Paralysis Patients Tout Adult Stem Cells

Portuguese Surgery Soon to Seek FDA Approval in U.S.

From the WebMD Archives

June 24, 2004 -- An experimental surgery using stem cells from adult organs is showing promise in helping patients paralyzed with spinal cord injuries.

Two patients paralyzed in automobile accidents in 2001 say the experimental procedure has helped them gain use of muscles they were told by doctors would never function again. Both say they are now able to walk with the use of leg braces.

"I'm also walking with braces, like one-fourth of a mile," says Laura Dominguez, a 19-year-old from El Paso, Texas.

The surgery, called olfactory mucosa transplantation, involves removing cells from the nerve that transmits the sense of smell to the brain. These brain cells -- located near the roof of the nasal cavity -- regenerate efficiently and are then transplanted into the injured area of the spinal cord. These transplanted cells seem to be able to transform into nerve cells that help repair the spinal cord injury. These cells serve as alternatives to using embryonic stem cells for the same purpose.

The surgery was pioneered by Carlos Lima, MD, a neurologist at Hospital Egaz Moniz in Lisbon, Portugal. Lima has treated 26 patients, all of whom have shown some improvement, according to Jean D. Peduzzi-Nelson, PhD, a university of Alabama at Birmingham researcher conducting studies with Lima in the U.S.

Susan Fajt, 26, of Austin, Texas, says that she has learned to walk with the help of leg braces following her transplant performed by Lima in June 2003. Fajt says that doctors told her following her injury, "I would never walk, swim, you name it, take a bath by myself." Now she says she can do all those things.

Stem Cell Debate a Factor

Both Fajt and Dominguez appeared at a press conference in the Washington office of Sen. Sam Brownback (R-Kan.). Brownback promotes adult stem cell procedures, like olfactory mucosa transplants, to help cure diseases but opposes the use of embryonic stem cells, which require the destruction of a human embryo to obtain cells.

Many researchers and lawmakers want to expand the use of embryonic stem cells, arguing that they could have the potential to treat more diseases than adult stem cells because they may be able to differentiate into a wider range of tissues and have an unlimited capacity for self-renewal unlike stem cells from adult organs.

Rehabilitation Critical

According to Peduzzi-Nelson, most patients have not enjoyed as much success as the two young women.

She says most people who have undergone the procedure have shown improvements in sensation rather than improvements in muscle skills.

Much of the surgery's success so far depends on extensive physical rehabilitation for patients, says Jay Meythaler, MD, chair of physical medicine and rehabilitation at Wayne State University in Detroit.

"Without rehabilitation, apparently, you don't get recovery," he says. Meythaler is part of a team preparing a study aimed at gaining FDA approval for olfactory mucosal transplantation in the U.S.

Researchers are still busy figuring out the best rehabilitation procedures in an attempt to maximize improvement in people who undergo olfactory mucosal transplant.

Lima has yet to publish his findings in a peer-reviewed scientific journal. Peduzzi-Nelson says that she, Lima, and other researchers will publish a report of the patients as well as results from two animal studies within the next six months.

Show Sources

SOURCES: Laura Dominguez, patient, El Paso, Texas. Susan Fajt, patient, Austin, Texas. Jean D. Peduzzi-Nelson, PhD, research associate professor of physiological optics, department of physiological optics, University of Alabama, Birmingham. Jay Meythaler, MD, chief, physical medicine and rehabilitation, Wayne State University, Detroit.
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