A Matter of WHO
Iceland's popular ex-president, Vigdis Finnbogadottir (left), helped the conference become a reality. "Icelandic women were the strategic energy behind all levels of the meeting," says article author Laurance Johnston (right).
An infusion of fresh ideas marked a World Health Organization conference for SCI researchers.Audur Gudjonsdottir, an Icelandic nurse, had little experience with spinal-cord injury (SCI) until her daughter was severely injured in an automobile accident 12 years ago. With a committed mother's relentless energy, Gudjonsdottir began searching the world for therapies that could help her daughter.
One direct outcome of her search was a conference held in Reykjavik, Iceland, on June 1-2. The World Health Organization (WHO) and Icelandic health officials sponsored "New and Emerging Approaches to SCI."
The international scope of the conference resulted in presentation of diverse SCI approaches, ranging from mainstream to alternative medicine, from the status quo to the controversial, from the large academic medical center to the small independent clinic, and from Western to Eastern medicine.
Attendees included about 30 scientists representing the United States, Brazil, China, England, France, Iceland, Israel, Mexico, Russia, and Sweden.
Several presentations focused on using transplanted precursor cells to promote regeneration. Paul Reier (Gainesville, Fla.) summarized his studies involving fetal-tissue cell transplantation. In one recently completed clinical trial, such tissue was transplanted into human syringomyelia cysts (an expanding cavity that causes loss of function). The study proved the procedure is feasible and safe, and the cavity-filling tissue can apparently restore function lost due to cyst expansion. Reier also discussed the intriguing potential of certain cancer cells to transform themselves into neuronal cells.
Reier now believes his fetal-tissue results are due to the presence of stem cells within the tissue. These cells are the focus of Evan Snyder's (Boston) cutting-edge research. Snyder told how these omnipotential "master cells" can develop into motor neurons able to integrate into existing spinal-cord circuitry. He indicated stem-cell differentiation is triggered by repair signals the damaged spinal-cord host issues.
Semion Rochkind (Tel Aviv, Israel) discussed how laser irradiation enhances cellular transplantation. In his experiments, the transected rat spinal cord was filled with a gel containing embryonic spinal cells. Functional recovery was much greater in rats then irradiated with laser energy.
Giorgio Bunelli (Brescia, Italy) and Zhang Shaocheng (Shanghai, China) explained their use of peripheral-nerve bridges (the nerves outside the brain and spinal cord) to restore function. For example, Shaocheng has rerouted the intercostal peripheral nerve (i.e., leading to the side rib area) that emanates from the cord above the injury site to the spinal-cord nerve roots below the injury. Most of the 30+ patients (including Gudjonsdottir's daughter) treated with this procedure regained significant function.
Several scientists discussed function-restoring surgical procedures that create new, supporting circulatory and physiological connections to the injured cord. Georgie Stepanov (Moscow, Russia), Hernando Rafael (Mexico City), and Harry Goldsmith (Reno, Nev.) have grafted to the injured cord omental tissue, a physiologically active, gut-associated tissue that promotes regeneration (see The Omentum Momentum,? March 2001 PN). Goldsmith emphasized that restored function is greatly enhanced through aggressive therapeutic exercise, discussed previously by SCI exercise physiologist Arnie Fonseca (Phoenix).
Several speakers focused on various alternative and Eastern healing traditions such as acupuncture, qigong, and Ayurvedic medicine. Albert Bohbot (Sense-Beaujeu, France) discussed laserpuncture, a treatment combining elements of acupuncture and laser therapy.
Several speakers focused on research surrounding increasingly sophisticated functional electrical stimulation (FES) devices and applications. In FES, an electrical current is applied to the paralyzed neuromuscular system to control paralyzed muscles. Some speakers—Anatoly Vitzenson (Moscow, Russia), Nick Donaldson (London, England), and Maurizio Ferrarin (Milan, Italy)—focused on studies associated with FES-stimulated walking. In contrast, Michael Keith (Cleveland) summarized the results of implanting FES neuroprostheses to restore hand function in more than 200 people with quadriplegia.
The conference's whole-is-greater-than-the-sum-of-the-parts philosophy believed big breakthroughs will happen only if we open-mindedly bring together divergent yet often synergistic treatment and research perspectives. Recognizing that today's cutting-edge scientific insights are often tomorrow's anachronisms, this conference attempted to set aside the illusion of knowledge that so frequently inhibits discovery.
S. Laurance Johnston, Ph.D., who lives in Boulder, Colo., contributes the Heali ng Options column and frequent feature articles.
A Matter of WHO
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