A serious injury to the upper spinal cord can not only lead to a loss of mobility, but also to respiratory problems. In fact, the inability to breathe is the leading cause of death among individuals with injuries to the spine. Now, using a novel drug-based therapy, researchers have managed to restore breathing in rats with severe spinal cord damage.

Currently, quadriplegic individuals who have respiratory issues must rely on expensive—or even dangerous—ventilator apparatus to breathe comfortably. By taking the brain out of the equation, researchers hope to free paralysed patients from such bulky or expensive equipment and allow them to breathe on their own. A new study from researchers at Cleveland-based Case Western Reserve University School of Medicine under Dr. Jerry Silver suggests that the brain may not be a necessity when it comes to the lungs.

The study, published recently in Cell Reports, indicates that drug therapy may be able to awaken nerve pathways in the spine that take the brain out of the equation, potentially allowing patients with spinal cord injuries to breathe on their own.

The Mechanics of Breathing

Typically, breathing is controlled by messages to and from the brain. The diaphragm, a sheet of muscle under the lungs essential to breathing, receives a signal to either tense or relax in order to control breathing. This process is typically autonomous, though it is possible to control breathing consciously.

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Breathing without a Brain

Significant damage to the spinal cord in areas around or above the neck can lead to respiratory problems, as the injury interferes with direct communication channels between the brain and body. This makes it difficult to send out signals necessary to maintaining autonomic bodily functions such as breathing.

Previous research on respiratory issues after a spinal cord injury typically concentrates on reconnecting damaged nerves to the brain. According to recent studies, however, there’s an alternative nerve pathway that can help patients to regain the ability to breathe independently. The spine contains a system that’s able to control the diaphragm. Using a combination of drug and light therapy, also known as optogenetics, researchers tapped into this spinal cord system to restore diaphragm movement to rats with spinal cord injuries.

Normally, the body represses signals from this spinal system unless under extreme stress. The spine is programmed to respond to emergency situations only if the brain is out of commission, such as when an individual is concussed or unconscious. This new treatment is thought to work by blocking nerve signals that would normally repress communications from the spine, allowing the nerves there to control breathing instead of relying on the brain.

A Promising Future

While rat models pose a promising future for patients with spinal cord injuries, it’s unclear whether the proposed drug treatment would work in the long-term. Researchers plan to extend the study to more animal studies to gain a better understanding of the link between spinal nerves and respiration. While more studies are needed, this new drug therapy could pose a life-changing alternative to mechanical ventilators for quadriplegic patients.