Working 2 Walk

Just another weblog

Breakout 1: Wise Young

Posted by katewillette on April 13, 2008

Gahh, my laptop just had a meltdown, so I’ve been frantically trying to fix it and simultaneously take notes.

Wise has been doing the quick rundown about what an injury to the cord means, physiologically.  If I had to miss something, I guess this part would have been my first choice . . . it’s the standard information. He’s explaining how it is that things pass through damaged cords. . .  talking about reflexes . . . he says that Chris Reeve’s reflexes were so strong that if you gave him a hug, his spacticity would toss his 250# body right out of the chair.

He says that people should stop thinking about axons as if they were wires . . . they’re not.  They’re living body parts, like arms.  And when we talk about regenerating them, we’re talking about re-growing body parts.

It takes a long time to grow an axon–as long as a year for a quad to get an axon all the way down the cord.

Spasms are the result of messages from above that get mixed up trying to get through the dead part of the spine.  Neuropathic pain is the result of messages from below that get mixed up trying to get through the dead part.

Putting in stem cells and expecting people to walk is never going to work, because 3 things are necessary for regeneration.

The first one is to replace the damaged injury site with something that is hospitable to axonal growth, but not so hospitable that the axons enjoy the environment so much that they just stay there.  What we need is something just friendly enough to be a bridge.  Hello, nice to see you, move along.

The second one is to have something that is a sustained source of growth factors that will stimulate the system to grow and keep growing.

The third one is to find a way to deal with the things natural to the cord that inhibit growth–the blockers.

In order to get regeneration, we need all 3: a bridge, a source of growth factors, and blockers.

The process of figuring out how to make this work in humans is about combination therapies.

Wise says that after the 2004 elections he looked at the situation in the USA and realized that there was no hope for any federal funding.  At about this time he met Suzanne Poon, a Chinese woman whose son has an SCI.  Earlier he had met the parents of the Chinese girl who broke her neck at the NY Olympics in 1998, who came to his lab and asked about therapies.  His first trip to China was in 1999, where he was invited to talk about methylprednisolone, the steroid that has helped so many injured people.  In this way he met virtually every doctor working on sci in the country.

He and Suzanne decided to do the clinical trials in China.  He got all the doctors together at Hong Kong University, with the blessings (but not the funding) of the Chinese government.  Wise had made the case to them that curing sci was better than going to the moon. . . they were hoping it would happen before the Olympics this year. (So was I.)

There are more than a million people living with sci in China.

Dr. Young’s group is on track with the clinical trials, which are unbelievably complicated to run.

Okay, lithium.  Some Chinese doctors published a paper saying that lithium promotes regeneration.  Here are 3 recent findings that, says Wise, really opened his eyes.

1.  Lithium attacks a critical enzyme GSK3beta, which turns on growth programs in cells.  There are 2 nuclear factors . . . he had his undergrads sprinkle lithium on stem cell cultures, which caused them to grow 3 or 4 times faster than controls.

2.  He found out that vets knew that if they gave lithium to dogs, it would improve their white blood cell count.

3.  People with manic depression who have been taking lithium for years have lots more neurons than the rest of us.  Lithium grows neurons!

4. In 2005, a study was done with 44 patients who had ALS.  A control group (half of them) got a drug that improves survival by 33 months.  In August of 2007, a quarter of the control group patients had died, and all of them had lost a lot of function.  NONE of the lithium group had died, and they hadn’t lost function either.

Lithium makes neurons grow!  So, in China this is the plan.

Test lithium alone for safety and feasibility.  (In progress. A lot of the patients dropped out, but there have been no problems — especially no increased pain, which was the big worry.)

Test umbilical cord blood cells alone. (Has been given to many thousands of people already, with no problems.)  There are places in India and China that are doing umbilical cord blood through IV for $30,000 per procedure.  Wise says it’s a scam.

Combine the two of them in a randomized trial to find out if the combination is better than either one alone. Design a study to make sure it wasn’t the surgery itself that made the difference.

The thing I hear from Wise (as I have every single time I’ve ever been lucky enough to hear him speak) is his absolute determination to make the cure a reality.

Add the antibodies, of which there are 3 great candidates (rhok & rho, chase, IN-1)

People ask:  Wise, should I go to China for clinical trials???

He says that he used to say, yes.  Now his thinking is that –because the pope himself would be thrilled with the treatments they’re using in China–there’s no reason at all why the USA could not do these trials.

The problem is money.  No CDRPA for all these years. No money from the NIH.  No money from the state of New Jersey.

How much money?  The more, the faster.  In China they’re trying to do the trials with $6 million.

In the USA, it would cost $20 million for a single clinical trial.  This is the entire budget of the CDR foundation. Companies would do this if there were a way to make money, obviously.

The passage of CDRPA would mean $300 million, which would be a great beginning.  Oh, man.

Guy in a chair asks if it will ever be profitable for companies to do a full-on, back-to-normal cure.  Wise says that Acorda is now making a profit, but that it’s a very hard sell to convince executives.

Combination therapies are only approved by the FDA if it can be shown that the combination is better than each of its elements all alone.

In China they’re working on chronics, which most labs will not touch.  In Wise’s lab they keep 150 rats with sci.  He has 4 people whose only job is to squeeze the bladders of these little guys.  They don’t like catheters!

He holds workshops to train researchers how to work on sci — 4 times a year, year after year.  This is why there are a couple of thousand people who now understand how to do this kind of research.

Todd asks for a popcorn test . . . if this were a movie, and I’d just run out for popcorn, and I came back in and said “what did I miss in your life in the past year?” how would you answer?

Wise says that he’s been mostly in China.  In addition to everything else, he’s been focusing on the question of how to overcome the need for immunosuppression drugs.  He spends a huge amount of time trying to find money, not just for his lab but for the industry as a whole.

Question: Who should we ask for $$$$?

Google? Gates? Let’s have a lot of baskets, says Wise.

End . . . we love you, Wise.

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