A man who was told he would never walk again has recovered sensation and movement in his legs after receiving a revolutionary cell transplant.
Darek Fidyka had been paralysed for almost two years following a knife attack, and despite intensive physiotherapy, he showed no sign of recovery. Following the transplant, he began to regain feeling in his legs. He steadily continued on the road to recovery, and two years after the operation, he can now walk again with the aid of a frame.
The transplant was a world-first collaboration effort by surgeons at the Wroclaw University Hospital in Poland and scientists at University College London's Institute of Neurology in the UK, and the findings are published in the journal Cell Transplantation.
The cells that were used to achieve this miracle were taken from Fidyka's olfactory bulb, the structure that gives us our sense of smell. These nerve cells are continually damaged due to the different odours we smell and must be replaced regularly, which means the olfactory bulb is a very rich source of olfactory ensheathing cells (OECs) - specialist cells that form part of the sense of smell.
OECs provide the pathway for the damaged fibres in our nose to grow back, enabling nerve cells to regenerate themselves throughout our lifetime. The team used this unique regeneration quality to repair Fidyka's damaged spinal column cells.
Using these cells for the transplant meant there was no danger of rejection, and eliminated the need for immunosuppressive drugs that are typically used in transplants.
Professor Geoffrey Raisman, a spinal cord injury specialist at University College London's Institute of Neurology, who led the research, told Cahal Milmo from The Independent, "I believe this is the first time that a patient has been able to regenerate severed long spinal nerve fibres across an injury and resume movement and feeling".
The technique involved first removing one of Fidyka's olfactory bulbs, and culturing it in the laboratory to generate about 500,000 OECs. The OECs were then transplanted into the damaged area in his spinal cord. His incredible recovery suggests that the OECs provided a pathway for the fibres around the injury to rejoin, by creating a "nerve bridge" between the damaged ends of the spinal cord. This regeneration reopened communication pathways between his brain controlling muscles and his lower body.
"What the procedure does is provide a bridge that enables cut nerve fibres to grow across a gap. The cells open up a door on either side of the broken tissue and create a pathway for the nerves to follow," Raisman told Richard Hartley-Parkinson from Metro.
The team plans to assess the technique in more patients over the next few years, and hopes that it could be a future treatment for patients with spinal cord injuries.
Raisman told Milmo from The Independent, "We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury."
Sources: BBC, Metro, The Independent