Stem Cells Taken From the Nose May Cure Paralysis


New hope for paralysed woman

By Roger Highfield, Science Editor, The Guardian, London, UK
(Filed: 06/12/2004)

A British woman who was left paralysed by a riding accident has regained some movement after taking part in a pioneering trial in which stem cells were transplanted from her nose into her spine. In May 1998, her horse stumbled at the final jump of a cross-country course and she was catapulted into the air. “The way I landed just snapped my spine,” she said.

"When they come up to you and say you’re never going to walk again, you just think: ‘Oh, once I get out of hospital I’ll be fine’. "
Then reality sank in. “My whole way of life changed just completely.”

Now she has become one of the first patients to benefit from a pioneering trial by Dr Carlos Lima at the Egaz Moniz Hospital in Lisbon.

“If there’s a chance that you could possibly be better than being stuck in a wheelchair, paralysed, I think you’ve got to take it,” she said. “All of our patients have some kind of recovery. We have no doubts about sensory recovery and some voluntary motor recovery,” said Dr Lima. “They move and feel below the lesions as never before. And there is even some bladder and bowel control recovery.”

Kim will be featured in an award-winning Carlton Television/ITV programme, Miracle Cell, to be broadcast in the new year.
The first patient to have the operation three years ago is still improving, Dr Lima said. Some of his patients can now walk with braces or a walking frame.

Speaking from her home in the south of England yesterday, Kim Gould described the impressive progress that she has made since the operation in October last year.

At first she felt more sensation down her right side then a difference in her lower back and abdominal muscles. Now there is some movement in her hamstrings.

“It is very exciting,” she said. “I can crawl around the floor. I am quite balanced now and I can actually lift each leg and move it forward.”

She added: “What I have recovered in a year, after six years of no movement, is quite remarkable. It is quite amazing. Of course, my goal from the surgery would be to walk again and be as I was before, but I told him anything I didn’t have before, any little bit, was gravy for me.”

She would also like to ride again, but her family are against it, she said.

Her case is all the more remarkable because the olfactory tissue used for the transplant can diminish over time, so patient age is important. Kim Gould, at 43, is the oldest patient to participate in the trial.

“She is a very special person,” said Dr Lima.
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Another approach being studied by scientists is to create nerve stem cells from embryonic tissue. Pro-life groups reject the use of embryos and promote the use of adult tissue, as in this case. Dr Lima does not like the use of embryonic stem cells: “I am opposed but not only for ethical reasons. Mother Nature made embryonic stem cells to proliferate and adult stem cells to replace and repair. To defy Mother Nature’s laws is, at least, dangerous.”

But Mrs Gould said she believed that many people in her predicament would be prepared to try embryonic stem cells. She said of pro-life critics: “They are not the ones stuck in the wheelchair. If they were, I am sure they would try anything.”

Dr Lima, who last saw Mrs Gould at the end of November during her physiotherapy session in Tocha, near Coimbra, said: “She has electrophysiological evidence of voluntary movement of the muscle in the leg. That means that there is some control Kim is already having on the leg muscles.”

When Mrs Gould returns from her therapy in Portugal, her husband and son notice the improvements more than she does, she said.

"They say: ‘We can see the difference in you. Just by your balance, the way you are sitting and what you do.’ "

Mrs Gould’s parents, Tony and Ann Bassett, were with her when she underwent the operation. “Ever since she had the accident she’s been looking into everything” said Ann Bassett. “Tried everything, you know. And she was convinced that one day there would be something that would help her.”

“And it’s here,” added her husband. “We’re still a bit apprehensive for her, but it should all go well and we’re hoping it will.”

Dr Lima was inspired to develop the operation by work conducted in the late 1970s by Pasquale Graziadei, from Florida State University, and his wife Ariella Monti-Graziadei, who found that there is one part of the nervous system, a region in the nasal cavity concerned with the sense of smell, in which nerve fibres are in a state of continuous growth throughout adult life. “It was when I was reading their discoveries that my mind was awakened with the idea and rationale for what we are doing now,” said Dr Lima.
In Britain, related work has been carried out by Prof Geoff Raisman, who is the first director of the new Spinal Repair Unit at University College London.

While working at the National Institute of Medical Research, Mill Hill, Prof Raisman’s team transplanted cells from the nose into the injured spinal cord of laboratory rats and found that the cells had a remarkable capacity to integrate into the damaged pathways and lay a “bridge” over the gap in the nerve fibres caused by injury.

“When we transplant the cells into that area of damage, the function comes back. You’re seeing a glimpse through a doorway that has never been opened before.”

Prof Raisman said the transplanting of stem cells had vast potential. “This is what will get people out of wheelchairs. This is what will make stroke patients get better. This is what will restore the optic nerve in blindness, and the auditory nerve in deafness. This will be revolutionary, if successful.”

He stressed that he doubted full recovery would be possible. “But if a person can’t even move their arms, to be able to throw a switch, to be able to manipulate a piece of machinery, to be able to drive a car - it’s going to make an enormous difference to their way of life.”


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