A group of Polish scientists and English physicians may have restored some function and sensory sensation to a 38-year-old man who sustained a traumatic transection of the spinal cord at the T9 vertebra.
By removing one of his olfactory bulbs and transplanting his own olfactory ensheathing cells (OECs) and olfactory nerve fibroblasts (ONFs) into the damaged area along with a nerve “bridge” constructed between the two stumps of the damage spinal column, the researchers saw some voluntary limb function and sensation recovery during a 19-month follow-up.
“After OEC transplantation and the building of the nerve bridge, this patient improved from ASIA A to ASIA C,” Pawel Tabakow, MD, PhD of the Department of Neurosurgery at the Wroclaw Medical University in Wroclaw, Poland, stated in a press release. “Prior to the transplantation, we estimated that without this treatment, our patient’s recovery chances were less than 1%. However, we observed a gradual recovery of both sensory and motor function that began 4 months after the surgery.”
Olfactory ensheathing cells are a type of cell that resides in both the peripheral and central nervous system. Together with ONFs, they make bundles of nerve fibers that run from the nasal mucosa to the olfactory bulb where the sense of smell is located. The technique of bridging the sectional spinal cord using autologous (derived from the patient) sural nerve grafts has been used in animal studies for 3 decades, but never in combination with OECs, commented the researchers.
“The OECs and the ONFs appeared to work together, but the mechanism between their interaction is still unclear,” said Geoffrey Raisman, MD, PhD, FRS, professor at the Spinal Repair Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology in London.
The researchers stated that further laboratory studies would be needed to better understand the interactive properties between the human OECs and ONFs within the nerve bridge.
“While this study is only in one patient, it provides hope of a possible treatment for restoration of some function in individuals with complete spinal cord injury,” John Sladek, PhD, Cell Transplantation section editor and professor of neurology and pediatrics at the University of Colorado School of Medicine stated in the release. “Determination of the precise mechanisms of action, repetition in more patients and more long-term follow-up are all necessary to help validate whether this promising procedure is of clinical relevance.”
Disclosure: The authors have no relevant financial disclosures.
Tabakow P. Cell Transplant. 2014; doi:http://dx.doi.org/10.3727/096368914X685131.