Spinal injuries are both common and devastating, leaving many victims paralyzed and relegated to wheelchairs for the rest of their lives. But in most cases, the worst spinal cord damage doesn't happen at the scene of the injury - it's the swelling around the spinal cord and the crazy firing and burning out of otherwise healthy neurons in the hours and days following the incident that turns a bad situation permanently worse. Now, scientists in Rochester, New York, have discovered a simple way to stop a lot of this secondary damage in its tracks - using the same, familiar blue food dye that gives M&Ms; and blue icy poles their color. Patients with spinal injuries could escape with vastly reduced loss of function - but they'll turn bright blue in the process.
I'll admit a personal interest in this story: two years ago, a friend of mine, Lenna, had a nasty motorcycle accident, and I was present at the scene. It was clear she had spinal injuries - her back was twisted fairly badly. But she was able to move her feet and wiggle her toes, so we held out hope that the injury wouldn't be too severe.
As it turned out, she became a paraplegic, with virtually no feeling or movement below her navel. The original injury, as it turns out, does a certain amount of damage to the spinal cord - but the major, unfixable damage is done over the next few hours and days.
Much of this is because of a chemical called adenosine triphosphate, or ATP. ATP is used as a kind of cellular battery to deliver energy to cells around the body in normal life. But in the event of spinal trauma, the area around the injury is flooded with ATP, which causes otherwise healthy neurons to fire like crazy until they burn themselves out and die. It also increases the swelling around the wound. Swelling around an injury site is a positive healing factor in most parts of the body, but the spinal cord lives in a tightly enclosed column of bone, and the swelling, on top of the bleeding from the trauma, can cut off oxygen supply to the lower spinal cord.
In effect, a patient might receive a spinal injury of low or medium severity - but the actions of ATP in the hours and days after the trauma can completely destroy the function of the spinal cord, leaving patients paralyzed. This is exactly what happened to Lenna.
But a study published in July 28's Proceedings of the National Academy of Sciences (PNAS) seems to show that it's possible to block the actions of ATP and greatly reduce the severity and permanence of spinal injuries - using the same type of food dye that gives blue M&Ms; their color, a food dye called Brilliant Blue G, or BBG.
BBG can be administered intravenously - so there's no need to inject directly into the injury site - and it has the ability to cross the blood-brain barrier, which gives it access to the spinal cord. It happens to bind to the same neuroreceptor (P2X7) as the ATP binds to - but it has a stronger affinity for the receptor than ATP has - so it effectively blocks the action of the ATP at the injury site.
As a fun side effect, it also turns the patient's skin blue - as the researchers found when trialling BBG on rats. See the full method of the experiments here (PDF). The rats were administered either a high or low dose of BBG, or a water injection as a control, 15 minutes after receiving a spinal injury.
While all the rats were severely injured, the BBG-injected rats showed a greatly improved ability to support their bodyweight on their hind legs, control their bladders, and even walk in some cases. The blue skin coloring eventually faded as well, and no side effects were noted - after all, BBG has been an FDA-approved food dye since the 1920s. It's the chemical that turns your tongue blue when you eat a blue ice-cream, and it's well understood as a safe substance at lower concentrations.
Human testing would be required before BBG moved forward into clinical use - but the idea would be to use this study to develop treatments that ambulance drivers and paramedics can use to begin treatment right at the site of the incident, and that hospitals can use from the moment the patient is admitted.
"It could be [as simple as] you drink blue Gatorade on the way to the hospital," lead researcher Maikn Nedergaard, from the University of Rochester Medical Center, told ScienceNews' Rachel Ehrenberg in a recent interview.
Blue food dye! If only we'd known... Then again, I'm not sure how you'd go about getting somebody in extreme shock, confusion and physical agony to drink Gatorade or eat a pile of blue M&Ms.; We'll be catching up with Lenna very soon in the Gizcast - her journey since the accident has been equal parts fascinating, inspiring and high-tech: she's undergoing experimental stem cell treatments in India right now and she's been working hard to get back out on the road on a cleverly modified Suzuki motorcycle. But I bet she'd swap it all for an IV drip of BBG as she lay on the road a couple of years ago, that might have prevented a large part of her paralysis in the first place.
Here's hoping that this simple technology shows similar results in humans, and that it makes it through into clinical use around the world as soon as possible. Any treatment that can reduce the severity of spinal cord injuries stands to vastly improve the quality of life for victims, and for such little expense this seems like an enormous breakthrough.
