| One of the first articles to mention stem cell therapy | | | | property is that stem cells are "pluripotential." |
| for osteoarthritis was an article published in the | | | | While most research and ethical concerns have been |
| December 2003 article Arthritis and Rheumatism | | | | centered on the use of embryonic stem cells, adult |
| (Murphy JM, et al. Arthritis Rheum. 2003; 48: | | | | stem cells are more accessible with no ethical |
| 3464-3474.) | | | | "baggage." The cells that were used in the above |
| The research team took two groups of goats and | | | | study were adult stem cells obtained from the bone |
| created osteoarthritis in their knees by removing the | | | | marrow. |
| medial meniscus and cutting out the anterior cruciate | | | | At the Arthritis and Osteoporosis Center of Maryland, |
| ligament. After six weeks, one group of goats | | | | research efforts have been aimed at using adult |
| received an injection of sodium hyaluronan (a lubricant | | | | stem cells obtained from the bone marrow to treat |
| commonly used to treat symptomatic osteoarthritis | | | | osteoarthritis of the knee or hip. Stem cells are |
| of the knee) while the other group received a single | | | | obtained from the iliac crest of the patient's hip and |
| dose of 10 million stem cells, originally extracted from | | | | then concentrated using a special technique. The area |
| the goats' bone marrow, and then suspended in | | | | of interest- usually the medial compartment of the |
| sodium hyaluronan before injection into the knee. | | | | knee is then prepared with a special instrument under |
| In the knees which had been treated by stem cell | | | | ultrasound guidance. This technique ensures that local |
| injections, researchers observed a regeneration of | | | | inflammation is created at the site of needed repair. |
| joint tissue and a decrease in cartilage degeneration. | | | | This is a critical component of the procedure since |
| The authors commented on their findings... "there | | | | the exact location of pathology will determine where |
| may be a therapeutic benefit associated with local | | | | the stem cells will be placed. |
| delivery of stem cells following traumatic injury to the | | | | Along with stem cells, platelet rich plasma, also |
| knee. The longer term effect of this may be a | | | | obtained from the patients is infused. The platelet rich |
| reduction or delay in the progression to | | | | plasma attaches to tyrosine kinase receptors on the |
| osteoarthritis." | | | | cell surface of the stem cells and triggers gene |
| The authors concluded that "this is a scaffold-free | | | | expression within the nucleus of the stem cell. This |
| method for cell delivery and is therefore | | | | "turns on" the stem cell to divide and differentiate |
| unencumbered by the complexities associated with | | | | into cartilage. |
| placement of a solid cell construct." This latter | | | | The entire procedure is done using local anesthetic |
| statement is important because so many techniques | | | | with ultrasound guidance. |
| to date have involved the complicated use of | | | | According to Dr. Nathan Wei, "Preliminary results are |
| different scaffolds (frameworks) to hold stem cells in | | | | very promising. Longer term data is required and we |
| place. | | | | are specifically addressing not only patient function |
| Stem cells are progenitor cells- the cells that all others | | | | but also measurements of cartilage thickness." He |
| are derived from. They have three interesting | | | | adds, "the best approach as far as framework |
| characteristics that make them prime candidates for | | | | preparation for the stem cells and ensuring an |
| tissue regenerative techniques. They are capable of | | | | adequate number of stem cells are of key |
| dividing and renewing their numbers for an unusually | | | | importance. If you don't have enough viable stem |
| long period of time; they are undifferentiated, | | | | cells, the procedure won't be effective. Also, the |
| meaning they have not yet committed to being a | | | | stem cells need to be primed properly... and have a |
| "heart" cell or a "lung" cell; and they can become any | | | | scaffold (framework) to attach to. |
| type of specialized cell. Another term to refer to this | | | | |