June 2018 – Restoration of hand function in spinal cord injury

Researchers at King’s College London have shown that rats with spinal cord injuries can re-learn skilled hand movements after being treated with a gene therapy.

People with spinal cord injury often lose the ability to perform everyday actions that require coordinated hand movements, such as writing, holding a toothbrush or picking up a drink. Regaining hand function is the top priority for patients and would dramatically improve independence and quality of life. No regenerative treatments are currently available.

The researchers tested a new gene therapy for regenerating damaged tissue in the spinal cord that could be switched on and off using a common antibiotic.

After a traumatic spinal injury, dense scar tissue forms which prevents new connections being made between nerve cells. The gene therapy causes cells to produce an enzyme called chondroitinase which can break down the scar tissue and allow networks of nerve cells to regenerate.

Professor Elizabeth Bradbury from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) said: ‘What is exciting about our approach is that we can precisely control how long the therapy is delivered by using a gene switch. This means we can hone in on the optimal amount of time needed for recovery. Gene therapy provides a way of treating large areas of the spinal cord with only one injection, and with the switch we can now turn the gene off when it is no longer needed.’

Most human spinal cord injuries occur at the neck level and affect all four limbs. The researchers gave the gene therapy to rats with spinal injuries that closely mimicked the kind of human spinal injuries that occur after traumatic impacts such as car crashes or falls.The researchers had to overcome a problem with the immune system recognising and removing the gene switch mechanism. To get around this, the researchers worked with colleagues in the Netherlands to add a ‘stealth gene’ which hides the gene switch from the immune system.

Our Patron, Melanie Reid, writes Spinal Column The Times each Saturday about life with a spinal cord injury, her recent article was hopeful about this potential therapy

Dr Mark Bacon, Executive and Scientific Director, Spinal Research said: “Transferred to the clinic, this research, which we are proud to fund, could be life-changing for the millions of people worldwide with paralysis caused by a spinal cord injury. An improvement in hand function will increase independence and decrease reliance on care. The collaborative nature of the research is an example of the innovation that is needed in medical research, and one that Spinal Research aims to promote and fund in order to accelerate effective treatments for spinal cord injury.”

Visit KCL website for further information and a video

Original article: ‘Immune-evasive gene switch enables regulated delivery of chondroitinase after spinal cord injury’, Burnside et al, Brain June 14 2018