NEW HOPES, NEW DREAMS

CHRISTOPHER REEVE IS PREPARING TO WALK AGAIN. WHAT PROSPECTS CAN DOCTORS REALLY OFFER VICTIMS OF SPINAL-CORD INJURY?

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Other potentially useful substances include the fibroblast growth factor, which is found in nearly all tissues and aids in the healing of wounds; and gangliosides, which appear on the surface of cells and may protect and promote the growth of axons.

At the Miami Project to Cure Paralysis, another major center for research, the focus is not so much on coming up with the perfect formula to promote the growth of cells as on transplanting the peripheral cells to a hospitable environment in the central nervous system. "The question," says Mary Bartlett Bunge, a cell biologist and half of the husband-wife team that oversees the project's research group, "is how to get the adequate amount of regeneration for the adequate length so that the fibers can get to their appropriate target."

Miami's researchers cut a small section of spinal cord from rats and constructed a tiny "bridge," which looks like a drinking straw filled with cables of cells immersed in growth factors. They placed this bridge in the rats that were missing a section of spinal cord and found that axons began growing into the graft. The next step will be to treat the rats with more nerve growth and protective factors before grafting the straw, to see if the nerves will venture out of the graft to connect with other nerves and eventually reach muscles and glands.

At the Weizmann Institute in Israel, Michal Schwartz has been working with compounds taken from fish brains. Her approach is to culture them and inject them into the site of the lesion, bridge the gap across the scar tissues and make a new connection. Schwartz has visited Reeve, and is in touch with him regularly.

So the progress went until two months ago, when a group of researchers at the Karolinska Institute in Stockholm succeeded for the first time in helping spinal-cord-injured rats to move. The rats' cords had been completely severed, yet after a bridge transplantation similar to those in the Miami experiments, across a gap of about one-fifth of an inch, they started to flex their hind legs. A year after the surgery, the rats could support their weight and move their legs.

Young, who wrote an editorial in the journal Science to accompany and support the study, notes that the Stockholm technique will not be of immediate use to humans because very few spinal-cord injuries result in totally severed cords. In most cases there is an injury but no gap to bridge. "The bridging technique," he says, "is a proof of concept, an alternative technology that ought to be used if we need to build a bridge. What I think the study should do is to quell some skeptics. We have said that the spinal cord can regenerate... This study is a milestone in showing that something that had been regarded as impossible is possible."

One sidelight of the Stockholm story is that it made front-page news in this country and elsewhere and was a feature item on television news programs. It is doubtful that would have happened before Reeve brought the cause to national and international attention. After the Stockholm success, he smiled and looked eager. "If that's what they're doing over there," he said, "bring me to them. I'm a rat."

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