For the many millions of osteoarthritis sufferers around the globe, stem cell research has been a beacon of hope in an otherwise depressing situation. Even then, the newspaper headline writers, eager to get a scoop on medical breakthroughs, often jump the gun by turning promising early trial results into miraculous and imminent cures.
However, there is a common thread emerging from a growing body of evidence, from Europe, Asia, Australia and the United States: successful treatment for early stage arthritis could finally be available within the next five years. This treatment may fall short of an outright cure, at least at first, but researchers are optimistic that osteoarthritis sufferers could soon see significant improvements in their prognoses, potentially through a simple injection of their body’s own stem cells.
The Present Picture of Arthritis
Arthritis is an umbrella term for a number of joint-related diseases that together affect over 50 million adults and 300,000 children in the US alone. Osteoarthritis, or osteoarthrosis, the most common form of arthritis, is a degenerative condition which occurs when the hyaline cartilage covering the articular surfaces between bones of a joint gets damaged and wears down. Eventually, the bones come into contact with each another, damaging the joint further, causing increasing pain and inflammation, restricting movement, causing laxity of the ligaments and increasing instability of the joint. The patient ends up in daily pain, ranging from acute and severe to chronic and disabling, with loss of functionality. As osteoarthrosis largely affects the older individuals, and those are increasingly making a larger slice of the population, there will inevitably be more needing treatment as time goes by.
[Image courtesy: Medicalnewstoday.com ]
For a long time, there has been no way of curing or even slowing down the progress of osteoarthrosis which would eventually progress to a stage where joint replacement surgery becomes the only option. Keyhole surgeries such as micro-fractures (literally causing small breaks to stimulate cartilage formation) and debridement (clearing away debris around the joint) can ease symptoms, and some very recent advances have seen the introduction of new drug treatments which may slow down the progress of the condition to a degree. But stem cell therapy remains the only light at the end of the tunnel for many people.
Why Scientists are Excited about Autologous Stem Cell Therapy
Many people associate stem cells with bone marrow transplants or the use of discarded human embryos, but it is the stem cells that already exist within each and every one of us that are causing a great deal of excitement to researchers in the field of regenerative medicine. The extraction and redeployment of such adult (or stromal) stem cells is known as autologous stem cell therapy and numerous trials have sprung up in the past two or three years to find out exactly what kinds of stem cells are most effective and how they can be most efficiently cultivated. Although these trials do take a long time, and seem particularly slow to long-suffering patients, the good news is that the results from small-scale human trials have been so promising that already there are large-scale trials running across numerous countries. These large-scale trials will incorporate the final safety and efficacy tests that are needed before treatments are given a marketing license.
In some cases, for example where there is no laboratory manipulation involved, autologous stem cells are not classified as drugs and can be used in treatments without recourse to clinical trials, providing the equipment used is suitable for the purpose and the team carrying out the procedure are suitably skilled and experienced.
Recent Trial Results: What do they Reveal?
An example of a recent successful autologous stem cell trial comes from the National University of Ireland, Galway, where Professor Frank Barry, Director of the Regenerative Medicine Institute, gave a one-time injection of stem cells into the knee joints of a preliminary sample of 18 arthritic patients. Prior to injection, the stem cells had been separated out from a small sample of the patient’s own fat and then cultivated over a period of several weeks. The results, both in terms of pain reduction and increased joint mobility were so promising that Professor Barry immediately started securing funding for a much larger multi-million dollar pan-European trial involving 150 patients from ten hospitals.
Although Professor Barry is excited and optimistic about the future, he admits that his research is still in its early stages. Nevertheless, Professor Christian Jorgensen from Montpellier University, one of those involved in Barry’s trial, is hopeful that arthritis patients could start seeing arthritis stem cell therapy within the next five years. The signs from large-scale trials already carried out elsewhere are promising. For example, a trial in Australia, involving nearly 400 patients ended with 80 percent of those treated reporting a significant reduction in pain, improved sleep and an increase in joint movement. Still, there are many questions left unanswered including the important issue of whether the healing is permanent or will require multiple repetitions over time.
Other patient trials, including one being carried out in the RJAH Orthopedic Hospital in Shropshire, UK, are trying to find out which types of stem cell are most effective in treating arthritis. This particular research trial uses keyhole surgery to extract chondrocytes (cartilage-forming cells) from patients’ knees and MSCs (mesenchymal stem cells) from their hips. The cells are then grown under laboratory conditions with some patients then injected with chondrocytes, some with MSCs and a third group with a combination of both types of cell. None of the patients, who have each been selected based on a strict set of criteria, are told which treatment they have been given.
Meanwhile, other research is looking at optimizing the large-scale production of stem cells by exploring different growth factors. For example, Dr. Naoki Nakayama and his team from the University of Texas discovered that small molecules could be used to direct the differentiation of stem cells rather than less stable and more expensive proteins, opening the way to the scaling up of stem cell production once they do become available on the market. Donor cell banking is another way in which future therapies might be economized, with pre-loaded injections replacing time-intensive harvesting and deployment procedures. This focus on saving time and cost are clearly important to ensure that future treatments are as affordable as possible.
Although arthritis may be the next health condition for which a breakthrough will be made, stem cell research, including large patient trials, are ongoing in a wide range of medical areas. For example, researchers in Belgium recently ran a trial involving nearly 300 patients suffering from Crohn’s Disease, an inflammatory bowel condition. This trial was conducted over two years and led to improvements in patients’ symptoms and reduced infections. Scientists are also excited about the possibility of stem cells to revolutionize the treatment of heart disease, stroke and multiple sclerosis. In the future, stem cell therapy could even be used to regrow missing hair and teeth, restore sight to the blind and help those with spinal cord damage to walk again.
The Gulf Coast Stem Cell & Regenerative Medicine Center uses a safe and minimally-invasive procedure to harvest and deploy patients’ own fat tissue-derived stem cells for use in the treatment of various health conditions. To schedule a consultation, or to find out more about arthritis stem cell therapy procedure, please call (886) 855 4823 or visit our website at http://www.gulfcoaststemcell.com
Arthritis.org; last accessed 20/04/16