Dr. Dong Kim always had faith in stem cells, even when others didn’t. After the birth of his first child 18 years ago, Kim wanted to preserve his son’s umbilical cord blood, knowing full well the possibilities within.
“Back then everybody looked at me like I was crazy,” laughs Kim, for whom the anxieties of new fatherhood produced a unique set of questions. “Can I take some of this blood and stick it in my freezer?” he remembers thinking. “I knew even back then that this cord blood had huge potential for treating people down the road.”
Nearly two decades later, research has proved Kim prescient.
As the Director of the Mischer Neuroscience Institute at Memorial Hermann and the Chair of Neurosurgery at UT Health Medical School, Kim, 49, is pioneering the use of stem cells in treating spinal cord injuries. He’s already shown how lab rats paralyzed by broken spines can be made ambulatory again thanks to rebuilt nerve cells, and the potential implications of his work for humans cannot be overstated. “There’s no hope for these spinal cord–injury patients otherwise,” he says. “It could change practice in the whole world when you come up with the right thing.”
Changing the whole world is what Kim and his team at the Mischer Institute are aiming for. Bringing in 50 faculty members to the institute during its first six years, Kim and others have been working to build it into the city’s most impressive neurological group—both in terms of number of patients treated and the amount of research done. “What put Houston on the map was doctors DeBakey and Cooley,” says Kim. “M.D. Anderson was a big deal in cancer. What we want to bring to Houston is the same kind of thing in neurological sciences.”
Kim and his team have found that even among patients whose spinal cord injuries result in paralysis, some surviving yet damaged neurons are usually left behind. It may be possible to rebuild these using stem cells, which can work to recreate the myelin sheath around the axons, the “fingers” of the damaged neurons that send electrical impulses to make our muscles move. Once sheathed again with myelin, the neurons may begin working again, permanently reversing paralysis.
Kim is at least three years away from a full trial in human patients—using their own adult stem cells harvested with a simple skin biopsy—but he has plenty to do in the meantime. He’s hard at work on another project to develop a technique using cooling therapies to treat traumatic brain injuries. Called the HOPES project, Kim’s institute is about to enter into a full-scale trial to investigate the effectiveness of inducing hypothermia via cooling catheters.
This is the first possible advance in non-surgical treatments for traumatic brain injuries in a long time. “There’s been nothing that’s really been shown to improve outcomes in decades,” says Kim. “There have been over 100 neurological trials that have been negative.”
Cranial subdural hematomas are silent, sneaky brain injuries that can be caused by various injuries to the head—including reperfusion, which occurs when oxygenated blood rushes back to delicate tissue following a patient’s revival from, say, full cardiac arrest. This trauma can cause permanent brain damage. Cooling catheters protect the brain by keeping it just below body temperature. They allow blood flow to return to the brain normally, but the brain tissue itself to absorb that blood—and oxygen—much more slowly.
“It’s very similar to what people have known forever,” says Kim, speaking of the miraculous recoveries often made by patients whose body temperatures are lowered in accidents. “If you drown in an icy river and you get fished out later, a lot of those patients do better.” Cooling therapy has already proven to be effective on other parts of the body, helping victims of heart attacks and strokes recover more easily.
In initial cooling trials of patients with all kinds of traumatic brain injuries, patients with subdural hematomas caused by reperfusion were shown to have a 67 percent increase in survival when hypothermia was induced, says Kim, “which was huge.” He has upcoming trials taking place concurrently in Houston, Pittsburgh, and Miami, and is aiming for a very conservative—but nevertheless remarkable—25 percent increase in survival rates, although he’ll take more if he can get it.
While drastically different in their technologies, his developments for the spine and brain show great promise, in part because Kim is both smart enough to know when not to reinvent the wheel—rebuilding damaged neurons instead of creating them from scratch, using a proven therapy to help other damaged areas of a patient’s body—and passionate enough to devote years to research and trials.
“We want to put Houston on the map for the center for neurological advances,” he says. “There is no place like that anywhere else in the world right now.”
“Somebody’s going to take the lead. I just hope it’s us.”