National Institute of Arthritis and Musculoskeletal and Skin Diseases
What Research Is Being Done on Osteoarthritis? continued...
This technology involves removing cells from a healthy part of the body and placing them in an area of diseased or damaged tissue to improve certain body functions. Currently, it is used to treat small traumatic injuries or defects in cartilage, and, if successful, could eventually help treat osteoarthritis. Researchers at NIAMS are exploring three types of tissue engineering. The two most common methods being studied today include cartilage cell replacement and stem cell transplantation. The third method is gene therapy.
Cartilage cell replacement: In this procedure, researchers remove cartilage cells from the patient’s own joint and then clone or grow new cells using tissue culture and other laboratory techniques. They then inject the newly grown cells into the patient’s joint. Patients with cartilage cell replacement have fewer symptoms of osteoarthritis. Actual cartilage repair is limited, however.
In one area of research, scientists are testing fibroblastic cells (precursors to cells that make up components of connective tissue) for their ability to differentiate into cartilage cells in a lab dish. The researchers will then see if the resulting cartilage cells can form functional joint cartilage.
Stem cell transplantation: Stem cells are primitive cells that can transform into other kinds of cells, such as muscle or bone cells. They usually are taken from bone marrow. In the future, researchers hope to insert stem cells into cartilage, where the cells will make new cartilage. If successful, this process could be used to repair early cartilage damage and avoid the need for surgical joint replacements later in life.
Gene therapy: Scientists are working to genetically engineer cells that would inhibit certain enzymes that may help break down cartilage and cause joint damage. In gene therapy, cells are removed from the body, genetically changed, and then injected back into the affected joint. They reside in the joint and secrete substances that inhibit the damaging enzymes.
Effective treatment for osteoarthritis takes more than medicine or surgery. Getting help from a variety of health care professionals often can improve patient treatment and self-care. (See “Who Treats Osteoarthritis?”) Research shows that adding patient education and social support is a low-cost, effective way to decrease pain and reduce the amount of medicine used. One NIAMS-funded project involves developing and testing an interactive Web site by which health professionals and patients could communicate concerning appointments and treatment instructions, thus giving patients a greater role in and control of their care.