Monthly Archives: January 2013

The jelly made from stem cells that might mend your wobbly knees

Doctors are using a type of jelly made from stem cells to treat arthritic knees. The stem cells, which are extracted from donated umbilical cord blood, appear to trigger the repair and re-growth of damaged cartilage. knee

A small study found the one-off treatment led to a 67 per cent improvement in cartilage repair, and researchers believe it could become an alternative to joint replacement surgery. Two clinical trials are under way assessing its effects.

Cartilage acts as a shock absorber in the joint, and provides a smooth surface that allows the bones to glide smoothly over each other. However, this layer can break down with age-related wear and tear, triggering pain and swelling — a condition known as osteoarthritis.

Once damaged, joint cartilage does not renew itself as easily as other tissues, as it is poorly supplied with blood vessels and nerves. Current treatments include painkillers, physiotherapy and steroids — or partial or total knee replacement. Around 40,000 of these procedures are carried out every year, but the hope is that stem cells may reduce this.

Stem cells are like blank slates, and can turn into a variety of different cells in the body. There are some stem cells found naturally in the knee, and while these can turn into cartilage cells, their number reduces with age and they become less efficient, so cannot cope with the damage. To overcome this, scientists extract stem cells from the knee, then increase their numbers in a lab before implanting them back into the knee.

However, this requires extraction and implantation, and due to the limited number of stem cells available, it seems only to repair small areas of damage.

The latest treatment is based on stem cells from donated umbilical cord blood. These are much more active than adult stem cells, and animal studies suggest they are better at producing cartilage.

Stem cells are removed from the blood then grown in a lab and turned into a gel-like material — the orthopedic surgeon uses keyhole surgery techniques to put the gel into the damaged area.

The treatment could be particularly suited to older patients as their own stem cell reserve is depleted

Researchers say this could be particularly suited to older patients (as their own stem cell reserve is depleted), as well as those with large areas of damage.

Following an early, small study involving ten patients in Seoul, there are now two trials under way with 50 people at Rush University in Chicago, and Brigham and Women’s Hospital, Massachusetts, and at seven hospitals in Korea.

Professor Alan Silman, Medical Director of Arthritis Research UK, said: ‘Using stem cells from various sources to regenerate cartilage has huge potential.

‘Although the technology is still some way off being available for routine use, this is an area of research with substantial activity and could provide an alternative to surgical joint replacement in the future.’

Source: Roger Dobson, http://www.dailymail.co.uk

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Regenerative medicine: Clinical trials launched for the treatment of delayed union fractures

The clinical trials aim to repair bones using adult stem cells combined with biomaterials. It will be conducted in France in the Créteil University Hospital Centre and the Regional University Hospital Centre in Tours, in collaboration with the French Blood Establishment. open-fracture

The REBORNE project began three years ago and its originality lies in using mesenchymal stem cells (MSC), found in bone marrow, to help heal fractures. Adult stem cells are amplified in culture, then are associated with biomaterial before being implanted on the fracture. Promising pre-clinical trials have now paved the way for the launch of these new clinical trials.

Following trauma (fall or road accident), there is a high incidence of delayed union or non-union in tibia, femur or humerus bones requiring a surgical apposition of an autologous bone graft (patient’s own bone). However, the bone graft available is limited and complications are often observed at the second surgical site. The partners of the European project REBORNE propose an alternative treatment using autologous mesenchymal stem cells associated with a synthetic bone substitute. Thanks to a bone marrow aspiration under local anesthesia  the mesenchymal stem cells are isolated and amplified in culture for 21 days. During the surgical intervention stem cells are associated with biphasic calcium phosphate ceramic granules and implanted at the site of the fracture. In this way, the biomaterial is used as “scaffolding” and encourages stem cell proliferation. The stem cells are then differentiated into bone cells and regenerate the bone tissue around the fracture. The French Medicinal Agency ANSM gave its green light on 3 January 2013 so that these Inserm-sponsored trials can now begin in France, with seven patients receiving treatment in the Créteil University Hospital Centre and the Regional University Hospital Centre in Tours. Ultimately, thirty patients will be included in France, Spain, Germany and Italy to be part of this multi-centre European study.

“The objective of this trial is to show that biomaterials and stem cells are safe and are at least equivalent to standard treatments, without their disadvantages. This surgery is less invasive and preserves the patients’ bone stock. For these reasons, it is preferable to bone grafts in terms of triggering bone healing” explains Pierre Layrolle, director of Research, Inserm and coordinator of REBORNE.

 

Source: phys.org, Institut National de la Sante et de la Recherche Medicale