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  • Originally posted by Young
    Actually olfactory ensheathing glia can also myelinate axons in the spinal cord.
    In regards to the Geron trial, how does an OEG get into the spinal cord if Geron is utilizing a purified, well differentiated population of oligodentrocytes?

    Comment


    • Originally posted by Schmeky View Post
      In regards to the Geron trial, how does an OEG get into the spinal cord if Geron is utilizing a purified, well differentiated population of oligodentrocytes?
      You pointed out that you are only aware of two cell types that myelinate the spinal cord and asked if any other cell would remyelinate the cord. So, I pointed out that OEG's would. Both endogenous and exogenous oligodendroglia will remyelinate axons in the spinal cord.

      In the case of Geron's trial, myelination by exogenous oligodendroglia may not necessary be associated with more improvement than in untreated patients because remyelination is going on in the acutely injured spinal cord by both endogenous oligodendroglia and Schwann cells.

      However, if there is immune rejection of the transplanted cells, there may be delayed demyelination and loss of function.

      Wise.

      Comment


      • Originally posted by Wise Young View Post
        • Despite my concerns, I think that the trial is worthwhile and ethical. The trial has three outcomes. First, the subjects show worsening due to the cells becoming tumors. This is in my opinion unlikely. But, if it happens, this would lead to a strong recommendation against using these cells. It would raise the hurdles for future trials of human embryonic stem cells. Second, the subjects show no change. I think that this is the most likely outcome. The cells may have been rejected and did nothing. It could also mean that the cells were present, remyelinated, and did not improve function. In both cases, the absence of complications would allow the trial to go ahead to a phase 2 or 3. My guess is that the company may not be able to raise the money to go on. Third, the subjects show some improvement of function. In that case, there will be great enthusiasm for the treatment to go into further trials.


        • I don't expect the cells to survive a lifetime. I hope, however, that with HLA-matching that they will survive long enough to provide a temporary bridge that allows axons to cross the injury site. The longer they survive, the better I think that regeneration will be. In any case, we will be giving the lithium for only 6 weeks. In rats, we have seen them survive up to 12 weeks (which I guess would be perhaps equivalent to a year in humans). It is interesting that cord blood cells do not seem to evoke an glial response in the spinal cord, suggesting that the glial cells are regarding them as part of the central nervous system.

        Wise.
        Dr.Young,

        Could this hypothetically mean, as cord blood cells do not evoke a glial response in the spinal cord, that they could be the perfect cell type to get axons to grow through the gliosis at the injury site, therefore bypassing the need for things like Decorin or Chondroitinase? Thanks in advance for your reply.

        Comment


        • Originally posted by zokarkan View Post
          Dr.Young,

          Could this hypothetically mean, as cord blood cells do not evoke a glial response in the spinal cord, that they could be the perfect cell type to get axons to grow through the gliosis at the injury site, therefore bypassing the need for things like Decorin or Chondroitinase? Thanks in advance for your reply.
          Zok, I don't know. Decorin and chondroitinase may still be helpful.

          At the time that I chose to do the trial, there were not many GMP (good manufacturing practice certified) sources of cells to choose from. Bone marrow and umbilical cord blood were the only ones that could be HLA-matched or autografts. I chose cord blood because it is well tolerated by the spinal cord, sticks around where it is transplanted without migrating everywhere, and has a long history of safe use in humans.

          I considered fetal OEG and neural stem cells but rejected them because neither the quality nor availability of the cells could be assured. I considered but rejected nasal mucosa because I didn't think that the data was convincing and the method of transplantation used by Carlos Lima was acceptable. We continue to have discussions with Geron, Celgene, other companies that have cells that may be candidates.

          Another important reason for testing umbilical cord blood mononuclear cells in clinical trial is that many clinics are charging people money to treat them with umbilical cord blood. I am very skeptical that the cells can be given intravenously or even intrathecally to have beneficial effects. If you implant the cells in the spinal cord, you don't have to assume anything about their passage through the blood brain barrier or the number of cells that would get there.

          Wise.
          Last edited by Wise Young; 03-12-2009, 08:09 AM.

          Comment


          • Question

            Dr.Young,I from Taiwan

            I have a question.

            CN102b has started to experiment?Which time will have the result?

            Because of TaiwanTzuchi,Did not have any progress.

            Comment


            • Originally posted by Yao 璘 View Post
              Dr.Young,I from Taiwan

              I have a question.

              CN102b has started to experiment?Which time will have the result?

              Because of TaiwanTzuchi,Did not have any progress.

              same question here Dr. Young.....

              Comment


              • Originally posted by TEMO View Post
                same question here Dr. Young.....
                CN102B has not yet started. Wise.

                Comment


                • Originally posted by Wise Young View Post
                  CN102B has not yet started. Wise.
                  CN102B has not yet started. Wise.

                  Dear wise!

                  Please tell us when to start?

                  Comment


                  • Originally posted by christina-china View Post
                    CN102B has not yet started. Wise.

                    Dear wise!

                    Please tell us when to start?
                    I am hoping that it will start at the beginning of 2010. As soon as I know that recruitment is starting, I will post here. It will also be posted on http://clinicaltrials.gov.

                    Wise.

                    Comment


                    • Originally posted by Wise Young View Post
                      I am hoping that it will start at the beginning of 2010. As soon as I know that recruitment is starting, I will post here. It will also be posted on http://clinicaltrials.gov.

                      Wise.
                      Mr. wise!

                      Forum in China, the partners have begun to argue CN102B program has begun which, I would like to know the exact answer! ! !

                      There are too many successful people who look forward to your good news! There are too many people wish to be a successful treatment! ! !

                      Because we very much hope to be healthy! ! !

                      Thank you for everything! ! !

                      Comment


                      • Originally posted by christina-china View Post
                        Mr. wise!

                        Forum in China, the partners have begun to argue CN102B program has begun which, I would like to know the exact answer! ! !

                        There are too many successful people who look forward to your good news! There are too many people wish to be a successful treatment! ! !

                        Because we very much hope to be healthy! ! !

                        Thank you for everything! ! !
                        Christina, I had posted an announcement: /forum/showthread.php?t=129584

                        We held the meeting and more than a dozen people have signed up for screening interviews. The doctors are contacting patients that they know and have written to them. A second meeting may be scheduled. If so, I will announce it here as soon as I know.

                        I don't know how long the screening process will take. We are hoping to find 20 qualified subjects before the Chinese New Year. The trial probably will not start until we find all 20 subjects, so that we can randomize them to the treatments.

                        We are still test-shipping cells between California and Hong Kong and making sure that everybody on both sides of the Pacific are doing the right things with the cells and they match stringent quality requirements.

                        At the present, we are recruiting subjects only from Hong Kong. The reason is because the subjects need to be Hong Kong residents to take advantage of the hospital facilities that are doing the surgery.

                        Wise.

                        Comment


                        • Originally posted by Wise Young View Post
                          Christina, I had posted an announcement: https://www.carecure.net/forum/showthread.php?t=129584

                          We held the meeting and more than a dozen people have signed up for screening interviews. The doctors are contacting patients that they know and have written to them. A second meeting may be scheduled. If so, I will announce it here as soon as I know.

                          I don't know how long the screening process will take. We are hoping to find 20 qualified subjects before the Chinese New Year. The trial probably will not start until we find all 20 subjects, so that we can randomize them to the treatments.

                          We are still test-shipping cells between California and Hong Kong and making sure that everybody on both sides of the Pacific are doing the right things with the cells and they match stringent quality requirements.

                          At the present, we are recruiting subjects only from Hong Kong. The reason is because the subjects need to be Hong Kong residents to take advantage of the hospital facilities that are doing the surgery.

                          Wise.
                          Mr. wise!

                          Thank you very much timely reply!

                          Looking forward to the process faster and more!

                          To support you!

                          Christina

                          Comment


                          • Suggestion

                            Dr. Young
                            I knew that you have a lecture in Hong Kong in August 29
                            Why hasn't managed the lecture which in Taiwan exchanges with the patient?

                            Comment


                            • Wise, will you have an update on the trial when you visit Hong Kong in August? Have we made any progess on starting the trial sonce your last post?

                              keeping on

                              Comment


                              • Dr. Young

                                Now had the new progress?

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