Breakout Three: Murray Blackmore

First, to finish out the Jerry Silver thing from Breakout Two . . .

This guy will not be stopped.

What mother nature is doing during rehab is trying to stop chaos from developing . . . this is why it’s so effing hard to make gains in rehab.  One of the earliest populations of patients who ought to be tested are those patients who have worked very hard in rehab and reached a plateau  Just a little boost, according to Susan Harkema, might change the outcomes.

Talking about the effect of drugs like Prozac on recovery . . . there have been reports that SSRIs (selective serotonin reuptake inhibitors) have benefit for some people, at least in a small way.  The ones on the market don’t have nearly as much serotonin as you would need to get the kinds of benefits they’ve seen in rat models.

Okay, just about done with this one.  It’s 4 pm and we’ve been at this for 8 hours now.  One more to go today; I think it will be the Blackmore room.  Wheeee!


There are only six of us here with Dr. Blackmore at the start, who is a soft-spoken, dark-haired young man sitting 10 feet away from me in shirtsleeves, looking thoughtful while we (the advocates) talk about the problems of advocacy . . . finding the balance between acceptance and pushing for a cure.

Sometimes there are issues with being macho and the feeling that the way to do that has to do with being great at sports, which become where many injured people put their energy and time.  It’s a way of reclaiming their health and energy, and it’s good . . . and yet it’s also turning away from the cure.

Talking now about the neurons being not dead but just sleeping . . . they’re atrophied.  They’re not expressing the genes they need in order to grow.  The gene therapy he was talking about seems like a natural direction to go.

About technology . . . right now it takes 4 to 6 months for the Miami Project project to grind through seven hundred genes .  . the problem is that not many will have an effect all alone, so you need to test for combinations, which just explodes the number of things you must test.  We need more and more combinations to be explored.  Another thing — screening is really expensive, he’s been through about a thousand, and 12 showed stuff in the culture dish, and none in the animals.

It took many molecular tricks to get one to really work . . . the goal would be to work with your most likely 200 candidates and inject them in combination pools in vivo, not in vitro.  (fyi, in vivo means in living creatures and in vitro means in petri dishes.  roughly.)  That would be expensive but it would get the job done.

What about taking the people who recover more than doctors expected  and see if their genes give you a clue.  He’s thinking about it . . . how about looking across the patient population and trying to see if there’s something in their genes that’s different from that of people who don’t get better?

Aren’t they doing something like that with cancer?  Yes.

You have to be careful . . . maybe the immune system didn’t attack as aggressively, there could be a lot of reasons.

You could also take skin cells from humans, turn them into stem cells, turn them into neurons, put them into a dish and compare their growth behavior to that of other nerve cells.

How would that turn into a treatment?  You’d have to follow the pipeline that was described this morning . . . one thing we know for sure is that the fetus version of you had the ability to regenerate neurons, so we’d stay focused on that.  Using viral vectors would change the expression of genes so that your cells were more like they were in utero.

Physically, how would that work?  Right now we can inject a virus into the brain.  The limit is that this can only help for a very small focal area.  That would make a real difference in hand function for quads, for example.  Down the road, what needs to happen is that you don’t have to deliver the virus to the “tennis ball” you can bring it to the “string” — which means that it could get to ALL the axons in the injury site, which would then deliver it backwards to the affected neurons.

We also imagine injecting the viruses systemically (in the acute situation).   — lol, he apologizes to the room, which has been steadily gaining people as we talk, for the very idea of working with acutes!

Maybe there could be a second treatment then to recapitulate the guidance molecules — but even as he says this he’s thinking it’s too complicated and not going to get you anywhere.  The better idea is to set up the growth and then count on training and plasticity.

Are we talking about return of motor function or sensation?  Well, potentially . . . if you could reboot the growth machinery and get axons to grow going down, why not have them grow going up.

He asks the room, do they want motor function more than sensory function?  One woman says both, basically.

How many neurons are there in the body?  Oh, millions.

What about pain coming through?  My son’s been injured for 10 years & he’d want bowel and bladder first, but he’d walk without sensation if he could.

(this is just an impossible question)

Blackmore says there’s a science-y engineering answer to the question.  The cell membrane has a channel that’s only activated if it’s exposed to an outside agent.  You could put in your gene treatment so that you could get growth, you could also set it up so that the nerves could be silenced.  (First time I’ve ever heard somebody describe a way that might happen.  Wow.)

He’s now moved away from the Miami Project and into a lab where the focus is just elsewhere (ending cocaine addiction) and some new ideas — completely new ideas — are there in front of him.  If there’s to be a Big Project sometime for SCI, it would need to be seeded somehow from outside.

The sparks come from outside the big centers for SCI, like Miami Project or even RIRC . . . pten came from Harvard.  You still need the big SCI centers because there has to be someone who recognizes the potential of that spark.

Corrine mentions a scientist she knows in Holland who also works on gene treatments.  Blackmore knows his name but hasn’t worked with him; she’ll put them in touch.

Okay, so given that everybody is different and probably no chronic is going to return to the pre-injury body, how do we define what a cure is?

We’re looking toward the next generation, maybe . . . OR there could be a Eureka, and why not hope for that?

It’s wine-thirty!

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One Comment on “Breakout Three: Murray Blackmore”

  1. The term “cure” means that, after medical treatment, the patient no longer has that particular condition anymore.

    Please let’s not get into the trap of re-defining a CURE, the meaning of the word CURE is clear and well understood.
    we may want to call “effective treatments” what can restore functions

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