Arthritis Treatment: Nanofibers in Stem Cell Treatment For Osteoarthritis of the Knee

The most common form of arthritis, osteoarthritis (OA), affects more than 20 million Americans. OA preferentially affects weight-bearing joints and one of the primary targets for this disease is the knee.

OA is a disease of articular cartilage, the gristle that caps the ends of long bones. Articular cartilage consists of a matrix of proteoglycans which are complex arrangements of proteins and sugar molecules. In addition, there is a framework of tough collagen fibers. Within the proteoglycan/collagen structure are cells called chondrocytes. These cells are the ones that are responsible for the synthesis of proteoglycans. The normal maintenance of cartilage integrity is highly dependent on the normal metabolic function of these chondrocytes.

When osteoarthritis develops as a result of cartilage injury, the chondrocytes begin to manufacture enzymes that are detrimental to normal cartilage function. In addition local inflammation of the synovium as well as altered metabolism of the underlying bone leading to osteophyte (spur) formation also takes place.

The treatment for osteoarthritis has been largely symptomatic including exercise, physical therapy, non -steroidal anti-inflammatory drugs (NSAIDS), thermal modalities (heat and cold), braces, and injections. When these fail to relieve pain or function is compromised, the patient is usually offered surgery in the form of joint replacement.

Articular cartilage, unfortunately, has limited repair and regeneration potential. Because such a large void between symptomatic therapies and joint replacement exists, there have been attempts to engineer tissue matrices that can meet the functional demands of cartilage.

Cartilage tissue engineering requires three components: cells, scaffold or frame, and nurturing environment. Adult stem cells, specifically multipotent mesenchymal stem cells, are considered the cell type of choice for tissue engineering.

Reservoirs of these adult stem cells are present in the bone marrow, fat, periosteum of bone, deciduous (baby) teeth, and a few other locations.

Previous articles have discussed the various components of current available technologies. This article will discuss nanofibers. Nanofibers (NF) are defined as fibers with diameters less than 1000 nanometers (Wikipedia). These fibers consist of either carbon, graphite, or synthetic polymers.

Successful outcome of stem cell-based cartilage tissue engineering depends on the proper differentiation of stem cells into cartilage cells and the assembly of the appropriate cartilaginous matrix to reach the load-bearing capabilities of the natural cartilage.

Harvesting mesenchymal stem cells and supplying growth autologous growth factors are part of the equation for a successful stem cell procedure.

However, the production of a suitable scaffold remains somewhat elusive.

Autologous fat may meet some of the needs but there is compelling evidence that NF will provide a much more stable framework. This is important because of the need to protect the fragile recently harvested mesenchymal stem cells within their new hostile environment.

The framework must mimic normal cartilage matrix as much as possible for a successful outcome. The type of fiber that has garnered most interest is the electrospun polymeric NF. There is evidence that these polymeric NF structures actually stimulate stem cell differentiation into chondrocytes.

These models have been shown to be effective in both tissue culture as well as animal models. It is hoped that they will be used shortly in humans.

Nathan Wei, MD FACP FACR is a board-certified rheumatologist and nationally known arthritis authority and expert. For more info: Arthritis Treatment and Arthritis Treatment Center

Nathan Wei, MD FACP FACR is a board-certified rheumatologist and nationally known arthritis authority and expert. For more info: http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html Arthritis Treatment and Arthritis Treatment Center

Author Bio: Nathan Wei, MD FACP FACR is a board-certified rheumatologist and nationally known arthritis authority and expert. For more info: Arthritis Treatment and Arthritis Treatment Center

Category: Medicines and Remedies
Keywords: arthritis treatment, osteoarthritis knee treatment, stem cells, nanofibers

Leave a Reply