In 2010, a 40-year-old Polish man named Darek Fidyka sustained multiple stab wounds that rendered him paralyzed. Today, Mr. Fidyka is walking with the aid of a frame, following a cutting edge treatment performed by a UK research team and Polish neurosurgeons, led by Prof. Geoff Raisman and Dr Pawel Tabakow, respectively. The collaborative effort involved transplanting the man’s own nasal cavity cells (olfactory ensheathing cells or OECs) into his spinal cord, together with an autologous nerve graft. OECs act as a cellular scaffold for regenerating neurons in the olfactory system. The treatment consisted of two surgeries: the first to remove one of Mr. Fidyka’s olfactory bulbs as a source for culturing OECs and the second to obtain nerve grafts from the patient’s ankle and transplant them, together with the OECs, into the patient’s severed spinal cord. Micro-volumes of OECs were injected into spinal cord tissue directly above and below the site of injury for a total of approximately 100 injections of 500,000 cells. The nerve grafts were transplanted across the gap of the injured spinal cord.
Despite ongoing intensive physiotherapy before the treatment, improvements in Mr. Fidyka’s status only occurred after the transplant. Remarkably, three months following treatment and the sustained physiotherapy regimen, Mr. Fidyka began showing physical improvements, including increased leg muscle mass, the ability to weight-bear using leg braces, and eventually movement. Based on previous preclinical studies, the research and surgical teams believe that the positive treatment effect is a result of neural regeneration, with the OECs acting as a biological scaffold to promote neural regrowth and reconnection across the nerve grafts that fill the gap of the injured cord.
While the results of this case are extremely promising, they act primarily to provide data for initiating clinical trials, rather than evidence of a cure. Further studies are needed on a large cohort of patients, tracked long-term, to determine if this therapy is effective and safe for repairing the injured spinal cord.
Here’s a BBC report about the research:
Study in Cell Transplantation: Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging
University College London: UCL research helps paralysed man to recover function
