Philippa Warren
Title: “Drawing breath after spinal cord injury”
Abstract: In his 1913 seminal work Santiago Ramon y Cajal stated “In adult centers the nerve paths are something fixed, ended, immutable. Everything may die, nothing may be regenerated” Is this still accurate?
Seventy percent of individuals with a spinal cord injury loose capacity to regulate their breathing, often leading to ventilator dependence. This loss of respiratory capacity is the primary cause of recurrent illness and death following spinal cord injury. There exists no current clinical treatment for these injuries that can substantially and reliably restore sensory or motor function to paralysed patients. This is despite a large amount of pre-clinical research. Multiple reasons play into this complex problem. A major obstacle in finding a resolution to this challenge is the ever changing pathophysiological complexity which is inherent following an injury to the CNS.
Here we discuss the pathophysiological changes that occur to the respiratory motor systems following experimental spinal cord injury. Why endogenous recovery is possible but whether it leads to substantive functional change. What mechanisms can be utilised to aid functional recovery through plasticity inducing treatment strategies. When is the best time to apply a treatment strategy. How aiding functional respiratory recovery impacts restoration of activity in other critical motor systems e.g. hand function. Finally, we will discuss how using an innovative cross-disciplinary approach to treat spinal cord injury and we can determine if restoration of this activity is sufficient to potentially mitigate increased rates of morbidity and mortality in the clinical patient population
Bio: 27 million people worldwide suffer from spinal cord injury (SCI) for which there is currently no cure. The work of Dr. Philippa Warren, and her group, has largely focused on the physiology and mechanisms of neurodegeneration and recovery following such trauma.
Philippa began her career working for Eli Lilly as an in vivo electrophysiologist assessing the causes, and pharmaceutical treatments, of temporal lobe epilepsy. She started working on SCI research in 2006 during her PhD at the University of Cambridge supervised by Prof.’s Fawcett and Keynes, where she helped develop viral therapeutics for this devastating disorder. Her group are still collaborating with wok on this treatment, facilitating its current development into first-in-human trials. During her four years at Case Western Reserve University (USA, supervised by Prof Silver and Dr. Alilain) Philippa focused her work on critical treatments for respiratory dysfunction after CNS injury or disease and facilitated in establishing ventilatory pattern variance as a novel method to assess respiratory function after SCI. During this time, and as a Wellcome Trust ISS Fellow at the University of Leeds, she showed that respiratory motor recovery from SCI can occur readily after a near lifetime of paralysis in rodent models through a plasticity-inducing treatment. These data were the first to demonstrate that significant functional recovery can occur long after a SCI.
Philippa joined King’s College London in 2018 where she forged her tenured independent research group. She was recently awarded the Sir Henry Dale Senior Research Fellowship from the Wellcome Trust and Royal Society. Her work focuses on understanding the mechanisms of deficit throughout the spinal-motor-axis following spinal cord injury and the development and assessment of clinically relevant treatment strategies to recover essential function.
Affiliation: Wolfson Sensory, Pain and Regeneration Centre, King’s College London, London. United Kingdom
