A new niche for mesenchymal stem cells…Researchers from Duke University Health System may have found a promising stem cell therapy for preventing osteoarthritis after a joint injury. The team used mesenchymal stem cells (MSCs) in mice with fractures that typically would lead to them developing arthritis. Their findings could lead to a therapy that would be used after joint injury and before signs of significant osteoarthritis.
New Stem Cell Therapy for OA Prevention
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“The stem cells were able to prevent post-traumatic arthritis [PTA], ” said Farshid Guilak, Ph.D., director of orthopaedic research at Duke and senior author of the study, in the August 10, 2012 news release.
The researchers also thought that a type of mice bred for their super-healing properties would probably fare better than typical mice, but they were wrong.
“We decided to investigate two therapies for the study, said lead author Brian Diekman, Ph.D., a postdoctoral researcher in the Guilak lab. “We thought that stem cells from so-called superhealer mice would be superior at providing protection, and instead, we found that they were no better than stem cells from typical mice. We thought that maybe it would take stem cells from superhealers to gain an effect as strong as preventing arthritis after a fracture, but we were surprised – and excited – to learn that regular stem cells work just as well.”
Certain people appear to fall into the superhealer category, too. They bounce back quickly and heal well naturally after a fracture, while other people eventually form cases of arthritis at the fractured joint, said Dr. Guilak, who is a professor of orthopaedic surgery and biomedical engineering.
“The ability of the superhealer mice to have superior healing after a fracture may go beyond the properties of their stem cells and be some beneficial factor, like a growth factor, that we don’t know about yet, ” Dr. Guilak said.
The delivery of 10, 000 typical or superhealer stem cells to the joint prevented the mice from developing PTA, unlike a control group that received only saline.
Dr. Diekman said the team looked at markers of inflammation and saw that the stem cells affected the inflammatory environment of the joint after fracture.
“The stem cells changed the levels of certain immune factors, called cytokines, and altered the bone healing response, ” said Dr. Diekman, who is also with the Duke Department of Biomedical Engineering.
“We found that by placing the stem cells into low-oxygen conditions, they would grow more rapidly in culture so that we could deliver enough of them to make a difference therapeutically, ” Dr. Diekman added.
Dr. Guilak told OTW,
Our next step would be to test this effect in a larger animal, and to further study how these stem cells were responsible for preventing post-traumatic arthritis. If these studies are successful, we would hope to try this approach in patients within a few years.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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