Wings for LIFE - Edition No. 2

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We have one goal: Make spinal cord injury curable.

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EDITION NO. 2

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SPINAL CORD RESEARCH FOUNDATION

Suddenly Paralysed A young man shares his story

Fundraising Triathlon

Joy and agony in three stages

Pioneering Work

A portrait of Samuel David

Under Pressure New monitoring technique in the ICU

David Lama

Extreme-Alpinist and Wings for Life Supporter

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FOREWORD

IMPRINT Wings for Life International Spinal Cord Research Foundation Fürstenallee 4 5020 Salzburg Austria

Dear friends and supporters, Spinal cord injuries happen in the blink of an eye and change lives

Phone: +43-662-6582-4244

forever. Every year, more than 250,000 people are confronted with

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this heartbreaking diagnosis, often accompanied by the painful words,

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“You’ll probably never walk again.” The majority of those diagnosed

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hadn’t even put themselves at risk; they were merely in the wrong place

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at the wrong time. This is exactly what happened to Yoshij Grimm,

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a fun-loving, successful young man in his prime. The day that changed

Chief Executive Officer:

his life forever started like any other… but then he was hit by a truck

Anita Gerhardter

on his way to work. The Berlin-born youngster was left paralysed from

Wings for Life United Kingdom

the chest down and is still struggling to come to terms with his fate.

155-171 Tooley Street London SE1 2JP Great Britain

Not many people know that the initial trauma – usually a contusion

UK Registered Charity No:

of the spinal cord – is followed by secondary damage. Inflammatory

1138804

reactions (see page 16) and swelling result in further damage to

Contributors:

the neural tissue, which, in turn, worsens the extent of the injury.

Vieri Failli, Wolfgang Illek,

Besides general ICU treatment and surgical care, there are no specific

Rosi Lederer, Verena May Editors: Marco Gröbner,

treatments to prevent nerves from dying. At least, not yet. However,

Stefanie Spreitzer

science has good news in terms of acute care: two researchers from

Creative Director: Dominik Uhl Photo Editor: Markus Kučera

London have found out that the level of paralysis can be reduced

Lithography: Clemens Ragotzky

with optimal blood circulation and ideal pressure conditions within

Translation: Manfred Thurner

the injured spinal cord. They hope to see their methods set new

Chief Sub-Editor: Nancy James Deputy Chief Sub-Editors:

standards of treatment in just five years’ time (page 18).

Davydd Chong, Lucy Cripps Managing Editor: Lisa Blazek

Cover Photo: Richie Hopson

Producer: Matthias Zimmermann

This impressive study is financed by your donations. Many more

Creative Consultant: Boro Petric

research projects of this kind are required before we can reach our

Acknowledgement:

ultimate goal of curing spinal cord injuries. It is faithful, committed

We would like to express our

supporters like you who give us hope that our goal is achievable.

gratitude to Sappi Fine Paper and Red Bull Media House for producing this magazine

Thank you for your ongoing support,

free of charge.

Your Wings for Life Team ... LIFE | 3

START

For comparison

CONTENTS

France

EDITION NO. 2

Epidemiology

Approximately 840 traumatic spinal cord injuries every year Incidence: 12.7 people in one million affected per year

4

Spinal cord injuries facts and figures.

Did you know that‌

6

Sports

... many paralysed patients experience difficulties when coughing?

Snapshot

Other causes 21%

8

Aron Anderson scaled a spectacular cliff in Norway, despite his spinal cord injury.

I Used to Feel so Free

Falls

8% 47%

Road accidents

24%

10

Tetraplegia

Paraplegia

16

49%

51%

Berlin-born Yoshij Grimm opens up about his serious accident and how it changed his life.

The Yin & Yang of our Immune System Why inflammatory reactions following a spinal cord injury also have a dark side.

Under Pressure

Mortality within one year after the accident tends to zero 18

Two researchers from London are working on new monitoring techniques for the ICU, in the hope of preserving the important bodily functions of acute spinal cord injury patients.

The Pioneer

South Africa

Approximately 1,530 traumatic spinal cord injuries every year Incidence: 29 people in one million affected per year

26

At the beginning of the 1980s, Samuel David proved that nerve cells within the spinal cord are capable of regeneration.

Gift Ideas

Other causes 6% Falls

8%

30

Spread festive joy and support a good cause by giving one of these gifts.

Editorial, Imprint

25%

61%

Violence

32

How two Brits and an Austrian completed a triathlon and raised more than 70,000 euros for spinal cord research in the process.

3

Photo: iStockphoto.com

Joy and Agony in Three Stages

Road accidents

Tetraplegia

Paraplegia

25%

75%

13% die within one year 4 | WINGS FOR ...

after the accident

Spinal Cord Injury

Epidemiology Global

250,000 More than

Tetraplegia

47%

Paralysis of the torso muscles, the lower limbs and the arm muscles

traumatic spinal cord injuries every year

9% Other causes

53%

Paralysis of the torso muscles and the lower limbs

Sports

17%

Paraplegia

50%

Road accidents

24% Falls

Average age:

25

Ratio:

Life expectancy for people with spinal cord injuries has increased in developed countries since the 1950s. Between 1973 and 2004, there was a 40% decrease in mortality during the first two years post-injury. The reason: better medical care.

These numbers are partially based on extrapolation and estimation. A detailed review of spinal cord injuries worldwide is currently impossible; many countries do not even do a survey. Even if a country is monitoring patients with spinal cord injuries, only one-tenth of the population (or even less) is captured by the survey. In addition, there is no international standardised method of assessment.

Source: Global prevalence and incidence of traumatic spinal cord injury. Singh A, Tetreault L, Kalsi-Ryan S, Nouri A, Fehlings MG. Clin Epidemiol. 2014 Sep 23; 6:309-31.

SPINAL CORD INJURY

Respiratory training at the Swiss Paraplegic Centre: patients with better respiratory muscles have a stronger voice and are better able to cough.

6 | WINGS FOR ...

Did you know that

Photo: Walter Eggenberger

many paralysed patients experience difficulties when coughing?

A fter catching a cold, most people don’t worry too much about when and how they cough. They just do it. I was exactly like them, until I had a serious and life-altering bicycle accident in 2004. I sustained injuries to my spinal cord in the cervical area, which resulted in high spinal cord injury .

As a result, my entire immune system shut down, which ultimately led to severe pneumonia. I tried so hard to cough up the mucus, but I did not succeed. I found that I could not produce more than a rattling breath. I panicked and thought I was about to suffocate. In the end, the mucus had to be suctioned, which is a painful process.

The doctors told me that the paralysis had also affected my breathing. The higher the paralysis is, the fewer muscles you have as support for breathing and coughing.

Coughing is a hugely important protective reflex of the lungs; it ensures that the respiratory tract remains clear. Coughing removes anything that blocks the human airway.

In my case, the most important muscle for breathing, the diaphragm, is fortunately still fully operational. The same does not, however, apply to my intercostal muscles.

This means that I need to rely solely on my diaphragm and neck muscles for both breathing and coughing.

Today – 11 years after my accident – I use a technique that helps me to cough: I try to compress my abdomen and diaphragm through a rapid forward movement of my upper body. This allows me to squeeze out the air faster.

Nevertheless, I am very careful not to get ill, especially during the colder months.

I am always very concerned that a common cold could escalate quickly into lifethreatening pneumonia.

Wolfgang Illek is a project manager at Wings for Life. ... LIFE | 7

Photo: Aron Anderson

SNAPSHOT

8 | WINGS FOR ...

This photo shows 27-year-old Aron Anderson from Sweden.

The professional adventurer and motivational speaker had just scaled the Trolltunga, a spectacular cliff ledge in south-western Norway.

Following an incomplete spinal cord injury to his lower back (L3 level), he still has limited leg movement if he uses immense physical effort. “The bad weather – with rain and snow – made the climb more difficult.

Nevertheless, I continued to push myself on my crutches,” he says.

It usually takes climbers eight hours to reach the top. Aron, who faced the challenge with friends, took 22 hours.

“The feeling of sitting in a place that I only knew from photographs was both frightening and incredibly moving at the same time.”

... LIFE | 9

SPINAL CORD INJURY

“I Used to Feel so Free” Photo: Andreas Brandl

Yoshij Grimm really lived life to the fullest. He was athletic, popular and had a highly successful career. Then an accident changed everything. Today, the 24-year-old is ready to share his story with us.

10 | WINGS FOR ...

... LIFE | 11

SPINAL CORD INJURY

YOSHIJ’S SIGNATURE ROLE “Voice acting brought me much more pleasure than acting – you don’t have to be creative.

You have a clearly defined project, need to be fully alert and there is only one way to get it right.” Yoshij learned quickly, which is evident in his skill for language and accents. “I find it easy to immerse myself in specific roles and moods, which led to my being successful in the field fairly quickly,” he says, while recalling his early professional talents. At 12 years old, he was doing voice-over work for movies and performing in radio plays on a regular basis.

His signature role is Peter Shaw in the German kids’ version of The Three Investigators. “This particular character is often a little timid, but still athletic and adventurous. It was a part I felt I was born to play.”

IN THE FAST LANE In line with the film hero’s character, Yoshij was eager to try everything. He was a member of a gymnastics and trampoline club, he 12 | WINGS FOR ...

practised Capoeira, excelled at wakeboarding, snowboarding, and skateboarding, and climbed with the county youth squad of Berlin. “I discovered my love for motorcycles when I was 15,” he says. “I got into trial motorcycling and become a trainer and guide for Enduro Motocross. I was on a motorcycle as often as I could be.” After completing his A levels, Yoshij started studying philosophy and German literature. “I financed my hobbies with voice acting. I only really started studying out of general interest. I would study and work during the week and follow my passion for motorsport at the weekends. And I went out to all the big clubs in Berlin where I knew a thousand people. It was perfect!”

TORN FROM LIFE The athlete becomes serious when he talks about the events that played out on June 17, 2014, two days after his 23rd birthday. It normally took him no more than five minutes to travel from his home to the dubbing studio.

Yoshij rode his motorcycle past a green light at the 50km/h speed limit. “A truck in the opposite lane simply ignored all the traffic and turned left. It took my right of way. I didn’t stand a chance.” His account is 100 per cent in line with the official police report.

Yoshij’s condition was critical, and he owes his survival to mere chance. An ambulance was parked just around the corner and was able to reach the scene of the accident within a few minutes. “At exactly that time, a paramedic who had spent a long time in the cardiac surgery department of Berlin’s Charité hospital was on duty.

1. Yoshij in front of his 1980s Suzuki in spring 2012 2. Summer 2010 – at the prom with good friends 3. The traffic-light controlled junction where Yoshij had his accident 4. July 2014 – Vivantes Klinikum Neukölln a few weeks after the accident 5. Early-stage rehab in BeelitzHeilstätten with his sister Luizza in September 2014 6. Yoshij’s first physiotherapy attempts

Photo: private

M

y life was brilliant. I was an athlete and a voice actor – I got to travel a lot. Then everything changed because a truck driver didn’t give me the right of way.” While 24-year-old Yoshij Grimm tells his story, he often stares into space. He strives to come across as strong and to smile every now and then, but he has to fight back tears time and time again.

Yoshij was born in Berlin, where he lived with his older sister and single mother. “I was quite active, even as a child. I tried nearly every sport there is,” he recalls. At six years of age, his then-best friend was offered a role in a movie. “It was so cool that I wanted to be a part of it too,” he says. Yoshij’s mum signed him up with an acting agency, and he was soon offered parts in German TV productions.

“It was all very exciting for me, but I soon realised how conceited and off-track all the other child actors were.”

“A truck in the opposite lane simply ignored all traffic and turned left. It took my right of way. I didn’t stand a chance.”

3

1

2

5

6

4

7

9

8

10 11 12

“Slowly but surely, I realised that my spinal cord was injured beyond repair.”

Photo: private

7. Music therapy during early-stage rehabilitation 8. Exercise during physiotherapy – ground-towheelchair transfer 9. Yoshij with two friends in November 2014 as he attempts to stand on parallel bars outside an official rehab unit 10. The voice actor during his regular breathing and speech exercises 11. At Lake Linow with friends 12. Yoshij wants to record a new episode of The Three Investigators Kids in the studio

“My vertebrae were injured; I had a thorax and brain trauma, and my broken ribs had punctured my lungs. Luckily, the paramedic with his vital experience knew how to apply the respiration technique correctly. He saved my life.” Yoshij was admitted to hospital with serious injuries. “After the accident, I was unconscious. I underwent emergency surgery and was then placed in an artificial coma for three weeks. All body functions were shut down.” When he finally woke up, he had all but forgotten his previous life.

INJURED SPINAL CORD In the following weeks, the voice actor was haunted by severe panic attacks. “After two months, I was transferred to Belitz for earlystage rehab work. I still needed artificial respiration at that point. I woke up and didn’t know where I was for weeks. I’d feel an urge to run away, scream, and fall back asleep again.”

Then he started to remember his past. He began to recognise his mother and Lulu, his sister. “I noticed a beautiful young woman at my bedside and figured that she must be my girlfriend.” His family and friends repeatedly tried to help Yoshij remember what had happened. They told him that he had been seriously injured in an accident. They tried to help him come to terms with the fact that he would remain paralysed from the chest down for the rest of his life. “Slowly but surely, I realised that my spinal cord was injured beyond repair. I began to realise that I couldn’t feel or move anything below where my spinal cord was broken,” he remembers with a blank look on his face.

LOSS OF FREEDOM Yoshij went through seven months of rehabilitation. “There were only three people younger than 40 in the facility. Eighty per cent of the people there were stroke patients. I couldn’t bear that I actually belonged there.

I often thought it would have been better if I had been killed in the accident.”

Yoshij slowly regained full consciousness.

“The clearer I became in my head, the more I felt the loss. I became more and more aware of what I could no longer do and what I will never be able to do again due to my spinal cord injury.” One of the worst blows was the realisation that the spinal cord injury would prevent any future involvement in motorsport. “I had spent years jumping all over the place and I used to feel so free everywhere I went. I imagined a jump in my head and I was able to go and make it happen. I have lost that ability forever.”

Yoshij returned home nine months after his injury. Countless friends, who had already visited him in hospital and at the rehabilitation clinic, continued to pop round to talk about the past and make plans for the future. “I still can’t fully remember my girlfriend from that time. Today, our contact is minimal,” he says.

HOPE FOR CURE Yoshij is still unable to return to work and university. His head injuries were too severe, so he is still struggling with his limited memory capacity and the serious consequences of his spinal cord injury. However, his aim is to return to the voice acting business soon and possibly even go on to directing. He puts all his hope in Wings for Life. “Spinal cord injuries should not enslave us for the rest of our lives. I strongly believe that research is progressing and that some kind of cure will be found. I don’t care if it takes 10 or 15 years, as long as my life can be like the life I loved so much before my accident.” ... LIFE | 15

RESEARCH

Neuroinflammation

The Yin & Yang of our Immune System After sustaining a spinal cord injury, a patient’s inflammatory responses get to work quickly to repair damaged nerve tissue. However, this response by our immune system also has a detrimental effect.

16 | WINGS FOR ...

around the injury, so they end up contributing significantly to what is known as secondary injury. Secondary injury is best described as a wildfire that spreads rapidly in the first few days after the trauma and worsens the initial injury. As a result, patients with spinal cord injuries lose additional bodily functions.

So, healing and damaging processes are closely interlinked, like yin and yang.

Research aims to influence this delicate balance in favour of the patients. An ideal scenario would be to initially contain the wildfire, thereby reducing the harmful effect of neuroinflammation. In a second step, medication or therapy could stimulate the growth of damaged cells. The combination of both promises a significant recovery of neural tissue and the rescue of the patients’ important bodily functions.

Although it is difficult, in practice, to really make any difference to the balance, some therapies are being tested on patients with spinal cord injuries. There is hope that, in the not too distant future, it will be possible to decrease the effect of the dark side of neuroinflammation (yin) and promote the positive effects (yang).

Right, is a microscopic image of spinal cells (red) and immune cells (green). It symbolises the positive and negative effects of immune cells on post-injury regeneration.

Graphic: Vieri Failli

I

t happens quicker than you’d think: a slip of the knife while chopping vegetables or a finger cut on some broken glass.

Lacerations are commonplace. The human body responds automatically to injuries like this with inflammation (Latin, Inflammatio).

An army of white blood cells and other cells are immediately dispatched to the wound.

There they destroy bacteria and heal the damaged tissue. As soon as you feel the signs of inflammation, such as heat or swelling, the healing process is already well underway.

A spinal cord injury also triggers an inflammatory response in the nerve tissue.

The technical term for this reaction is neuroinflammation. The processes are similar to those triggered by a cut finger. At first, the blood platelets attempt to stop the bleeding in the spinal cord. Then highly specialised immune cells remove damaged tissue debris and start repairing the injury with specific molecules, and a scar forms to seal the wound. These are the positive effects of neuroinflammation.

Unfortunately, neuroinflammation also has a dark side. The immune cells release substances that damage healthy neural tissue

EXTRACT OF THERAPEUTIC APPROACHES TO NEUROINFLAMMATION Therapy

Effect

Phase

Hypothermia

This therapy lowers the body temperature to between 32 and 34 degrees Celsius in order to prevent the damaged tissue from dying.

Clinical Phase-II Study in preparation

Minocycline

This antibiotic has far-reaching impacts that go beyond its antibacterial effect. Among other effects, it protects neurones, is anti-inflammatory, and inhibits programmed cell death.

Clinical Phase-III Study underway

Oestrogen

The female hormone oestrogen is a real all-rounder. It reduces oedema in the neural tissue, slows the penetration of inflammatory cells and curbs the loss of myelin (insulating layer of nerves).

In pre-clinical phase

... LIFE | 17

Photo: Richie Hopson

CLINICAL STUDY

18 | WINGS FOR ...

Under Pressure

Doctors in the intensive care unit (ICU) stabilise patients with spinal cord injury when they arrive. To date, it has not been possible to monitor the damaging reactions within the spinal cord itself. Now, two researchers from London are striving to change this in order to save the patients’ important body functions.

Their special field of expertise: the pressure within the injured spinal cord. ... LIFE | 19

CLINICAL STUDY

PRESSURE IS KEY It is the hunt for ways to limit secondary injury and to prevent intact nerves from dying on which Professor Marios Papadopoulos and Doctor Samira Saadoun from St George’s University Hospital in London have focused their research. The two have been a team for the past 15 years: he is a doctor, she, a researcher. Together they form the perfect symbiosis for pursuing a science project that

SECONDARY INJURY Following the initial trauma, cell death automatically releases substances that trigger inflammatory reactions

is destined to work its way from their laboratory and into clinics.

“Our goal is to improve the early care of patients with spinal cord injuries,” says Papadopoulos, who completed his studies at the elite universities of Cambridge and Oxford. To this end, he and his scientific colleague, Saadoun, focus primarily on the pressure in the injured spinal cord. The injury leads to inflammation and swelling, which increases the pressure in the spinal cord, which, in turn, is bad for nerve cells.

“The higher the intraspinal pressure, the more nerve cells are destroyed,” explains Saadoun, a neuroscientist born in Morocco.

The problem is that the exact pressure in an injured spinal cord has never been determined before. It is also impossible to determine the optimal pressure conditions to protect the spinal cord from further damage.

Currently, there is no clinical monitoring of the reactions within the spinal cord. Until now, early treatment focuses primarily on stabilising the patients’ general vital functions and – if necessary – on repairing the bone fracture. In the case of patients with severe brain injuries, medical management is different: in addition to life-sustaining measures, their brain pressure is monitored and adjusted in the ICU to reduce brain damage risk.

in the tissue, which, in turn, leads to swelling. This results in further

MULTI-MODAL MONITORING

tissue damage and worsens the

In their clinical study, Papadopoulos and Saadoun use a similar technique. After

extent of the injury.

20 | WINGS FOR ...

The probe for monitoring the intraspinal pressure is normally used for traumatic brain injuries.

It has a diameter of 1.2mm. Data is transmitted via a 0.7mm thin nylon cable.

Photos: Richie Hopson

I

mmediately after injuring his spinal cord, Peter was still able to speak, move his arms, and call for help. However, his condition had deteriorated dramatically after just a few days. When he awoke from artificial deep sleep, a tube was protruding from his throat. Peter needed artificial respiration; he was neither able to communicate with his voice nor his arms. It was a nightmare within a nightmare. Many victims of spinal cord injuries share Peter’s fate. Spinal cord injury worsens after the accident and patients lose control of further bodily function in a process called secondary injury, which can be even more serious than the initial injury.

At St George’s, Professor Papadopoulos and Dr Saadoun are perfectly placed for their clinical study, with the research laboratories and the ICU not far apart.

“The higher the intraspinal pressure, the more nerve cells are destroyed.”

Dr Saadoun

Until now, early treatment focuses primarily on stabilising the patients’ general vital functions such as breathing and blood pressure.

... LIFE | 21

CLINICAL STUDY

“We don’t know what exactly happens inside the human spinal cord.

Not yet…”

Professor Papadopoulos

Computer tomography determines whether the probes are in the right place.

The probes can only be used once. One probe costs around 700 euros.

Photos: Richie Hopson

Papadopoulos uses a microscope to place the probes on the spinal cord. The surgery takes around 15 minutes.

stabilising the spine of a trial participant, Papadopoulos places a probe on the surface of the injured spinal cord. This can be done without additional surgery. The probe measures the spinal pressure at the site of injury. Data is transmitted from the probe within the body to a computer via a thin nylon cable. Subsequently, the neurosurgeon attaches a second probe to the tissue. This second probe provides information about the metabolic condition in the spinal cord.

“The micro-dialysis probe allows us to determine the metabolism of the injured cells. Are the cells still alive? Are they getting enough oxygen? Are they getting enough food? Are toxic substances building up inside the tissue?” explains Saadoun, who had the idea for this project back in 2008.

The probes remain in the patient’s body for one week, during which time, the gathered data is constantly investigated. An increase

in pressure, in combination with a worsening of tissue metabolism, presents a warning sign for the physicians. “In such cases, we need to urgently relieve the high pressure,” says Papadopoulos. One possible way to achieve this is decompression, which means that parts of the vertebrae are surgically removed to give the swelling more room.

Papadopoulos and Saadoun argue that the dura mater, a thick membrane surrounding the spinal cord, should also be cut open to relieve the spinal cord pressure.

“In addition”, says Saadoun, “we have found that lying the patients on their side, rather than on their back, can further reduce the pressure.” Another means of regulation is the perfusion pressure or blood flow. Among other things, the high tissue pressure compresses the blood vessels. As a consequence, the blood flow is impaired. The tissue does, however, need an optimal blood ... LIFE | 23

CLINICAL STUDY

PROMPT SURGERY Papadopoulos and Saadoun have already monitored 42 patients at St George’s in this manner. Thirty more will follow. As is common in all clinical studies, all participating patients have to meet the study’s strict criteria and give their informed consent. In line with current care standards, many patients only undergo surgery one to two days after the accident, which means there is sufficient time to inform them about the study and how to participate. While the timing makes implementing the study easier, Saadoun believes it is, however, not ideal for the patients: “In our experience, one should not wait for the surgery. The spinal cord needs to be monitored straight away.”

LEVEL OF PARALYSIS DECREASES So far, Papadopoulos and Saadoun have not identified any major side effects. “Initially, we were worried that infections could occur or that the probes would cause further spinal cord damage. These worries have not been confirmed,” says Papadopoulos. This makes the positive results of the study all the more impressive. As soon as Papadopoulos and Saadoun optimise the spinal cord perfusion pressure, patients often find their ability to feel below the injury site has improved, so the level of paralysis has decreased. Therefore, Papadopoulos dares to be optimistic for a time when their technique becomes more widespread. “Some patients who would normally be completely paralysed will be able to leave the hospital with partial paralysis. In other cases, we will be able to decrease the level of paralysis by one or more segments. It does make a huge difference, after all, if you can move your fingers or not.”

24 | WINGS FOR ...

OPEN QUESTIONS The study will continue for at least another three years, and the researchers hope to gain further insights during this time, to determine the optimal pressure conditions in real time for example. In addition, both researchers are pondering whether the optimal perfusion pressure range changes during the course of the healing process. They also want to know whether a change of pressure causes abnormal electrical activity in the injured spinal cord tissue. In order to find answers to all these questions, the project has decided to add an engineer to its ranks to push ahead with programming special software to handle the complex computing tasks.

GOAL: NEW CARE BENCHMARK Papadopoulos and Saadoun have started to travel to conferences to present their findings.

“We hope that doctors at other ICUs try our technique, too,” says Saadoun. “Then we can get together and compare our results.” The hope is that their method will set a new care benchmark in five years’ time. That is the dream of these scientists, who are devoting their lives to treating patients with spinal cord injuries.

Dr Saadoun and Professor Papadopoulos invest all their energy into spinal cord research.

They have hardly any free time.

HOW YOUR MONEY IS PUT TO WORK The clinical study is funded by your donations. The researchers use the money to pay for, among other things, probes for pressure and micro-dialysis analysis devices and chemicals devices for measuring electrical activity a salary for the software engineer

Photos: Richie Hopson

and nutrient supply in order to survive.

Papadopoulos and Saadoun achieve this by adjusting the blood pressure where possible.

“We can learn a lot from the treatment of traumatic brain injuries and apply these findings to the spinal cord.�

Professor Papadopoulos

Saadoun, the neuroscientist, completed her studies in neurobiology at the Universidad Autonoma de Barcelona and University of California in San Francisco.

Impressive research results: patients often find their ability to feel below the injury site has improved.

PORTRAIT

Professor Samuel David consults for Wings for Life, helping to decide which research projects deserve to be funded.

26 | WINGS FOR ...

The Pioneer

Professor Samuel David paved the way for modern Neuroregeneration.

At the beginning of the 1980s, he published a groundbreaking research paper that proved the nerve cells of the spinal cord are capable of regeneration in the right environment.

A

s Austrian neurologist and thinker, Sigmund Freud, so famously said: “The progress of science is slow, tentative, and laborious,” which also applies to spinal cord research. Quick results are exceedingly rare. More often than not, researchers have to be content with small steps. From time to time, however, a scientist achieves a significant breakthrough. Professor Samuel David, a researcher at McGill University, is one of the few who have succeeded in making a huge leap forward. Up until 1981, it was believed that damaged nerves in the spinal cord are unable to recover. David proved the otherwise.

Samuel David’s lab employs an international team consisting of scientists from Germany, England, Canada and Spain.

Photos: Felix Rioux

A FEW YEARS EARLIER David’s career path can be described as atypical. At 18 years of age, he studied physiotherapy and worked in various hospitals in India, before finally emigrating to Canada in 1969. As part of his day-to-day work, David spent a lot of time with patients suffering from spinal cord injuries. He assisted them in adjusting to their new life and maximising their potential. Soon he started to wonder why the spinal cord is unable to recover from an injury, especially as peripheral nerves are capable of regenerating. David decided that he needed to know more about the biological background of this specific type of injury, which is why he went to university and studied neuroscience in Winnipeg, Canada.

REVOLUTIONARY INSIGHTS After successfully completing his PhD, David began his research at McGill University in Montreal. He and his colleague, Albert Aguayo, started looking for answers to David’s questions. In one experiment, he bridged the spinal cord injury with a peripheral nerve extracted from the leg. He attached one end of the inactive nerve graft to the spinal cord above the injury, while attaching the other end below the injury. Six weeks later, he observed that new axons had formed over the entire length of the graft – a veritable sensation. This discovery was a turning point and inspired science to search for more factors that stimulate or inhibit the growth of nerve cells. ... LIFE | 27

PORTRAIT

FURTHER DISCOVERIES Samuel David had no intentions of resting on his laurels and continued his research. A few years later, he and his colleagues discovered that a molecule called MAG (myelin associated glycoprotein) inhibits the growth of nerve cells. Yet another discovery followed shortly after. David found out that certain immune cells (macrophages) can contribute to the regeneration of the adult nervous system. This realisation inspired other scientists to research macrophages and their potential intensively. David’s most recent discovery was published in the Neuron journal in 2014. He described how the protein TNF and the element iron can exacerbate secondary damage following a spinal cord injury.

David is currently investigating how inflammation and its associated immune cells contribute to secondary damage after a spinal cord injury (editor’s note: see page 16) and other diseases, such as multiple sclerosis.

Furthermore, he is eager to find out more

about the role iron plays in respect of neurological conditions.

In his rare spare time, Professor Samuel David enjoys nature.

CONSULTANT AND MENTOR David has received numerous awards for his research. He is also an in-demand reviewer for prestigious journals such as Cell, Neuron, and Nature. David is also keen to pass on his vast knowledge to the next generation, in the hope that others can make equally significant leaps forward in terms of regenerative medicine in the future.

PROFILE Name:

Significant publications:

Professor Samuel David

1981:

injury (Journal of Biological Chemistry)

Institute:

Central nerve cells can regenerate

2007:

Institute of Neurology &

when placed in the right

Role of Nogo receptor in macrophage

Neurosurgery at McGill University in

environment (Science)

clearance (Neuron)

Montreal, Canada

1990:

2014:

Position at Wings for Life:

Diffusible factors released by a

Cytokine TNF and iron can worsen

Member of the Scientific Advisory

special type of immune cells called

inflammation-induced secondary

Board

macrophages can stimulate adult

damage after spinal cord injury

Number of publications: 106

central nervous system regeneration

(Neuron)

(Neuron)

Hobbies:

1997:

Reading (biographies, history, and

Ceruloplasmin is expressed by

fiction), cooking (Indian and North

astrocytes. It regulates iron levels in

American cuisine), classical music

28 | WINGS FOR ...

Photo: Felix Rioux

the CNS and prevents free radical

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THE WORLD WILL RUN TOGETHER JOIN US ONE DAY AT THE VERY SAME TIME ALL OVER THE WORLD

MAY 8, 2016 11:00 A.M. UTC

100% OF THE ENTRY FEE GOES TO SPINAL CORD RESEARCH

WINGSFORLIFEWORLDRUN.COM

BE A PART OF IT!

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Gift Ideas

Sharing the joy and doing something for a great cause does you good, too. Sort out your friends and family with these wonderful gifts and make everyone happy.

Stylish hats

Photo: Walter Eggenberger

Step out in style with the new Wings for Life beanies.

With their on-trend knitting pattern in blue, grey, blue/ grey or iconic bobble, they’re true eye-catchers. The fleecy inserts will keep you snug and warm all winter.

Available in our partner shop for â‚Ź29.95: www.redbullshop.com

30 | WINGS FOR ...

Global pass

For notes of all kinds

Don’t forget anything with our Red Book. An elegant hard cover featuring the official Wings for Life design binds 192 squared, perforated pages, marked with a ribbon bookmark, all secured with a snap strap, to keep all your best ideas in place. Be inspired by the photos from the Wings for Life World Run that grace the tab pages of the Red Book.

Available in our partner shop for €19.95: www.redbullshop.com

co 10 rd 0% res o ea f th rc e it i h. T reve s t ha nu rul nk e y a yo goe pp u f s rec or to iat you spin ed r s al up . po rt,

On May 8, 2016, the world will once again run for those can’t in 34 locations. This voucher puts you, your family and your friends on the starting line, wherever you choose to run. After all, running together is more fun than running alone.

Available on www.wingsforlifeworldrun.com

... LIFE | 31

Foto: Olaf Pignataro

FUNDRAISING

32 | WINGS FOR ...

Anthony swims in Dover’s harbour basin in the morning sun.

Fundraising Triathlon:

Joy and Agony in Three Stages 35.4km (22 miles)

– 281.6km (175 miles)

– 57.9km (36 miles)

From the English Channel to Milton Keynes – one Austrian and two Brits decided to face their greatest sporting challenge yet, to raise funds for Wings for Life.

... LIFE | 33

FUNDRAISING 1

1 Last preparations before the long ride. 2 Marcus’ route leads from the English coast to the university city of Oxford.

3 Marcus literally flies during the first kilometres of his ride.

2 3

A

nthony Ward takes deep breaths while standing on the shores of the English Channel at Dover in his wetsuit. It is 6.30am and the sun is rising slowly above the English coastline. His sports watch shows an air temperature of 10 degrees Celsius.

“I trained in pools, lidos and in open water. At my peak, I was swimming six times a week for about two and a half hours each time, with one long weekly swim in excess of four hours. My longest open-water swim before the challenge was six hours, before I had to get out due to mild hypothermia. The training regime has prepared me well physically,” says Anthony, before wading into the cold, 15-degree water of the English Channel. He is about to embark on a 35.4-kilometre (22-mile) swim. It is the 34 | WINGS FOR ...

last stage of the TriHard Challenge, a very special kind of fundraising triathlon.

THE FIRST STAGE Marcus Prosser, 36, Red Bull Relations Manager at Red Bull Racing.

“Whenever I have free time, I spend it with my family”

Two days earlier, Anthony’s co-worker, Marcus Prosser, kicks off the TriHard Challenge. His part of the triathlon involves cycling from Dover to the university city of Oxford. “Everything is as good as it can be.

I’m mentally ready to get this underway,” says Marcus before he starts. In addition to combining his training regime with his job, he faced a quite different challenge over recent months: “My first child was born in January, so I had to fit the training sessions in between looking after the baby. It was tough.” Marcus puts the finishing touches

4

5

6

Photos: Olaf Pignataro

7

to his preparations before cycling off. It is sunny, but very windy. Nevertheless, he literally flies along the first stretch through the hilly Kent landscape.

He reaches Buckingham Palace in London shortly after midnight. His muscles have started aching and he is struggling with the temperature drop: “The penultimate section, between three and five o’clock in the morning was the worst. The wind was icy cold, and then nearing Oxford it gets quite hilly. I was running out of both physical and mental strength,” he says after the finish. Marcus regularly eats porridge to warm up while cycling. Giving up is not an option he is willing to consider. “I had a couple of guys from the factory riding with me for the last

20 miles and this gave me the push I needed.

I owed them and the sponsors. I knew I was doing something for a good cause.” Marcus hopes that he can pass the hypothetical baton to Dominik Mitsch, the runner of the team, at approximately six o’clock in the morning.

THE IDEA BEHIND IT In December last year, the three co-workers had no idea how tough their TriHard Challenge would be. Back then, Wings for Life explained its work in a presentation.

“After the lecture, we all agreed that we needed to do something special to raise funds for the foundation,” says Dominik, while recalling the moment when they decided to go ahead with the fundraising exercise. They

4 An exhausted Marcus arrives at Buckingham Palace at midnight. From this point on, he struggles with pain and the cold.

5 Marcus with his Wings for Life shirt. He’s been in the saddle for 15 hours: “Body and mind are incredibly resilient.” 6 Dominik prepares for his run.

7 Dominik’s supporters join him in stages.

... LIFE | 35

FUNDRAISING 8

8 Christian Horner, the head of the Red Bull Racing team, congratulates the boys on the successfully completed challenge.

9 Dominik receives congratulations from a colleague. 10 Dominik needs to run almost 60 kilometres from Oxford to Red Bull Racing’s factory in Milton Keynes.

9

10

36 | WINGS FOR ...

CRAMPS AND PERSONAL BEST

Dominik Mitsch, 36, Head of Marketing at Red Bull Racing.

His interests are running, tennis, cooking, eating out and travelling

Dominik’s route extends over almost 60 kilometres (37 miles), from Oxford to Red Bull Racing’s factory in Milton Keynes. “I started training in May, but I was struck by injuries early on,” says Dominik, whose training had to go on hold for four weeks. “I guess I’m getting old, but I suppose it wouldn’t really be a challenge if it was easy,” he says. The Formula One team’s physiotherapist was a source of strength for Dominik during that time.

On the day of the TriHard Challenge he is, at the least, well prepared mentally. He progresses well during the first few kilometres. Then leg cramps kick in. “I am afraid that my legs will give way if I stop, but I’m in serious pain here,” he calls out to his colleagues, who take turns

Photos: Olaf Pignataro

firmed up their plans over a pint during their Christmas party at work.

“We agreed to organise a triathlon. None of us is overly ‘sporty’, so we gave ourselves quite a mountain to climb,” explains Marcus. The three aspiring fundraisers made use of their large, global network of friends, colleagues and acquaintances to secure sponsorship. “We know a lot of people through work. We sent them emails, promoted our event on social media and told everyone about our challenge.”

Nine months later, Marcus has completed his part. He actually ended up covering 281.6 kilometres (175 miles) from the English coast to the county of Oxfordshire in 16.5 hours. There, Dominik is already waiting in his running shoes.

11

11 Deceptively calm: the water is just 15 degrees Celsius 12 Under observation: Anthony’s supporters keep a constant eye on him and calculate the distance. 13 Final preparations take place at six o’clock in the morning.

12

in accompanying him and cheering him on.

He continues running and even manages to beat his personal best. “I never ran more than 18 miles during training,” he confesses.

As he draws closer to Milton Keynes, Dominik feels a surge of competitiveness and increases his pace. After slightly more than six hours, he is greeted with applause as he runs onto the factory site and celebrates by diving in front of his colleagues. “I have pulled this off for the camaraderie, the good cause and the many sponsors,” he says breathlessly, but happily.

FIGHTING THE COLD The next day, everyone turns their attention to crossing their fingers for Anthony. It remains unclear whether he can even go into

13

Anthony Ward, 38, Head of Brand & Events at Red Bull.

Likes racing swimming, tennis, golf, art collecting, photography, cinema and going out with friends

the water until the last minute. “It all depends on the currents in the Channel. Since August, we have been forced to call off numerous attempts due to bad weather conditions. It’s tough when that happens, especially as you need to be mentally strong in terms of preparation,” the 38-year-old amateur swimmer explains, while warming up. Even today, his planned crossing of the Channel is hampered by strong currents. As an alternative, he has set his mind on swimming the 35.4 kilometres in the harbour basin of Dover.

He shifts his goggles and swimming cap into the correct position, wades into the water, and begins to front crawl. He pushes himself through the cold water for more than 10 hours. Every 60 minutes, he recharges his ... LIFE | 37

FUNDRAISING

YOU DON’T HAVE TO DO A TRIATHLON...

FUNDRAISING GOAL EXCEEDED

Would you like to support a good cause with your own

The trio covered 374,9 kilometres (233 miles) over the three days of their challenge.

However, they are even prouder of the fact that they raised more than 70,000 euros for Wings for Life. “I don’t think any of us expected to pull

athletic performance, a private party, or something

38 | WINGS FOR ...

completely different? Launch your personal fundraising project on wingsforlife.com. Motivate your friends and collect sponsorship. There are no limits to your creativity.

Funds raised go directly to spinal cord research. Have fun!

Photo: Olaf Pignataro

off something like this. That’s why we were able to inspire so many people,” says Dominik.

Then he laughs as he reveals the secret of their success: “I suspect that many of our supporters wanted to see us suffer, and gladly paid to see just that happen.” Anthony agrees and adds: “It is great to pass on this money to something we believe in. I have the greatest respect for people with spinal cord injuries. I see them as mentally the strongest people out there. We collected sponsorship to ensure that the huge problems connected with spinal cord injuries can be solved at some point in the future.”

batteries with hot tea and gummy bears, without leaving the water. At this point, Anthony has started trembling all over. “It took an incredible amount of willpower to stay in the water as I was so cold,” he says later about his part in the TriHard Challenge. “I thought about my work and my upcoming wedding for the first four hours,” he says. “After that I literally could think of nothing else but the cold.” He attempts to focus his thoughts on warm places. While he struggles with hypothermia in the open sea, his team keep a close eye on him with binoculars and calculate the distance. After 10 hours and 21 minutes in the water, Anthony has pulled off a sensational achievement. As he exits the water, he is welcomed by his exuberant team with a champagne shower.

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It also extends to our customers, supporting and encouraging their eco-effective choices.

Sustainability at Sappi starts with each one of our people, resulting in a company-wide eco-effectiveness supported by all.

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THANK YOU FOR YOUR ONGOING SUPPORT

100% OF YOUR DONATIONS GO TO SPINAL CORD RESEARCH DONATION ACCOUNTS INTERNATIONAL Bankhaus Carl Spängler & Co, Salzburg, IBAN: AT27 1953 0001 0001 1911 BIC: SPAEAT2S Beneficiary: Wings for Life – Spinal Cord Research Foundation, Fürstenallee 4, AT-5020 Salzburg UNITED KINGDOM HSBC, Account No: 83882101 Sort code: 40-05-30 IBAN: GB72 MIDL 4005 3083 8821 01 BIC: MIDLGB22 Beneficiary: Wings for Life Spinal Cord Research Foundation, 155-171 Tooley Street, London SE1 2JP, UK USA www.cafamerica.org Donation in favour: Wings for Life, Austria, Europe