World first research a game changer for spinal cord injuries

Monday 26 July 2021

Mater Research Principal Fellow, Professor Jean-Pierre Levesque, will lead game-changing international research to discover new treatments to stop neurogenic heterotopic ossifications (NHO)— an extremely debilitating complication of spinal cord injuries.

First observed in battlefield injured soldiers during World War One, today NHO affects 1 in 5 people with spinal cord injuries (SCI).  It is even more prevalent in soldiers with SCI, affecting up to 60 per cent of cases.

It involves the formation of bones in soft tissues outside the skeleton. These misformed bones usually grow around joints such as the knee, hip, elbow or shoulder. They start to develop within weeks of the injury and can become so large (up to 2 kg) that patients can no longer bend their joints, as their joints are encased in bone. These bones can also entrap large blood vessels and nerves which contribute to increasing pain and paralysis. 

“Currently, there is no effective treatment to prevent or stop the formation of these bones. The only treatment is complicated surgical removal and even after this, the bones can still grow back, requiring another surgery to remove them again,” Professor Levesque explained. 

But this is all set to change with Professor Levesque’s new research.

He has been awarded a US Department of Defense (DoD) Spinal Cord Injury Research Program – Expansion Award grant and will lead an international collaboration involving research and clinical experts in Australia and France.

The grant will allow Professor Levesque to conduct the world’s first prospective study into NHO to develop new treatments that stop these bones from growing and predict which patients are most likely to develop the condition, so they can commence treatment straight away.

“A few years ago, we successfully developed a pre-clinical animal model to replicate SCI associated NHO and discovered that heterotopic bones only develop when there is an injury of the central nervous system combined with muscular trauma. We also discovered that NHO is driven by a type of white blood cell, called a macrophage, which stimulates the formation of heterotopic bones instead of muscle repair. 

“From our previous research projects, we also know a stress response from the spinal cord injury leads to the release of a stress hormone into the blood which directly promotes NHO development.

“In this new Mater research, we will explore how this stress response, excessive inflammation and infectious microbes combine to enhance NHO, and determine whether combining medicines that block the stress hormone and inflammation can prevent NHO development.

“We also aim to validate our findings in people with SCI, which if successful will result in the development of biomarkers to predict early NHO development.  

“For this, we’re teaming up with Professor Genet, head of the rehabilitation and physical medicine department at Raymond Poincaré Hospital near Paris, the main referring hospital in Paris region for victims of spinal cord and brain injuries. They treat about a  hundred of new SCI patients at this hospital each year, which will help us complete our research faster. 

“If successful, this will be life changing for affected patients and their caregivers. These new treatments will vastly improve patients’ everyday lives as maintaining joint mobility allows them to progress through rehabilitation. They will also reduce the need for long and complicated surgeries to remove these unwanted bones.

“If our experiments confirm the efficacy of selected drugs to reduce the development of NHOs in mice, this could be rapidly translated into pilot clinical trials in Brisbane and Paris, as the selected drugs are already well characterised and used in patients to treat other inflammatory diseases,” he said.

Find out how you can get involved in life changing Mater research today.

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