Summary: A multinational clinical trial demonstrated that a novel antibody, NG101, successfully preserves existing nerve tissue and accelerates the regression of spinal cord lesions following acute injury.
The antibody operates by neutralizing Nogo-A, a naturally occurring protein that structurally blocks the regeneration of damaged nerve fibers. By combining advanced magnetic resonance imaging (MRI) with clinical data, researchers have objectively visualized the therapeutic mechanics early in treatment, establishing an essential blueprint for restoring functional brain-to-muscle signal pathways.
Key Facts
- Removing the Healing Barrier: NG101 targets and neutralizes Nogo-A, an unhelpful protein found in the sheaths of nerve fibers within the brain and spinal cord that actively blocks damaged fibers from healing after an acute trauma.
- Accelerated Lesion Regression: Advanced imaging methods confirmed for the first time that the antibody therapy speeds up the healing of spinal cord lesions, allowing nerve fibers to regenerate in the tissue surrounding the impact site.
- Tissue Loss Interception: The therapy considerably slows down the loss of existing nerve tissue and offsets structural degradation by stimulating the regrowth of entirely new nerve fibers.
- Functional Reconnection: The newly formed and surviving nerve fibers successfully navigate across or around the injury site, re-establishing vital connections with the spinal cord centers that control the peripheral nerves of the hands, arms, and legs.
Source: University of Zurich
Spinal cord injuries – often caused by sports or traffic accidents – can result in tetraplegia or paraplegia and severely limit independence.
In late 2024, an international research group led by the University of Zurich (UZH) and Balgrist University Hospital completed a multinational clinical trial in which patients with acute spinal cord injuries were successfully treated with the novel antibody NG101.
The results showed that NG101 accelerates the regression of spinal cord lesions and preserves existing nerve tissue.
Antibody neutralizes unhelpful protein
Discovered at UZH roughly 30 years ago, NG101 targets the protein Nogo-A, which is found in the sheaths of nerve fibers in the spinal cord and brain. This protein blocks the healing of damaged nerve fibers in the spinal cord following acute injury.
By neutralizing Nogo-A, NG101 removes this barrier to growth and healing, thereby boosting nerve fiber regeneration and supporting the functional regeneration of spinal cord tissue.
Visible results in the spinal cord
The research team’s latest study has revealed another critical piece of the puzzle. “In our new study, we were able to use advanced imaging methods to show for the first time how this antibody therapy works directly in the spinal cord,” says Patrick Freund, UZH professor and head of the Spinal Cord Injury Center at Balgrist University Hospital.
The magnetic resonance imaging data revealed two important effects. First, spinal cord injuries healed more quickly in the presence of NG101, which suggests that nerve fibers were able to regenerate in the tissue surrounding the injury. Second, the loss of nerve tissue slowed down considerably and was offset by the regrowth of new nerve fibers. Previous animal experiments conducted by the researchers had already established how critical this stage is.
This is due to newly formed nerve fibers needing to find a way to navigate across or around the injury site in order to restore the pathways linking the brain and the spinal cord.
New connections to peripheral nerves
The group’s latest findings suggest that it is precisely this process that is supported by NG101.
“This allows surviving and newly regenerated nerve fibers to re-establish connections with the spinal cord centers that control the hand, arm and leg nerves,” says Freund, who led the study.
“These connections are essential for relaying signals from the brain to the muscles.” For some patients, this means a greater chance of recovering arm and hand function.
NG101 not only improves the function of the spinal cord but has also been shown to alter its structure, which supports the regeneration of nerve tissue. This marks an important step toward new, effective treatments for spinal cord injuries.
“We are now able to visualize the effect of the therapy early on and in an objective way,” says Freund. “This opens up the possibility of using future treatments more strategically and conducting a more reliable evaluation of their outcomes.”
Key Questions Answered:
A: While it is too early to guarantee full mobility for every patient, the clinical trial proved that NG101 helps surviving and newly grown nerve fibers reconnect with the spinal cord centers controlling the arms, hands, and legs. For patients with acute injuries, this significantly increases the mathematical probability of recovering crucial hand and arm functions.
A: The central nervous system contains a literal molecular brake pad. A specific protein called Nogo-A resides in the protective sheaths of your nerve fibers. Following a sudden trauma, this protein actively stops damaged nerve fibers from growing or repairing themselves. NG101 acts as a shield that shuts down Nogo-A so natural regeneration can take over.
A: Researchers used high-resolution MRI data to track the treatment on a cellular and structural level. The imaging objectively showed two clear visual markers: the physical holes (lesions) in the spinal cord shrank much faster, and the rapid degradation of delicate nerve tissue was replaced by the visible architecture of freshly sprouting nerve fibers.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this spinal cord injury and neurology research news
Author: Kurt Bodenmueller
Source: University of Zurich
Contact: Kurt Bodenmueller – University of Zurich
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Anti-Nogo-A NG101 treatment induces changes in spinal cord micro- and macrostructure following spinal cord injury: A multicenter MRI study” by Lynn Farner, Paulina S. Scheuren, Kiomars Sharifi, Tim M. Emmenegger, Maryam Seif, Michèle Hubli, Martin Schubert, Marc Bolliger, Rüdiger Rupp, Norbert Weidner, Rainer Abel, Doris Maier, Klaus Röhl, Michael Baumberger, Margret Hund-Georgiadis, Marion Saur, Jesús Benito, Kerstin Rehahn, Mirko Aach, Andreas Badke, Jiri Kriz, Tim Killeen, Alan J. Thompson, Nikolaus Weiskopf, Martin E. Schwab, Armin Curt, Patrick Freund & the Nogo Inhibition in Spinal Cord Injury (NISCI) Study Group. Nature Communications
DOI:10.1038/s41467-026-71412-0
Abstract
Anti-Nogo-A NG101 treatment induces changes in spinal cord micro- and macrostructure following spinal cord injury: A multicenter MRI study
NG101 is a recombinant antibody that neutralizes the nerve growth inhibitor Nogo-A, promoting neural repair and improving upper extremity motor function in spinal cord injury (SCI).
This study evaluated spinal cord MRI biomarkers to detect treatment-related structural changes and enhance patient stratification using data from 106 participants with acute cervical SCI in the phase 2b NISCI trial.
We assessed lesion volume, tissue bridges, and remote changes in cross-sectional cord area (CSA), and tract-specific myelin-sensitive magnetization transfer saturation (MTsat) over six months.
Compared to placebo, NG101-treated participants exhibited faster lesion volume reduction and a slower decline of CSA and MTsat in the corticospinal tracts and dorsal columns.
Crucially, multimodal stratification incorporating MRI and electrophysiological measures substantially enhanced the detection of clinical treatment effects. These findings suggest NG101 slows trauma-induced progressive macro- and microstructural degeneration or promotes fiber sprouting.
Combining MRI with electrophysiology enables sensitive detection of treatment effects and efficient trial designs. ClinicalTrials.gov identifier: NCT03935321.
