hESC-Derived Motor Neurons For the Treatment of Cervical Spinal Cord Injury

Funding Type: 
Comprehensive Grant
Grant Number: 
Award Value: 
Disease Focus: 
Amyotrophic Lateral Sclerosis
Neurological Disorders
Spinal Muscular Atrophy
Spinal Cord Injury
Neurological Disorders
Stem Cell Use: 
Embryonic Stem Cell
Public Abstract: 

Cervical spinal cord injuries result in a loss of upper limb function because the cells within the spinal cord that control upper limb muscles are destroyed. The goal of this research program is to create a renewable human source of these cells, to restore upper limb function in both acute and chronic spinal cord injuries. There are two primary challenges to the realization of this goal: 1) a source of these human cells in high purity, and 2) functional integration of these cells in the body after transplantation.

Human embryonic stem cells (hESCs) can form any cell in the body, and can reproduce themselves almost indefinitely to generate large quantities of human tissue. One of the greatest challenges of hESC research is to find ways to restrict hESCs such that they generate large amounts on only one cell type in high purity such that they could be used to replace lost cells in disease or trauma. Our laboratory was the first laboratory in the world to develop a method to restrict hESCs such that they generate large amounts of only one cell type in high purity. That cell type is called an oligodendrocyte, which insulates connections in the spinal cord to allow them to conduct electricity. Transplantation of these cells was useful for treating spinal cord injuries in rats if the treatment was given one week after the injury. That treatment is being developed for use in humans.

Recent studies in our laboratory indicate that we have succeeded in restricting hESCs to generate large quantities of a different cell type in the spinal cord, that which controls upper limb muscles. We have generated large quantities of these human cells, grown them with human muscle, and demonstrated that they connect and control the human muscle. The cells also express markers that are appropriate for this cell type.

Here we propose to generate these cells in high purity from hESCs and genetically modify them so that they can be induced to grow over inhibitory environments that exist in the injured spinal cord. We will then determine whether these human cells have the ability to regenerate the injured tissue in the spinal cord, and restore lost function. All of our studies will be conducted in an FDA-compliant manner, which will speed the translation of our results to humans if we are successful. The studies outlined in this proposal represent a novel approach to treating spinal cord injury, which might work for both acute and chronic injuries.

Statement of Benefit to California: 

This research plan will position California for international competitiveness in this emerging area of biotechnology, as our research strategy addresses critical scientific problems limiting the development of this sector in California and abroad. High purity cultures of hESC-derivatives enable transplantation approaches to disease, drug discovery, and predictive toxicology. This research plan will lead to the development and thorough characterization of a renewable source of human motor neurons that enables these 3 strategies as they pertain to acute spinal cord injury, chronic spinal cord injury, amyotrophic lateral sclerosis, polio, and spinal muscular atrophy. Clinically relevant scientific advance leads to the development of biotechnology companies, creating jobs and taxation. The treatment and care of individuals with disease or trauma-induced disorders of the central nervous system represents a significant economic burden to the State of California. If successful, our research plan will form the basis of a clinical strategy to improve the function and quality of life of spinal cord injured individuals, which may lessen the cost that the State bears in terms of patient care.

Progress Report: 

We have completed the first two AIMs of our proposal on time, and on budget, and we reported on these AIMs in our previous progress report. During this reporting period we have made progress on AIMs 3, 4 and 5. In AIM 3, we transplanted hESC-derived motor neuron progenitor cells into sites of motor neuron death in adult rats. We experienced minor technical difficulties that have set us back by a few months, due to sub-optimal expression of a growth factor in muscles, which is necessary to draw motor neuron axons out to muscles. We have fixed the problem and have confirmed long term growth factor expression in muscles. We have also confirmed that our toxin model induces motor neuron death using several methods, that transplanted motor neurons survive and connect with the spinal cord, and standardized all testing protocols to determine whether transplants along with growth factor addition to muscles will benefit the behavior of the treated animals. Our final experiment is in progress. This delay will not alter the project costs.
With regards to AIM 4, we are well ahead of schedule. This AIM was to begin in Year 3, but we began the experiments in Year 2. In this AIM, we transplanted hESC-derived motor neuron progenitor cells into sites of spinal cord injury in adult rats. We have confirmed that transplanted motor neurons survive and connect with the spinal cord, that transplantation enhances the survival of the host spinal cord that otherwise would have been lost, that transplantation enhances axon branching of the host spinal cord, and that these ‘nursing’ effects cause behavioral improvement of locomotion. Our increased productivity has not affected the budget.
With regards to AIM 5, are on track and on budget. We have generated FDA-compliant documents for all of the studies listed above.

We are on schedule with our research plan, having made progress on the last two AIMs of the proposal according to schedule. The goal of the 4th AIM was to transplant cells to the spinal cord of rats and see if they connect to muscle in the limbs that had been engineered to express an attractant for the processes of the cells in the spinal cord. We confirmed that we can induce the muscle in the limbs to express the attractant, and have the cells in the spinal cord survive, differentiate appropriately, become connected in the spinal cord to other circuits, and extend processes. In addition, we have evidence that these treatments benefit the locomotor ability of the rats. We wrote a scientific article concerning some of this work, and it was accepted for publication in an excellent journal. The goal of the 5th AIM was to document regulatory oversight for the project, to ensure compliance with FDA policies. We have generated FDA-compliant paperwork for all of our studies to date. Thus, our progress is in line with the original proposal.

This study tested the hypothesis that high purity motor neurons (MNs) derived from human embryonic stem cells could benefit spinal cord injury. In the first AIM, we proved that MNs could extend processes to muscle and cause it’s contraction, in a dish. In the second AIM, we proved that we could enhance process extension to muscle, in a dish. In the third and fourth AIMs, we proved that MNs transplanted into the diseased or injured spinal cord could integrate and benefit the function and spinal cord tissue structure of animals. In neither case did we see projection of MN processes to muscles, despite the provision of a MN process attractant in the muscles. Nonetheless, MN transplantation reduced tissue loss that normally results from injury or disease, and enhanced regeneration of the spinal cord and functional recovery of the animals.