recent therapeutic approaches

I will try to present some basics and recent therapeutic approaches in the field of spinal cord injury for the interested audience. Please be aware that i am not an expert, but nevertheless the blog could be helpful.

First some basics.

The main obstacles to be overcome are:

- the scar tissue, "synthesized" by reactive astrocytes

- the distance that has to be bridged

- the damaged cell skeletons

- the lost pathway to the other side of the gap

Who are the researchers and how do they address these obstacles?

What are the promising clinical trials?

Regarding the researchers my first important candidate is Prof. Dr. Martin E. Schwab of the University of Zürich. He discovered the structure of Nogo-A protein, a protein that blocks axon growth. On the basis of his work it was possible to develop an antibody against Nogo-A protein, very well done by Novartis (Switzerland) and approved by European regulatory authorities (registry number: EU/3/08/605). The Nogo-A protein is a membrane protein of the myelin. The myelin (a mixture that consists of phospholipids and proteins) is produced by glia cells. The glia cells cover the axon. Promising results were achieved when the antibody against nogo-A protein was used for the treatment of fresh injuries.

For the interested reader: http://www.balgrist.ch/Portaldata/1/Resources/_files/forschung_und_lehre/Antikoerper_bei_Querschnittlaehmung.pdf 

So, the antibody works, the growth is no longer blocked? The system is ready to go?

Yes, of course, but now we reach the next hurdle, the strong scar tissue (in the case of old injuries)

As an analytical chemist by training i have only limited knowledge in this field, but i learned about Natalia`s group working on nanozymes at the University of Moscow, about Emre`s sophisticated microjet reactor being able to deliver an amazing variety of "nanos", about Geoffrey`s plasticity model based on olfactory ensheathing cells, about the research on calpain and cortactin. So, in my opinion it would be very promising connecting all these projects. 

Are there ideas how to realize such a global project. What would be necessary? 
Sponsors? 
Budget? 
Timelines? 
Project leader? 
Cooperation with pharmaceutical industry?

In addition Novartis developed a computer model for a simulation of the circulation of spinal fluid, incorporating pulsations generated by heartbeat and respiration and the effect of spinal nerve roots on the flow path; so the model shows the way how to administrate the treatment into the spine.

The Chinese Wujing General Hospital in Beijing developed a CT-guided intraspinal injection technique;

Stephen Strittmatter's team at Yale works on a recovery from chronic spinal cord contusion after Nogo-1 receptor intervention. They use a new compound, the NgR1 decoy receptor protein which prevents binding of growth inhibitory proteins to NgR1 receptor. This strategy blocks all 3 myelin inhibitors (Nogo-A, MAG and OmGP).

Frank Bradke and his team (Max Planck Institute of Neurobiology) used a special microscope to see inside living nerve cells.