Recombinant Drug (Cethrin): Might be Effective Treatment for Spinal Cord Injury (SCI) or Myelopathy
Both the brain and the spinal cord are protected by bone: the brain by the bones of the skull, and the spinal cord by a set of ring-shaped bones called vertebrae. They're both cushioned by layers of membranes called meninges as well as a special fluid called cerebrospinal fluid. This fluid helps protect the nerve tissue, keep it healthy, and remove waste products.
Infections of the brain and spinal cord that are usually caused by bacteria or viruses. Meningitis is an inflammation of the coverings of the brain and spinal cord, and encephalitis is an inflammation of the brain tissue. Both conditions may result in permanent injury to the brain.
The spine (vertebral column) - composed of blocks of bone (vertebrae) separated by soft-centred fibrous discs (intervertebral discs), which are bound together by ligaments and muscles - protects the spinal cord of the nervous system. Injuries range from damage to the vertebrae, ligaments and discs, to damage to the spinal cord itself.Most often the damage is to the cervical or upper thoracic regions of the spinal cord, and characterized by weakness in the arms with relative sparing of the legs with variable sensory loss
Central nervous system tissue has very limited, if any, regenerative capacity, it is of utmost importance to limit the damage caused by neuronal death. During the past decade, considerable progress has been made in understanding the process of cell death.Acute and chronic neurodegenerative diseases are illnesses associated with high morbidity and mortality, and few or no effective options are available for their treatment. A characteristic of many neurodegenerative diseases — which include stroke, brain trauma, spinal cord injury, amyotrophic lateral sclerosis (ALS), Huntington's disease, Alzheimer's disease, and Parkinson's disease — is neuronal-cell death.
Most trauma to the spinal cord causes permanent disability or loss of movement (paralysis) and sensation below the site of the injury. Paralysis can involve all four extremities, a condition called quadriplegia or tetraplegia, or only the lower body, a condition called paraplegia.A diagnosis of spinal cord injury can be devastating. The sudden presence of disability can be frightening, frustrating and confusing to those affected and their families and friends. They naturally wonder how spinal cord injury will affect their everyday activities, their jobs, their relationships, their dreams and their long-term happiness.
Trauma to the neck and back can lead to spinal cord injury and permanent disability. If trauma occurs, the neck and back should be splinted and movement should be avoided.Most spinal cord trauma occurs to young, healthy individuals. Males between ages 15 and 35 are most commonly affected. The death rate tends to be higher in young children with spinal injuries.
A spinal cord trauma is a medical emergency requiring immediate treatment to reduce the long-term effects. The time between the injury and treatment is a critical factor affecting the eventual outcome.
Today, there's still no way to reverse damage to the spinal cord. But modern injuries are usually less severe, partial spinal cord injuries. And advances in recent years have improved the recovery of patients with a spinal cord injury and halved the amount of time survivors must spend in the hospital.
Rat stem cells developed into neurons and other mature brain tissue when transplanted into normal and stroke-damaged adult rats. This suggests the possibility that brains and spinal cords can be repaired following trauma from stroke or other diseases.
We need to encourage people with SCI to exercise," says William Scelza, M.D., who led the study while completing his residency in physical medicine and rehabilitation at U-M this year. "There are indeed exercise regimens that can increase the health and well being of these patients, and make them more robust so they can participate in life to a greater degree and live a longer, healthier, happier life - as well as being healthier for any potential cure." Scelza is now doing a fellowship in spinal cord injury at the Kessler Institute for Rehabilitation in New Jersey.
A drug called Cethrin shows promise in treating people with spinal cord injury (SCI), according to a study by American and Canadian researchers.
Cethrin inhibits Rho, a signaling master switch that, when activated, triggers cell death and increases damage after SCI. Tests in animals with SCI have found that Cethrin inhibits cell death and promotes neural regeneration.
This one-year study looked at the use of Cethrin (a recombinant protein) formulated with a fibrin sealant in 37 patients who had just suffered an SCI that left them with no sensory or motor function below the area of the injury.
All the patients had an "A" grade injury as ranked by the American Spinal Injury Association (ASIA). Grades of injury go from A through E. An "A" is the most serious while "E" is normal.
After the patients had surgical decompression/reconstruction, the researchers started treatment with Cethrin, an average of 53 hours after the injury occurred. The patients received increasing doses of the drug (0.3, 1.0, 3.0 and 6 milligrams) administered extradurally to the injured spinal cord. The patients were assessed at various points over a year.
The study found that at six weeks, 30.6 percent of the patients improved by one or ASIA grades of injury. At six months, 28 percent of patients improved by one or more ASIA grades. Five patients improved to "C" and two improved to "D." One patient died from acute respiratory distress syndrome.
The study, which was funded by BioAxone Therapeutique of Montreal and Boston Life Sciences Inc., was presented Monday at the annual meeting of the American Association of Neurological Surgeons, in Washington, D.C. The findings from this Phase I/II study warrant moving on to a prospective randomized trial of Cethrin, the researchers said.