TCS interview: Professor Robin Franklin on neural regeneration

Shreya Kulkarni 31 October 2014

Following last week’s news on the treatment of a paralysed man, Darek Fidyka by Olfactory Ensheathing Cells (OECs), The Cambridge Student interviewed Professor Robin Franklin, Professor of Stem Cell Medicine and Head of Translational Science at the Wellcome Trust-MRC Cambridge Stem Cell Institute. The Franklin lab focuses on regeneration of the Central Nervous system (CNS) in particular the process of remyelination, whereby myelin sheaths are restored to demyelinated axons. Additionally in 2012 Prof. Franklin led a clinical trial using OECs in dogs with spinal cord injury, the same treatment received by Mr. Fidyka.

“The clinical trial involving dogs was a randomized double blind control trial involving over 30 dogs”. The dogs were paralysed due to ‘real life’ injuries to their spinal cords. While not all the dogs regained function, showing that the “response to treatment was very variable”, the study “supported the use of OECs in humans”.

Just like the recent case, the dogs were injected with their own OECs at the site of injury, however without the added nerve strips.

OECs have three functions that may confer their neuroregenerative capacity; they “promote regeneration, remyelination and plasticity”. The way that they aid treatment of spinal cord injuries is still unknown but Professor Franklin suspects they are mainly promoting plasticity.

OECs have so far been studied for their ability to treat acute traumatic injuries. Both the dogs and the Polish patient had  severe, stable paralysis. While OECs show much promise in this field they do have limitations in full neuronal regeneration; they would be unsuited for treatment of neurodegenerative disease or in the treatment of brain injuries as “in the brain axon injuries are more diffuse”. In contrast, the “the anatomy of the spinal cord lend itself well to this sort of treatment”.

Regarding the recent news of the treatment of Darek Fidyka, Professor Franklin warns that although the case shows promise for the future we need to “keep it in perspective”. Currently the recovery of Mr. Fidyka is still “modest”, quoting the independent UK-based spinal cord injury specialist who examined him. Furthermore, “to say he is walking again is a slight exaggeration. He has some motor function but no normal sensory function”. However, the case does show significant potential -“what needs to be done now is a proper controlled clinical trials in many humans”..