Patients paralyzed by injuries to their spinal cords have the hope of walking again thanks to stem cell therapy, which is expected to become widely available by 2006.
Chosun University professor Song Chang-hun, who gained global prominence last week with the case of a miracle stem cell cure, made the remarks in an interview with The Korea Times.
Due to fast-developing stem cell research and strong aspirations for breakthrough remedies, two years will be enough for it to become,” the 48-year-old scientist said.
During a press conference last week, Song surprised the world by announcing that a person with a spinal-cord injury had successfully been treated with stem cells from umbilical cord blood.
Hwang Mi-soon, who had been paralyzed for the last 19 years due to a back injury, stood up from her wheelchair and shuffled a few paces back and forth with the help of a walking frame.
Song’s team transplanted multi-potent stem cells in Hwang’s spine on Oct. 12 this year and in just three weeks she was able to walk aided by a walker.
Some hailed the research as opening a new era in dealing with spinal cord injuries, but skeptics point out that uncertainty remains because it is just one case.
Song conceded the new treatment has to be duplicated and validated by a report in an international journal, but was optimistic about future success.
“We expect to be able to replicate the success via imminent follow-up tests. We plan to stage clinical trials with four more patients within this year after getting the go-ahead from Chosun University’s ethics board and the government,” Song said.
Almost everything is already set to go aside from the approval process as Song’s team has prepared matched umbilical cord blood stem cells for three patients and is now culturing stem cells for the other.
“Anyway, we will be able to know early next year whether Hwang’s case is just a one-off miracle or represents a bona fide medical innovation to change the face of the treatment of diseases,” he said.
Cord Blood Stem Cell
Umbilical cord blood is a small volume of blood retrieved from the vein of the umbilical cord after the delivery of a baby, with the umbilical cord being cut without any threat to mother or child.
According to Song, most researchers previously believed cord blood didn’t contain the multi-potent stem cells that enabled Hwang to walk.
However, Song’s compatriot Han Hoon from the Seoul Cord Blood Bank (SCB) reversed the general belief by successfully isolating multi-potent stem cells in 2000.
Song’s team started animal tests based on Han’s discovery of multi-potent stem cells, which, despite the name, can only develop into certain types of cells, such as those of blood and bone.
After witnessing mobility restored to paralyzed rats, the team applied the cord blood cells to the human body in Oct. 2003, after first gaining approval from the Korea Food and Drug Administration.
The first patient was a then 17-year-old high school student surnamed Kang, whose lower limbs had been paralyzed as the result of a motorcycle accident.
The outcome was disappointing as the operation yielded little improvement, but Song attributes the failure to the spot where the stem cells were transplanted.
“We injected the stem cells into the spinal fluid instead of directly targeting the spine and that didn’t work. Back then we didn’t even think about injecting something into the spine since it was so dangerous,” Song said.
After the first setback, Song’s six-member team decided to brave the risk of directly attacking the spine after getting agreement from the patient Hwang and that made all the difference.
A Miracle Occurs
About 30 days after the operation, Hwang was able to walk with the help of a walker.
For Hwang, who had been bedridden for the past two decades, the sensory and Motor nerves showed signs of improvement 15 days after the operation was conducted on Nov. 12. After 25 days, her feet responded to stimulation.
“Many of my colleagues including myself still can’t believe Hwang’s rapid progress. We didn’t expect she would improve this fast,” Song said.
Hwang fell from a bridge into a creek on a night in July 1985 while trying to escape from someone she believed was trying to rape or rob her and lost consciousness.
A night watchman found her and moved her to a nearby hospital. Doctors treated her ruptured lung immediately but her spine was damaged too seriously.
When she regained consciousness about 45 days after the accident, she found her lower limbs were paralyzed. She spent the following 19 years in bed or in a wheelchair.
However, she has never given in and has continued to seek ways to improve her condition and her unwavering will resulted in a meeting with professor Song and the current success.
With tears in her eyes, she said at last week’s press conference: “This is already a miracle for me. I never dreamed of getting to my feet again.”
Song’s team plans to carry out a second round of stem cell therapy on Hwang next week with the ultimate goal of having her walk unaided.
“I hope all paralyzed people around the world will be able to get their feet again through stem cell therapy and walk hand-in-hand,” she said.
Two Types of Stem Cell Research
Stem cells refer to primal and undifferentiated cells, which retain the potential to produce any kind of cells in the body.
They are categorized according to their source as either adult or embryonic. Embryonic stem cells are cultured cells obtained from embryos.
Adult stem cells allude to cells obtained from human cells or tissue other than eggs and early embryonic cells. Umbilical cord blood stem cells are unique adult stem cells.
Scientists have tried to apply both types of stem cells to therapeutic uses, and embryonic cells have often been touted as having much potential.
The therapeutic hype for embryonic stem cells grew after Seoul National University professor Hwang Woo-suk cloned a human embryo and took stem cells from it for a world-first time in February.
However, embryonic stem cell research has fanned ethical debate that spans science, politics and religion since it requires the destruction of embryos, which to many are human beings.
In comparison, adult stem cells like those found in umbilical cord blood don’t present an ethical dilemma. In the case of cord blood, it is routinely discarded after the birth of a baby.
Embryonic stem cells also have a dangerous tendency to form teratoma (cancer or tumor of cells) when injected into animals or human beings, something that doesn’t happen with adult stem cells.
“All in all, embryonic stem cell studies have yielded little in the way of concrete results while we are now conducting clinical trials with cord blood stem cells,” Song said.
Stem Cell Therapy on Foreign Patients
On behalf of readers who filled the bulletin board with a flood of questions after an article concerning Hwang, The Korea Times asked Song whether or not expatriate patients can get into the trials.
“Well, we may be able to carry out operations on foreign spinal cord patients after the cord blood stem cell therapy is validated and recognized globally. But it would be difficult to conduct clinical tests on foreigners for now,” Song said.
As a primary reason, Song mentioned the procedures needed in the lead-up to the operation, which are complicated even for Koreans.
However, he added he wants to forge ahead if such barriers can be cleared away.
“I am not sure about the likelihood. But we have no reason not to apply our research to foreigners in an early stage if there are no legal restrictions,” he said.
He noted the late Christopher Reeve, the star of the “Superman” movies and who suffered from a spinal cord injury after being thrown from a horse during a competition in 1995, made contact with his team last year.
“Through the SCB, Reeve asked about the possibility of being treated by our cord blood stem cell therapy, although the talks fell apart for some reason,” Song said.
Reeve died on the eve of the groundbreaking operation on Hwang, to the sorrow of the team, which regarded him as an important target patient.
“We were deeply grieved by his sudden death just a day before our operation on Hwang started. If he were alive, we could conduct an operation on him,” Song said.
Reeve, who made his name through four “Superman” films from 1978 to 1987, died of heart failure on Oct. 10 (U.S. time).
Asked if he would agree to the disclosure of his contact details, the professor said he welcomes any comments or questions through the Internet.
By Kim Tae-gyu