After an innovative operation performed at the University Teaching Hospital in Wrocław, a patient with a ruptured spinal cord began to walk with the help of orthopedic equipment. For the first time in the world, a patient with such an injury was transplanted with glial olfactory cells taken from the brain.
In 2010, now XNUMX years old Darek Fidyka was stabbed several times in the back, which resulted in paralysis of the muscles below the chest. Now he can walk using the walking frame. When you do not feel almost half of your body, you are helpless, but when the feeling returns, it is as if you were born again – he said in an interview with the BBC.
This is just a light at the end of the tunnel. The patient resumed his motor functions with the help of orthopedic equipment. This direction of research is good, the head of the Department of Neurosurgery of the USK in Wrocław, Prof. Włodzimierz Jarmundowicz.
Implantation operation performed by a team led by prof. Jarmundowicz and Dr. Paweł Tabakow, took place one and a half years ago. Surgeons performed several dozen punctures of the spinal cord and over a hundred injections of previously multiplied olfactory glial cells, which have exceptional regenerative abilities. They were injected above and below the site of the core damage.
Before the transplantation took place, doctors took the olfactory glial cells from the olfactory bulb, which is located in the brain. To do this, they had to open the patient’s skull. It was the first such procedure in the world.
We had the consent of the bioethics committee for this – said prof. Jarmundowicz.
The regenerative abilities of glial olfactory cells were discovered over 20 years ago by Prof. Geoffrey Raisman from University College London. He has been repairing core damage for 40 years. In his opinion, achievement is more important than sending a man to the moon.
After the transplant, the patient underwent rehabilitation. Doctors cooled down the emotions related to the effects of the treatment. On Tuesday evening, material about this medical case is to be broadcast by British BBC television.
The nose is the only part of the body where the adult nerve fibers continue to grow. The olfactory sheath cells (OEC) are located at the back of the nasal cavity. They surround receptor neurons that both smell and transmit signals to the brain. Nerve cells require constant replacement, which is provided by OEC. For decades, scientists believed that OECs could prove to be useful in repairing the spinal cord because they allow nerve fibers to renew themselves. In the case of rats and dogs, the spinal cord was repaired a few years ago.
According to the BBC, collaborating with prof. Raisman, the Polish neurosurgeon, Dr. Paweł Tabakow, conducted trials on three patients, which showed that the therapy was safe, although the small amount of cells used did not significantly improve their health. Finally, it was Darek Fidyka’s turn.
Doctors first took one of the two olfactory bulbs from the patient and then multiplied the obtained OEC cells in the laboratory. Two weeks later, they transplanted an OEC into a spinal cord that had been cut during a knife attack. Only a strand of scarred tissue on the right was connected between the lower and upper spinal cord. With just one drop of material at their disposal – around 500 cells – the specialists performed 000 microinjections above and below the site of the injury.
Four thin strips of nerve tissue were taken from the patient’s ankle and placed across an eight-millimeter gap on the left side of the spine. Thanks to the presence of OEC, the connection between the two parts of the core has been rebuilt.
Before treatment, Mr. Fidyka was partially paralyzed for almost two years and despite several months of rehabilitation, his condition did not improve. Rehabilitation – five hours of exercises five times a week – was continued after the transplant at the “Akson” Neurorehabilitation Institute in Wrocław.
Three months after the operation, the patient noticed that his left thigh was becoming more muscular. After six months – describes the BBC – supported by a physiotherapist, he made his first steps. Two years after the surgery, he can leave the rehabilitation center using a walking frame and hopes to function independently. He has partially regained control of his bladder and bowel movement, and his sexual function has returned. The MRI scan confirmed that the spinal gap had closed
Dr Paweł Tabakow from the University Teaching Hospital in Wrocław, who led the Polish team, told the BBC: It is amazing to see how spinal cord regeneration – something that has been unthinkable for many years – becomes a reality.
I have been waiting for 40 years for something like this – Prof. Wagih El Masri, surgeon-consultant dealing with spinal cord injuries.
Patients did not have to pay, and doctors and scientists did not benefit financially. However, the research costs were millions of pounds. The research was financially supported by the Nicholls Spinal Injury Foundation (NSIF) and the UK Stem Cell Foundation. The NSIF was set up by chef David Nicholls when his son Daniel was paralyzed from his shoulders down after a pool accident in 2003.
The specialists involved in the research emphasize that further successful surgeries are needed to talk about the possibility of core regeneration. In the coming years, treatment is to cover 10 patients from Great Britain and Poland, but funds are needed for this. As Dr. Tabakow emphasizes, these are especially cases of cutting the core with a knife, which give special hopes for success due to a clean cut.
The number of paralyzed people worldwide is estimated at 3 million.
For a year, the “BBC One’s Panorama” program had exclusive access to the pioneering therapy project. The details of the experimental treatment are published in the magazine “Cell Transplantation”.
We treat what was written about our operation in the magazine + Cell Transplantation + and what will be in the material of BBC television as our success. However, the program that we are implementing requires many clinical applications, including outlays – said prof. Jarmundowicz.
The head of the Department of Neurosurgery at the University Teaching Hospital in Wrocław announced a press conference on Wednesday, at which he will discuss the details of the operation. (PAP)