New injectable cell therapy shows promise to treat osteoarthritis

NEW YORK: Scientists have created a promising injectable cell therapy to treat osteoarthritis that both reduces inflammation and also regenerates articular cartilage.

Recently identified by the US Food and Drug Administration (FDA) as a public health crisis, osteoarthritis affects more than 520 million people worldwide who deal with pain and inflammation.

Osteoarthritis is typically induced by mechanical or traumatic stress in the joint, leading to damaged cartilage that cannot be repaired naturally.

"Without better understanding of what drives the initiation and progression of osteoarthritis, effective treatment has been limited," said lead author Johanna Bolander of Wake Forest Institute for Regenerative Medicine (WFIRM) in North Carolina.

"Initially, we studied what goes wrong in osteoarthritic joints, compared these processes to functional environments, and used this information to develop an immunotherapy cell treatment," Bolander added.

Osteoarthritis is a disease of the joint system. In healthy joints when an injury occurs, the body recruits an army of inflammatory cells and sends them to the injury site to contribute to cleaning of the damaged tissues. In the osteoarthritic joint, however, a traumatic injury leads to inflammation of the synovial membrane and cartilage damage.

"With time, the inflammation worsens, leading to degradation of the cartilage lining the joint bones and chronic inflammation in the surrounding tissues. For patients, this causes severe pain, swelling and often limits daily activities," said co-author Gary Poehling, an orthopaedic surgeon at Atrium Health Wake Forest Baptist.

For this study, published in the journal Science Advances, the research team set out to investigate what is taking place in the osteoarthritic joint environment that keeps the healing process from happening.

The team isolated cells from the joint fluid of osteoarthritic patients, separated the cells from the fluid and investigated them alone, but also in the presence of the autologous fluid. Separated from the fluid, they saw that the cells had the ability to undergo processes required for functional tissue repair.

When they added a small percentage of the fluid back into the cell culture assay, the cells' abilities were impaired - they couldn't do their job - suggesting that the specific osteoarthritic environment stops them.

Based on these findings and what is known about functional tissue repair, a cell therapy was designed that can overcome the inflammatory environment and also regenerate cartilage.

In the pre-clinical model, the therapy was found to have the ability to reverse cartilage damage and diminish the inflammation. Another study was conducted in nine patients with confirmed osteoarthritis who each received one or two injections.

Once treated, the patients experienced improved quality of life, ability to participate in recreational activities, and reduced pain as well as had cartilage regeneration.

The team suggested additional clinical studies to evaluate the outcome in a larger patient population.