MESSAGE FROM THE SCIENTIFIC DIRECTOR

W. Dalton Dietrich, Ph.D.

As we begin a new decade, The Miami Project Research Program is well positioned to identify and treat novel mechanisms of injury following brain and spinal cord injury and translate these discoveries to the clinic. Our scientists and clinicians conduct a wide variety of translational and clinical research that is already touching the lives of persons with paralysis due to central nervous system (CNS) injury. In the area of discovery, sophisticated screening approaches are identifying new treatments to protect against cell death as well as promote the regenerative capacity of the injured brain and spinal cord. Translational studies using clinically relevant animal models are providing encouraging results that are so important as we attempt to translate our studies to the clinic. Finally, clinical studies are completed or are currently underway that show that our discoveries can be successfully translated to people with both acute and chronic spinal cord injury. The Project is involved in single as well as multi-center trials that will change the way we treat people with paralysis.

In the area of cell protection, therapeutic hypothermia is making a big difference in people’s lives with some type of CNS trauma. Following traumatic brain injury, hypothermic therapy is being used to reduce elevations in brain pressure and temperature that can cause serious secondary insults to the nervous system following the initial trauma. In people suffering from acute spinal cord injury, cooling strategies have also been shown to be safe and effective. In both cases, therapeutic hypothermia is being directed toward clinical trials in larger populations to determine safety and efficacy. These examples of successful translation of laboratory findings to the clinic emphasis the importance of our interdisciplinary program in terms of developing new treatments for brain and spinal cord injury.

In the area of regenerative medicine, The Miami Project researchers are advancing human Schwann cell transplantation strategies to target both acute and chronic spinal cord injury. Pre-clinical (animal) work has shown that these cells can both protect and promote recovery of function even when administered in a delayed fashion after spinal cord injury. The ability of Schwann cells to remyelinate, or reinsulate, damaged axons appears to be a clinically relevant target for reparative therapy. Work continues in The Miami Project to obtain the necessary safety and pre-clinical data to seek approval for an FDA approved trial in the near future. These studies are again based on basic science discoveries made by Miami Project scientists that are now being translated to the clinic.

In addition to neuroprotective and reparative strategies, our clinical scientists are significantly contributing to the quality of life of people living with paralysis due to spinal cord injury today. Exercise conditioning strategies to improve strength and skill as well as improve cardiovascular function and other consequences of aging are now being advanced. All of which have a positive impact on quality of life. Novel rehabilitation strategies including robotic assisted locomotion and whole body vibration as well as upper extremity rehabilitation approaches are also leading to improved function. Our vision to combine neuroprotective, reparative, and rehabilitation strategies to maximize recovery of function after brain and spinal cord injury is challenging but real.

A major aim of our program is to provide information and education to individuals that need to learn more about what research and clinical progress is being conducted in the spinal cord field. Thus, our Education Department is extremely active in providing critical information to individuals with paralysis as well as loved ones who are seeking appropriate rehabilitation facilities, advice about unproven therapies, and other information regarding paralysis. Our faculty is training the next generation of scientists to conduct these extremely specialized studies to continue to advance this scientific field. Training of graduate students, postdoctoral fellows, and visiting scholars is therefore an important component of our overall program.

Over this past year, there has been a continued smooth translation of our discoveries to the clinic. Though the progress may seem long and slow at times, it is critical that the therapies we develop cause no harm. The Miami Project’s researchers and scientists are collaborating with scientists and investigative groups throughout the world in terms of testing novel therapies targeting individuals with paralysis. In addition to moving our own discoveries to the clinic, we are also working with biotech and pharmaceutical companies to test new therapies in large numbers of subjects. These collaborations enable the entire field to move forward at a faster rate. This is an exciting time in the history of The Miami Project and we believe this coming year will be the most exciting ever. Our scientists and clinicians are truly blessed with the continued support of our many friends, individuals, foundations, and government agencies that are helping us achieve our goals. Thank you for this continued support, and we look forward to an even more exciting 2010.