GAINESVILLE, Fla.---University of Florida researchers have performed the nation's first nerve tissue transplant on a paralyzed man to slow the progression of spinal cord damage. The experimental treatment involved injecting small pieces of human embryonic spinal cord cells directly into an expanding cavity that sometimes forms at the site of a specific type of spinal cord injury. Neurosurgeons at the UF Brain Institute performed the procedure Friday (July 11) at Shands at UF to test the safety and feasibility of embryonic spinal cord grafts, which in landmark studies have been shown to help cats regain some use of their paralyzed limbs. "Our primary goal in this first clinical experience is to test whether these grafts can survive and, if so, to what extent they can fill the cavity in the human spinal cord as they have in our animal studies," said UF neurosurgeon Richard Fessler, who performed the transplant. "We are advising patients that our primary goal in this pilot study is not to restore lost mobility or feeling, but to plug the expanding cavity and prevent further spinal damage." Researchers say the test is an important first step in developing a future treatment that can restore at least partial use of limbs or organs left paralyzed by a crushing spinal cord injury. "Our first clinical experience will reveal a lot about cellular transplantation in humans, particularly about the effects of short-term, drug-induced immune suppression (so the body will accept the foreign tissue), how long it takes for the grafted tissue to grow, and how much transplanted tissue is needed to plug the spinal lesion," said UF neuroscientist Douglas Anderson. "You can only answer so many questions in animal studies. If this procedure is successful and causes no adverse consequences to our first patients, it will help us reach our goal faster to aid the recovery of many people disabled by spinal cord injury." Some 10,000 people become paralyzed each year. Most are men injured in automobile crashes. Actor Christopher Reeve, who became paralyzed from the neck down in 1995 after falling from a horse, has increased public awareness of the problem while crusading for more funding to support research of spinal cord injury. The Florida man treated Friday is the first of 10 paralyzed volunteers who will undergo the procedure as part of a four-year pilot study at UF. The transplant recipient's identity was not disclosed to protect his privacy. Only patients who have a chronic disorder called syringomyelia are being considered for the transplant. The condition is characterized by expansion of a fluid-containing cavity within the damaged spinal cord that can cause unbearable pain and progressive loss of sensation and movement. Study participants will be rigorously screened so any existing spinal function or high recovery potential will not be placed at risk. Patients will receive the tissue grafts while undergoing standard surgery for syringomyelia, which exposes the spinal cord and drains the cavity through a tube. Many patients must undergo the treatment repeatedly. The embryonic spinal cord graft was obtained from aborted tissue, 6 to 9 weeks old, which otherwise would have been discarded. Researchers said they used such tissue because of its exceptional ability to grow and fill cavities, and because it develops into all of the cell types normally seen in the adult spinal cord. The tissue was obtained from health-care facilities not affiliated with the university. Researchers at UF and elsewhere report they already are exploring alternatives to embryonic tissue in spinal-cord repair, including laboratory-grown cells and grafts using other nerve tissue cell types. Friday's milestone has been years in the making, beginning with studies of rat embryos in 1983. In 1992, eminent scholars Paul Reier and Anderson, UF chairman of neuroscience and a research career scientist at the affiliated Gainesville Veterans Affairs Medical Center, conducted studies at the UF Brain Institute involving 15 cats with spine injuries. They showed that transplants of embryonic nerve tissue -- from cat to cat -- helped 40 percent of the animals regain at least partial walking ability. Prompted by that success, a team led by neuroscience Research Assistant Professor Ed Wirth adapted the technology for humans. Research indicates embryonic tissue transplants also could offer promising advances in the treatment of Parkinson's, Alzheimer's, Huntington's, epilepsy, diabetes, leukemia and other debilitating and deadly conditions. "Everybody talks about a cure for crippling spinal cord injury," Reier said. "But our philosophy is there's no single 'magic bullet' that will make someone get out of the wheelchair and walk. It will take a combination of approaches. At this point, no other technique has received the degree of scrutiny and work that embryonic tissue transplants have in actually restoring function of a damaged spinal cord." What may be practical now are what the researchers call "little victories," subtle improvements in function that can make a big difference to paralysis patients. "If you can restore bowel or bladder function, relieve muscle spasticity or restore sexual function," Reier said, "it would yield huge improvements in quality of life and independence for paralysis patients."

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