Dr Marc Ruitenberg’s work on inflammation response after SCI

Marc Ruitenberg is an Associate Professor at The University of Queensland and Head of the Neurotrauma Research Laboratory.

He has a longstanding relationship with SpinalCure Australia that goes back to 2012, when SpinalCure Australia awarded him a prestigious Career Development Fellowship in partnership with The University of Queensland for his work on the inflammatory response to SCI, and its role in recovery.

SpinalCure continues to provide funding assistance to A/Prof Ruitenberg in recognition of the internationally acclaimed contributions that his group is making to this vital field of research.

Inflammatory response after SCI

“What we are doing in the lab, and also on the clinical side of things, is to really try and understand what happens following a spinal cord injury at the cellular and molecular level, focusing in particular on the inflammatory response,” explained Dr Ruitenberg.

“As with any tissue of the body that gets injured, there are inflammatory changes. With spinal cord injuries, however, these changes do not support wound healing and repair. Rather, we know that if they are left unchecked – meaning that if we leave the inflammatory response to develop naturally, without intervention – it will actually cause more damage to the spinal cord then what was inflicted at the time of the accident,” he added.

“This is a very important thing to realise as most injuries are not a complete severance of the spinal cord, and there are thus still very likely connections between above and below the lesion site that we must protect as losing these will negatively affect the outcome for individuals with an SCI,” explained Dr Ruitenberg.

“That said, the inflammatory response to SCI is very complex, and non-discriminatory suppression of it will not work, and may in fact do more harm than good. For example, our research has demonstrated that some aspects of the inflammatory response are actually good, and we need them for wound healing, but then we also know of other aspects that are bad and becomes non-resolving.”

“So there is something about this type of neurological injury itself that negatively influences the inflammatory response itself and gives you that extra tissue damage.” he added.

“With SpinalCure’s help, we are creating new insights into what immune cells are recruited to the injured spinal cord, how they get there, the molecules that they produce, and how they communicate together to influence the recovery process.

“It is very exciting that some of this work has progressed into the clinical trial stage (ACTRN Trial ID 12616001385437),” Dr Ruitenberg said, “and we hope to be able to comment on its outcomes in the not too distant future”.

A/Prof Marc Ruitenberg’s relationship with SpinalCure Australia goes back 2012. (Photo: uq.edu.au)

As explained in his latest research paper, Dr Ruitenberg got a step closer to understanding how to manipulate the inflammatory response to reduce the level of spinal cord injury.

This study, published here, is the result of eight years of work.

“We just had this paper published and the core of the work was funded by SpinalCure”.

“We discovered that there was a new molecule or a molecular mechanism that in a way acts as a break on the inflammatory response so what we found is that that molecule is really controlling the way that the immune system is responding to the spinal cord injury, and if we manipulate or interfere with that response, we can influence the outcome either positively or negatively”.

Lab data cross-validated with human data

Dr Ruitenberg’s team also cross-validated the lab findings with human data.

“We work very closely with clinicians at Prince Alexander Hospital, which is our main trauma hospital, to look at all clinical registry data that is available there and what we were able to show is that the cell types that we were studying were linked with that particular molecule that we discovered.

“[We discovered] that the mobilisation of these cells into the blood (because they are normally stored in the bone marrow, until they come out into the blood and go to the lesion site) cause damage.

“The extent of that mobilisation response, that response to trauma, in human patients also correlates with outcomes in the lab, so that’s very strong because it means that whatever we are studying in the lab also translated or validates itself in the human population and that’s of course very important that we are not studying a phenomenon that may be not relatable to real patients”.

Insights critical for development of new anti-inflammatory therapies

Generating these insights is critical for the development of new and effective anti-inflammatory therapies that can improve recovery.

“This work is discovery driven, gives mechanistic insight. And to develop new drugs in association with that is very costly,” said Dr Ruitenberg.

“So what we are also doing is we say, ‘Okay, we may not have the perfect drug sitting on the shelf, but what medicines are there that are already in clinical use and we know they have an effect on the pathways that we have identified through our research that can affect positively the outcomes of spinal cord injury?’”.

“One of the things that we came up with, was, for example, the intravenous immunoglobulin in therapy.

“So that’s a drug that was already in use for other clinical conditions.

“We are able to show in the lab, in the animal model, that it’s highly effective there as well and because it’s a drug that is already in use and we know that is relatively safe, then the pathway to medical translation and to make a fast and real impact into people’s lives becomes very fast.

IVIg is now being used to treat new injuries in a world-first clinical trial.

Click here to look at the research paper.

Finding the funding

Marc says finding the funding for these kinds of projects is never easy.

“If you want to do high impact research it often takes many years or a long time to develop the stories and to do effectively the things that we need to do”.

“If there weren’t organisations like SpinalCure we wouldn’t be able to do what we do and generate the scientific data and the results that we need, to then go on and ask for grant applications from other organisations”.

“The funding is vitally important”.

If you would like to make a tax-deductible donation to life-changing research today – please visit www.spinalcure.org.au/donate.