In March 2016, a car crash left 21-year-old Kristopher Boesen of Bakersfield, California, paralyzed from the neck down. In what is nothing short of a miracle, researchers have succeeded in restoring some hand and arm function in the young man with a stem cell treatment that is still experimental.
The severe trauma Kris suffered to his cervical spine in the car accident left him a quadriplegic. He could not use any of his four limbs and needed ventilator assistance to breathe. His surgeons were focused on preventing further damage and stabilizing his spine. Any improvement in movement or sensation is rare, they told him. He was resigned to never using his arms and legs again.
It was at this point that Kris learned of a clinical trial enrolling patients with spinal cord injuries. The trial, which is ongoing, is testing the effects of AST-OPC1 injections in paralyzed patients. This novel agent consists of embryonic stem cell-derived oligodendrocyte progenitor cells which are responsible for forming myelin, a whitish insulating substance made of proteins and phospholipids that surround nerve fibers and increases the speed at which nerve impulses are conducted.
Dr. Edward D. Wirth III, the chief medical director of Asterias Biotherapeutics, the company that has developed AST-OPC1, says preclinical trials showed several improvements in models of spinal cord injury. The size of the injury cavity was reduced, the protective myelin covering of nerve cells was restored, nerve cell growth stimulating factors were produced, and blood vessels were recruited to deliver nutrients and oxygen to the site of injury.
One of the enrollment criteria for this trial—called SCiStar—is that the patient must be able to breathe unassisted. It usually takes up to three weeks to wean a patient from a ventilator, but Kris was able to come off assisted breathing in just five days with the help of his excellent respiratory team. Further testing confirmed his eligibility in the trial, and in April he underwent the injection under the supervision of Dr. Charles Liu of the Neurorestoration Center at USC.
About 10 million progenitor cells (AST-OPC1) were injected directly into Kris’ spinal cord. He achieved some movement in his hands and arms just two weeks later. Three months following the treatment, he had regained enough movement to feed himself, write his name, hug his family, and operate a motorized wheelchair—all things deemed impossible before the stem cell treatment.
The two-spinal-level gain that Kris achieved is remarkable and significant in terms of quality of life, according to Dr. Liu. “It’s the difference between being able to use your hands to do simple everyday activities like brushing your teeth, using a computer, and functioning independently,” he states. “The importance of his gain cannot be overstated.”
Data gathered by the National Spinal Cord Injury Statistical Center indicates that motor vehicle accidents are the leading cause of the roughly 17,000 cases of spinal cord injury that occur in the United States each year.
The researchers cannot predict whether Kris will eventually regain the use of his lower limbs as well, but the results in his case are extremely encouraging. They hope that AST-OPC1 will improve neurological function in other patients with severe spinal injuries as well to a degree that will mean the difference between living life as a quadriplegic and being relatively more independent with the use of the hands and arms. “This level of functional independence can significantly improve a patient’s daily life,” says Dr. Liu.