Paralyzed Man Walks Again After Olfactory Stem Cell Transplant

A paralyzed Bulgarian man recently regained the use of his legs from a new process which harvested stem cells from his nose.

A team of Polish and English doctors led by Professor Geoffrey Raisman – Director of the Department of Neural Regeneration at University College London’s Institute of Neurology – performed the operation. Raisman defined the achievement as “more impressive than man walking on the moon.”

The patient, Darek Fidyka, is the first person ever to regain use of his legs after a total loss of functionality of the nerves of the spine. The 40-year-old man became paraplegic after being repeatedly stabbed during a 2010 incident. For two years, the patient participated in intensive rehabilitation without any positive results.

He said walking again “incredible,” adding, “when you can’t feel almost half your body, you are helpless, but when it starts coming back it’s like you were born again.”

Patient Treatment Plan

In the first of two operations, surgeons removed one of the olfactory bulbs from the patient and cultured stem cells (1). Two weeks later, the cells were transplanted into the spinal cord. Physicians applied approximately a hundred micro-injections above and below the lesion (2). Later, four thin strips of nervous tissue were harvested from the ankle and placed on a lesion with an eight millimeter gap, on the left side (3).

After the transplant, the patient underwent intense muscle training for five hours per day, five days a week at the Akson Neuro-Rehabilitation Center in Wroclaw.

• After three months: Fidyka started to recover muscle movement in the left leg and to feel heat, cold, and needle pricks in his lower body.
• At six months: he took his first steps with the help of a physiotherapist.
• After two years: the patient can walk outside of rehab with the support of a walker, and also recovered some bladder and bowel sensation and sexual function.

Researcher Dr. Pawel Tabakow said, “it’s amazing to see how regeneration of the spinal cord, something that was thought impossible for many years, is becoming a reality.” The journal Cell Transplantation published the results.

BBC One’s Panorama program monitored the patient’s rehabilitation after transplantation.

The Quantum Leap

Olfactory cells continually renew nerve fibers in the olfactory system. This treatment used olfactory ensheathing cells (OECs) – specialist cells that form part of the sense of smell. Previous studies conducted by Raisman on animals showed OECs injected into the rat spinal cord could reverse paralysis.

Tabakow, a consultant neurosurgeon at Wroclaw University Hospital, was working on similar research and approached Raisman to collaborate on a human recipient of the treatment.

Doctors didn’t need to use immunosuppressive drugs because they were using the patient’s olfactory bulb reducing the risk of rejection. Furthermore, MRI scans suggest the eight mm gap in the cord has closed following the treatment – evidence of recovery due to the regeneration of cells.

More patients needed

Despite the exciting results, the team involved in this study don’t want to raise false hopes in patients.   They would like to find ten additional patients to try the procedure again. Dr Tabakow said, “our team in Poland would be prepared to consider patients from anywhere in the world who are suitable for this therapy.”

Future challenges for Regenerative Medicine

This patient outcome would not be possible without the collaboration of researchers and physicians. As medicine becomes more sophisticated and as genomics begin influencing patient treatment options, there is much to learn and share through these collaborations.

As a physician, what do you think of this novel approach to spinal cord injury? Would you like to see more research like this in your country? We will be discussing this in detail in the Sermo community, come join us.