Nerve fibers in the adult central nervous system (i.e., the spinal cord and brain) fail to regenerate after injury, and to date there are no therapies for enhancing their repair. Spinal cord injuries have dramatic and long-term effects on people’s lives, and the social and economic burdens of lifelong care are enormous.
For a long time, it was generally believed that damaged fiber tracts of the central nervous system were incapable of regeneration. However, there is growing evidence that specific inhibitory molecules found in myelin (i.e. the protective layer surrounding the nerve fibers) prevent nerve fiber regeneration and are the cause of poor functional recovery after injury. This explanation was first proposed by Professor Martin Schwab and his group at the University of Zurich; they also discovered the most potent growth inhibitor that has been identified so far: the membrane protein Nogo-A. Moreover, Schwab and his team demonstrated that antibodies blocking the function of Nogo-A lead to long-distance regeneration of injured nerve fibers in the spinal cord of monkeys and rats and greatly improve the animals’ functional recovery.
With the support of Wyss Zurich’s Regenerative Medicine Technologies Platform, the team manufactured the final drug product to enable a clinical trial to test the efficacy of antibodies against Nogo-A in patients with spinal cord injury. The antibody enabled the critical transition to Phase II clinical trials, intended to demonstrate the clinical efficacy of the anti-Nogo-A antibody in patients with spinal cord injuries.
Beyond the field of spinal cord injury, these clinical studies served as a model for other conditions in which the nerve fibers of the central nervous system have been injured and may, therefore, have a substantial impact on the treatment of neurological diseases in general. A positive outcome of the clinical trials would constitute a major breakthrough in the fields of neurology, neuroscience, and tissue regeneration and repair.