Medical College of Wisconsin
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Neurosurgery

Kurpad Lab

Dr. Shekar Kurpad

Spinal cord injury (SCI) is a relatively frequent event; estimates suggest that 12,500 new cases of SCI occur every year in the US alone. In the US, approximately 276,000 persons live with SCI, which has a huge impact on their lives and families, and has tremendous socioeconomic and medical costs. The main causes for SCI are motor vehicle accidents (38%), falls (30%), acts of violence (14%), and sports injuries (9%) (National SCI Database).

The type and degree of disability that is caused by SCI is determined by the location and extent of the injury. Spinal cord tissue is damaged in the injury process and this damage occurs in two steps. The initial damage, the primary injury, is caused by the mechanical trauma to the spinal cord during the accident. This is followed by the secondary injury, which is caused by a number of events, including hemorrhage and inflammation. While acute inflammation is observed in all tissues as a response to injury and is an important prerequisite for the healing process, prolonged and unresolved inflammation, as it is present after SCI, strongly contributes to the tissue damage. Immune cells in the tissue produce factors that maintain and stimulate the inflammatory response and produce factors that contribute to tissue damage.

Red blood cells (RBCs), which are present in the spinal cord tissue due to the hemorrhage, are taken up by phagocytic cells like macrophages. This can result in increased production of pro-inflammatory cytokines and chemokines, factors that activate immune cells. Previous experiments have shown the relevance of some of these factors after SCI. For example, the absence of one of these cytokines, TNF, leads to a better recovery in mice after SCI and reduces inflammatory activation of cells at the injury site. However, these extent of these results suggests that other factors also contribute to the tissue damage.

We are now attempting to investigate further mechanisms contributing to the secondary tissue damage, including other cytokines and chemokines which may play a role after SCI. We aim to modulate these and investigate the effect on recovery after SCI.

Ultimately, our goal is a translational treatment approach to reduce secondary damage after injury and to improve the outcome and quality of life after SCI. In summary, the broad goal of my research is to investigate and modulate the inflammatory tissue response after spinal cord injury (SCI) with the aim to reduce the secondary damage and thereby to improve the functional outcome after SCI.

Ongoing Studies

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AST-OPC1-02: A Long-term Follow-up Study of Subjects with Cervical Spinal Cord Injuries Who Received AST-OPC1 in Protocol AST-OPC1-01
The purpose of this study is to monitor long-term safety in subjects with cervical SCI who received injections of AST-OPC1 under the study protocol AST-OPC1-01.
INSPIRE 2.0: Randomized, Controlled, Single-blind Study of Probable Benefit of the Neuro-Spinal Scaffold (TM) for Safety and Neurologic Recovery in Subjects with Complete Thoracic AIS A Spinal Cord Injury as Compared to Standard of Care
The purpose of this study is to evaluate whether the Scaffold is safe and demonstrates probable benefit for the treatment of complete T2-T12 spinal cord injury as compared to standard of care open spine surgery.
MT-3921-A01: A Phase 2a, Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy and Safety of MT-3921 in Subjects with Acute Traumatic Cervical Spinal Cord Injury
The purpose of this study is to compare the efficacy and safety of intravenous (IV) infusions of MT-3921 to placebo in subjects with acute traumatic cervical spinal cord injury.
ELASCI: A Randomized, Double-Blind, Placebo-Controlled Proof of Concept Study to Assess the Safety and Efficacy of Elezanumab in Acute Traumatic Cervical Spinal Cord Injury
The purpose of this study is to see if elezanumab is safe and to assess change in Upper Extremity Motor Score (UEMS) in participants with acute traumatic cervical SCI.

Completed Studies

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MT-3921-G01: A study to Investigate the Safety, Tolerability, Pharmacokinetics of Single Ascending Dose of MT-3921 in Subjects with Acute Spinal Cord Injury
The primary objective of this study was to evaluate the safety, tolerability, and pharmacokinetics of MT-3921 in spinal cord injuries.
RISCIS: A Multi-Center, Randomized, Placebo-Controlled, Double-Blinded, Trial of Efficacy and Safety of Riluzole in Acute Spinal Cord Injury
The purpose of this study was to evaluate the efficacy and safety of Riluzole in the treatment of patients with acute SCI.
AST-OPC1-01: A Phase 1/2a Dose Escalation Study of AST-OPC1 in Subjects with Subacute Cervical Spinal Cord Injury
The purpose of this study was to evaluate the safety of cross sequential escalating doses of AST-OPC1 administered among five cohorts at a single time-point between 21- and 42-days post injury, inclusively, to subjects with subacute cervical spinal cord injuries (SCI).
The INSPIRE Study: Probable Benefit of the Neuro-Spinal Scaffold for Treatment of AIS A Thoracic Acute Spinal Cord Injury
The purpose of this study was to evaluate the safety and probable benefit of the poly(lactic-co-glycolic acid)-b-poly(L-lysine) Scaffold ("Scaffold") in subjects with thoracic AIS A traumatic spinal cord injury at neurological level of injury of T2-T12.
A Double-Blind, Placebo-Controlled Study of AC105 in patients with Acute Traumatic Spinal Cord Injury
This was a phase 2 double-blind, randomized, placebo-controlled study to determine the safety, tolerability, and potential activity of AC105.
A Phase 1 Safety Study of GRNOPC1 in Patients with Neurologically Complete, Subacute, Spinal Cord Injury
The purpose of the study was to evaluate the safety of GRNOPC1 administered at a single time-point between 7- and 14-days post injury, inclusive, to patients with neurologically complete spinal cord injuries (SCI).
Study of Human Central Nervous System (CNS) Stem Cell Transplantation in Cervical Spinal Cord Injury
The purpose of this study was to evaluate the safety and efficacy of human central nervous system stem cell transplantation into patients with traumatic injury in the cervical region of the spinal cord.

Recent Publications

Publications of Shekar N. Kurpad MD, PhD from the Faculty Collaboration Database