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Mary Ann

Mary Ann Benitez

A combination therapy - using a psychiatric drug and cord blood - based on discoveries by Hong Kong scientists will be used in trials  this autumn on Chinese patients with spinal cord injuries.

The trials, which follow encouraging laboratory results, are the cornerstone of a two-year effort to find a cure for such injuries.

A network of doctors and scientists from 17 centres in Hong Kong, on the mainland and in the US are to test whether lithium - a  drug used to treat  bipolar disorder  - and a transplant of  cord blood  will work to quicken the pace of regeneration of damaged  spinal cord. Three more centres are expected to join the China Spinal Cord Injury Network.

The University of Hong Kong's Clinical Trial Centre is the network's co-ordinating centre, while the university's Spinal Cord Injury Fund  is the initial umbrella organisation for the fund-raising efforts.

About 3 million  people worldwide   with  spinal cord injuries are  hoping that a cure  will be found.

High-profile sufferers included the late actor Christopher Reeve  and Hong Kong's Tang Siu-pun,  better known as Ah Pun.

In Hong Kong, it is estimated that there are between 400 and 1,000 people with  spinal cord injuries.

The absence of accurate data is because the Hospital Authority does not have a classification for spinal cord injury - only recording 2,269 cases, including deaths, of  neck, thorax or pelvis fractures in 2003.

'Hong Kong is at the centre of the China-wide effort to find a cure for spinal cord injury,' said Wise Young,  professor   at the department of cell biology and neuroscience at Rutgers, the State University of New Jersey, in the US.

'Our goal is to demonstrate that within three years, we will be able to go from phase 1 to phase 3 clinical trials with less than US$10 million,' Professor Young said.   'What we want to do is to make spinal cord injuries not an orphan disease anymore ... [In which governments and drug companies] think the treatment is too expensive and too risky so nobody invests.'

To develop a drug and bring it to market takes on average US$800 million and 10 years, he said.

'The first trial [of 20 patients] is  to look at safety and feasibility of lithium in chronic spinal cord injury,' Professor Young said.

Lithium works for the mental illness by stimulating nerve growth factor neurotrophins (families of molecules that help nerves survive and grow).  Laboratory tests in 2004 by University of Hong Kong  scientists So Kwok-fai  and Wu Wutian    showed that lithium stimulated regeneration of the spinal cord.

The second clinical trial involving 60 patients  will  look at the efficacy of lithium.

In phase three, 400 patients will be given transplants of   cord blood into the spinal cord and then randomly separated into groups using  lithium and those without.

Professor Young said:  'It is the first combination therapy [in the world].'

Candidate patients would  be those with a chronic spinal cord injury that was more than a year old and who have been stable for six months, he said.

Six months ago, Professor Young and the Hong Kong team  discovered the combination of  cord blood and lithium resulted in  a tremendous amount of nerve growth factor production.  'And so we were able to show that lithium increases the amount of growth factors by more than 10 times in the spinal cord and so this is a way of treating the spinal cord with growth factors and at the same time, providing a material to bridge the injury site' to allow the fast growth of nerve fibres, he said.



HK to test spinal injury remedy