Building bridges to restore spinal function

Losing the ability to walk is a frightening thought – but have you ever considered the many other effects of spinal cord injury?

“If you have a spinal cord injury and you’re paralysed, you’re paralysed for life. But it’s not just about walking – paralysis can lead to broader loss of movement, feeling, and autonomic bowel, bladder and sexual functions. People living with spinal cord injury are also impacted by depression, loss of independence, and reduced involvement in employment and education,” said Professor James St John. “We need a treatment that gives people living with spinal cord injury their bodies back.”

Professor James St John, Dr Mariyam Murtaza, Dr Ronak Reshamwala, Dr Mo Chen and their team of more than 40 researchers at the Clem Jones Centre for Neurobiology and Stem Cell Research, based within the Institute for Biomedicine and Glycomics, Griffith University, are on the verge of a human Phase I/IIA clinical trial for treating spinal cord injury to be delivered in Queensland, Australia.

They have developed an innovative, world-first nerve bridge therapy that uses olfactory ensheathing cells obtained from the patient’s own nose.

Olfactory ensheathing cells help protect and repair the sense of smell (olfactory) nerve and they have numerous therapeutic properties that are useful for repairing other regions of the nervous system including the spinal cord. While olfactory ensheathing cells have been tested before in clinical trials, the method of transplantation has always been problematic. To improve outcomes, the team has invented a technique to make three-dimensional nerve bridges using the olfactory ensheathing cells. After transplantation into the injury site, the olfactory ensheathing cells help repair the injury and aid regeneration of functional motor, sensory, and autonomic connections.

The nerve bridge aims to alleviate the negative health, economic, and social impacts affecting an estimated 20 million people globally who live with spinal cord injury. In Australia alone, the lifetime cost of care and lost economic activity for someone with quadriplegia is $9 million and the total current cost to the community for all spinal cord injuries exceeds $3 billion annually.

Professor St John and his team have used a co-design approach across their research, including working with a Spinal Cord Injury National Consumer Research Panel consisting of eight people from around Australia living with spinal cord injury. This has allowed them to go beyond the laboratory to set their work up for success.

To de-risk the upcoming human Phase I/IIA clinical trial, two intensive rehabilitation clinical trials were run with partner organisation Making Strides for people living with spinal cord injury who were either experienced or inexperienced with rehabilitation.

Both trials were very successful – all participants completed the program and there were minor identifiable improvements in their physical and psycho-social health. After the program one assessor noted that participants were much more confident and happier and were looking forward to continuing doing rehabilitation in their own time.

The upcoming human Phase I/IIA clinical trial will look at how participants living with chronic spinal cord injury respond to both the nerve bridge transplantation and rehabilitation program.

“For too long there has been no hope for people, and now this incredible team of medical researchers are starting to make changes that we’ve never seen before,” said Perry Cross AM, Perry Cross Spinal Research Foundation.

Since the opening of the Clem Jones Centre for Neurobiology and Stem Cell Research in 2016, the Centre’s major funders have included the Clem Jones Foundation, Perry Cross Spinal Research Foundation, the Queensland Government, the Motor Accident Insurance Commission (MAIC), the National Health and Medical Research Council (NHMRC) and the Medical Research Future Fund (MRFF).

This funding also supports the team’s wider research program looking at neurodegeneration (particularly Alzheimer’s disease) and nerve repair.

“Our latest round of funding will also allow us to expand the nerve bridge technology to a wider range of nervous system injuries including peripheral nerve and brain injuries,” said Professor St John.

“We can’t underestimate the independence and self-worth that we can give back to people by reversing spinal cord, nervous system and brain injuries. Restoring movements, sensation and autonomic functions, such as having control of their bladders or being able to move their fingers are significant steps forward for people living with such injuries.”