For the first time, researchers have restored significant bladder function through nerve regeneration in rats with the most severe spinal cord injuries (SCI). The breakthrough paired a traditional nerve bridge graft with a novel combination of scar degrading and growth factor treatments to grow new nerve cells from the thoracic level to the lower spinal cord region. Details of the discovery appear in the June 26 issue of the Journal of Neuroscience.
Neuroscientists from Case Western Reserve University School of Medicine and Cleveland Clinic built a regeneration bridge across a lesion in animals with complete gap transections of their spinal cords. Although the animals did not regain the ability to walk, the procedure did allow them to recover a strong level of bladder control.
Jerry Silver, PhD, professor of neurosciences at the School of Medicine, and Yu-Shang Lee, PhD, assistant staff scientist in the Lerner Research Institute of Cleveland Clinic, created the bridge using a scaffold of multiple segments of the animals' own peripheral nerves. Key to the regeneration was surrounding the graft and both spinal cord stumps with a stimulating growth factor and an enzyme to dissolve scar tissue, which inhibits the nerve fibers from crossing over the bridge and traveling down the spinal cord.
"While urinary control is complex and recovery took several months, it was clear that this primitive function lost to spinal cord injury does possess the capacity to rewire itself, even when a relatively small number of axons are regenerated," Silver said.
The spinal cord's role in bladder function is critical, as it relays information between the brain and body. After suffering SCI, urinary dysfunction occurs. The loss of control happens because the axons, or nerve fibers which transmit information from neuron to neuron, are disconnected from the brain stem where the body's urination commands reside.
The creation of the ne
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Case Western Reserve University