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Scientific articles

Bioscaffold infused with growth factor may yield human biologic joint replacements

Bioscaffold infused with growth factor may yield human biologic joint replacements
James Cook, DVM

Posted on the ORTHOSuperSite January 7, 2011


Investigators from University of Missouri and Columbia University say a proof of concept study that created biological joints in animals leads them to believe that biological joint replacement for humans is not far behind, according to a University of Missouri press release.

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Adult Mesenchymal Stem Cells for Osteoarthritis Therapy

Ulrich Nöth; Andre F. Steinert; Rocky S. Tuan
07/03/2008; Nat Clin Pract Rheumatol. 2008;4(7):371-380. © 2008 Nature Publishing Group


Despite the high prevalence and morbidity of osteoarthritis (OA), an effective treatment for this disease is currently lacking. Restoration of the diseased articular cartilage in patients with OA is, therefore, a challenge of considerable appeal to researchers and clinicians. Techniques that cause multipotent adult mesenchymal stem cells (MSCs) to differentiate into cells of the chondrogenic lineage have led to a variety of experimental strategies to investigate whether MSCs instead of chondrocytes can be used for the regeneration and maintenance of articular cartilage. MSC-based strategies should provide practical advantages for the patient with OA.

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Stem Cells Offer Cartilage Repair

Stem Cells Offer Cartilage Repair Hope For Arthritis Sufferers

ScienceDaily (Apr. 14, 2008) — Research being presented April11 at the UK National Stem Cell Network Annual Science Meeting in Edinburgh could offer hope that bone stem cells may be harnessed to repair the damaged cartilage that is one of the main symptoms of osteoarthritis.

Scientists at Cardiff University have successfully identified stem cells within articular cartilage of adults, which although it cannot become any cell in the body like full stem cells, has the ability to derive into chondrocytes - the cells that make up the body's cartilage -- in high enough numbers to make treatment a realistic possibility. The team have even been able to identify the cells in people over 75 years of age.

Osteoarthritis affects over 2M people in the UK and occurs when changes in the make up of the body's cartilage causes joints to fail to work properly. At its worse it can cause the break up of cartilage, causing the ends of the bones in the joint to rub against each other. This results in severe pain and deformation of the joint. One current treatment to treat damaged cartilage due to trauma in younger patients is to harvest cartilage cells from neighbouring healthy cartilage and transplant them into the damaged area. Unfortunately, only a limited number of cells can be generated.

The research team, funded by the Arthritis Research Campaign and the Swiss AO Foundation, have identified a progenitor, or a partially derived stem cell in bovine cartilage that can be turned into can be turned into a chondrocyte in culture. Their breakthrough came in identifying a similar cell in human cartilage that was more like a stem cell with characteristics that they could be used to treat cartilage lesions due to trauma but also mark the onset of osteoarthritis

Lead researcher Professor Charlie Archer from the Cardiff School of Biosciences said: "We have identified a cell which when grown in the lab can produce enough of a person's own cartilage that it could be effectively transplanted. There are limitations in trying to transplant a patient's existing cartilage cells but by culturing it from a resident stem cell we believe we can overcome this limitation.

"This research could have real benefits for arthritis sufferers and especially younger active patients with cartilage lesions that can progress to whole scale osteoarthritis."

Prof Archer commented: "We have embarked on the next stage which is to conduct and animal trial which is a necessary pre-requisite to a clinical trial which we hope to start next year if the results are positive"



Growing Cartilage From Stem Cells

ScienceDaily (Oct. 22, 2009) — Damaged knee joints might one day be repaired with cartilage grown from stem cells in a laboratory, based on research by Professor Kyriacos Athanasiou, chair of the UC Davis Department of Biomedical Engineering and his colleagues.

Using adult stem cells from bone marrow and skin as well as human embryonic stem cells, Athanasiou and his group have already grown cartilage tissue in the lab. Now they are experimenting with various chemical and mechanical stimuli to improve its properties.

Cartilage is one of the very rare tissues that lacks the ability to heal itself. When damaged by injury or osteoarthritis, the effects can be long-lasting and devastating.

"If I cut a tiny line on articular cartilage (the cartilage that covers the surfaces of bones at joints), it will never be erased," Athanasiou said. "It's like writing on the moon. If I go back to look at it a year later, it will look exactly the same."

Work that Athanasiou's group began in the early 1990s at Rice University has resulted in the only FDA-approved products for treatment of small lesions on articular cartilage. (In total, Athanaisou's patents have resulted in 15 FDA-approved products.)

"This will be live, biological cartilage that will not only fill defects, but will potentially be able to resurface the entire surface of joints that have been destroyed by osteoarthritis," Athanasiou said. Currently, joint replacements using metal and plastic prosthetics are the only recourse for the one in five adults who will suffer major joint damage from osteoarthritis.

Stem Cells Therapy

Stem Cells Therapy
The Institute of Regenerative & Molecular Orthopaedics

Dr. Joseph Purita M.D.

Medical Director


What are stem cells?

Although stem cells sounds innovative and cutting edge, this therapy has been around for quite some time. In the past, these cells were very difficult and expensive to procure. With newer techniques and equipment, stem cells can easily be obtained and concentrated by a simple office procedure.

Stem cells are in people of all ages. Stem cells are the repairmen of the body. The most common is known as hematopoietic stem cells (HSC-CD 34+).  The type of adult stem cell that is most often seen in research as being associated with tissue repair is a mesenchymal stem cell (MSC).  These cells usually travel to the injured areas via the blood stream.  If the injured area has a poor blood supply, this is called an area of hypoxia or low oxygen content. Areas of hypoxia include the joints, meniscus tissue, rotator cuff and other tendon injuries. These are areas that typically do not heal on their own.  The body is not able to get enough of the repair cells to these injured areas.  Since there is a poor blood supply in this area, the body has trouble sensing an injury is present.If the injury is not that severe, we are usually able to treat the area with platelet rich plasma. We are in a sense mimicking a blood supply in that the platelets sense the injury, release growth factors which than signal the body to send in various types of stem cells to repair the body in this area.

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Application of Mesenchymal Stem Cells in the Regeneration of Musculoskeletal Tissues

From Medscape General Medicine > Departments > Review Articles
Application of Mesenchymal Stem Cells in the Regeneration of Musculoskeletal Tissues
Edward J. Caterson, BS, Leon J. Nesti, PhD, Todd Albert, MD, Keith Danielson, PhD, Rocky Tuan, PhD, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Published: 02/05/2001

Abstract
Mesenchymal stem cells are a rare population of undifferentiated cells, isolated from adult tissue sources, that have the capacity to differentiate into mesodermal lineages, including bone, fat, muscle, cartilage, tendon, and marrow stroma. These cell populations may be expanded in culture and subsequently permitted to differentiate into the desired lineage. This directed differentiation may be reached by the application of bioactive molecules, specific growth factors, and signaling molecules. Understanding the functional potential of these cells and the signaling mechanisms underlying their differentiation should lead to innovative protocols for clinical orthopaedic interventions. Clinically applicable techniques to isolate, expand, and reimplant these autogenous cells will become part of the repertoire of orthopaedic therapy. In the presence of extrinsic signaling molecules, provided by both the clinician and the local cellular environment, the intrinsic multipotential nature of the stem cells may be realized for applications such as the replacement of bone graft for segmental defects, nonunions, and spinal fusions. Additional applications may include treatment of full-thickness articular defects and articular resurfacing by site-specific delivery of stem cells. The ultimate goal is directed cellular regeneration of damaged or diseased musculoskeletal tissue. Currently, the limitation is our knowledge and ability to direct this differentiation, but with further study molecular orthopaedic interventions should become a reality. [MedGenMed, MedGenMed, February 5, 2001. © Medscape, Inc.]

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