Looking for a Spark

A new clinical trial on the use of Schwann cells is among many hopeful SCI studies taking place at the Miami Project.

If there is such a thing as all-stars of spinal-cord injury (SCI) research, Schwann cells could be it — and the Miami Project to Cure Paralysis is leading the way when it comes to studying these amazing nerve messengers in the human body.

The Miami Project recently got the first Food and Drug Administration green light to try transplanting autologous [the person’s own] Schwann cells in recently-injured patients.  

Kim Anderson-Erisman, PhD, director of education at the Miami Project, says they’re becoming a major part of emerging medical science for reducing the effects of some forms of SCI. Transplanting Schwann cells was previously tried in clinical animal studies.

“We saw a lot of anatomical changes that are reparative in the spinal cord as well as behavioral changes in the animals,” Anderson-Erisman remarks.

Meaning things looked good, so researchers moved on to the human trials.

Moving Strategically

Doctors at the University of Miami’s (Fla.) Jackson Memorial Medical Center have already started Phase I of a clinical trial that’ll eventually include eight research participants.

A medical team recently transplanted autologous Schwann cells into a patient with a month-old neurologically-complete thoracic SCI. As with all things science, testing autologous Schwann cell transplantation will move slowly, deliberately, and with few promises offered until consistent results are demonstrable.

Rehabilitation in spinal-cord-injured patients is a key part of the Miami Project to Cure Paralysis.

“We had more animal evidence demonstrating that it was safe and rational to do it,” Anderson-Erisman offers. “We’re doing this very strategically.”

Schwann cells were named after physiologist Theodor Schwann. They’re among the cells that wrap around peripheral axons forming myelin sheaths. They participate in nerve repairs as well as conduct and speed nerve pulses.

Mary Bartlett Bungy, PhD, at the Miami Project has examined Schwann cells as a possible reparative therapy for spinal-cord injury and diseases since the 1980s. They’re among the most widely-studied cells for repairing the spinal cord. In addition to speeding signals, they naturally do reparative work on the peripheral nervous system and usually migrate to SCI sites.

“The only time they don’t work is when you totally damage the nerve,” Anderson-Erisman says.

Sacking SCI Cold

The Schwann cell trial is just one of numerous projects taking place at the organization founded by Pro Football Hall of Fame linebacker Nick Buoniconti and Barth Green, MD.

Buoniconti’s son, Marc, sustained an SCI during a college football game while playing for The Citadel (Charleston, S.C.) against East Tennessee State in 1985. Marc is now president of the Buoniconti Fund to Cure Paralysis, which raises money to support the Miami Project.

The project’s Christine E. Lynn Clinical Trials Initiative seeks to speed promising research to human trials and use. Scott Roy, director of communications, says hypothermic treatment is one of the project’s great visible successes. 

“The Miami Project was born on a lot of hope, and now it’s on concrete science,” he says.

Perhaps Kevin Everett is the most famous success of hypothermic treatment. The Buffalo Bills tight end sustained a life-threatening spinal-cord injury in a violent collision during a 2007 game against the Denver Broncos.

Using research done at the Miami Project, doctors infused cooled intravenous fluids 15 minutes after his injury. While it’s always difficult to know how much role any one treatment plays in recovery, Everett is walking and has credited much of that to the hypothermic treatment.

Anderson-Erisman says the immediacy of competent care had much to do with Everett’s remarkable recovery, too. 

After Everett’s success, physicians from all over the world started contacting the Miami Project for more information about the research. 

“There are over 250 people (at the project) that are working on this problem,” Roy offers. “Whether it’s robotics or cell therapies or bypassing the spinal cord, anything and everything that seems plausible we’ve been interested in trying.”

SCI People Are the Key

The work being done on SCI research isn’t limited to scientists and doctors. Mario Moran, 25, has participated in three studies at the Miami Project.

A gunshot wound left Moran with a T9 injury at age 18. The last study he was in tested whether the eLeg, a bionic exoskeleton from Berkeley Bionic, helped make any neurological changes doctors could use to increase the benefits of other SCI therapies. 

“The device, it’s like a robot that walks you,” Moran says. “It was a three-month period; I’d get on the device three times a week. I heard about the device before, and it was a privilege to be a study volunteer. For the eLeg, I was handpicked from a group of people.”

Anderson-Erisman, who has a 24-year-old C5 injury from an automobile accident in her teen years, says ultimately cures for paralysis will be combination therapies. Just no one yet knows what the right combinations will be in which cases. She, too, has participated in studies.

“I know how complicated SCI is on so many different levels, and everything we do can help put the whole picture together,” she says. “Even if it doesn’t do anything for me, it can help someone down the road. We have 17 studies ongoing right now for people who are at least one year postinjury. We have four clinical trials going for early injury.”

Anderson-Erisman adds that those with SCI should stay fit and healthy so they, too, can participate in research studies.

“It’s the people living with SCI that hold the key to this,” Anderson-Erisman says. “If people with SCI aren’t willing to take the risk to be in trials, then we’ll never have treatments.”

Thomas Martineau, board member of the Florida Gulf Coast Chapter of the Paralyzed Veterans of America, says he’s eagerly watching as researchers work with new therapies.

“I’m just really excited to see what is done in the next ten years with science,” he says. “I won’t lie; if they come with a promising procedure, I would be in line.”

For more information about the Miami Project, visit miamiproject.miami.edu.


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