At public lectures at the Trinity College Institute of Neuroscience, University College Cork, and in Galway City, leading expert in regeneration of the nervous system, Prof. Anthony Windebank, outlined new research into spinal cord injury ongoing at the Regenerative Medicine Institute (REMEDI), NUI Galway.

Professor of Neurology at the prestigious Mayo Clinic, Rochester, Dr. Windebank has been involved in research into regeneration of the nervous system for more than 25 years. The expertise available at REMEDI in adult stem cell therapy attracted him to Ireland, and he spent one year at REMEDI, NUI Galway, on a fellowship funded by Science Foundation Ireland. A research collaboration between REMEDI and the Mayo clinic has been set up and is ongoing following Prof. Windebank’s return to the Mayo Clinic. The team at REMEDI is combining stem cell therapy approaches, with microengineering and scaffolding techniques that are being developed by Prof. Windebank and colleagues in a large research team at Mayo.

At the lectures Prof. Windebank outlined the research he has been working on at Mayo for a number of years. Biodegradable scaffolds are being used to bridge the injured area in the spinal cord that results from spinal cord injury. In the research programme at REMEDI he is combining this approach with the ability of adult stem cells to regenerate and support repair in many tissues.

Biodegradable scaffolds are made from synthetic and natural materials that can be made into shapes that naturally guide regrowing nerves across the damaged area. They can be designed so that they retain their shape for long enough to support re-growing tissue, but then disappear and allow the normal tissue to take over. They are similar to "dissolving stitches" that have been in use in surgery for many years.

The research group at REMEDI in Galway has extensive experience with the use of stem cells collected from the bone marrow. These adult stem cells have already been shown to have the potential to develop into many different tissues, including heart muscle, bone, blood and cartilage. The collaboration between Mayo and REMEDI researchers is now bringing this approach to spinal cord injury. Bone-marrow derived stem cells have the advantage that they can be easily obtained from the injured person and then returned to them for repair purposes. This reduces problems with rejection and side-steps the ethical issues associated with the use of embryonic stem cells.

The lab-based studies under way in Galway have shown that adult stem cells can be genetically modified to produce "growth factors" known to support nervous system regeneration. Growth factors are the "fertiliser-like" materials needed to stimulate nerves to regrow. At Mayo, the research teams have shown that cells in scaffolds will support successful nerve growth in the spinal cord.

Prof. Windebank, who is a practicing neurologist at the Mayo Clinic, stressed that these are currently pre-clinical laboratory studies. In Ireland, clinical trials with adult stem cells for heart disease are being designed to begin within 1 -2 years and trials with biodegradable polymers for peripheral nerve injuries are being planned with projected starts in 2-3 years. These will provide important information about the compatibility of polymers with regrowing nerves in patients and will be a forerunner to studies in spinal cord injury.

Studies with stem cells and polymers in patients with spinal cord injury will probably be ready to begin within 5 - 7 years. Windebank cautioned strongly against stem cell therapies that were being advertised where patients had to pay large sums of money to avail of the treatment. These he said were often carried out in countries where safety issues were not of prime concern and he pointed out that in all of the major European and North-American research centres, it is not legal to charge patients for experimental procedures. Stem cell treatments for spinal cord diseases offered in private clinics are not tested under the rigorous conditions applied in North-America and Europe and they may be unsafe.

In conclusion, Prof. Windebank said that these are very exciting times for researchers, patients and their families. The tools are becoming available that could allow us to solve the problem of spinal cord repair. We must be cautious and the gains will initially be small - but every small gain is a big step for a person confined to bed or a wheelchair.