper1; 29 Oct 2011, 8:40 PM.

                      Comment


                        #12
                        Originally posted by jsilver View Post
                        If you watched the video, you saw and heard 2 more important pieces of the puzzle. the most important is the very last bit where we show a strong return of function in the respiratory system in animals that had sustaing a cord lesion 1 year earlier. Recovery occurs rapidly (within 1 week) with a single injection of enzyme. Importantly the return of function at chronic time points is even stronger than the effect we see at acute stages. If you're interested we can begin to discuss various experiments that we have done which have helped us to begin to understand why this should be. the results are very exciting and are relevant to all treatments (including the use of stem cells) that target chronic injury. Hopefully , this new work will strongly stimulate Acorda to get going with a chondroitinase clinical trial. Secondly, I showed new work where we completely transected the cord and built a bridge across the gap. here we focused on the return of bladder function that continued to improve nicely at around 6 months following treatment. In the case of complete transection injuries we need to build a bridge and our new work shows that for the urinary system, at least, we can surely restore a good measure of function. By the way If you look carefully at one of the slides you may notice that I also describe a nice improvement in locomotor function in these same animals from a BBB score of 2 to a score of 7, a 5 point increase. However, I need to stress that a score of 7 is far from normal walking but there is improvement (I didn't stress walking in my talk) Thus, if we wait long enough regenerating axons can travel relatively long distances in the spinal cord and hook up synaptically to restore certain critical functions. I'm hoping that a courageous team of neurosurgeons in our country joins me in attempting a clinical trial in people with cord injuries below the respiratory nuclei. They have been hesitant to move forward with a bridge building + ch'ase clinical trial in people with very high injuries for fear of doing more damage. There's is not much left working is high quads. By the way Henrich Cheng in Taiwan has already attempted many such surgeries in humans so this procedure is certainly feasible in humans. He has yet to combine bridging +ch'ase.
                        Dr. Silver, How does the nerve graft restore sensation to the restored function?

                        Comment


                          #13
                          Originally posted by jsilver View Post
                          If you watched the video, you saw and heard 2 more important pieces of the puzzle. the most important is the very last bit where we show a strong return of function in the respiratory system in animals that had sustaing a cord lesion 1 year earlier. Recovery occurs rapidly (within 1 week) with a single injection of enzyme. Importantly the return of function at chronic time points is even stronger than the effect we see at acute stages. If you're interested we can begin to discuss various experiments that we have done which have helped us to begin to understand why this should be. the results are very exciting and are relevant to all treatments (including the use of stem cells) that target chronic injury. Hopefully , this new work will strongly stimulate Acorda to get going with a chondroitinase clinical trial. Secondly, I showed new work where we completely transected the cord and built a bridge across the gap. here we focused on the return of bladder function that continued to improve nicely at around 6 months following treatment. In the case of complete transection injuries we need to build a bridge and our new work shows that for the urinary system, at least, we can surely restore a good measure of function. By the way If you look carefully at one of the slides you may notice that I also describe a nice improvement in locomotor function in these same animals from a BBB score of 2 to a score of 7, a 5 point increase. However, I need to stress that a score of 7 is far from normal walking but there is improvement (I didn't stress walking in my talk) Thus, if we wait long enough regenerating axons can travel relatively long distances in the spinal cord and hook up synaptically to restore certain critical functions. I'm hoping that a courageous team of neurosurgeons in our country joins me in attempting a clinical trial in people with cord injuries below the respiratory nuclei. They have been hesitant to move forward with a bridge building + ch'ase clinical trial in people with very high injuries for fear of doing more damage. There's is not much left working is high quads. By the way Henrich Cheng in Taiwan has already attempted many such surgeries in humans so this procedure is certainly feasible in humans. He has yet to combine bridging +ch'ase.
                          Dr. Silver,
                          Yes I certainly would like to discuss/learn more about the various studies you have done to better understand why there has been such success with Chronic injuries versus Acute injuries. I think I speak for everyone on this board when I say we are all VERY interested in Chronic therapies.

                          I totally understand the risk in bridging higher injuries but I'm sure there are some high level Quads that would be willing to take some risk for a possibility of getting off a ventilator. I would think it would make more sense to start with Thoracic injuries and work towards restoring Bladder and Bowel, perfecting that treatment and then move to high level quads.

                          I did watch your W2W video and listened to the end where you were talking about the successes you were seeing in chronic injuries, that's what has me so excited. I have been digging around the research about nerve grafting (Periferal) for a couple years and have thought it might be the way to go, making a "Patch Cord" to by pass the injury and with your successes it seems like my hunch was correct. Dr. John Martin is doing something similar to you but using nerve roots but not have quite as much success, Maybe he needs chondroitinase. I also heard the part about walking but i figure it"s just a matter of time before you figure that out too.

                          As you mentioned there are surgeons that have been doing nerve grafting for years and I would think they could learn this type of procedure pretty quickly.

                          How can our SCI community help you take your work to an available treatment? I would hate to see you retire (LOL) before this is realized....

                          Comment


                            #14
                            please, some of us want to walk more than anything else

                            that is one trouble with us with sci; we all seem to want different things, partly due to our different injuries

                            Comment


                              #15
                              Originally posted by rjames View Post
                              Dr. Silver,
                              Yes I certainly would like to discuss/learn more about the various studies you have done to better understand why there has been such success with Chronic injuries versus Acute injuries. I think I speak for everyone on this board when I say we are all VERY interested in Chronic therapies.

                              I totally understand the risk in bridging higher injuries but I'm sure there are some high level Quads that would be willing to take some risk for a possibility of getting off a ventilator. I would think it would make more sense to start with Thoracic injuries and work towards restoring Bladder and Bowel, perfecting that treatment and then move to high level quads.

                              I did watch your W2W video and listened to the end where you were talking about the successes you were seeing in chronic injuries, that's what has me so excited. I have been digging around the research about nerve grafting (Periferal) for a couple years and have thought it might be the way to go, making a "Patch Cord" to by pass the injury and with your successes it seems like my hunch was correct. Dr. John Martin is doing something similar to you but using nerve roots but not have quite as much success, Maybe he needs chondroitinase. I also heard the part about walking but i figure it"s just a matter of time before you figure that out too.

                              As you mentioned there are surgeons that have been doing nerve grafting for years and I would think they could learn this type of procedure pretty quickly.

                              How can our SCI community help you take your work to an available treatment? I would hate to see you retire (LOL) before this is realized....
                              @rjames: Did you see the chondroitinase video that was uploaded just before Dr. Silver's? http://www.unite2fightparalysis.org/video_library__1
                              http://spinalcordresearchandadvocacy.wordpress.com/

                              Comment

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