A Breakthrough in spinal cord injury treatment (interview with doctor Wise Young)

[Mitchitsu]

https://drive.google.com/file/d/1GcS...FLLCgPobX/view

Paolo, are you a complete injury? If this isn't exciting to you, then I imagine you must be incomplete because this is pretty damn exciting to me. Dude barely has any muscle at all and is doing pretty good for having a complete SCI.

It really is incredible to watch.
I am really looking forward to seeing the results of the people in the 6 x 6 x 6 without stem cells...

Just very curious to see how much extreme amounts of exercise / practice would help people.

I guess I'm a bit 'lucky' in that I'm fairly incomplete and can ambulate. So maybe instead of 30 minutes a day, if I do many hours a day, I can get my functional life back.....

[paolocipolla]

https://drive.google.com/file/d/1GcS...FLLCgPobX/view

Paolo, are you a complete injury? If this isn't exciting to you, then I imagine you must be incomplete because this is pretty damn exciting to me. Dude barely has any muscle at all and is doing pretty good for having a complete SCI.

Hope you can enter the US trial.

[Jim]

It really is incredible to watch.
I am really looking forward to seeing the results of the people in the 6 x 6 x 6 without stem cells...

Just very curious to see how much extreme amounts of exercise / practice would help people.

I guess I'm a bit 'lucky' in that I'm fairly incomplete and can ambulate. So maybe instead of 30 minutes a day, if I do many hours a day, I can get my functional life back.....

The nine who are randomized to the 6-6-6 only group will be offered the cells after the trial, followed by 6 more months of training. This group will probably do the best.

The 6 weeks of outpatient PT will only be 5-5-5, the rehab centers can't do 6-6-6.

They had a trial in Kunming, hasn't been published yet. Thirty subjects, complete, C5-T10, randomized to surgery, no surgery, both 6-6-6. The surgery consisted of aggressive untethering and removal of adhesions to restore normal cerebral spinal flow. About 25% in each group 'walked' between Kunming level III/IV. 85% of the surgery group regained bowel/bladder. Pretty incredible.

[lunasicc42]

The nine who are randomized to the 6-6-6 only group will be offered the cells after the trial, followed by 6 more months of training. This group will probably do the best.

The 6 weeks of outpatient PT will only be 5-5-5, the rehab centers can't do 6-6-6.

They had a trial in Kunming, hasn't been published yet. Thirty subjects, complete, C5-T10, randomized to surgery, no surgery, both 6-6-6. The surgery consisted of aggressive untethering and removal of adhesions to restore normal cerebral spinal flow. About 25% in each group 'walked' between Kunming level III/IV. 85% of the surgery group regained bowel/bladder. Pretty incredible.

when might that paper you speak of be published?

[Jim]

I'll ask Wise

[LukeTheDuke]

After the trial is complete, Wise plans to hold trials for groups that aren't in the inclusion criteria. Those under the age of 17 and over 65, and those who have injuries above C5. There is a lot to do, we need more clinical trials in the US.

Couple of questions:

1) What about the people with an injury below T11? Will you look into it? Will clinical trials start for such an injury as well? Can the central pattern generator be regenerated again if for example injury between T11 and L3 happened?
2) What about the people whose dura was cut/crushed/torn open? If fibroblasts entered the cord/ a real scar formed; can it be repaired?
3) How many times can surgeons open the dura to apply treatments? Umbilical cord cells now, Courtines stimulator in 3 years, Axer-204 in 5 years ... Would that work?

Please speculate if you are not 100% sure. Thanks so much in advance

[Ajstevens]

They said 500 years, you heard 5 years. So the solution is we just have to live a whole lot longer.

Yeah that....

[Ajstevens]

GreaseLightning, I've worked for Wise for nine years, so I'll give some backround.

Download the PDF of the published paper from the trials in Hong Kong and Kunming- https://journals.sagepub.com/doi/10....6368916X691411
If you look at the graph on pg 1930 (Kunming Trial) it gives the ages of the 20 participants, under that, how many years they have been injured. The range was 2 to 20 years post-injury, and there was no difference in recovery. All of these subjects received the 6-6-6 training.

If you look at the results of the first trial in Hong Kong (8 subjects/pg 1930), you will see a major difference, none had substantial recovery. This group did not do 6-6-6.

You asked, why 6-6-6?
Chinese neurosurgeon, Zhu Hui, began the 6-6-6 walking program many years ago, at the SCI Military Hospital in Kunming, China. Wise met her while he was there organizing ChinaSCINet. He was very impressed by the recoveryof these patients and decided to make it part of the trial. I visited there several years ago, very impressive.

We learned from the Hong Kong/Kunming trials, that without intensive training, the participants don't recover. Is 6-6-6 necessary to recover? We don't know. Are there less time consuming ways to exercise and get the same/better results, probably. We first need to confirm that this therapy is effective before we radically change any part of it. It is very possible that the cells + transcutaneous stimulation could be more effective that 6-6-6.

After the trial subjects are operated on, this therapy will be available for expanded compassionate use. Anyone can apply to the FDA to have it done, unfortunately, you would have to pay the cost, about 200K. After the trial is complete, Wise plans to hold trials for groups that aren't in the inclusion criteria. Those under the age of 17 and over 65, and those who have injuries above C5. There is a lot to do, we need more clinical trials in the US.

What I don't understand if things are happening and working well why isn't it a TOP NEWS STORY on every news station available. "We" could go on there and tell every "normal" person what it's like to start their day shoving a finger in their ass just to start the day...... Etc,etc,etc.
Baseball, football, basketball, ceo's, and every other person that makes millions and millions of dollars a year would donate I'm sure!! It's gotta be publicized for anything to happen.

[Ajstevens]

Couple of questions:

1) What about the people with an injury below T11? Will you look into it? Will clinical trials start for such an injury as well? Can the central pattern generator be regenerated again if for example injury between T11 and L3 happened?
2) What about the people whose dura was cut/crushed/torn open? If fibroblasts entered the cord/ a real scar formed; can it be repaired?
3) How many times can surgeons open the dura to apply treatments? Umbilical cord cells now, Courtines stimulator in 3 years, Axer-204 in 5 years ... Would that work?

Please speculate if you are not 100% sure. Thanks so much in advance

T11 & L3, shit that's workable....

[Jim]

Couple of questions:

1) What about the people with an injury below T11? Will you look into it? Will clinical trials start for such an injury as well? Can the central pattern generator be regenerated again if for example injury between T11 and L3 happened?
2) What about the people whose dura was cut/crushed/torn open? If fibroblasts entered the cord/ a real scar formed; can it be repaired?
3) How many times can surgeons open the dura to apply treatments? Umbilical cord cells now, Courtines stimulator in 3 years, Axer-204 in 5 years ... Would that work?
Please speculate if you are not 100% sure. Thanks so much in advance

3) I have not heard of any issue with opening the dura and injecting more than once. In fact, Wise has said, more than 1 injection may be necessary, he doesn't know. It is very likely that a combination therapy will wind up being the most effective.

2) Most of the patients in the Hong Kong/China trial showed long growth across the injury site. We don't believe the 'scar' prevents growth. It may make it harder, but the DTI images that you see in the published paper, show it possible.

What I don't understand if things are happening and working well why isn't it a TOP NEWS STORY on every news station available. "We" could go on there and tell every "normal" person what it's like to start their day shoving a finger in their ass just to start the day...... Etc,etc,etc.
Baseball, football, basketball, ceo's, and every other person that makes millions and millions of dollars a year would donate I'm sure!! It's gotta be publicized for anything to happen.

We have deliberately not publicized the results of the trial. If the results are repeated in the upcoming trial, that will be the time publicize.

Our lab has been working on T11 and below. Here's somthing Wise wrote about those injuries-

The lumbosacral spinal cord is located at T11-L1. It contains the neurons (gray matter) that innervate the muscles of the leg. Damage to the lumbosacral cord results in loss of gray matter including the neurons responsible for innervating muscle and the circuitry for reflexes and programmed movements. When you have flaccid paralysis, you don't have spasticity.

I believe that restoring function to lumbosacral injuries will require neuronal replacement. Neural stem cells can make neurons and some animal studies suggest that they can also replace motoneurons. There are several sources of immune-compatible neural stem cells. One is induced pluripotent stem (iPS) which can be differentiated to neural stem cells. The other is autologous call pluripotent adult stem cells which can be differentiated into neural stem cells, including the MUSE cells described by Mari Dezawa.

Please note, however, that much research still needs to be done to find out the best kind of cells to transplant to replace motoneurons, to get these cells to send axons out of the spinal cord to innervate muscle, to regenerate sensory and descending axons to connect with these neurons to reform reflex circuits, and to program the spinal cord for micturition (urination), bowel movements, walking, and other programmed motor function.

People who have injuries to L2 or lower segments will have primarily spinal root (cauda equina) injuries. These roots need to be regenerated. Axons must be coaxed to grow into the spinal cord. Motor axons must be grown from the spinal cord into the muscle. If the injury is close to the spinal cord, motoneuronal replacement may be necessary.

Finally, flaccidity (complete loss of muscle tone) usually results in marked atrophy of muscles. For a long time, clinicians thought that denervated muscles could not be restored. However, a group in Vienna has reported that very intense electrical stimulation of muscle can not only maintain but restore denervated muscles.

I know that the reversal of flaccid paralysis sounds daunting but I think that we will be surprised by how flexible the spinal cord is.

Wise

[KyleP2112]

The interview with Dr. Wise Young was really interesting and inspiring to watch. I would love to know more about these trials and if I could participate... my spinal cord injury at the level C4-C5 and happened in 1995 when I was 17

[Mitchitsu]

The interview with Dr. Wise Young was really interesting and inspiring to watch. I would love to know more about these trials and if I could participate... my spinal cord injury at the level C4-C5 and happened in 1995 when I was 17

You are going to have to change your signature to say your injury is 'complete' and then fool them

I think one person in Asia was actually able to do that. I'm sure unintentionally. It would be great to see how that person progressed as an incomplete who went through the entire process but unfortunately it's difficult to dig up too much information on it...

[STOLhorse]

I just watched this interview and I enjoyed seeing Dr. Young speak after only reading his words for a lot of years. I think it is exciting to hear about such results!

One question I have is how long did the results last for the patients after they stopped the 6-6-6? He mentioned that good bowel and bladder control remained for many at the one year follow-up but what about walking ability?

Also, could any of the patients go from sitting to standing on their own? What about taking a step up like on a curb?

Thanks for posting this Lunasicc. And thank you Jim for your comments.

David

[flying]

Humm, makes me want to walk for 6 hours a day, to ditch the catheters. Would that really work?
Glad to see Wise still going strong. Refreshing

[crispy1981]

STOLhorse (David) and flying, i too am excited/following this closely. And yes i had the same questions...i asked some questions during the last webinar that might help:

1. Dr. Young advised 1 hour of walking post 6-6-6 would suffice to retain any function recovered and i think that would include the walking recovered.
2. I never heard a question that might answer if any of the patients could transition from sitting to standing on their own but if with enough upper body function i would imagine they could with momentum and arm strength combined?
3, Yes flying i too am keen about 6-6-6 just to regain the bladder/bowel functions (and i expect many other benefits). So i'm seeking a trial with the device used so i can explore doing 6-6-6 at home for as long as it takes to recover functions!

The trial is on hold until spring 2021 so 6-6-6 DIY is our only option right now. Not sure if funding of Covid caused the recent delay in the trial.

cheers, dan