Stopping arthritis before it starts

A novel off-the-shelf bio-implant containing embryonic stem cells has the potential to revolutionize the treatment of cartilage injuries

More than a million Americans undergo knee and hip replacements each year. It’s a last resort treatment for pain and mobility issues associated with osteoarthritis, a progressive disease caused by degeneration of the protective layer of cartilage that stops our bones grinding together when we sit, stand, write, or move around.

But what if doctors could intervene and repair damaged cartilage before surgery is needed?

For the first time, researchers at the Keck School of Medicine of USC have used a stem cell-based bio-implant to repair cartilage and delay joint degeneration in a large animal model. The work will now advance into humans with support from a $6 million grant from the California Institute of Regenerative Medicine (CIRM).

The research, recently published in npj Regenerative Medicine, was led by two researchers at the Keck School of Medicine of USC: Denis Evseenko, MD, PhD, associate professor of orthopaedic surgery, and stem cell biology and regenerative medicine, director of the skeletal regeneration program, and vice chair for research of orthopaedic surgery; and Frank Petrigliano, MD, associate professor of clinical orthopaedic surgery and chief of the USC Epstein Family Center for Sports Medicine.

Osteoarthritis occurs when the protective cartilage that coats the ends of the bones breaks down over time, resulting in bone-on-bone friction. The disorder, which is often painful, can affect any joint, but most commonly affects those in our knees, hips, hands and spine.

To prevent the development of arthritis and alleviate the need for invasive joint replacement surgeries, the USC researchers are intervening earlier in the disease.

“In some patients joint degeneration starts with posttraumatic focal lesions, which are lesions in the articular (joint) cartilage ranging from 1 to 8 cm2 in diameter,” Evseenko said. “Since these can be detected by imaging techniques such as MRI, this opens up the possibility of early intervention therapies that limit the progression of these lesions so we can avoid the need for total joint replacement.”

That joint preservation technology developed at USC is a therapeutic bio-implant, called Plurocart, composed of a scaffold membrane seeded with stem cell-derived chondrocytes—the cells responsible for producing and maintaining healthy articular cartilage tissue. Building on previous research to develop and characterize the implant, the current study involved implantation of the Plurocart membrane into a pig model of osteoarthritis. The study resulted in the long-term repair of articular cartilage defects.

“This is the first time an orthopaedic implant composed of a living cell type was able to fully integrate in the damaged articular cartilage tissue and survive in vivo for up to six months,” Evseenko said. “Previous studies have not been able to show survival of an implant for such a long time.”

Evseenko said molecular characterization studies showed the bio-implant mimicked natural articular cartilage, with more than 95 percent of implanted cells being identified as articular chondrocytes. The cartilage tissue generated was also biomechanically functional—both strong enough to withstand compression and elastic enough to accommodate movement without breaking.

With support from the $6 million translational grant from CIRM, the researchers are using this technology to manufacture the first 64 Plurocart implants to be tested in humans.

“Many of the current options for cartilage injury are expensive, involve complex logistical planning, and often result in incomplete regeneration,” said Petrigliano. “Plurocart represents a practical, inexpensive, one-stage therapy that may be more effective in restoring damaged cartilage and improve the outcome of such procedures.”

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Stopping arthritis before it starts

New Non-Invasive Back Pain Treatments Using Stem Cell Therapy!

Causes of Back Pain Addressed with Bone Marrow Stem Cell Therapy at Miami Stem Cell:
*Degenerative disc disease
*Bulging Discs
*Spinal Stenosis
*Sprains or strains to muscles or ligaments
*Herniated discs
*Inflammation in the sacroiliac joint
*Pinched nerves
*Injury from a fall or accident
*Nerve compression
*Facet Arthritis
*Slipped Disc
To learn more, please visit Miami Stem Cell or call us (305) 598-7777 to schedule a free evaluation today! 

How Stem Cell Research is Transforming Medicine

‘This is such an important moment’: how stem cell research is transforming medicine

A new documentary shines a light on the breakthroughs that are being made or are close to being made in finding cures to previously incurable diseases.

Ryan Custer was a freshman basketball player at Wright State University in Dayton, Ohio, when, in April 2017, he jumped into a pool at a house party and shattered his C5 vertebra. Paralyzed from the chest down, Custer entered a clinical trial in Chicago for an experimental stem cell therapy that could restore limited nerve function one centimeter – shoulder shrug, bicep motion, tricep use – at a time.

Cheryl Wiers, a mother in her 40s, saw her aggressive non-Hodgkin’s lymphoma return twice, with a vengeance. Chemotherapy wasn’t working, but a clinical trial for a transplant of stem cells at City of Hope medical center in Duarte, California, offered hope.

In San Francisco, Andrew Caldwell, who is HIV-positive, underwent an experimental therapy which transfused his own genetically modified stem cells back into his body; if the modified cells produced enough HIV-resistant fighter cells, known as T-cells, to suppress the virus, the treatment could functionally cure HIV.

All three are vanguards on the slowly unfolding horizon of stem cell therapies, which could offer reprieve from diseases such as certain types of cancers, Type 1 diabetes, lupus and other auto-immune disorders. And all three, along with several others, offer up their emotional, idiosyncratic, and casually radical stories in the film Ending Disease, a collection of intimate portraits of experimental medicine under the culturally fraught, politically vulnerable, and extremely promising umbrella of stem cell research.

Such research has long been a game of potentials – treatments that could cure a host of incurable diseases or conditions, from HIV to certain causes of blindness to quadriplegia; research whose funding could get kneecapped by the whims of political power, treatments that could become available to the masses but are limited to select clinical trial groups. Ending Disease, which followed several trial participants between 2016 and 2019, takes its name from the farthest reaches of said potential: “we are on the cusp of a tremendous number of cures,” said director Joe Gantz.

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A Comparison of Health Outcomes in the Use of Stem Cells, Surgical, and Nonsurgical Approaches to Treat Degenerative Disk Disease: A Systematic Review

Systematic literature review.

This study provided a systematic review of randomized controlled trials which assessed the therapeutic effects of stem cell treatments, surgical interventions, and nonsurgical treatments on the outcomes of patients diagnoses with intervertebral disk degeneration (IDD).

A MEDLINE (2000-2017), PubMed (2000-2017), and Google scholar (1995-2000) database search was performed to identify published articles reporting on patient-reported clinical outcomes. A total of 12 articles were identified and met the inclusion criteria.

Literature evaluating the comparative treatment outcomes between patients who underwent surgical versus nonsurgical interventions demonstrated mixed findings in treatment efficacy. Although studies involving the manipulation of endogenous stem cells in fibrocartilage suggested that this application could be a potentially noninvasive, stem cell–based strategy to treat fibrocartilage degeneration, especially in patients with IDD.

The reviewed literature suggested that no clinical significance exists between surgical and nonsurgical treatment for IDD. The decision to undergo surgical or conservative treatment should depend on the patient’s state of health at the time of surgery, as well as any other potentially alarming factors (altered mental status, level of consciousness, comorbidities, etc) that could be exacerbated with the proposed treatment. Mesenchymal stem cells and fibrocartilage stem cells may also be an effective therapeutic option for the regeneration of a degenerated intervertebral disk. To move forward in finding an effective therapeutic treatment protocol for IDD, further research needs to be implemented that minimizes the limitation discussed in this review.

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Importance of Stem Cells

Stem cells are important for living organisms for many reasons. In the 3- to 5-day-old embryo, called a blastocyst, the inner cells give rise to the entire body of the organism, including all of the many specialized cell types and organs such as the heart, lung, skin, sperm, eggs and other tissues. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for cells that are lost through normal wear and tear, injury, or disease.

Given their unique regenerative abilities, stem cells offer new potentials for treating diseases such as diabetes, and heart disease. However, much work remains to be done in the laboratory and the clinic to understand how to use these cells for cell-based therapies to treat disease, which is also referred to as regenerative or reparative medicine.

Laboratory studies of stem cells enable scientists to learn about the cells’ essential properties and what makes them different from specialized cell types. Scientists are already using stem cells in the laboratory to screen new drugs and to develop model systems to study normal growth and identify the causes of birth defects.

Research on stem cells continues to advance knowledge about how an organism develops from a single cell and how healthy cells replace damaged cells in adult organisms. Stem cell research is one of the most fascinating areas of contemporary biology, but, as with many expanding fields of scientific inquiry, research on stem cells raises scientific questions as rapidly as it generates new discoveries.

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Recent Advancements in Stem Cell Treatments


Stem cells are undifferentiated cells with a high degree of self-renewal, that can differentiate into many different specialized cell types. Stem cells can be manipulated to provide treatment for illness and disease.

Manipulating Stem Cells for Treatments

Stem cells (SCs) have been studied in great detail regarding regenerative medicine, and in the last few decades, there have been major achievements in the manipulation of SCs. Manipulation of certain types of SCs allows for the research into and treatment of disease. The types of SC used to do this are:

Somatic cells such as fibroblasts can be reprogrammed into iPSCs by employing genetic modifications or chemical treatments. This was first achieved by Yamanaka using 4 genes involved in the maintenance of ECS pluripotency (Oct4, Sox2, c-Myc, and Klf4). The iPSCs can then be directed towards the desired cell type.

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