Nasal nerve cells used in spinal repair in world first

The world's first clinical trial into repairing damaged spinal cords using transplanted nasal nerve cells now underway in Queensland could have global significance.

The project was launched last month when a surgical team at Brisbane's Princess Alexandra Hospital injected olfactory ensheathing cells into the spinal cord of a volunteer paraplegic patient.

It will be three years before an independent assessment of the progress of eight patients in the trial - half of them control subjects - is due to be released publicly.

But the Phase I trial is already being hailed by Premier Peter Beattie as an early dividend from Queensland's "Smart State" investment in biotech and medical research.

If successful, it will give hope to millions of paraplegics and concentrate world attention on the project, Beattie said.

The eight-hour operation was conducted by a team led by neurosurgeon Dr Adrian Nowitske which included ear, throat and nose specialist Dr Chris Perry.

Using a specially-designed syringe, they injected nerve cells harvested from the lining of a paraplegic patient's nose into an exposed section of spinal cord.

The cells, known as olfactory ensheathing cells, have been shown to assist regrowth of injured spinal nerves in rats.

At a press conference, the team of scientists and surgeons carrying out the Queensland project warned against over-optimistic expectations for the human trials.

"We don't expect to see people getting out of a wheelchair and walking as a result of this," said Dr Tim Geraghty, director of rehabilitation (spinal injuries) at PA Hospital.

"This is very emotive research but our approach is conservative. The major aim of the trial is to ensure we can do this safely without causing harm to patients."

However, ear, nose and throat specialist Dr Chris Perry noted that even small positive developments such as regaining some bladder or bowel function would be of tremendous significance to a paraplegic.

The trial is an extension of pioneering work on cells surrounding the olfactory nerve in the nose by neurobiologists Prof Alan Mackay-Sim and Dr Francois Feron of Griffith University's School of Biomolecular and Biomedical Science.

They have concentrated on olfactory ensheathing cells - a specialised form of the glial cells which form one of the two classes of cells in the brain.

Such cells have long interested researchers because they promote axon growth and can exist both within and outside the nervous system.

The two scientists are recognised as the first in the world to concentrate on the nose, rather than the brain, as a source of glial cells for transplanting into spinal cord injuries.

The distinction becomes important because of the relative ease of harvesting nasal cells from patients compared with brain cells.

Mackay-Sim and Feron have been purifying and cultivating human ensheathing cells since 1998 and have perfected a process by which millions of glial cells can be grown within a few weeks of taking a sample from a patient.

In a collaborative venture with the University of NSW, they showed that transplanted nasal glial cells promoted recovery of locomotor behaviour in the lower limbs of paraplegic rats.

Their work has resulted in patents on the extraction of nasal cells being held by co-sponsors of the research, Griffith University and the Queensland Health Department.

Other patents are held on the specialised syringe developed to give surgeons pinpoint control over the injection process.

In last month's operation, micron-sized volumes of fluid holding cultured cells were injected at 160 sites along a damaged section of spinal cord and in immediately adjacent undamaged areas.

The implantation of cells cultured from a patient's own body eliminates the risk of cell rejection and the need for anti-rejection medication.

However the chance of overgrowth by glial cells in the spinal cord is one of the risk factors which will be monitored in the trials.

Speculating on how the intellectual property held in the process might be commercialised if the trial turns out to be success, Mackay-Sim suggested the state could create a facility to culture olfactory glial cells in injectable proportions from biopsy samples.

The team declined to comment on whether a successful trial of glial cell therapy would remove one of the drivers for embryonic stem cell research.

However, Mackay-Sim noted that very little work had been done on the use of ES cells in spinal cord regeneration. "Everyone has been talking about stem cells but the use of these (glial) cells is where the science has been going for years," he said.