Stem Cell Therapy for Osteoarthritis

What is Osteoarthritis? 

Osteoarthritis (OA) is a progressive and debilitating joint disease that is expected to affect up to 25% of the population by 2040 and represents an enormous socioeconomic health care burden. According to the Centers for Disease Control and Prevention (CDC), osteoarthritis affects an estimated 30 million people in the United States.

Osteoarthritis is predominantly a disease of older age, affecting more than 10 million people over the age of 60 years. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine.

Osteoarthritis symptoms can usually be managed, although the damage to joints can’t be reversed. Staying active, maintaining a healthy weight and receiving certain treatments might slow progression of the disease and help improve pain and joint function.

What are Common Signs and Symptoms? 

Symptoms often develop slowly and worsen over time. Some of them can include: 

• Pain. Affected joints might hurt during or after movement.
  
• Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.
  
• Tenderness. Your joint might feel tender when you apply light pressure to or near it.
  
• Loss of flexibility. You might not be able to move your joint through its full range of motion.

What Causes Osteoarthritis? 

Osteoarthritis occurs when the cartilage that cushions the ends of bones in the joints gradually deteriorates. Eventually, cartilage wears down completely and bone will rub on bone.

OA has often been referred to as wear and tear disease. It affects not only the cartilage, but also the entire joint. It causes changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone. 

Factors that increase the risk of OA include: 

• Older age. The risk increases with age. 
• Sex. Women are more likely to develop OA.
• Obesity. Increased weight adds stress to the joints. 
• Joint injuries. Previous injuries, such as one that can occur playing sports or an accident can increase the risk of OA.
• Repeated stress on the joint. If your job or sport places repetitive stress on a joint, it may develop OA.
• Genetics. Some people inherit a tendency to develop OA.
• Bone deformities. People born with malformed joints or defective cartilage have increased risk of OA.

Current Treatment Options

Patients with OA are initially treated with a combination of physical therapy, activity modification, weight loss, nonsteroidal anti-inflammatories and/or intra-articular injections with the goal of symptom modification. When OA progresses to the end stages and nonoperative care fails, total joint replacement can be an effective alternative.

New Treatments with Cellular Therapies

Mesenchymal stromal cells (MSCs) are a leading investigational therapeutic product because of their multiple mechanisms of action. MSCs have been tested in a number of smaller-phase trials and are effective in alleviating pain and patient symptoms. In some cases there are reported improvements to cartilage morphology.

Recently, a group of researchers from the Krembil Research Institute, University Health Network in Toronto, Canada looked into the potential use of stem cells to treat KOA. They published their results in the journal STEM CELLS Translational Medicine.

The scientists wanted to know whether it might be possible to regenerate knee cartilage using mesenchymal stromal cells (MSCs). These cells can develop into a number of different cell types, including muscle, bone, and, importantly, cartilage.

They included 12 participants with moderate-to-severe knee osteoarthritis and extracted MSCs from each person’s bone marrow. In this study, one of the main aims was to understand what constituted a safe and viable dosage, so the researchers injected each participant with one of three different doses of MSCs.

Over the next 12 months, follow up visits were performed, assessing their progress using different tests. They measured the levels of inflammatory markers and the rate of carticalle breakdown and also took regular MRI scans of the affected joints. 

At the end of the 12 months, the team found that there was a significant reduction in pain and increase in self-reported quality of life. The participants tolerated all three doses well, and there were no serious adverse events. Those who received the highest doses experienced the most positive results.

They reported that the use of bone marrow mesenchymal stem cells is safe and results in improvement in self reported outcome measures in the patients with late-stage knee osteoarthritis, 12 months after a single MSC injection. Also, there was a significant reduction in inflammation within the knee joints in the participants, which is important because experts now consider inflammation to be an important driver of osteoarthritis. 

This is not the first time that researchers have pitted stem cells against osteoarthritis. For instance, the authors of a 2015 study involving 30 participants concluded that “MSC therapy may be a valid alternative for the treatment of chronic knee osteoarthritis.”

Larger scales studies are expensive, but are needed to see if they are able to replicate the benefits that these small-scale studies have revealed. If done, stem cell therapy could become the future of osteoarthritis treatment. 

Stem Cell Therapy at Zignagenix

At our clinic, we offer stem cell therapies using umbilical cord-derived mesenchymal stem cells. We combine Mesenchymal stem cells with Platelet-rich Plasma (PRP) to potentialize the anti-inflammatory and regenerative capacities of the therapy. PRP contains a variety of anti-inflammatory cytokines and growth factors. The injection is performed directly on the joint space and depending on the joint that is being treated the quantity of MSCs can vary.

We also include MSCs therapy with intravenous (IV) infusion for all of our patients to increase the efficacy of the therapy. 

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Sources: 

Jaskarndip Chahal, et al. Bone Marrow Mesenchymal Stromal Cell Treatment in Patients with Osteoarthritis Results in Overall Improvement in Pain and Symptoms and Reduces Synovial Inflammation. Stem Cells Translational Medicine. Vol 8, Issue 8. p. 746-757.

Tim Newman (2019, Apr 23). Using stem cells to combat osteoarthritis. Medical News Today. Retrieved from:
https://www.medicalnewstoday.com/articles/324979

https://www.mayoclinic.org/es-es/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925

Image from: 

https://www.everydayhealth.com/osteoarthritis/will-i-need-knee-surgery/