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New Treatment Helps Cure Spinal Injuries

wap writes "Researchers have found that an injection of polyethylene glycol (PEG) into the site of neural injury was very effective in saving neurons in dogs, allowing them to recover their movement after the injury. This is an amazing development. PEG is a simple, safe chemical. Using it as a post-injury treatment could prevent paralysis in thousands of accident victims every year, if hospitals start using it. This doesn't mean we don't need stem cell research, but it is a simple and potentially cheap way to get many of the benefits for spinal injury."

25 of 193 comments (clear)

  1. Safe? by xanthines-R-yummy · · Score: 5, Insightful

    I wasn't aware that PEG was safe. Don't you use that stuff punch holes in cellular membranes? Like when making hybridomas (antibody-producing cells used in research).

    1. Re:Safe? by xanthines-R-yummy · · Score: 3, Informative

      For those that want a link.

    2. Re:Safe? by Anonymous Coward · · Score: 3, Funny

      I wasn't aware that PEG was safe.

      It isn't! I knew this one guy who had a hot girlfriend. And she was really into pegging. My buddy was squimish about it, of course, but she was treatening to dump him and find someone who'd let her do it. Anyhow, she just rode him silly. He was so torn up that he had to go to the Emergency Room that night and tell them what happened! Man, talk about embarrasing! I would never let my girlfriend ... what? Oh. I thought we were talking about something else. Nevermind.

    3. Re:Safe? by obiwanjabroni · · Score: 5, Informative

      PEG is already used in a number of treatments as "PEGylation". PEGylation, or the addition of the polyethylene glycol group, to interferons are already being tried as therapy for Hepatitis C. The advantage lies in the ability of the pegylated compound to resist excretion in the kidneys and to increase solubility.

    4. Re:Safe? by Muhammar · · Score: 4, Interesting

      PEG linker is attached to some injectable drugs to modify (prolong and delay) onset of their effect. PEG is also part of some IV formulations. I don't remember that safety of PEG would ever be a big concern. Besides, these patients with spinal injury have to take only one or few doses, it is not like they would be on it for lifetime.

      --
      I doubt that we will ever figure out - and I suspect that even if we did figure out we couldn't do much about it
    5. Re:Safe? by Synbiosis · · Score: 3, Informative

      PEG is used to alter a solutions viscosity in lab. By itself it has no detrimental effect on cells I'm aware of, which is why it's used for that purpose.

    6. Re:Safe? by Psychofreak · · Score: 3, Insightful

      I'll take a temporary increased risk of a severe heart attack to sure death or paralysis. That may be just me, but I also plan to never have more nerve damage done than I already have. Not having full feeling in a few fingertips because of a drift-fence post is unpleasent, but tolerable (sliced through 2 fingers to the bone). Not having any ability to move on my own would be a fate worse than death I think.
      Phil

      --
      Laugh, it's good for you!
    7. Re:Safe? by Idarubicin · · Score: 4, Informative
      I wasn't aware that PEG was safe. Don't you use that stuff punch holes in cellular membranes? Like when making hybridomas (antibody-producing cells used in research).

      As they say, the dose makes the poison. Apparently they've got a working concentration of PEG that can be IV injected that is sufficiently low to not harm healthy tissues--the effect is confined to the location of spinal trauma.

      Actually, I'd strongly recommend looking at the linked article. As with making hybridomas, the scientists here are deliberately fusing cells together. In this case, the idea is that even if a cell is fatally damaged, fusing it to an adjacent healthy nerve cell can allow it to survive.

      Apparently, the PEG also mucks with signalling so that the death of a few cells doesn't lead to apoptosis (cell death) in nearby structures. That's a great bonus. Altogether a very neat result. I'm kind of surprised that this works, actually--I would have expected a lot of fusions between axons and Schwann cells, or something equally useless...very interesting.

      --
      ~Idarubicin
  2. Yes, but... by k4_pacific · · Score: 4, Funny

    Yes, but, does it work if you are paralyzed from the neck up?

    --
    Unknown host pong.
  3. I read 20 years ago... by HotNeedleOfInquiry · · Score: 5, Interesting

    That an injection of DMSO would halt swelling and stop nerve and brain damage in trama injuries.

    As far as I know, nothing came of it, alledgedly because nobody wanted to do clinical trials since it couldn't be patented.

    History repeating itself?

    --
    "Eve of Destruction", it's not just for old hippies anymore...
    1. Re:I read 20 years ago... by nido · · Score: 4, Interesting
      DMSO is wonderful stuff. I once took a divot out of my forehead (stood up into the corner of a cabinet door). I could feel the blood starting to pool up, so I went to look in a mirror. "Yeah, that's going to scar up nicely..." Fortunately I'd heard that DMSO can prevent scars from forming, so I poured some onto a cotton pad and put it on my forehead. It burned a little bit, but it slowed the bleeding down by 90%. Nice. If I look real close I can see a tiny scar. It could've been much worse.

      DMSO takes stuff right through the skin. You can dissolve asprin in dmso and apply it topically, and that asprin will go right to where you need it. I did that for a while, but stopped when I realized I couldn't tell the difference between DMSO+Asprin and straight DMSO.
      It was also shown to relieve pain and swelling, relax muscles, relieve arthritis, improve blood supply and slow the growth of bacteria. It relieves the pain of sprains and even of broken bones. It enhances the effectiveness of other pharmacological agents. If you apply DMSO to a bruise, the bruise dissolves and disappears in a matter of minutes! If you apply it to the jaw after wisdom tooth removal, all pain and swelling is prevented! The pain of acute gout can be handled with the application of 5 cc of seventy percent DMSO in water four times each day. Application to a fever blister results in rapid resolution of this problem. DMSO also relieves the pain of minor burns and if applied soon after the burn happens, will decrease the tissue damage suffered. DMSO speeds all healing, approximately doubling or tripling all healing responses.
      - http://www.medical-library.net/sites/_dmso_dimethy lsulfoxide.html
      I love DMSO, and in fact am about to break out a new bottle, 'cause I've spent too much time on this stupid laptop computer, and my shoulders and forearms are all inflammed. Bathe/dry off/apply/wait 10 minutes/rinse.

      Everyone who's considering using DMSO thing should get a book on the topic, 'cause it's possible to do some stupid stuff. I know a guy who soaked a cotton pad in DMSO and put it on his foot with an ace bandage. His nerves were firing painfully for days... :).
      --
      Learn the rules so you know how to break them properly.
      www.teslabox.com
  4. with advancement comes obsolescence... by viva_fourier · · Score: 5, Funny

    ...and we now sadly bid adieu to the doggy hind-leg cart.

    --
    and now back to the fallout shelter...
  5. Re:What not Stem Cells? Have we been lied to? by johnpaul191 · · Score: 3, Insightful

    this is also to be given right after the accident.... the stem cell work is for people with conditions that have set in, let alone all the other possibilities.

  6. Another recent story on recovery from nerve damage by F13 · · Score: 3, Interesting
    The other day there was a Sciencedaily article on a guy who recoved from nerve damage after a liver transplant.

    Although his problem was due to "a 20-year history of drinking more than 100g of alcohol per day who had end-stage liver disease and weakness in both legs."

  7. Re:cheap? not when it's made by glaxosmithklinemer by Tyler+Eaves · · Score: 3, Informative

    Well, in all fairness, there is a reason for that, to a degree. Medical stuff has to be very, very, very sanitary.

    --
    TODO: Something witty here...
  8. wiener dogs make another contribution to mankind.. by dvd_tude · · Score: 4, Funny

    ... besides eating and burrowing under the covers in one's bed.

    (I'd wish they had tried this on my Roxy when she blew a disk a couple of years back.)

  9. Re:cheap? not when it's made by glaxosmithklinemer by dAzED1 · · Score: 4, Informative
    polyethylene glycol != ethylene glycol

    Don't let yourself be confused. Its not "medical grade antifreeze." That, and stuff you inject into yourself damn well should have higher standards than antifreeze for your car.

  10. Polyethylene glycol is used for... by IO+ERROR · · Score: 5, Informative
    liquid body armor, tattoos, to treat constipation, as a cleaning agent, to stabilize green wood, in cosmetics and many other applications.

    Material Safety Data Sheet

    --
    How am I supposed to fit a pithy, relevant quote into 120 characters?
  11. This is what happens when I read /. at midnight by deathazre · · Score: 5, Funny

    confused polyethylene glycol with ethylene glycol and wondered what they were doing injecting antifreeze into dogs (and wouldn't it be easier to put it in their water dish?)

    --
    Karma: Negative (Mostly affected by dorm trolling)
  12. Bingo by TheBurrito · · Score: 5, Insightful
    I worked in the spinal inury repair field for a number of years, and I think you've hit the nail right on the head. At least one of the nails.

    A while ago, literally about a dozen papers would come out each month professing some miraculous breakthrough in the field. Usually all pretty well done, almost always in big peer-review journals. Very few of these methods have been followed through to clinical trials. The skeptic in me says it's because, as you said, there wasn't always a clear way to profit from it.

    My even-more-skeptical side says that a lot of these results get fudged quite a bit because, thanks to recent attention paid to Christopher Reeve/stem cells et al, there's a lot of money floating around and many opportunities for researchers to make a name for themselves. That's why they never pan out -- they don't work.

    This isn't to discredit anyone working in academic sciences, almost all of whom are grossly overworked and underpaid. However, the trend in NSF funding in the last five years has been to limit the number of researchers receiving grants, and dole out much larger grants to those few promising studies. It creates very cutthroat competition, forces researchers to overhype their studies, and ultimately causes a lot of scientific dead ends. Worst of all, it gives a lot of false hope to people suffering from a number of injuries/diseases that a cure is just around the corner (as long as you write your congressman to give us more money).

    It's really quite sick, and was one of the reasons why I left the field.

  13. Uh, what? by mcc · · Score: 4, Insightful

    There isn't really a "larger issue" here; spinal injuries are one of the most immediately promising applications of stem cell research, and there was an article just like a week or something ago here about curing certain spinal injuries in rats by injecting cordal stem cells.

    Since stem cells are currently in the news as a directly competing potential technique for doing the exact same thing the technique in this article does, it seems mentioning them here is both reasonable and germane. If nothing else I think that saying that new experimental spinal cord research techniques are only "marginally related" to new experimental spinal cord research techniques is perhaps not quite fair.

  14. Times have changed by Bill_Royle · · Score: 3, Funny

    Does that mean we'll have to refer to these recovered dogs as PEG-legs?

  15. DMSO not so great it seems by DoubleReed · · Score: 5, Informative

    A bit of googling turned up the following:

    DMSO
    William T. Jarvis, Ph.D.

    DMSO (dimethyl sulfoxide) is derived from lignin, the binding substance of trees. The Crown Zellerbach Corporation, a mammoth lumber company, holds a number of patents on DMSO for use as an industrial solvent or liniment for treating pain in horses. Crown Zellerbach licenses DMSO exclusively to Research Industries of Salt Lake City for marketing as a drug called Rimso-50. Topically-applied DMSO has the unusual ability to act as a "chemical hypodermic needle" which is to say that it is rapidly absorbed through the skin and can take with it other substances that ordinarily would not cross the skin's barrier. Topically-applied DMSO produces a garlic-like taste in the mouth and a breath odor. Topical use can cause a rash, blistering, itching, hives, and skin thickening. Intravenous use can cause kidney damage and other adverse side effects.

    DMSO was approved by the FDA in 1978 for only one purpose, the treatment of a rare bladder disorder, interstitial cystitis. However, scandal surrounded the FDA's approval of DMSO and some still believe that a cloud hangs over it. Stanley Jacob, MD, served as an supposedly unbiased medical monitor of DMSO between 1974 and 1979, but for three of those years (1974, 1978, and 1979), he was on the Research Industries board of directors. In addition to getting consulting and director's fees, Jacob is said to have bought 50,000 shares of the company's stocks. The medical officer charged with reviewing data from clinical trials of DMSO, K.C. Pani, accepted $36,500 in gratuities from Dr. Jacob during the time. A detailed account of the dubious FDA approval of DMSO is provided by Howard Rosenberg in "The DMSO Affair." [1 ]

    DMSO became a darling among the promoters of quackery after CBS-TV's 60 Minutes portrayed the substance as a medical breakthrough [2]. Some arthritis sufferers testified that DMSO had provided relief. The Arthritis Foundation says that DMSO can act as a liniment with a counter-irritating effect temporarily relieving pain, but it does not reduce inflammation as do truly effective arthritis remedies (Arthritis Foundation, undated). A detailed Public Information Memo was issued to the Chapter Executive Directors of the Arthritis Foundation on November 13, 1981, following the publication of a popular trade book.

    Mildred Miller, owner/administrator of the Degenerative Disease Medical Center in Las Vegas, Nevada, promoted DMSO for a variety of disorders including arthritis, mental illness, emphysema, and cancer. Miller wrote a book touting DMSO entitled A Little Dab Will Do Ya! (Quality Advertising, 1981). Miller also published Preventive Health News, a tabloid-sized newsletter in which she promoted DMSO and carried on a harangue against the establishment (Miller published another book with the disrespectful title Up Yours FDA). Miller was eventually convicted of Medicare fraud and went to prison [2]. The American Cancer Society issued a statement advising against the use of DMSO for cancer [3].

    During its heyday, black market DMSO could be purchased in health food stores, military surplus stores, hardware stores, at swap meet booths, or even from vendors working out of the trunks of their cars parked along highways. Very often black market DMSO is industrial grade, not medical grade. A problem with industrial grade DMSO is that companies bottling the substance as an industrial solvent use the same equipment to bottle other substances. Residual toxic materials can contaminate industrial grade DMSO and may be taken into the body by DMSO's action as a "chemical hypodermic."

    Because of DMSO's dangers and legal status, the FDA has had a running battle with DMSO distributors. In 1980, the agency discussed the controversy surrounding the drug in the FDA Consumer [4]. In 1982, the agency reported on actions taken against companies distributing DMSO in the Pacific Northwest [5]. A book touting DMSO, The Persecuted Drug: The Story of DMSO, by Pat McGrady became the

  16. A little discussion by maximilln · · Score: 3, Interesting

    I didn't know that PEG had therapeutic uses. I've always seen it as a solid support for reagents used in chemical reactions. As a chemist, I like PEG because it's inert to a majority of chemical reactions and is insoluble in many common laboratory solvents.

    In this study I imagine they're using a solubilized form of PEG. It's probably a lower polymeric weight and in a polar/protic solvent--probably aqueous.

    There are a few parts of the article which struck me as questionable, though:

    PEG is able to stop this cascade of injury by repairing initial membrane damage

    I don't think PEG so much repairs anything as it insulates the cells from each other so that they can all repair themselves without the toxic necrosis products causing further harm. I imagine that PEG also helps to moderate pH and prevent further damage that way.

    or by fusing two damaged cells together into a larger functional nerve cell.

    That's a neat theory. I doubt it.

    Significantly, the polymer is attracted only to damaged nerve cells and tissue when it's injected into the blood stream. It doesn't move into undamaged regions nearby.

    That's another neat theory. The pharmaceutical industry would love to know how a molecule with no particular shape or form manages to distinguish between "good" and "bad" cells. I'd be interested to see where the authoring reporter received this idea. I doubt highly that this is from a study of "inject in arm, observe in spine". Most likely the injection site was very close to the damages area and the injected aliquot had a mass and volume low enough to make distribution arbitrarily interpretable.

    --
    +++ATHZ 99:5:80
  17. Go To The Source by Eponymous+Mallard · · Score: 5, Informative
    Whenever I read such an article in the popular press I always try to access the actual scientific journal article about the study. In this case the study was published in the December 2004 issue of The Journal of Neurotrauma which is available online. Just click in the link labelled "Scientists Reverse Paralysis in Dogs" and you can download the complet pdf file of the research paper. (I hope they don't mind being slashdotted.)

    Here is the abstract of the article:

    Lavert, PH et al. A Preliminary Study of Intravenous Surfactants in Paraplegic Dogs: Polymer Therapy in Canine Clinical SCI. Journal of Neurotrauma. December 2004, Vol. 21, No. 12, Pages 1767-1777

    Hydrophilic polymers, both surfactants and triblock polymers, are known to seal defects in cell membranes. In previous experiments using laboratory animals, we have exploited this capability using polyethylene glycol (PEG) to repair spinal axons after severe, standardized spinal cord injury (SCI) in guinea pigs. Similar studies were conducted using a related co-polymer Poloxamer 188 (P 188). Here we carried out initial investigations of an intravenous application of PEG or P 188 (3500 Daltons, 30% w/w in saline; 2 mL/kg I.V. and 2 mL/kg body weight or 300 mL P 188 per kg, respectively) to neurologically complete cases of paraplegia in dogs. Our aim was to first determine if this is a clinically safe procedure in cases of severe naturally occurring SCI in dogs. Secondarily, we wanted to obtain preliminary evidence if this therapy could be of clinical benefit when compared to a larger number of similar, but historical, control cases. Strict entry criteria permitted recruitment of only neurologically complete paraplegic dogs into this study. Animals were treated by a combination of conventional and experimental techniques within 72 h of admission for spinal trauma secondary to acute, explosive disk herniation. Outcome measures consisted of measurements of voluntary ambulation, deep and superficial pain perception, conscious proprioception in hindlimbs, and evoked potentials (somatosensory evoked potentials [SSEP]). We determined that polymer injection is a safe adjunct to the conventional management of severe neurological injury in dogs. We did not observe any unacceptable clinical response to polymer injection; there were no deaths, nor any other problem arising from, or associated with, the procedures. Outcome measures over the 68-week trial were improved by polymer injection when compared to historical cases. This recovery was unexpectedly rapid compared to these comparator groups. The results of this pilot trial provides evidence consistent with the notion that the injection of inorganic polymers in acute neurotrauma may be a simple and useful intervention during the acute phase of the injury.

    Eponymous Mallard. "It it quacks like a duck, it may be the Eponymous Mallard."