Introduction to Antibody Therapy for Spinal Cord Injuries
Recent breakthroughs suggest that antibodies could play a crucial role in the rehabilitation of individuals with acute spinal cord injuries.
This exciting field of research has shown particularly encouraging results, especially in identifying groups of patients who are likely to benefit significantly from such therapies.
The NISCI Trial and Its Findings
A pivotal study published in The Lancet Neurology originates from the NISCI trial—short for the Nogo-A Inhibition in Acute Spinal Cord Injury Study.
This large-scale clinical trial, conducted across multiple centers, aimed to assess the impact of the antibody called NG 101 (anti-Nogo-A).
This specific antibody works by blocking the Nogo-A protein, which the body produces naturally.
Previous animal research highlighted Nogo-A as a major barrier to nerve fiber regeneration after spinal cord injuries.
By neutralizing this protein, the antibody seeks to enhance nerve healing and promote recovery.
The trial included 126 participants aged between 18 and 70, all of whom experienced varying levels of spinal cord injuries in the cervical region—commonly leading to tetraplegia, a condition affecting mobility in the arms and hands.
Among these participants, 78 received targeted injections of the antibody into their spinal canal, while the remaining 48 were given a placebo.
Every participant followed a rigorous treatment protocol, which consisted of six injections alongside comprehensive inpatient care.
The design of the study was robust: randomized, double-blind, and placebo-controlled, ensuring that neither the participants nor the healthcare providers knew to which group the individuals belonged.
Motor function, particularly focusing on hand and arm movements essential for daily activities among those with tetraplegia, was meticulously evaluated.
After a six-month period, the results were analyzed to see how the antibody treatment stacked up against the placebo.
Potential for Future Research
The results indicated that individuals with complete spinal cord injuries saw no improvement from the treatment.
However, those with incomplete injuries demonstrated significant enhancements in voluntary muscle activation and greater functional independence in everyday tasks.
Safety was reassuringly documented, as no notable side effects were reported.
This important research, primarily pursued by Balgrist University Hospital, underscores the potential for transformative changes in rehabilitation techniques.
While these initial findings in acute tetraplegia patients are heartening, more research is necessary to confirm and expand upon these results.
A follow-up study featuring an improved antibody is set to begin in December 2024, with a focus on selecting patient subgroups that are most likely to respond positively based on the current findings.
This multinational initiative was led by the University of Zurich, under the guidance of Prof. Martin Schwab, alongside Balgrist University Hospital, directed by Prof. Armin Curt.
Notably, Prof. Norbert Weidner from Heidelberg University Hospital contributed significantly to the Lancet publication.
The research is bolstered by a European clinical network of specialized centers dedicated to spinal cord injury care across Germany, Switzerland, Spain, and the Czech Republic, which will also facilitate the pending follow-up study.
The test antibody’s development was made possible through collaboration with the CeNeReg project, supported by the Wyss Zurich Translational Center’s Regenerative Medicine Technology Platform.
Funding for the NISCI trial came from various avenues, including the EU’s Horizon 2020 Research and Innovation Programme, the Swiss State Secretariat for Education, Research and Innovation (SBFI), as well as the Swiss Paraplegic Foundation, the Wings for Life research foundation, and the “International Research in Paraplegia” foundation.
Source: ScienceDaily