Quotes of the Day

Monday, Aug. 16, 2004

Open quoteThe Chaoyang hospital in central Beijing is an unlikely place to seek cutting-edge treatment. Orderlies in the shabby five-story building pile surplus furniture in the crowded hallways and push patients around on jerry-rigged gurneys made with bicycle wheels. Yet Nan Davis has traveled halfway around the globe to undergo a new procedure available only here. Six hours ago, Dr. Huang Hongyun injected 1.5 million fetal cells into her damaged spinal cord. Davis, a teacher from Ohio, hasn't walked since 1978 after a car crash left her paralyzed from the bottom of her rib cage down. Shortly after she awakens, Davis signals with a thumb and index finger that she can feel nearly two inches lower than before. "My goal," she says, "is to regain my stomach and back muscles enough to sit up straighter."

That might not sound like a breakthrough, but more strength in her trunk would significantly ease the pain in Davis' joints. And she's not alone in pinning her hopes on Huang. In three years, Huang says, his cell-transplant surgery has helped nearly 500 paraplegics and quadriplegics regain functions that received medical wisdom said were lost forever. Word of his success has spread, and Huang has already drawn 40 patients from the U.S., with about 200 more Americans on the waiting list. Near the hospital, a dozen recovering foreign patients have turned a hotel's fifth floor into a Hall of Miracles. Bob Wolfbauer of Michigan can use his index finger well enough to write his signature for the first time since a bicycle accident two years ago; Jake Giambrone of Alabama can move his right wrist for the first time since a wrestling injury four years ago; and Cade Richardson of Washington State can feel his rag-wool socks for the first time since his paraglider accident in 2001—"my feet itch," he says, "and it feels great."

Huang's novel procedure involves injecting cells from a fetal olfactory bulb, the part of the brain where nose cells terminate, into the damaged area of the spinal cord. Huang says the transplanted olfactory cells help repair damaged nerve cells in the spine. Although he hasn't yet published his findings, the results so far seem compelling. "I'm pretty convinced of definite sensory improvement and modest motor improvement" in Huang's patients, says Dr. Wise Young, a prominent expert in spinal injuries and chairman of cell biology and neuroscience at Rutgers University (where Huang studied under Young as a postgraduate student).

It's rare to see a Chinese doctor blazing such a trail in the surgical field, but Huang has a distinct advantage over American counterparts. China's comparatively lax medical rules mean the safety trials he ran were more cursory than those required in the U.S., where they would typically take up to two years. And the olfactory cells he uses are taken from aborted fetuses, which America's antiabortion lobby would furiously oppose. His follow-up information about former patients remains spotty, and Huang says his bosses have refused to let him share cell samples with other researchers so that they can ascertain just what he's injecting. "Something very interesting may be happening here, but what's needed is independent validation," says Dr. James Guest of the Miami Project to Cure Paralysis at the University of Miami, the world's premier research center on spinal injuries.

Huang, in turn, considers Western research standards too strict. He says some Americans insist his results will remain inconclusive until he conducts a double-blind study, which would mean operating on some patients but not injecting them with the fetal cells that could help them. "Even if it were legal, it's unethical," he says. And he rejects the idea that a lack of experimental controls undermines his claim to having developed a successful technique. "We can compare what happens to people before and after the procedure, and that is enough," Huang says. "The operation is safe, doable and effective."

His single-mindedness stems from personal experience. Huang, who grew up in the remote desert province of Xinjiang, first entered a hospital at age 17 after his father was partially paralyzed by a stroke. The doctors treated the teen with scorn when he asked for information. Says Huang: "I decided then that I would become a different kind of physician." Still, the chance seemed slim. This was during the 1966-76 Cultural Revolution, when universities had been closed; Chairman Mao ordered students into the countryside to learn from the peasantry, so Huang spent years planting wheat on a farm. When the nearest medical school reopened in 1978, he won a place in its first class at age 23. He later studied at New York University and Rutgers, where Dr. Young introduced him to the wonders of the nose.

When olfactory cells regenerate, they grow long neural shoots called axons, which connect to the brain. The axons are like phone wires that carry the signals that allow the brain to differentiate between various smells. They transport these signals with the help of olfactory ensheathing glia (OEG) cells. Because axons extend from all nerve cells, scientists have long wondered what would happen if OEG cells were taken from the olfactory bulb and introduced somewhere else—say, in the spinal cord of someone like Nan Davis.

That's just what Huang does, injecting fetal OEG cells into the damaged spinal cord. What's odd is that they appear to have such a rapid effect. Axons regenerate only as fast as a hair grows, so it should take months for an axon to extend from the point of injury to a paralyzed area. Yet Huang's patients seem to improve within hours of surgery. "Something is happening that we can't understand, but can't ignore," Huang says.

Far from waiting for more research, Huang is branching out. Eighteen months ago he began performing the surgery on patients suffering from the degenerative disease ALS, better known as Lou Gehrig's disease. ALS kills most victims within five years. By transplanting OEG cells to just below the cortex of the brain and in the spine, Huang claims to have slowed the progress of the disease in "several" of his 40 patients, and offers video evidence of one who regained the ability to walk. Another patient, Chicago-based playwright Ben Byer, was diagnosed with ALS in 2002 and underwent surgery by Huang on July 20. Byer says the operation strengthened his weak voice and revived some hand dexterity. "Even minimal improvement is a major gain," he says.

What Huang wants now is a high-profile patient to showcase his procedure. He has approached Christopher Reeve, but says the quadriplegic actor opted against having the operation. "I can't be sure, but maybe he could come off the ventilator after treatment," says Huang. A week after her surgery, Nan Davis is no longer sure that her sense of touch has improved, but her back and stomach muscles feel stronger. She hopes "in a decade this will become standard treatment." Until the results are more verifiable, though, it's unlikely the procedure will spread far beyond this one crowded hospital in Beijing. Close quote

  • Matthew Forney | Beijing
  • A controversial procedure for injured spines has turned a Beijing hospital into a medical mecca
| Source: A controversial procedure for injured spines has turned a Beijing hospital into a medical mecca