subject: Is cartilage regeneration a remedy for osteoarthritis? [print this page] Is cartilage regeneration a remedy for osteoarthritis?
Osteoarthritis is one of the most common form of arthritis. According to the recent estimates, around 20 to 40 million Americans are suffering from Osteoarthritis. The main reason for the disease of osteoarthritis is the premature deterioration of articular cartilage. The cartilage is responsible for capping the ends of the long bones. Cartilage is a kind of connective tissue; it receives the nourishments from the lining of the joint, which is known as the synovium. Cartilage itself does not have any blood vessel or nerve.
The pain involved in osteoarthritis is due to the irritation caused by the local inflammation. This inflammation occurs due to the production of some destructive enzymes as well as due to the altered bio-mechanism. Until very recently, the osteoarthritis was treated based on the symptomatic regulations of a patient. Anti inflammatory drugs which are non steroidal are usually administered on the patient. These drugs are usually administered in oral or the topical form along with local injections of glucocorticoids or intra articular viscosupplement injections.
The above mentioned approaches definitely allevated the pain temporarily, but these also comes with a lot of side effects. These approaches although very helpful in the initial stages, do not address the main issue of the articular cartilage loss. However, in the 1990's, disease modifying osteoarthritis drugs (DMOADS) was developed. But the research efforts were not very hopeful. Very recently, there has been an interest in the use of stem cells to help with the Cartilage regeneration.
However, the present worry is, what type of stem cells are used? what keeps the stem cells within the joints? What can make the stem cells more productive so that cartilage preservation can be done etc. There has been a major breakthrough in the human pluripotent stem cells (hPSCs). The ground work on stem cell research was initiated by Shinya Yamanaka in 2007. Yamanaka was able to show the ability of the adult stem cells, take and reprogram them- which essentially means reprogramming the bio clock so that the adult stem cells behave like that of the embryonic cells. The major advantage of such reprogrammed stem cells is that they can transform into any kind of tissues when they are placed in the right kind of environment.
Currently, however, there are a lot of technical problem involved with cartilage preservation or for that matter cartilage regeneration. The reality is now the mesenchymal stem cells (MSCs) are being used. In this process, adult stem cells are collected from the bore marrow and are placed in the affected location. Along with growth stimulators, the process seems to be effective. MSCs are of great potential as they can become various kinds of tissue organs in a short time with proper growth stimulator. Thankfully, MSCs are able to convert themselves to cartilages too.
It is too early to say whether this process has any good long term effect as there isn't many controlled studies on this matter. All that are presently available are anecdotal reports which do not serve as good scientific journals.
