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A team at the Spinal Repair Unit at University College, London, has begun recruiting the first patients who might benefit from the therapy, which uses cells from the lining of their own noses to regrow damaged nerves. The procedure, which has been shown to work in rats, will first be used experimentally on patients with brachial plexus avulsion (BPA), an injury in which the nerves are pulled out of an arm, leaving the limb paralysed.
It is typically sustained in motorcycle accidents and never improves on its own.
If successful, the trial will be extended to more extensive forms of paralysis brought on by spinal injuries, potentially helping many people to walk again and restoring the sight of those blinded by glaucoma.
The experiments, which are expected to begin in January, are the culmination of years of research by Geoffrey Raisman.
While nerve cells that are cut or damaged will often regrow, they struggle to sprout in the right direction and to reconnect with the rest of the central nervous system.
Professor Raisman’s work suggests that one reason is that a guide layer of glial cells, which direct the development of nerves in a developing foetus, seal off the injury and prevent regenerated nerves from joining up.
“This layer is like a motorway on which the cars are the nerves,” he said. “If the roadway is damaged, the cars cannot go anywhere. What we aim to do is to repair the roadway, to provide a bridge that allows the injury to heal.”
Professor Raisman’s team will use olfactory ensheathing cells (OECs), a type of adult stem cell found in the nose which can regenerate itself. A substrata of OECs will be placed between the severed nerves and the spinal cord, to help them to regrow and plug themselves back into the nervous system.
As the OECs come from the patient’s own nose, there is no danger of rejection.
The first trial will focus on BPA as a “pilot injury”, chosen as there is never any spontaneous recovery. Other spinal injuries can improve on their own, sowing doubt about the results of experiments.
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