Nasal septum cells will restore cartilage in the knee
Every year, approximately 2 million people in Europe and the USA are diagnosed with damage to articular cartilage as a result of injuries or accidents. Articular cartilage covers the touching surfaces of the joints, acting as a shock absorber. The integrity of articular cartilage is a necessary condition for the painless operation of joints. Since this tissue does not have its own blood supply, its ability to repair damage is very limited, which causes the development of degenerative joint diseases such as osteoarthritis.
Traditional methods of preventing and delaying the degeneration of cartilage tissue after damage, such as surgical microfracturing, do not provide the formation of healthy cartilage necessary to protect joints from daily stress. Even new approaches based on the use of the patient's own cartilage cells (chondrocytes) do not guarantee the restoration of the structure and functions of cartilage in the long term. The inevitable aging of the population and an increase in human life expectancy cause a growing need to develop an effective method for repairing cartilage tissue damage.
Researchers from the clinic at the University of Basel, working under the guidance of Professor Ivan Martin, have developed an alternative approach, which consists in using fragments of cartilage tissue grown in laboratory conditions from the cells of the patient's nasal septum with a unique ability to grow and form new tissue to repair cartilage damage.
The phase 1 clinical trial involved 10 patients with end-to-end (full-layer) knee cartilage injuries, whose age ranged from 18 to 55 years. Small fragments (6 mm in diameter) of the nasal septum were isolated from patients under local anesthesia using a minimally invasive procedure. The cells isolated from it were cultured for 2 weeks in the presence of growth factors. The resulting cell population was seeded onto a collagen membrane and cultured for another two weeks, which ensured the production of a 30 by 40 mm cartilage fragment. This fragment was given the desired shape and implanted into the hole left after the removal of damaged cartilage from the patient's knee joint.
Despite the different degree of damage filling, magnetic resonance imaging performed after 2 years demonstrated the formation of a new tissue, the structure of which is comparable to the structure of the original cartilage. Moreover, nine patients (one patient was excluded from the study due to several independent sports injuries) noted significant improvements in the knee joint and a decrease in the severity of pain compared to the condition before the intervention. At the same time, no adverse reactions to therapy were recorded in any of the patients, however, two serious undesirable events unrelated to the procedure were registered, namely, independent damage to the second knee and the appearance of new cartilage damage in the operated joint.
The authors note that a small number of participants and a comparatively short follow-up period mean that further research is needed. Just as in other early phases of surgical clinical trials, there was no control group in this study, so in future work it will be necessary to compare the effectiveness of the new approach with the effectiveness of currently used methods, which will exclude the influence of the placebo effect.
Article by Marcus Mumme et al. nasalchondrocyte-based engineered autologous cartage tissue for repair of articular cartage defects: an observational first-in-human trial published in The Lancet.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru
25.10.2016