paraplegics see glimmer of hope

Martin Schwab's research could help make wheelchairs a thing of the past Keystone

Neurobiologist Martin Schwab is at the forefront of brain research in Switzerland, particularly that aimed at helping paraplegics walk again.

Schwab told swissinfo that science has progressed from the point where there was no hope of mobility to the stage where clinical trials may not be far off.

The chairman of Zurich’s Neuroscience Center has been investigating the molecular mechanisms responsible for the decreased capacity of the adult central nervous system to regenerate after an injury such as a spinal cord injury and also after brain trauma or a stroke.

His research has uncovered a protein-inhibiting nerve outgrowth known as Nogo. By administering an antibody to the protein, regrowth of the spinal cord is possible as shown in tests on rats.

swissinfo: What is the state of neurosciences in Switzerland?

Martin Schwab: Neurosciences is a field that has been traditionally strong in Switzerland, and at the

moment it’s particularly strong. We are among the world leaders. Ratings have placed us in second or third place in terms of productivity, and perhaps more importantly, citations of our published papers are equally high.

swissinfo: How important is it to carry out this research?

M.S.: The brain is often described as the last frontier or the last uncharted continent. We reckon that we have unlocked about ten per cent of the brain’s secrets. It’s obvious that it is the most complex thing on earth. So the scientific challenge is very big.

Another reason is medicine. Neurology has described a large number of diseases for which we

have no good treatment or even any treatment at all.

Psychiatry suffers from the same problem.

We don’t really understand psychiatric diseases, and the treatments we have are empirical and not based on a causal understanding of these illnesses.

Diseases like Parkinson’s, Alzheimer’s, multiple sclerosis – but also others such as manic depression and schizophrenia – are very common and very cruel because they destroy the individual and that person’s personality.

The demand to develop novel and good therapies as well as understand these diseases is

therefore very strong.

swissinfo: Your own research focuses in part on spinal cord repair. Do you feel pressure to get results, especially from patients?

M.S.: Of course. This encourages us to move forward as best we can, but this pressure should not influence our results.

We have to follow the path of scientific investigation and we cannot be influenced by the fact that we would like to have a therapy today rather than tomorrow.

We have to ensure the quality of our work is very, very high and we try to publish our results in the best

neuroscience – and sometimes general science – journals. The consequence is that we are perhaps slower than a paralysed patient would hope for in developing our new therapy, but our chances of success are higher.

swissinfo: Do you find it difficult to explain to patients why research is a slow process?

M.S.: Not really. A patient knows that a spinal cord injury is a catastrophe in the sense that an extremely delicate and complex system has been affected. The hope of being completely healed is very low.

In fact until recently it was zero. People know that because clinicians tell them that with a severe spinal

cord injury the chances of them walking out of the hospital is very low. We know now that the dogma that nothing can be repaired is wrong.

Experimentally, we have shown that a better outcome is possible. Patients are happy that we are addressing their problem and of course hope they will benefit. But many of them also say that they know that they will never leave their wheelchair. What is important to these patients is that their outlook is much better.

swissinfo: Some people say your research could earn you a Nobel Prize. What do you think?

M.S.: I don’t do science thinking of the Nobel Prize. If we succeed in

taking our research from the culture dish via the animal model to humans and see an improved outcome and partial recovery for patients, this will be a very big achievement for neuroscience and science in general.

swissinfo-interview: Scott Capper

In brief

In 1988, Martin Schwab identified a substance in the central nervous system, which prevents the brain and spinal cord from repairing themselves after an injury.

Dubbed Nogo because of its inhibiting effect, the gene produces a protein, which prevents damaged nerves from re-growing after they are cut.

His team subsequently developed an antibody that neutralises the blocking protein and allows the nerves to reconnect.

Researchers partially cut the spinal cords of rats, paralysing the animals, then gave them the antibody.

The nerves re-grew and the animals resumed normal activities such as grabbing food pellets and climbing a rope.

Key facts

The Swiss National Science Foundation and the Christopher Reeve Paralysis Foundation fund Martin Schwab’s research.
Schwab, a member of the Swiss National Science Foundation research council, was the first scientist to be awarded the Christopher Reeve Research Medal in 1996.