The use of these cells for spinal cord injury repair have been implemented for 30 years now with very controversial results in rodents, non-human primates, and patients. Extreme caution should be used when communicating these findings to the public in order not to elicit false expectations on people who already suffer because of their highly invalidating medical condition.
Fidyka, whose spinal cord was cut completely after a knife attack by his ex‑wife’s husband, had agreed to receive a transplant of cells taken from the nose. These particular cells, called olfactory ensheathing cells (OECs), are known to influence the regrowth of olfactory nerves, which transport smells to the brain and regenerate every 30 days.
In experiments on rats and dogs, OECs had shown promise as a “bridge” that could be used to reconnect severed nerves; previously paralysed animals regained the ability to move. Various teams of scientists around the world were racing to apply the technique in humans. But Fidyka’s surgeon in Poland was forced to take a particularly daring approach; Fidyka’s mucus membrane, ravaged by chronic allergic sinusitis, meant that OECs could not be harvested from the nasal passages.
Instead, the special cells – which are not stem cells but living adult cells – were collected through brain surgery. Neurosurgeons at Wroclaw University Hospital in Poland cut into Fidyka’s skull, extracted the left olfactory bulb and cultured a ready supply of OECs. These cultured cells were then transplanted into the spinal breach, along with strips of ankle nerves to act as a scaffold along which the nerves could regrow.
Within a year and a half, the effects of the pioneering operation were clear: the fireman, who was also undergoing physiotherapy, was able partially to move his lower limbs, could feel sensations in his legs, grew muscle on his left thigh and recovered some bladder sensation and sexual function.
From being struck down with a class A spinal injury – the most severe kind, usually indicating lifelong paralysis – Fidyka had shuffled, albeit with the help of a walking frame, along the spectrum to a class C injury, associated with limited movement. And even though most of us would regard it as a fair bargain, he didn’t lose his sense of smell.
Not only does the research help the injured, but there are longer-term goals in mind: the diseases of ageing, such as heart disease, cancer and Parkinson’s, are largely the result of cell deterioration and cell death. Being able to create healthy, transplantable replacement cells has an obvious place in the future of medicine.
Over the past decade, the hope of tissue repair, including nerve regeneration, has largely been fuelled by the hype of stem cells. Stem cells fall into two types: embryonic ones, which can be harvested from early embryos, with all the attendant ethical quandaries; and adult stem cells, which can be extracted from adult bone marrow and some body tissues.
The key feature of stem cells is their potential to grow into particular cell types; they have a potency that scientists have long dreamt of unlocking, with embryonic stem cells regarded as the most versatile. That is why they have been pursued eagerly as potential therapies for heart disease, diabetes, Parkinson’s and spinal cord injury.
- BBC: Paralysed man walks again after cell transplant
- International Business Times: Paralysed Man Darek Fidyka Walks Again: World-First Treatment Uses Nose Cells to Repair Spinal Cord Injury
- The Guardian: Paralysed man Darek Fidyka walks again after pioneering surgery
- Medical News Today: Paralyzed man walks again after nose cells repair his spinal cord
- The Telegraph: Paralysed man walks again: pioneering treatment could help stroke victims
- Business Week: Paralyzed Man Walks After Cells for Smelling Placed in Spine