July 1999

Cure  
by Clayton Lewis 

One of the refrains that I kept hearing during my rehab was that a cure is coming. That they are figuring out the human CNS (Central Nervous System) and that a cure is on the way. The best estimates are that within 15 to 20 years there will be a cure. I was also told that the best way to be ready for the cure when it comes is to stay in shape and take care of yourself. When you think about it, that advice is really just simple common sense.

I was looking recently at the SCS (Spinal Cord Society) newsletter, their motto is "cure, not care." I think that thinking like that is stupid, because without care there is no point of a cure. The people that mope around and don't do anything simply because they can't walk won't be able to be helped by a cure. It will be the people like me who take care of themselves that will benefit from a cure.
 
There are three basic theories behind the SCI cure, rejuvenation, regeneration and replacement.
 
Rejuvenation
 
The idea behind this theory is that since the spinal cord is rarely severed, the connections in the cord are there but just are not working. There is a problem though, the connections are there but they are not working because they have lost their natural insulation. Similar to what happens in MS, the connections cannot re insulate themselves and therefore do not work. The drugs out there to try to combat this problem are IN-1, 4-AP, and NT-4. The drugs all try to do the same thing, promote the growth of lost connections and to promote growth of the insulation on the connections that still exist yet do not function.

Regeneration
 
The basic theory behind this one is that the cord seems ready to try and rebuild itself after injury, but it can't because of the hostile environment. The problem is that the cord tries to regrow itself at first, but is stopped dead in its tracks by something the body produces. The idea is to keep the process which prevents regeneration at bay and to let nature take it from there. It is a simple idea but the human CNS is very complex. However, scientists are making huge strides in this area. There are many drugs under investigation that either keep the processes at bay or promote growth in spite of these processes. The drugs are NT-3, IN-1, NT-1, L-1, and GM-1. These drugs are either used alone or in combination with other drugs to see if they work. It is only a matter of time before we hit the right combination.
 
Replacement
 
The idea behind this one is that the cells can be swapped for fetal tissue or genetically engineered cells. The HUGE problem with this is that transplanting fetal human cells is scientifically difficult and also politically hard. Even if it can be done most of the cells transplanted in die soon after placement. Also, tissue from other species is usually rejected by the host in a short amount of time. Genetic engineering is still in the infantile stage and it will be a few decades before any good uses can be integrated. Replacement is one of the least popular ideas but it is still being investigated as a possibility.
 
The problem that all three of these theories face is that on occasion, a scar forms at the site of the injury and will not let any growth happen at all. There are many studies going into the battle of eliminating the scar so that the theories can be put into practice when they are ready. Also, research has proved that there is only modest scarring and that any of the treatments that are under investigation now will easily solve the problem. There is a line between some scientists that argues whether or not the scar prevents the growth of the connections. But even with all of the bickering science marches on.
 
As I said before, all I heard from most everybody, doctors, nurses, rehab techs and researchers is that a cure is on the way. They also said that the best way to benefit from it was to be prepared for it when it comes.

When a cure does come, it is not going to be something one just goes in for an operation and comes out just fine and dandy. Any operation/procedure would only repair the spinal cord. With some cases, people may not get a full recovery, some may just gain back bowel and bladder control, regain some feeling, etc. Those who do get full return will have to go through very extensive rehab, the will literally learn how to walk again. In any case, it is going to be a long, hard road.

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