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Stem Cell Therapies Show Promise IN A 2019 review of stem cell thera- pies for acute spinal cord injuries in the Journal of Neurosurgery, a group of Stanford University researchers concluded that these therapies have the potential to reverse paralysis, and that treatments using bio- materials, such as scaffolds, to supplement and support implanted stem cells exhibit promise. "While more extensive validation is required before transitioning cell-based therapies into the clinic, current results and ongoing efforts suggest that stem cell-based approaches may play a major role in improving acute [spinal cord injury] therapy," the researchers wrote. Stem cell therapies may repre- sent the future of spinal cord injury treatment, but in Japan, they're also the present. In a controversial and first-of-its-kind step, in early 2019, the Japanese government approved a stem cell therapy to treat spinal cord injuries following a clinical trial in which researchers used patients' own mesenchymal stem cells to partially restore motor and sensory function, according to Nature. The journal reported that researchers not involved with the study criticized the decision to approve the therapy for clinical use because the trial was not double-blinded, making it difficult to determine the true effects of the treatment or whether the risks outweighed the benefits. cost to the hea lthca re system. Ma ny individuals living with spinal cord injuries must cope with long-term complications, such as chronic pain or bowel and bladder dysfunction, according to the National Institute of Neurological Disorders and Stroke. A method of repairing injured spi- nal cords remains elusive, so treatment for spinal cord injuries often focuses on reha- bilitation and mitigating complications. Researchers and clinicians still have much to lea rn about the spina l cord, including its anatomy. A team of research- ers at the Seattle Science Foundation believes that unlocking the spinal cord's mysteries is key to finding a way to heal it. The group is in the midst of a five-year, $15 million project to create a novel, open- access, 3D spinal cord atlas that will serve as a resource for researchers developing new therapies. In a 2018 essay for STAT, resea rch team members Marc Moisi, MD, Chief of Neurosurgery at DMC Detroit Receiving Hospital, and R. Shane Tubbs, PhD, Chief Scientific Officer at the Seattle Science Foundation — a long with foundation ambassador Ricardo Lockette, a former profes sion a l footba l l player whose career ended as a result of a spinal cord injury — wrote, "One thing holding back the development of new treatments is a detailed atlas of the spinal cord. With a clearer understanding of this vital tis- sue at the macroscopic and microscopic levels, clinicians could better treat the complex chronic conditions linked with spinal cord injury." THREE PHASES Work on the spinal cord atlas will take place in three phases. Currently in progress, Phase 1 involves mapping the spina l cord at the macroscopic level. Using high resolution and depth- of-field techniques, researchers are digitizing the spinal cord and blending focal stacking, image stitching and 3D depth maps to reveal the spinal cord in exquisite detail. I n Ph a s e 2 , t he t ea m w i l l u s e high-powered microscopy to map the anatomy of cells and tissues. The spinal cord atlas project will culminate with Phase 3, during which the team will synthesize the data from the first two phases to create a comprehensive, virtual atlas of the spinal cord that will be accessible online. With this tool, researchers and clinicians will be able to peer inside the spinal cord for a 3D, layer-by-layer view of the tissue at every point along its length. The Seattle Science Foundation envisions the finished atlas as a kind of GPS to help users explore and orient themselves in the spinal cord. "This atlas will yield highly spe- cific views of each layer of the spinal cord and its microcircuitry. That will give researchers and physicians greater knowledge of the precise areas of the spine that control specific muscles and functions," wrote Drs. Moisi, Tubbs and Lockette for STAT. A POTENTIAL CATALYST FOR INNOVATION The atlas developers believe it could help researchers develop stem cell therapies to repair the spinal cord or allow for elec- trodes to be precisely placed to activate certain muscles, enabling recovery of movement below the level of a spina l cord injury. In a 2018 interview, Seattle Science Foundation President a nd CEO Rod O s k o u i a n , M D, t o l d L i f e S c i e n c e Washing ton's News Beat newsletter, "Direct electrical stimulation of deep brain structures for such diseases as epilepsy and movement disorders like Parkinson's disease is now an everyday occurrence. Therefore, with a new and better understanding of the spinal cord as afforded by the new 3D Atlas of the Spinal Cord, such direct stimulation of the spinal cord might be considered for various diseases that were once consid- ered untreatable." n M D N E W S . C O M /// M D N E W S C E N T R A l P E N N S y lvA N I A ■ 2 0 2 0 1 5