Category Archives: Stem Cells for Arthritis

Stem cells- autologous or mesenchymal cells- show promise in the treatment of osteoarthritis

What are my options for shoulder pain?

The shoulder has the honor of being is the largest, most complex, and most mobile joint in the body.  And it is this reason that makes it the most vulnerable to overuse.

The shoulder consists of three bones: the humerus (upper arm bone), clavicle (collarbone), and scapula (shoulder blade).

The rotator cuff muscles and tendons are responsible for movement and stabilization of the shoulder.

In addition, there are other muscles and a complex array of ligaments that also serve to ensure stability.

Another tendon, the biceps tendon, originates from the glenoid (the cup of the shoulder blade where the humerus sits) and extends down the humerus.  It is responsible for certain arm and shoulder movements.

The ironic fact is that a patient who complains of shoulder pain may have nothing wrong with the shoulder!shoulder-pain

For example, many medical conditions such as gall bladder disease, pneumonia, and ectopic pregnancies can present with shoulder pain.  Also, neck conditions often cause referred pain to the shoulder.  Patients with heart disease who are experiencing a heart attack may complain of pain in the left shoulder and arm.

Shoulder ailments fall into three major groups.  The first is trauma.  An example may be a skier who falls on an extended arm.  The impact can drive the head of the arm bone into the socket and cause damage to the cartilage, the bone, as well as the rotator cuff tendons. If the ligaments are stretched or torn, the shoulder can dislocate.  While the shoulder can be “relocated”, once dislocation occurs, the patient is at increased risk for another dislocation. Significant impact can cause damage to the cartilage that cushions the head of the femur as well as the “cup” of the scapula.  This cup is referred to as the glenoid.  The glenoid also has a lip of tougher cartilage that can be torn with impact injuries.

Trauma, if significant enough, can cause dislocation of the joint joining the collar bone to the shoulder blade. The common term for this is a “separated shoulder.”

A related but different type of ailment is wear and tear.  Because so many of the structures that permit shoulder movement and provide stability are made of connective tissue, it stands to reason that over time, they can begin to wear out.  And that is exactly what happens.  Tendons- the ropes that connect muscles to bone-, ligaments, and bursae (fluid filled sacks that cushion joint movement) all are prone to injury as a result of overuse.

When this occurs, conditions such as tendinopathy (previously known as tendonitis), bursitis, and ligament strain ensue.

While inflammation may be present, the overwhelming problem is tissue breakdown.

The last ailment that affects the shoulder is arthritis.  The three bones that make up the shoulder interact with each other at two specific points.  At these two points, there is a joint where two bones whose ends are covered with cartilage articulate.  The two joints are the glenohumeral joint- the joint that joins the shoulder blade and the humerus and the acromioclavicular joint that joins the collarbone to the shoulder blade.

Arthritis at these two areas can develop as a result of systemic disease such as rheumatoid arthritis or as a result of wear and tear- osteoarthritis.

The treatment of shoulder disorders depends upon both the underlying problem as well as the amount of patient discomfort and the impact on quality of life.

For traumatic disorder where there is obvious tissue disruption, surgery is usually required.  The type of surgery will be up to both the surgeon as well as to the individual who has the problem. The shoulder is a complex joint so it’s important to ensure whoever works on the shoulder is an expert.

For most wear and tear problems, non-steroidal anti-inflammatory medicines (NSAIDS) are sometimes, but not always, helpful. Ice and rest also can be useful.

Patients may require a steroid injection. For people who don’t respond to medicines, injections, and physical therapy, surgery may be an option. Ultrasound guidance is important.

Regenerative medicine techniques can be used for shoulder issues.  An example would be a procedure called percutaneous needle tenotomy which can be used to treat rotator cuff tendinopathy and tears.

In this procedure, a small needle is introduced using local anesthetic and ultrasound guidance. The needle is used to irritate the tendons of the rotator cuff and induce inflammation. Then, platelet-rich plasma, obtained from the patient’s whole blood is injected into the area where the tendons have been irritated. Ultrasound guidance here is mandatory. Platelets are cells in the blood that contain many growth and healing factors. This stimulates the production of new strong tendon tissue.

Another example of a regenerative medicine technique is the use of autologous stem cells (a patient’s own stem cells) for glenohumeral arthritis.

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“Ooohhh, My Aching Knee!” Insider Secrets on How You Can Get Relief Quickly and Easily!

When your knee hurts, getting relief is all that’s on your mind. Getting the right relief, though, depends on knowing what’s wrong. The correct diagnosis will lead to the correct treatment.

Know Your Knee!knee-arthritis

The knee is the largest joint in the body. It’s also one of the most complicated. The knee joint is made up of four bones that are connected by muscles, ligaments, and tendons. The femur (large thigh bone) interacts with the two shin bones, the tibia (the larger one) located towards the inside and the fibula (the smaller one) located towards the outside. Where the femur meets the tibia is termed the joint line. The patella, (the knee cap) is the bone that sits in the front of the knee. It slides up and down in a groove in the lower part of the femur (the femoral groove) as the knee bends and straightens.

Ligaments are the strong rope-like structures that help connect bones and provide stability. In the knee, there are four major ligaments. On the inner (medial) aspect of the knee is the medial collateral ligament (MCL) and on the outer (lateral) aspect of the knee is the lateral collateral ligament (LCL). The other two main ligaments are found in the center of the knee. These ligaments are called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). They are called cruciate ligaments because the ACL crosses in front of the PCL. Other smaller ligaments help hold the patella in place in the center of the femoral groove.

Two structures called menisci sit between the femur and the tibia. These structures act as cushions or shock absorbers. They also help provide stability for the knee. The menisci are made of a tough material called fibrocartilage. There is a medial meniscus and a lateral meniscus. When either meniscus is damaged it is called a “torn cartilage”.

There is another type of cartilage in the knee called hyaline cartilage. This cartilage is a smooth shiny material that covers the bones in the knee joint. In the knee, hyaline cartilage covers the ends of the femur, the femoral groove, the top of the tibia and the underside of the patella. Hyaline cartilage allows the knee bones to move easily as the knee bends and straightens.

Tendons connect muscles to bone. The large quadriceps muscles on the front of the thigh attach to the top of the patella via the quadriceps tendon. This tendon inserts on the patella and then continues down to form the rope-like patellar tendon. The patellar tendon in turn, attaches to the front of the tibia. The hamstring muscles on the back of the thigh attach to the tibia at the back of the knee. The quadriceps muscles are the muscles that straighten the knee. The hamstring muscles are the main muscles that bend the knee.

Bursae are small fluid filled sacs that decrease the friction between two tissues. Bursae also protect bony structures. There are many different bursae around the knee but the ones that are most important are the prepatellar bursa in front of the knee cap, the infrapatellar bursa just below the kneecap, the anserine bursa, just below the joint line and to the inner side of the tibia, and the semimembranous bursa in the back of the knee. Normally, a bursa has very little fluid in it but if it becomes irritated it can fill with fluid and become very large.

Is it bursitis… or tendonitis…or arthritis?

Tendonitis generally affects either the quadriceps tendon or patellar tendon. Repetitive jumping or trauma may set off tendonitis. The pain is felt in the front of the knee and there is tenderness as well as swelling involving the tendon. With patellar tendonitis, the infrapatellar bursa will often be inflamed also. Treatment involves rest, ice, and anti-inflammatory medication. Injections are rarely used. Physical therapy with ultrasound and iontopheresis may help.

Bursitis pain is common. The prepatellar bursa may become inflamed particularly in patients who spend a lot of time on their knees (carpet layers). The bursa will become swollen. The major concern here is to make sure the bursa is not infected. The bursa should be aspirated (fluid withdrawn by needle) by a specialist. The fluid should be cultured. If there is no infection, the bursitis may be treated with anti-jnflammatory medicines, ice, and physical therapy. Knee pads should be worn to prevent a recurrence once the initial bursitis is cleared up.

Anserine bursitis often occurs in overweight people who also have osteoarthritis of the knee. Pain and some swelling is noted in the anserine bursa. Treatment consists of steroid injection, ice, physical therapy, and weight loss.

The semimembranous bursa can be affected when a patient has fluid in the knee (a knee effusion). The fluid will push backwards and the bursa will become filled with fluid and cause a sensation of fullness and tightness in the back of the knee. This is called a Baker’s cyst. If the bursa ruptures, the fluid will dissect down into the calf. The danger here is that it may look like a blood clot in the calf. A venogram and ultrasound test will help differentiate a ruptured Baker’s cyst from a blood clot. The Baker’s cyst is treated with aspiration of the fluid from the knee along with steroid injection, ice, and elevation of the leg.

Knock out knee arthritis… simple steps you can take!

Younger people who have pain in the front of the knee have what is called patellofemoral syndrome (PFS). Two major conditions cause PFS. The first is chondromalacia patella. This is a condition where the cartilage on the underside of the knee cap softens and is particularly common in young women. Another cause of pain behind the knee cap in younger people may be a patella that doesn’t track normally in the femoral groove. For both chondromalacia as well as a poorly tracking patella, special exercises, taping, and anti-inflammatory medicines may be helpful. If the patellar tracking becomes a significant problem despite conservative measures, surgery is need.

While many types of arthritis may affect the knee, osteoarthritis is the most common. Osteoarthritis usually affects the joint between the femur and tibia in the medial (inner) compartment of the knee. Osteoarthritis may also involve the joint between the femur and tibia on the outer side of the knee as well as the joint between the femur and patella. Why osteoarthritis develops is still being scrutinized carefully. It seems to consist of a complex interaction of genetics, mechanical factors, and immune system involvement. The immune system attacks the joint through a combination of degradative enzymes and inflammatory chemical messengers called cytokines.

Patients will sometimes feel a sensation of rubbing or grinding. The knee will become stiff if the patient sits for any length of time. With local inflammation, the patient may experience pain at night and get relief from sleeping with a pillow between the knees. Occasionally, locking and clicking may be noticed. Patients with osteoarthritis may also tear the fibrocartilage cushions (menisci) in the knee more easily than people without osteoarthritis.

So how is the arthritis treated? An obvious place to start is weight reduction for patients who carry around too many pounds.

Strengthening exercises for the knee are also useful for many people. These should be done under the supervision of a physician or physical therapist.

Other therapies include ice, anti inflammatory medicines, and occasionally steroid injections. Glucosamine and chondroitin supplements may be helpful. A word of caution… make sure the preparation you buy is pure and contains what the label says it does. The supplement industry is unregulated… so buyer beware!

Injections of the knee with viscosupplements – lubricants- are particularly useful for many patients. Special braces may help to unload the part of the joint that is affected.

Arthroscopic techniques may be beneficial in special circumstances. Occasionally, a surgical procedure called an osteotomy, where a wedge of bone is removed from the tibia to “even things out,” may be recommended. Joint replacement surgery is required for end stage knee arthritis.

Research is being done to develop medicines that will slow down the rate of cartilage loss. Targets for these new therapies include the destructive enzymes and/or cytokines that degrade cartilage. It is hoped that by inhibiting these enzymes and cytokines and by boosting the ability of cartilage to repair itself, that therapies designed to actually reverse osteoarthritis may be created. These are referred to as disease-modifying osteoarthritis drugs or “DMOADs.” Genetic markers may identify high risk patients who need more aggressive therapies.

Newer compounds that are injected into the knee and provide healing as well as lubrication are also being developed. And finally, less invasive surgical techniques are also being looked at. Recent technological advances in “mini” knee replacement look very promising.

The technology that will revolutionize our approach to knee osteoarthritis is the use of mesenchymal stem cells.  These are stem cells derived from “non-blood” tissues such as fat, bone marrow, or even the lining of the joint. Studies in both animals as well as humans have shown great potential for these cells to regenerate cartilage.

For more information on arthritis treatments and other arthritis problems,  go to:

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Don’t be a victim of arthritis myths… Arthritis treatment is effective!

Ashley Macha, writing in Health online, reported on four arthritis myths.  This was done as part of a May is Arthritis Awareness Month campaign, featuring Joe Montana, Hall of Fame quarterback.

1. Myth: Arthritis only affects the aging.  Reality: This is the most common misconception. Anyone, at any age can be affected, according to the Arthritis Foundation. The most common type is osteoarthritis, the kind due to wear and tear on the joints over time (which is what Montana has), but also rheumatoid arthritis, an autoimmune disease that can occur at any age, juvenile arthritis, an autoimmune disease in children, and other types.

2. Myth: Joint health is not a serious issue. Reality: The population of those with arthritis in the United States is increasing, with approximately 70 million Americans predicted to have arthritis by 2030. It is the number one cause of disability in the United States.

3. Myth: Patients with arthritis should avoid exercise. Reality: The Arthritis Foundation recommends starting out walking or doing water workouts. Montana lifts weights to keep his muscles in shape. “When muscles are strong, it takes pressure off them [joints].” Patience White, MD, and vice president of public health for the Arthritis Foundation says resistance training can provide numerous benefits for those who suffer from arthritis. Dr. White recommends simple exercises, including hamstring and calf stretches, or weightlifting with something as simple as 16-ounce soup cans.

4. Myth: There is no treatment for arthritis. Reality: “I always thought initially that there was nothing you could do to help to ease your everyday life,” Montana said. There are medication and treatments, as well yoga moves to help ease pain, natural remedies, and new treatments are in the pipeline. Treatment also varies with the type of arthritis. There are more than 100 different kinds of arthritis and each is treated differently.

There are many other myths but the key points to remember are that arthritis, when diagnosed early is very treatable and that newer treatments such as stem cell therapy for osteoarthritis look extremely promising.

For more information on arthritis treatments and other arthritis problems,  go to:

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Stem Cells And Scaffolds For the Treatment Of Osteoarthritis

Osteoarthritis is the most common form of arthritis affecting more than 20 million Americans.  It is a disease of articular (joint) cartilage.

Normal cartilage  consists of a matrix constructed of a mixture of proteins,  sugars (proteoglycans), water, and collagen. Inside this matrix sit chondrocytes, cells that actually manufacture the matrix they sit in.

Under normal situation, cartilage is capable of withstanding both compressive forces as well as shear forces.  It deforms when loads are placed on it and then  expands to its normal contour once the load has been removed.

When cartilage is damaged as a result of trauma, injury, or other means, a change occurs in cartilage.  Chondrocytes produce destructive enzymes; the underlying bone deforms,  and the lining of the joint, the synovium, produces cytokines, protein messengers that stimulate inflammation.

The end result is wearing away of cartilage accompanied by chronic inflammation, and deformity related to abnormal mechanics of the joint.

To date, the treatment of osteoarthritis has been largely symptomatic using non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy, and joint injections of either corticosteroid or hyaluronic acid.

The rapid development of stem cell science has shown promise as a treatment that may restore joint integrity by regenerating cartilage.

A caveat: The proper application of stem cells is not merely injecting stem cells into a joint and hoping for the best.

Multiple attempts by various laboratories have searched for a method of introducing stem cells along with a scaffold to enable stem cell multiplication and growth in an organized fashion that will best stimulate cartilage regeneration. A whole new branch of basic science, termed “tissue engineering” has been used to describe these ventures.

An excellent review of the current state of the science was published by the Harvard Stem Cell Institute.

(Willerth SM, Sakiyama-Elbert SE. Combining stem cells and biomaterial scaffolds for constructing tissues and cell delivery.)

The authors reviewed the literature regarding types of scaffold materials that had been studied.

These included natural biomaterials such as collagen, fibrin, silk, sugars, algae cell walls, hyaluronan, and chitin as well as synthetic platforms such as various polymers, peptides, and ceramics.

These scaffolds are generally “seeded” with growth factors that stimulate stem cell multiplication and division while protecting the stem cells in the hostile environment of the arthritic joint.

For more information on arthritis treatments and other arthritis problems,  go to:

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Embryonic stem cells… controversy and effectiveness for arthritis treatment

Embryonic stem cells according to are “derived from embryos that develop from eggs that have been fertilized in vitro, in an in vitro fertilization clinic. They are donated for research purposes with informed consent of the donors. They are not derived from eggs fertilized in a woman’s body – a common misconception.”embryonic-stem-cell

Nonetheless, the use of embryonic stem cells for medical research purposes remains a lightning rod and litmus test for those who have various political and religious agendas.

Embryonic stem cells do have great capacity for growth and differentiation which makes them very attractive for basic scientists. Unfortunately, because of their multiplication ability, there is also the risk of malignancy, which has been reported with the use of embryonic stem cells.

So, combining the ethical objections as well as the capacity for malignant differentiation, the use of these cells for arthritis treatment, particularly osteoarthritis treatment,  is limited.

Here’s a great video about the topic:

For more information on arthritis treatments and other arthritis problems,  go to:

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And don’t forget to sign up for  free weekly arthritis tips and a free copy of our special report “The Consumer’s Guide to Arthritis”

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What are the approaches to treatment of osteoarthritis of the knee?

There are multiple treatment approaches for osteoarthritis (OA) of the knee.

osteoarthritis-knee-2The most important to start with is weight loss and patient education.  Without these, other therapies won’t work.

Analgesics such as acetaminophen may work for mild disease and non-steroidal anti-inflammatory drugs(NSAIDS) can be used for more symptomatic disease. The use of the latter category of drug needs to be tempered with the knowledge that potential gastrointestinal and cardiovascular side-effects are associated with these medicines.  Topical NSAIDS may be safer.

Alternative therapies such ass glucosamine/chondroitin, acupuncture, and so on, serve a complementary role.

Exercise and physical therapy, and, if necessary, braces, orthotics, and other assistive devices may be helpful.

Injections of glucocorticoids and viscosupplements can provide significant palliative relief.

Guided mesenchymal stem cell layering is a technique that can provide symptomatic relief, potentially regrow cartilage, and delay the need for surgery.

Total knee replacement is to be considered for patients with end-stage disease.

For more information on  arthritis treatments and other arthritis problems go to:

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And don’t forget to sign up for  free weekly arthritis tips and a free copy of our special report “The Consumer’s Guide to Arthritis”

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What can be done about osteoarthritis?

Osteoarthritis (OA) is the most common form of arthritis and affects approximately 28 million Americans.  While it has been viewed as a “wear and tear” phenomenon, it has become quite clear that it is a disease that is multifactorial in its development.

It is not a benign disease because, in addition to the pain, OA leads to functional disability.

The joint is a dynamic structure where anabolic (building) activities are counterbalanced by catabolic (destructive) activities.

With OA, the catabolic activities gradually overtake the anabolic ones. While there are attempts at repair, these attempts are dysfunctional , leading to the formation of bony spurs, called osteophytes.osteoarthritis-knee

There are three major risk factors for the development of osteoarthritis.  They are genetic (usually a family history is prominent), constitutional (obesity in the case of OA of the knee, and aging), and finally local components (injury and ligamentous laxity).

Cartilage consists of cells called chondrocytes that sit inside a “soup”, a matrix, which consists of collagen and proteoglycans.cartilage_1

The development of osteoarthritis starts with an initial injury to cartilage.

The injury may trigger an inflammatory response leading to the synthesis of cartilage matrix degrading enzymes, produced by chondrocytes. Over time, the catabolic activities override anabolic activities and abnormal repair mechanisms lead to the formation of osteophytes, while cartilage continues to degrade.

The treatment for osteoarthritis is primarily symptomatic.  Analgesics (pain nsaidsrelievers), non-steroidal-anti-inflammatory drugs (NSAIDS), weight loss, exercise, assistive devices such as wedge insoles, braces, canes, walkers, and such. Injection of glucocorticoids and viscosupplements (lubricants viscosupplementderived either from rooster combs or from bacteria) may also be helpful.

knee-joint-replacement-surgeryEventually patients will require surgery in the form of joint replacement. Joint replacement surgery has come a long way, but there are still concerns about them.  The first is the possibility of a surgical complication such as blood clot or infection.  The second issue is the finite lifespan of the prosthesis.  They usually last 10 to 15 years but this is a function of activity and joint replacement patients do have restrictions on their activity level.  Persistent pain due to particle induced inflammation can also be a problem.

Finally, the chance of faulty prosthetic devices such as the recent  Johnson & Johnson metal-on-metal hip debacle, makes the choice of total joint replacement less attractive.

Recent developments in stem cell technology may provide an alternative to joint replacement.

For more information on osteoarthritis treatments and other arthritis problems go to:

Arthritis Treatment

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The four types of stem cells that could be used for osteoarthritis treatment

stem-cellThere are four types of stem cells undergoing current study. They are embryonic SCs, allogeneic (donor) SCs, induced pluripotential adult SCs, and finally autologous SCs. Of these four, only two, donor SCs and autologous SCs have been used to treat arthritis so far.

However, this discussion would be incomplete without mentioning the other types as well.

Embryonic SCs (ESCs) are derived from embryos and are pluripotential, meaning they can easily differentiate into any body tissue.

stem-cell-differentiationSelf-renewing cells were first extensively studied in mouse cancer models. These cells showed the ability to not only self-duplicate but to also differentiate into multiple types of tissue. Obviously, though, cells that are capable of self-duplication are also capable of becoming malignant.

Potential pitfalls associated with embryonic stem cells are the following:

• The ethical dilemma which has restricted the amount of government spending towards ESC research.

• The risk of malignancy associated with cells that have not completely differentiated yet and are as potent as ESCs.

• The theoretical problem with a graft versus host reaction. While immunosuppressive drugs can be used to mitigate the effects of this, these drugs are not without significant side effects.

There is actually a variant of embryonic stem cells, the fetal stem cell.  For more about this, here’s a video:

The second type of SC is the induced pluripotential SC. In 2006, Japanese researchers used retroviruses to insert genes into mouse cells. They were able to take these adult mouse cells and cause them to revert back to a pluripotential embryonic state.

The identical technique was then applied to human skin cells. These “adult turned baby cells” are known as induced pluripotential stem cells (IPSCs). Therefore, it is technically possible to take any adult cell and make it function like an embryonic stem cell.

As one might expect, the primary concern is malignancy. How can these cells get controlled off once they start to multiply?

The third type of SC and one which has been used to treat arthritis in both animals as well as humans is the allogeneic or donor SC. These cells come from healthy donors. Advantages are that a tremendous number of SCs can be cultured. Downsides include the potential transmission of unknown genetic disorders as well as the possibility of infection.

The fourth and most commonly used type of SC in arthritis treatment are the autologous SCs or adult SCs. There are various techniques used to harvest these cells from the adult. Typically, they are obtained from bone marrow, fat, or blood, which is then concentrated to provide a maximum number of cells in the smallest possible volume.

Autologous SCs have the advantage of coming from the host – the patient. This helps avoid the consequences of rejection or graft versus host reaction which may occur with SCs that come from either embryos or donors.
These are multipotent, meaning they can be coaxed into becoming a limited number of different tissue types. This is one of the major differences between adult SCs and embryonic SCs (and induced pluripotential SCs).

For a great video about this topic:

Embryonic SCs and induced pluripotential SCs are pluripotent, meaning they can be converted into any type of tissue.

Nonetheless, the multipotent property of autologous (also known as “mesenchymal” SCs) is sufficient for them to be used to treat disorders involving connective tissue, such as blood, tendon, ligament, cartilage, bone, nerve, muscle, and liver.

These cells are programmed to zero in on areas of tissue injury to help with repair. While it is still not clear what the homing mechanism is, it is suspected that different types of chemical messengers are involved in “calling” mesenchymal SCs. These cells are capable of contributing to both repair as well as regeneration.

One danger is that some techniques using adult SCs involve the use of cell culture ex vivo, meaning outside the body. The possibility of contamination and infection is a concern. Also, when cultured for a lengthy period of time, these SCs may become unstable and the possibility of malignancy developing arises.

Finally, a major weakness of adult SCs is that they are restricted in their capacity to replicate and differentiate. In other words, they go through an aging process and have a limited life span. This is unlike embryonic SCs which have the capacity to multiply and divide forever.

For more information on stem cell treatments  go to:

Arthritis Treatment

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Seven tips about stem cells for arthritis


A feature article appearing on ABC News (Newcomb “Stem Cell Treatments for Zoo Animals Hold Promise for Humans) underscored the interest that both scientists as well as lay people have in the new technology of using stem cells to repair and treat degenerative conditions.

“We just extract them, concentrate them, wash them and in the same setting readminster them. Inject them in your heart or your knees, wherever you need them,” Dr. Eckhard Alt told ABC Station KTRK-TV in Houston after treating an arthritic pig at the Houston Zoo.”

So… can this technology be applied to humans?

Here are seven tips about stem cells (SCs) for arthritis treatment you might want to know…

1. There are four types of SCs currently being studied. They are embryonic SCs, allogeneic (donor) SCs, induced pluripotential adult SCs, and finally autologous SCs. Of these four, only two, donor SCs and autologous SCs have been used in either animals or humans to treat arthritis. Here’s a video that gives the basics on stem cells :

2. The SC that appears to generate the most interest is the autologous SC. This is the SC that is present in the patient and can be found in bone marrow, periosteum of bone, fat, and peripheral blood. Autologous SCs are referred to as “repair SCs” because these are the SCs that help with the healing process.

3. Arthritis occurs as a result of cartilage degeneration. Various attempts at inducing cartilage healing with SCs have met with mixed results. The results appear to be highly dependent upon the following factors: age of the patient, body mass index (BMI), extent of cartilage loss, and the technical expertise of the center performing the procedure.

4. The processing and administering of SCs for an arthritis problem is more than just getting SCs out and injecting them. There appears to be a need for some type of acute injury to help stimulate the stem cells to multiply and divide.

5. Possible complications of SC treatment can vary. They include the following: infection, rejection, graft versus host reaction, malignancy, and transmission of genetic disease.

6. The need for a cartilage restorative procedure is very evident since the only treatments available currently for osteoarthritis are palliative, meaning pain control only. This is not satisfactory.

7. In the proper hands autologous SC treatment can be successful. Early data indicating an improvement in cartilage thickness in the treatment of osteoarthritis of the knee has been published.

(Wei N, Beard S, Delauter S, Bitner C, Gillis R, Rau L, Miller C, Clark T. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

For more information on stem cells for arthritis and other arthritis problems go to:

Arthritis Treatment

And don’t forget to sign up for  free weekly arthritis tips and a free copy of our special report “The Consumer’s Guide to Arthritis”

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OA is the most common form of arthritis and affects more than 20 million adults.  It’s been estimated that by the age of 70 almost all people have OA to some extent.

OA is a disease of articular cartilage, the gristle that caps the ends of long bones.  Cartilage is a complex substance consisting of two basic materials: collagen and proteoglycans and one type of cell- the chondrocyte.  Cartilage provides shock absorption as well gliding functions.

With OA, there is premature wear and tear that occurs as a result of a metabolic abnormality that causes the chondrocyte to produce destructive enzymes.  There is a complex interplay of the cartilage, the synovium (lining of the joint), and the subchondral bone (the bone that lies underneath the cartilage. The result is premature wear and tear as well as local inflammation.

While OA is primarily a condition that affects weight-bearing joints such as the neck, low back, hips, and knees, it also affects other areas such as the hands and feet, particularly in women.

Risk factors for the development of OA include genetics, trauma (injury to the joint), and weight in the case of weight-bearing areas such as the low back and knees.  There is less evidence that weight plays a role in inducing OA of the hips.  However, once OA in the hips is present, weight plays a key role in making the symptoms worse.

Symptoms of OA include morning stiffness lasting less than one-half an hour, stiffness during the days with prolonged sitting, crepitus (crunching sounds that accompany joint movement), pain, and joint swelling. Joint fluid, called an “effusion” can develop.

As osteoarthritis progresses, it becomes harder for patients to limber up and to move without pain.

Diagnosis is usually suspected by history and physical examination.  While confirmation can be obtained by x-rays, unfortunately, by the time x-ray changes occur in OA, it is late in the course of disease.

While magnetic resonance imaging is much more sensitive for making the diagnosis, because of expense, it is often not used.

Laboratory tests are usually negative or normal.

Current forms of treatment for this condition are inadequate.

While advising a patient who is heavy to lose weight and exercise is admirable and necessary, it is an admonition that is usually ignored.

In addition, other measures such as analgesic medications (pain killers), non-steroidal anti-inflammatory drugs, physical therapy, bracers, and injections of glucocorticoids and viscosupplements provide only temporary and palliative relief.

Ultimately, patients will go on to get knee replacements.

In a recent report, Madonna Behan writing for Healthday reported, “The number of new-knee procedures doubled over the last decade, reached more than 620,000 in 2009, and the researchers said younger patients — those 45 to 64 — accounted for a disproportionate amount of that growth. In addition, researchers “estimate that nearly 53 percent of men and 52 percent of women diagnosed with symptomatic knee [osteoarthritis] will receive a total knee replacement in their lifetimes.”

Knee replacement surgery is not an innocuous procedure with the potential for complications such as infection, excessive bleeding, blood clots, worsening pain after the procedure, nerve damage, and death.

So what else can be done?  Attempts to find a pharmacologic solution, so-called disease modifying anti-osteoarthritis drugs (DMOADS) have been disappointing at best.

The most promising new development is the use of autologous mesenchymal stem cells.  These are adult stem cells found within many areas of the body including the bone marrow, fat, deciduous teeth, and periosteum of bone.

Anecdotal reports and small uncontrolled studies in both animal models as well as humans appear promising as a method for slowing down the rate of cartilage loss in knee OA and possibly even allowing for cartilage regeneration.

(Wei N, Beard S, Delauter S, Bitner C, Gillis R, Rau L, Miller C, Clark T. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

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