2026-03-09
Polylaminin and the return of voluntary motor contraction after complete spinal cord injury: a landmark pilot study
Neurology
By Carolina Lima | Published on February 9, 2026 | 3 min read
Acute spinal cord injury (SCI) remains one of the most complex and devastating conditions in medicine. Even with advances in emergency care, neurosurgery and rehabilitation, motor recovery in patients with complete SCI (AIS A) is extremely uncommon. Historical data consistently show that fewer than 15% of these individuals recover any degree of voluntary muscle activation below the injury level. Against this background, a recent Brazilian pilot study evaluating polylaminin — a stabilized polymeric form of laminin — offers unexpected and clinically meaningful findings.
Laminin is an extracellular matrix protein essential to neural development and regeneration. It supports neuronal survival, migration, axonal extension and integrity of the neurovascular tissue organization. When its expression is disrupted, neural regeneration becomes severely compromised. Polylaminin is a laboratory‑made version, more stable and structured, that mimics laminin. Preclinical studies in rats had already shown that polylaminin reduces inflammation, preserves tissue structure and increases the number of regenerating axons after SCI. Those results were consistent enough to give researchers confidence to move into human testing.
Reinforcing the preclinical findings
Before moving toward a human trial, the research team conducted five additional animal experiments using a mild compression model in rats. A total of 106 animals were evaluated, with 51 treated using polylaminin and 55 serving as non‑injected controls. Functional outcomes were assessed using BBB locomotor scores. Rats treated with polylaminin demonstrated significantly better locomotor recovery than untreated controls, achieving near-complete ambulation by the eighth week. Microscopy analysis further confirmed the presence of regenerating axons crossing the injury site, following laminin pathways: consistent with true structural repair.
The human pilot trial
Encouraged by strong preclinical evidence, the investigators conducted a first‑in‑human, single‑arm, open‑label pilot study. Eight adults with confirmed AIS A injuries were enrolled, based on strict AIS criteria including voluntary anal contraction, deep anal pressure and sacral sensory testing. All participants received a single intraparenchymal injection of polylaminin, typically within 2.3 days after trauma.
Despite the small sample size, the results were notable:
If these results are confirmed in future phases of clinical testing, polylaminin may represent a meaningful step forward in the treatment of acute spinal cord injury.
As a Brazilian HCP, it’s hard not to feel proud and encouraged — it’s not every day that a therapy developed entirely within our own scientific community shows such promising early results, especially in a disease where recovery has traditionally been so limited.
Naturally, enthusiasm must remain grounded. This first study was small, not randomized, and didn’t include a control group, so larger and more rigorous trials are essential before we can draw firm conclusions. Even so, the improvements seen so far go well beyond what we would normally expect from natural recovery alone, and that’s a signal worth paying attention to.
For people living with chronic tetraplegia and their families, research like this can offer renewed hope. Even if polylaminin ultimately works best in the acute phase, every step forward in spinal cord repair brings us closer to treatments that may one day help chronic patients too. Progress is rarely fast, but studies like this remind us that meaningful change is possible.
About the Author – Carolina Lima Dr.
Carolina Lima, a physician specialized in anesthesiology, has a deep passion for learning and sharing medical knowledge. Dedicated to advancing her field, Dr. Lima strives to bring new evidence-based perspectives to the medical community. Viewing medicine not simply as a profession but as a lifelong journey of learning, Dr. Lima is committed to making complex information clear, practical, and useful for healthcare professionals around the world.
Acute spinal cord injury (SCI) remains one of the most complex and devastating conditions in medicine. Even with advances in emergency care, neurosurgery and rehabilitation, motor recovery in patients with complete SCI (AIS A) is extremely uncommon. Historical data consistently show that fewer than 15% of these individuals recover any degree of voluntary muscle activation below the injury level. Against this background, a recent Brazilian pilot study evaluating polylaminin — a stabilized polymeric form of laminin — offers unexpected and clinically meaningful findings.
Understanding polylaminin
Laminin is an extracellular matrix protein essential to neural development and regeneration. It supports neuronal survival, migration, axonal extension and integrity of the neurovascular tissue organization. When its expression is disrupted, neural regeneration becomes severely compromised. Polylaminin is a laboratory‑made version, more stable and structured, that mimics laminin. Preclinical studies in rats had already shown that polylaminin reduces inflammation, preserves tissue structure and increases the number of regenerating axons after SCI. Those results were consistent enough to give researchers confidence to move into human testing.
Reinforcing the preclinical findings
Before moving toward a human trial, the research team conducted five additional animal experiments using a mild compression model in rats. A total of 106 animals were evaluated, with 51 treated using polylaminin and 55 serving as non‑injected controls. Functional outcomes were assessed using BBB locomotor scores. Rats treated with polylaminin demonstrated significantly better locomotor recovery than untreated controls, achieving near-complete ambulation by the eighth week. Microscopy analysis further confirmed the presence of regenerating axons crossing the injury site, following laminin pathways: consistent with true structural repair.
The human pilot trial
Encouraged by strong preclinical evidence, the investigators conducted a first‑in‑human, single‑arm, open‑label pilot study. Eight adults with confirmed AIS A injuries were enrolled, based on strict AIS criteria including voluntary anal contraction, deep anal pressure and sacral sensory testing. All participants received a single intraparenchymal injection of polylaminin, typically within 2.3 days after trauma.
Despite the small sample size, the results were notable:
- · All six participants who survived to the one-month mark regained voluntary motor contraction below the lesion. One participant recovered full walking capacity, while another experienced improved sensory levels and voluntary activation of muscles across multiple segments. The most pronounced gains occurred in individuals with cervical injuries.
- Overall, 75% of the cohort (6 out of 8) converted from AIS A to AIS C or D — far above the natural history expectation.
- Electrophysiological evaluations revealed reappearance of motor and sensory potentials in some patients, supporting the neurological improvements noted in physical examinations.
Looking ahead
If these results are confirmed in future phases of clinical testing, polylaminin may represent a meaningful step forward in the treatment of acute spinal cord injury.
As a Brazilian HCP, it’s hard not to feel proud and encouraged — it’s not every day that a therapy developed entirely within our own scientific community shows such promising early results, especially in a disease where recovery has traditionally been so limited.
Naturally, enthusiasm must remain grounded. This first study was small, not randomized, and didn’t include a control group, so larger and more rigorous trials are essential before we can draw firm conclusions. Even so, the improvements seen so far go well beyond what we would normally expect from natural recovery alone, and that’s a signal worth paying attention to.
For people living with chronic tetraplegia and their families, research like this can offer renewed hope. Even if polylaminin ultimately works best in the acute phase, every step forward in spinal cord repair brings us closer to treatments that may one day help chronic patients too. Progress is rarely fast, but studies like this remind us that meaningful change is possible.
About the Author – Carolina Lima Dr.
Carolina Lima, a physician specialized in anesthesiology, has a deep passion for learning and sharing medical knowledge. Dedicated to advancing her field, Dr. Lima strives to bring new evidence-based perspectives to the medical community. Viewing medicine not simply as a profession but as a lifelong journey of learning, Dr. Lima is committed to making complex information clear, practical, and useful for healthcare professionals around the world.
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