David Landewee already can feel sensations in his stomach. His breathing is stronger. He can even sit up and flex muscles in his legs.
Nearly 10 years after a car wreck left him paralyzed from the chest down, the 42-year-old Clay County man now is confident he’ll walk again.
Landewee gained this new optimism after traveling to China in February for a $20,000 operation to inject cells from aborted fetuses into his spine.
“I’ve already got way more than my money’s worth, and the real results haven’t begun yet,” Landewee said.
The procedure has drawn hundreds of paralyzed patients from the United States and other countries who hope these cells will stimulate their damaged spinal cords to regenerate. Patients with ALS also have gone to have fetal cells injected into their brains to halt the progression of their illness.
The Miami Project to Cure Paralysis, a research center at the University of Miami, has pointedly withheld its endorsement of Huang’s surgery and warned patients that they could be disqualified from tests of more promising treatments in the future if they undergo the procedure.
Even researchers who are supportive of Huang’s work are guarded in their opinions.
“It’s not a cure. It’s not a miraculous treatment, but this is a first step,” said Wise Young, a Rutgers University neuroscientist who helped train Huang and who has visited him in China and seen his work. “It appears to be producing modest improvements in some people. For many patients this is the first therapy that works.”
The spinal cord is a bundle of nerves that transmits sensations from the body to the brain and relays orders from the brain to the muscles that move the body.
Spinal cord injuries had long been considered permanent because the nerve cells in the cord do not grow back effectively. But in recent years, promising research into regenerating the damaged nerves has given new hope to the estimated 247,000 people in the United States with spinal cord injuries. Researchers are using stem cells, nervous system cells and experimental drugs to coax the nerves to grow.
The late Christopher Reeve, the actor who was paralyzed in a horse riding accident in 1995, made improved treatment of spinal cord injuries a high-profile issue and expressed hope he would walk again.
Reeve staunchly supported controversial research on stem cells to regenerate spinal cord nerves. Huang, however, has taken a different but equally contentious approach.
Instead of stem cells, his therapy employs specialized fetal cells that are involved in the sense of smell. The olfactory nerve, which sends sensations of smell to the brain, continually regenerates throughout a person’s life. The cells Huang uses, called olfactory ensheathing Glial Cells, support this Regeneration by wrapping around nerve fibers and promoting their growth.
After Landewee was injured, he kept himself in physical shape, confident that a cure for his injury would be available someday. He has worked out regularly on an exercise bicycle with electrodes that stimulate his thigh muscles. He’s used other machinery to keep his leg muscles stretched and limber.
Now, he is undergoing Physical Therapy to try to build on the improvements from the operation.
In September 1995, Landewee was on his way to his job as an electrician at the Ford Claycomo plant when he swerved to avoid a car entering the highway and his car rolled.
Several weeks later, he woke in a hospital bed. His spinal cord was nearly severed; only a few connecting strands remained at the point of the injury. He was told he would never walk again.
Like Reeve, Landewee became an advocate, helping pass a Missouri law to use some of the revenue from traffic violations for spinal cord research. He also began his search for an effective treatment.
“There’s a lot of things out there, but it’s like snake oil — they’re trying to take your money,” Landewee said.
Last year, when Huang’s work began to receive positive publicity, Landewee signed up for the surgery, paying for it out of pocket.
He and his father, Irvin, arrived in Beijing on Feb. 25. After eight days of X-rays, blood work and other medical tests, Landewee underwent the surgery.
Huang made small cuts into his backbone above and below the injured area of his spinal cord. Through those incisions, Huang injected the fetal cells.
About five or six days after surgery, Landewee noticed muscle movement in his legs.
“It takes a lot of focus,” he said. “You’re trying to use them after nine and a half years. But I can get them to tense up.”
While he recuperated, Landewee became somewhat of a celebrity at the hospital. He was interviewed by television crews from Turkey, Australia and several other countries who were there to cover Huang’s work.
Landewee also saw other patients at the hospital improve as well — spinal cord injury patients who also were able to move parts of their bodies. ALS patients regained dexterity in their hands and walked with assistance.
Huang has not offered much of an explanation for what is happening to his patients.
“It’s very hard to explain. It’s too fast, too quick (for nerve regeneration),” Huang told a Knight Ridder reporter in Beijing last year. “There is some mechanism. … I don’t know why it works. (But) it helps patients.”
Young, of Rutgers, said he has used laboratory rats to successfully duplicate Huang’s surgery. Just like the human patients, the animals quickly regained limited sensation and movement, he said.
What the fetal cells may do, Young theorized, is stimulate the surviving nerve fibers to sprout new connections.
“Those (connections) could happen in a few days,” he said.
A half-dozen other research groups also have reported positive results using olfactory cells to treat spinal cord injuries in animals, Young said.
“This is not fly-by-night therapy,” he said. “It has a strong scientific basis.”
But much of the U.S. medical community remains skeptical about Huang’s results, particularly any claims of long-term benefits.
“He believes he’s giving a cure to people,” said Maura Hofstadter of the Reeve-Irvine Research Center at the University of California-Irvine. “But he doesn’t follow his patients. They go there. They have the surgery. They’re monitored for two weeks and sent on their way. We don’t know what happens to them after that.”
Although the fetal cell injections may be stimulating nerves to make new connections, Hofstadter said, well-motivated patients also may be benefiting from the placebo effect by trying to do things they otherwise wouldn’t attempt.
Greg Cash of the ALS Association expressed similar doubts.
“We have more questions than we have answers about what he’s doing,” Cash said. “His methods aren’t being shared with the world, and there’s no follow-up to see if it’s doing anything.”
But Young thinks there’s enough evidence of benefits from Huang’s surgery to justify a well-controlled study that follows patients over time. Such a study in the United States would require approval of the Food and Drug Administration. But Young plans to help Huang set up a program next year for long-term monitoring of his patients in China.
For now, Landewee and his family have to believe.
“I heard Doctor Huang tell Dave, ‘You will walk.’ I heard it from his own mouth. I’m from Missouri and I want to be shown, but I hope it’s true,” Irvin Landewee said.
To reach Alan Bavley, call (816) 234-4858
