BY THE OPTIMIST DAILY EDITORIAL TEAM

Spider silk has always had a certain reputation: impossibly strong, faintly magical, and mostly reserved for nature documentaries and superhero origin stories. But in a humid lab in Oxford, it is being treated less like a wonder and more like a tool. A tool that might help surgeons solve a problem modern medicine still struggles with: getting severed nerves to reconnect across larger gaps.

Dr. Alex Woods, a trauma and orthopaedic surgeon for the NHS, is also the co-founder of a start-up called Newrotex. The setting he works in now looks a little different from an operating theatre: about 30 golden orb-web spiders sit in individual terrariums, spinning threads that researchers believe could guide nerve regeneration in a way the body often cannot manage on its own. Holding a fine strand between his fingers, Woods offers the simplest yet most poetic description of what they’re trying to do: “It acts like a scaffold for nerves to grow along like a rose on a trellis.”

It is, he says, a way to “bring this really cool ancient technology to patients.” The “ancient” part is doing a lot of work here, since spider silk is not new, not engineered, not invented. It is a biological material perfected over millions of years. The novelty lies in taking it seriously as a surgical device.

Why a nerve injury is not like a cut on the skin

When a nerve is cut, it does not simply knit itself back together in the way skin might. The body does attempt a repair by creating a temporary structure that the nerve can regenerate along, but that scaffold only survives for around 10 days before breaking down.

That short window becomes a major limitation when the gap is large. As Woods explains, “So if that gap is more than one centimetre with nerves regenerating at about one millimetre a day it can’t bridge big gaps and breaks down.” In other words, the nerve may still be trying to cross the injury when the bridge underneath it disappears. This is where the golden orb-web spider enters the chat.

The thread that matters most: drag-line silk

The spiders Newrotex works with are native to southern and eastern Africa, and the group in Oxford came from Madagascar. They are described as harmless to humans, though they are not especially sociable with each other. “They’re quite territorial so we keep them in their own terrariums and we keep the room very humid to mimic their natural environment,” Woods explains.

Their webs can be more than a metre wide, but the researchers are focused on a specific type of silk: drag-line silk, the thread spiders use to dangle and anchor themselves. Woods says this drag-line silk behaves like the body’s own nerve scaffold, “except it lasts for 150 days,” he says. “So now we can allow the nerves to get across the gap.”

Instead of relying on a structure that collapses after 10 days, the idea is to implant these silk fibres inside a vein or hollow conduit so they can serve as a longer-lasting guide. Over time, the fibres degrade in the body, meaning the scaffold can do its job and then exit the scene without demanding a permanent role.

Why this could be a big deal for recovery

Today, many nerve repairs require grafts, a technique that often means taking a nerve from elsewhere in the patient’s body and using it to bridge the damaged area. That approach can restore function, but it also creates a second injury site, and it can leave lasting numbness where the donor nerve was removed.

Helen Hide-Wright has experienced that trade-off firsthand. In 2022, she suffered a cardiac arrest while driving and crashed into a truck, breaking “almost every bone” in her body. She also severed nerves in her right arm, and surgeons had to remove nerves from behind her foot, leaving her without sensation there. She describes her treatment as successful, but still sees why a silk-based alternative is compelling.

“The surgery was brilliant,” she says, “but what Alex is offering would appear to be far more beneficial, a very exciting opportunity.”

Woods argues that a device that repairs a nerve immediately without needing a second operation site could also help with NHS costs. “It’s an extra operation site that has associated harm and that has a cost you won’t need if you have a device you can take and repair the nerve straight away,” he says.

The applications may stretch beyond trauma

Road accidents and severe injuries are an obvious starting point, but Woods is looking beyond that category. Nerve injuries can also occur during surgeries such as mastectomies or prostate cancer procedures, where nerves are sometimes damaged as an unintended consequence. These injuries can be difficult to treat, and the effects can be long-lasting.

“These are huge problems, which are nerve injuries which, right now, struggle to be treated,” Woods says. “So there’s a really exciting opportunity to take this simple device and open it up to people in all those different specialties.”

A promising idea still has to survive reality

For all the elegance of the science, Woods is candid about the distance between “works in principle” and “is available in hospitals.” Regulation, evidence thresholds, manufacturing demands, and cost can derail even strong medical concepts.

“I’m convinced that if my nerve was lacerated tomorrow I would have our implant put in,” he says. But, he adds, “Seeing all the steps you need to get through and the cost and the evidence you need to produce to bring that to patients has been really eye-opening, but there’s still a risk it’ll never see the light of day.”

Right now, the device is undergoing its first-in-human study in a hospital in Panama to establish safety, before further studies in the UK and the US.

If those steps go well, one of nature’s most famous materials may end up with a new reputation that is less superhero fantasy and more useful medicine.

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