COULD WE TREAT SPINAL CORD INJURIES WITH ASPARAGUS?

Pelling’s core message is that ‘dumb’ ideas, with vigorous testing, may not be so crazy after all. Suggesting to someone that you can scaffold the human spine with asparagus falls on the ‘seems crazy at the first listen’ spectrum. But what ‘seems crazy’ just needs to be rigorously tested. Then tested again, and then tested some more.

Scientists don’t have ideas and immediately put them into practice, they often go through years of testing and refining before they even consider testing on humans.

Doubts are important for safety, and Pelling had many:

“I constantly felt this weight of doubt when it came to thinking about spinal cords. So many scientists were using materials from traditional sources, like synthetic polymers and animal products - even human cadavers. I felt like a complete outsider with no real right to work on such a hard problem.”

So he pulled together a team of neurosurgeons, clinicians, biochemists and bioengineers to plan experiments. They began, as many medical trials, with animal experimentation to investigate if the microchannels in the asparagus scaffold could guide neuron regeneration:

“The basic idea is that we would take an animal, anesthetize it, expose its spinal cord and sever it in the thoracic region, rendering the animal a paraplegic. We would then implant an asparagus scaffold between the severed ends of the spinal cord to act as a bridge.”

Animal experimentation isn’t an easy thing to discuss, paralyzing an animal so they can't move their back legs isn't a pleasant task or concept. I am forever glad I don’t have to do this for my day job. In an ideal world animals wouldn’t have to suffer for our medical advancement, but the risk is often too high to start testing on humans. It doesn't make it an easy choice:

“My team struggled every day with these types of experiments, and we constantly asked ourselves why we were doing this.”

But, this was their method and it seemed to be working. The paralyzed rat could move its leg, beginning to walk:

“We started to observe something extraordinary. This is an animal that received an implant. Now she's not walking perfectly, but she's moving those back legs and she's even starting to lift herself up. And on a treadmill, you can see those legs moving in a coordinated fashion. These are crucial signs of recovery.”

It still took five years to publish the data. This was because of doubt - you can’t just jump at the first experiment, it has to be repeated and repeated. Pelling elaborated:

“Doubt drove us to repeat these experiments again and again, to the point of almost bankrupting my lab. But I kept pushing, because I knew these results could be the start of something extraordinary.”

Extraordinary it was, becoming the first time anyone showed that tissues can be used to repair such a complex injury:

“This technology has just been designated a breakthrough medical device by the FDA. And this designation means that right now we're in the midst of planning human clinical trials set to begin in about two years.”

The team has created a spinal cord implant, an asparagus scaffold, and they have a right to be proud of the innovation:

“See that it moves and bends and has the same feel as human tissue. And you know, I think the real innovation is that we're now able to design or program the architecture and structure of plant tissues in such a way that they could direct cell growth to address an unmet medical need.”

I was blown away at how a simple idea, using something you can find in your fridge, could potentially have huge ramifications for the thousands suffering from spinal cord injuries. Yes, it will take time for the human trials to run, another rigorous doubt-filled process, but all that scientific rigor was, and continues to be, worth it.

“The challenge we face is that while doubt can be destructive to your mental health, it's also the reason why scientific rigor is such a potent tool for discovery. It forces us to ask the difficult questions and repeat experiments. Nothing about that is easy. And often it becomes our responsibility to bear the burden of the hard and sometimes heart-wrenching experiment. This ultimately leads to the creation of new knowledge, and in some really rare cases, the type of innovation that just might change a person's life.”