Combating Osteoarthritis With Stem Cells

When cartilage naturally cushioning joints breaks down, osteoarthritis of the knee occurs, without this buffer bones can come into contact with each other causing pain, stiffness, and loss of flexibility.

Medications and physical interventions can ease symptoms of osteoarthritis, but currently there is no sure as it is not possible to regrow cartilage, once progressed to end stages the only option is surgical replacement of the joint. Stem cells were recently used to ease osteoarthritis in a small scale preliminary trial with promising results that will pave the way for more larger studies.

Krembil Research Institute, University Health Network in Toronto, Canada investigated potential use of stem cells to treat osteoarthritis of the knee to find out whether it might be possible to regenerate knee cartilage using mesenchymal stromal cells which can develop into a number of different cell types such as muscle, bone, and cartilage.

One of the main objective of this pilot study was to understand what constituted as a safe and viable dosage. As published in STEM CELLS Translational Medicine 12 participants were recruited with moderate to severe KOA and MSCs were extracted from their bone marrow, and each participant was injected with one of three different MSCs doses.

After the procedure subjects were followed for a year to assess progress using a variety of testing including measuring levels of inflammatory biomarkers, the rate of cartilage breakdown, regular MRI scans of the affected joints, and asking the individuals to rate how they felt they were doing. By the end of the study participants reported significant reduction in pain and increase in quality of life.

There were no serious adverse events, and participants tolerated all 3 doses well; those receiving the highest doses experienced the most positive results. All participants had significant reduction in inflammation within knee joints, which is important as inflammation is considered to be a driver of osteoarthritis.

"Pro‐inflammatory monocytes/macrophages and interleukin 12 levels decreased in the synovial fluid after MSC injection."

Larger trials are needed to be conducted before it will becomes possible to use this technique in real world clinical settings. Although the intervention did reduced pain and inflammation regrowth of cartilage was not detected as some earlier trials have reported, which may be due to the trial only including participants with end stage osteoarthritis; regenerative effects are more likely to be observed in earlier stages.

This is not the first time stem cells have fared well against osteoarthritis, in 2015 a study involving 30 participants concluded “MSC therapy may be a valid alternative for the treatment of chronic knee osteoarthritis” and another study in 2016 involving 60 participants came to similar conclusions.

When more extensive and larger projects replicate the same benefits that these small scale preliminary studies have concluded stem cells could become the future of osteoarthritis treatments.