Matrix Stem
Stem Cell Therapy for Osteoarthritis: What are the data?
In recent years, several methods have been developed to repair cartilage damage. These include osteochondral transplantation, microfracture surgery and autologous chondrocyte (cartilage cells) implantation.
A common feature of all these techniques is limited to the repair of focal lesions. Patients with osteoarthritis are excluded from treatment.
OA cartilage lesions are usually larger and not confined and thus do not provide a suitable environment for the chondrocytes to remain long enough to build a framework (matrix).
So ... successful repair of OA cartilage damage depends upon the ability to form a matrix within the joint.
Effective cartilage engineering protocols have been developed in which chondrocytes in young animal models have proven effective in creating cartilage.
Generation of cartilage using adult human cartilage cells is much more difficult. Older patients have OA cartilage that is less sensitive to stimulation stem cells and stem cells seem to respond less to the usual growth factors.
There are three possible ways to obtain stem cells. The first is the embryonic stem cells, which have the attraction of being relatively pristine. However, political and ethical concerns have made this source of cells unattainable mother. There is also the theoretical possibility that the theses of stem cells can grow uncontrollably leading to unregulated growth, ie cancer.
A second source is mesenchymal stem cells grown in a laboratory from healthy volunteers. While carefully screened for diseases and problems genetics, stem cells are carriers to avoid possible rejection reactions.
Finally, the ultimate source and appears to be most of promise-at least for now, are autologous stem cells. These stem cells are harvested from the iliac crest of the patient.
Autologous cells mother presents an attractive option for osteoarthritis patients and their physicians. However, we must also recognize that autologous therapies are expensive. Ideally, would be good for the treatment of the samples obtained from the iliac crest to growth factors, cytokines and chemokines, to stimulate an increase in the number of cells mother.
However, both government regulations and sterility concerns preclude this step.
Furthermore, the search for better matrix production to allow stem cells "home" to grow and multiply is still being studied.
There have been a few clinical trials have shown some promise. The first comes from Murdoch University in Australia.
Work with an adult mother company Australia cell Mesoblastic Limited (ASX: MSB), pre-clinical trials at the University of Mesoblastic patented adult stem cell therapy has shown that significantly protect against cartilage damage in osteoarthritis of the knee.
The project's principal investigator, Professor Rick Lee said: "We delighted with the significant protective cartilage Mesoblastic effects of allogeneic (donor unrelated) cells in our large animal model of Osteoarthritis of the knee, without any adverse effects from the cells at all. "
Mesoblastic cartilage trials evaluated the efficacy and safety of adults in the company allogeneic stem cells to treat osteoarthritis of the knee in 48 arthritic sheep joints.
The results showed that sheep knee osteoarthritis who receive stem cells had significantly higher Mesoblastic articular cartilage thickness, reducing the destruction of cartilage and greater biomechanical strength three months later than did control joints receiving hyaluronic acid.
In another study, researchers Duke University Medical Center have been "reprogrammed cells" adult stem taken from a small deposit of fat behind the kneecap in the operation cartilage, bone, fat or cells that could be grown in tissue replacement for osteoarthritis.
The research team has provided evidence that adult stem cells taken from different sources have the potential to become many types of specialized cells.
In the current study, researchers took the fat pads of patients whose knee joints were removed during surgery for total hip replacement. The layer Fat is a dense structure behind the patella, or kneecap that is unlike typical fat tissue found throughout the body.
They were capable of isolating and culturing adult stem cells from this tissue.
According to scientists at the University of Cardiff, stem cells identified their studies can become cartilage cells (chondrocytes) in huge quantities. This may mean that the limitations in cartilage transplants, which healthy cartilage cells are collected and transplanted into a damaged joint, could be overcome.
However, despite recent press reports announcing the identification of these stem cells as a breakthrough in the treatment of osteoarthritis, this research is currently only being considered to treat people with limited cartilage damage.
Says Dr. Nathan Wei, "Our current understanding of stem cell biology is obviously is not where it needs to be. However, the early work in our center with autologous stem cells obtained from the iliac crest bone marrow and concentrated then has shown very promising results in patients with osteoarthritis of the knee. It is important to note that before the introduction of cells mother, irritation of adjacent cartilage and the capsule is important to initiate an inflammatory response that leads to cell proliferation, which is an essential part healing and cartilage regeneration later. "
Dr. Wei added, "By the way, however, I think this approach is relatively easier it will be more effective than other therapies for osteoarthritis have today. "
For more information about cells mother and osteoarthritis, call the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800.
About the Author
Nathan Wei, MD FACP FACR is a nationally known board-certified rheumatologist. For more info:
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