Research Projects in Focus

from Wings for Life Magazine - Edition No. 10

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Projects Focusin

As you read this, numerous bright minds are researching a cure for spinal cord injuries. They strive to achieve their objectives by exploring a wide range of ideas, methods, and approaches. Here we shine the spotlight on seven research projects.

Interceptors in the blood

Tracking down the scar

THE MEDICAL COLLEGE OF WISCONSIN, INC., NEUROSURGERY, USA

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Tissue damage caused by a spinal cord injury occurs in two phases. Following the initial trauma inflicted by the accident, subsequent damage is incurred through haemorrhage and inflammation. Blood degradation products have a toxic effect and can further exacerbate inflammation. German scientist Antje Kroner-Milsch is researching methods to reduce the resulting damage to a minimum.

An enrichment with interceptor proteins aims to help bind the toxic blood pigment known as “haem”. The research lab in Wisconsin focuses on patients who have suffered a high-level spinal cord injury that affects many bodily functions. The hope is to contain secondary damage with the interceptor proteins and prevent haemorrhage and inflammation from occurring after the accident.

KAROLINSKA INSTITUTE, STOCKHOLM, SWEDEN

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Photos: Wimmer Photography, Erik Cronberg The human body typically does not repair damaged tissue. Instead, it replaces it with permanent scar tissue. However, such scar tissue impedes nerve growth. Christian Göritz and his team have therefore embarked on a search for the driving forces behind this scar formation. In doing so, they encountered connective tissue cells, so-called pericytes, which could play a key role in the process. These cells are usually located on the vascular wall.

The researchers are investigating which molecules and immune cells are responsible for the migration of these cells. This insight would help to develop drugs capable of limiting scarring to a minimum in the future. The intention is to improve regeneration of nerve fibres and functional recovery.

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Harnessing serotonin for improved movement

UNIVERSITY OF LOUISVILLE, KENTUCKY SPINAL CORD INJURY RESEARCH CENTRE, USA

A spinal cord injury destroys nerve cell extensions, so-called axons. This results in the direct breakdown of nerve connections. Consequently, the chemical signalling molecules can no longer be spread as effectively throughout the spinal cord. One of these important transmitters is serotonin, widely known in brain research as the “happiness hormone”.

There are several types of electrotherapies. Paralysed muscles can be activated briefly by electrical stimulation. Other procedures focus the electrical stimulus on central nerve tissue (brain and spinal cord) or peripheral nerve tissue. Both applications involve attaching electrodes to the skin. Kei Masani and Dimitry Sayenko from Canada combine both methods

An elevated serotonin level in the spinal cord could restore a certain level of motor function via the preserved nerve cell extensions. This highly interesting approach is currently being pursued by Jessica D’Amico and David Rouffet of the University of Louisville, USA. They are investigating whether patients with individually dosed serotonin tablets experience an increase in nerve excitability during movement training.

to stimulate spinal cord and muscles simultaneously. This dual electrotherapy is designed to enable patients to stand freely without relying on assistive devices. Their goal is to develop a pair of leggings that incorporates the relevant technology. To achieve stable standing, however, they must first lay the foundations for such a combination therapy.

Electricity enables self-sustained standing

TORONTO REHABILITATION INSTITUTE, TORONTO, CANADA

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5 The mystery of immune defence

UNIVERSITY OF CAMBRIDGE, CLINICAL NEUROSCIENCES, UNITED KINGDOM The exact pathological processes that take place in our body after a traumatic spinal cord injury have not yet been deciphered. However, chronic inflammation likely plays a central role in cell death and scar formation. The inflammation is fuelled by resident immune cells, the microglia, and by patrolling phagocytes from the blood, the macrophages, alike. It is difficult to determine which role each cell type plays in the processes, not least because migrated phagocytes appear in the same guise as microglia.

Stefano Pluchino and his team from Cambridge hope to solve the mystery of the two cell populations. Genetic analyses and fluorescent markers, i.e. the fluorescent labelling of cells, assist them in doing so. The researchers plan to use this approach to unravel the exact sequence of the inflammatory reaction.

Searching for the right kind of stem cell

TEXAS A&M UNIVERSITY, BIOLOGY, USA

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Stem cell transplantation promises a great deal of hope for a cure. Transplanted neural progenitor cells can generate different types of new nerve cells at the injury site. They are incorporated into the injured nervous system via neural connections. This makes the cells attractive candidates for restoring motor networks.

Resounding success has, however, failed to materialise to date. One reason for the lack of effective recovery could be that too little is known about the tasks and potential of the different nerve cell types. For example, the question arises as to which cell types are required to interact in order to restore leg movement. Scientist Ashley Tucker is currently studying this question in California. The results are expected to take research an important step forward in developing stem cell transplantation for humans.

A group of scientists from Lausanne, headed by Grégoire Courtine, recently succeeded in enabling chronically injured patients to retake their first steps. This project garnered considerable attention at the time. The researchers applied electrical spinal cord stimulation at the level of the lumbar spine and combined it with robot-assisted gait rehabilitation.

Now, they are trying to transfer the concept to patients with a high-level spinal cord injury (quadriplegics). The higher a spinal cord injury occurs, the more it impairs bodily functions. These patients are particularly interested in regaining the ability to move arms and hands. It is still necessary to conduct preliminary experiments to find out how to also restore arm and hand function through stimulation. The researchers are developing protocols that entail the correct anatomical starting points and optimal timing. In combination with rehabilitation, the treatment is intended to improve the grasping movement of hands.