Damage caused by osteoarthritis may be reversed by introducing stem cells inside the joint, writes Dick Ahlstrom
Stem cells may provide a way to reverse the damage caused by osteo-arthritis. A research project at NUI Galway will determine whether the cartilage lost to the disease can be regrown in situ to relieve symptoms.
The €6.25 million project is underway in Remedi, Galway's Regenerative Medicine Institute. This world-class biomedical research centre specialises in gene therapy and stem cell research and combines the two with the aim of regeneration and repair of tissues.
This new research initiative is an academic-industrial collaboration involving medical technology company Smith & Nephew, with additional financial support from IDA Ireland, explains joint project leader and scientific director of Remedi, Prof Frank Barry.
The work focuses on osteo-arthritis, a disease which sees the gradual degeneration and loss of the cartilage that serves as a cushion between bones within a joint, Prof Barry explains. "We will introduce adult stem cells into the joints to see if they have any influence on the progression of the disease."
Osteo-arthritis (OE) is the most common form of the disease, with one in three adults showing signs of it in at least one joint. Incidence increases with advancing age, and women are more likely to have it than men.
The collaboration hopes to change all of this by finding a way to halt and possibly reverse the loss of cushioning cartilage brought about by the disease.
The Remedi team will focus on a specific adult stem cell type recovered from bone marrow, the mesenchymal stem cell. These typically change or differentiate into cell types including heart and fat cells and also cartilage.
Unusually, these cells are also "non immunogenic", says Prof Barry. If transplanted they are not immediately attacked and rejected by the recipient's immune system. "We would introduce these cells using them in a fully mismatched individual without risk of rejection."
Part of the challenge is finding methods for growing the cells in large enough volumes for use in patients, one of the problems to be tackled by the Remedi team. "Scalability is very important, how you take this out of the lab and scale it up to an industrial level," Prof Barry says.
Smith & Nephew develops medical technologies related to orthopaedic reconstruction, endoscopy and other clinical therapies. It will devise a cell delivery system able to place the cells grown at Remedi into the affected joint.
"The question to answer is how to deliver these cells to the patient, whether by syringe or some other device," says Prof Barry.
Surprisingly, the mesenchymal stem cells don't actually have to differentiate and then grow inside the joint. Their presence alone and the cell to cell signalling they provoke is sufficient to trigger natural healing in what is known as the "trophic effect", Prof Barry explains.
Cells release signalling substances all of the time, factors that allow cells to communicate with one another and enable them to act in unison.
"We will deliver them as fully undifferentiated cells, but there is no need for them to differentiate to the cell type. The stem cells deliver repair factors and the host is able to use its own repair response."
In effect the damaged cartilage will heal itself because of the presence of the stem cells. "It should really be described as signalling therapy rather than stem cell therapy," Prof Barry says.
The project adds nine more researchers to Remedi including four scientists sent over by Smith & Nephew.