Researchers find method to regrow cartilage in the joints

Discussion in 'Serious Discussion' started by parrish, Dec 3, 2023.

  1. parrish

    parrish MDL Junior Member

    Oct 16, 2016
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    Researchers find method to regrow cartilage in the joints; AND, CATARACT EYE TREATMENT

    https://www.ncbi.nlm.nih.gov/pmc/?term=nac drops for cataracts CATARACT TREATMENT


    In laboratory studies, Stanford School of Medicine researchers have found a way to regenerate the cartilage that eases movement between bones.



    Researchers at the Stanford University School of Medicine have discovered a way to regenerate, in mice and human tissue, the cushion of cartilage found in joints.



    Loss of this slippery and shock-absorbing tissue layer, called articular cartilage, is responsible for many cases of joint pain and arthritis, which afflicts more than 55 million Americans. Nearly 1 in 4 adult Americans suffer from arthritis, and far more are burdened by joint pain and inflammation generally.



    The Stanford researchers figured out how to regrow articular cartilage by first causing slight injury to the joint tissue, then using chemical signals to steer the growth of skeletal stem cells as the injuries heal. The work was published Aug. 17 in the journal Nature Medicine.



    “Cartilage has practically zero regenerative potential in adulthood, so once it’s injured or gone, what we can do for patients has been very limited,” said assistant professor of surgery Charles K.F. Chan, PhD. “It’s extremely gratifying to find a way to help the body regrow this important tissue.”



    The work builds on previous research at Stanford that resulted in isolation of the skeletal stem cell, a self-renewing cell that is also responsible for the production of bone, cartilage and a special type of cell that helps blood cells develop in bone marrow. The new research, like previous discoveries of mouse and human skeletal stem cells, were mostly carried out in the laboratories of Chan and professor of surgery Michael Longaker, MD.



    Articular cartilage is a complex and specialized tissue that provides a slick and bouncy cushion between bones at the joints. When this cartilage is damaged by trauma, disease or simply thins with age, bones can rub directly against each other, causing pain and inflammation, which can eventually result in arthritis.



    Damaged cartilage can be treated through a technique called microfracture, in which tiny holes are drilled in the surface of a joint. The microfracture technique prompts the body to create new tissue in the joint, but the new tissue is not much like cartilage.



    “Microfracture results in what is called fibrocartilage, which is really more like scar tissue than natural cartilage,” said Chan. “It covers the bone and is better than nothing, but it doesn’t have the bounce and elasticity of natural cartilage, and it tends to degrade relatively quickly.”



    The most recent research arose, in part, through the work of surgeon Matthew Murphy, PhD, a visiting researcher at Stanford who is now at the University of Manchester. “I never felt anyone really understood how microfracture really worked,” Murphy said. “I realized the only way to understand the process was to look at what stem cells are doing after microfracture.” Murphy is the lead author on the paper. Chan and Longaker are co-senior authors.



    For a long time, Chan said, people assumed that adult cartilage did not regenerate after injury because the tissue did not have many skeletal stem cells that could be activated. Working in a mouse model, the team documented that microfracture did activate skeletal stem cells. Left to their own devices, however, those activated skeletal stem cells regenerated fibrocartilage in the joint.



    But what if the healing process after microfracture could be steered toward development of cartilage and away from fibrocartilage? The researchers knew that as bone develops, cells must first go through a cartilage stage before turning into bone. They had the idea that they might encourage the skeletal stem cells in the joint to start along a path toward becoming bone, but stop the process at the cartilage stage.



    The researchers used a powerful molecule called bone morphogenetic protein 2 (BMP2) to initiate bone formation after microfracture, but then stopped the process midway with a molecule that blocked another signaling molecule important in bone formation, called vascular endothelial growth factor (VEGF).



    “What we ended up with was cartilage that is made of the same sort of cells as natural cartilage with comparable mechanical properties, unlike the fibrocartilage that we usually get,” Chan said. “It also restored mobility to osteoarthritic mice and significantly reduced their pain.”



    As a proof of principle that this might also work in humans, the researchers transferred human tissue into mice that were bred to not reject the tissue, and were able to show that human skeletal stem cells could be steered toward bone development but stopped at the cartilage stage.



    The next stage of research is to conduct similar experiments in larger animals before starting human clinical trials. Murphy points out that because of the difficulty in working with very small mouse joints, there might be some improvements to the system they could make as they move into relatively larger joints.



    The first human clinical trials might be for people who have arthritis in their fingers and toes. “We might start with small joints, and if that works we would move up to larger joints like knees,” Murphy says. “Right now, one of the most common surgeries for arthritis in the fingers is to have the bone at the base of the thumb taken out. In such cases we might try this to save the joint, and if it doesn’t work we just take out the bone as we would have anyway. There’s a big potential for improvement, and the downside is that we would be back to where we were before.”



    Longaker points out that one advantage of their discovery is that the main components of a potential therapy are approved as safe and effective by the FDA. “BMP2 has already been approved for helping bone heal, and VEGF inhibitors are already used as anti-cancer therapies,” Longaker said. “This would help speed the approval of any therapy we develop.”



    Joint replacement surgery has revolutionized how doctors treat arthritis and is very common: By age 80, 1 in 10 people will have a hip replacement and 1 in 20 will have a knee replaced. But such joint replacement is extremely invasive, has a limited lifespan and is performed only after arthritis hits and patients endure lasting pain. The researchers say they can envision a time when people are able to avoid getting arthritis in the first place by rejuvenating their cartilage in their joints before it is badly degraded.



    “One idea is to follow a ‘Jiffy Lube’ model of cartilage replenishment,” Longaker said. “You don’t wait for damage to accumulate — you go in periodically and use this technique to boost your articular cartilage before you have a problem.”



    Longaker is the Deane P. and Louise Mitchell Professor in the School of Medicine and co-director of the Institute for Stem Cell Biology and Regenerative Medicine. Chan is a member of the Institute for Stem Cell Biology and Regenerative Medicine and Stanford Immunology.



    Other Stanford scientist taking part in the research were professor of pathology Irving Weissman, MD, the Virginia and D. K. Ludwig Professor in Clinical Investigation in Cancer Research; professor of surgery Stuart B. Goodman, MD, the Robert L. and Mary Ellenburg Professor in Surgery; associate professor of orthopaedic surgery Fan Yang, PhD; professor of surgery Derrick C. Wan, MD; instructor in orthopaedic surgery Xinming Tong, PhD; postdoctoral research fellow Thomas H. Ambrosi, PhD; visiting postdoctoral scholar Liming Zhao, MD; life science research professionals Lauren S. Koepke and Holly Steininger; MD/PhD student Gunsagar S. Gulati, PhD; graduate student Malachia Y. Hoover; former student Owen Marecic; former medical student Yuting Wang, MD; and scanning probe microscopy laboratory manager Marcin P. Walkiewicz, PhD.



    The research was supported by the National Institutes of Health (grants R00AG049958, R01 DE027323, R56 DE025597, R01 DE026730, R01 DE021683, R21 DE024230, U01HL099776, U24DE026914, R21 DE019274, NIGMS K08GM109105, NIH R01GM123069 and NIH1R01AR071379), the California Institute for Regenerative Medicine, the Oak Foundation, the Pitch Johnson Fund, the Gunn/Olivier Research Fund, the Stinehart/Reed Foundation, The Siebel Foundation, the Howard Hughes Medical Institute, the German Research Foundation, the PSRF National Endowment, National Center for Research Resources, the Prostate Cancer Research Foundation, the American Federation of Aging Research and the Arthritis National Research Foundation.


    SOURCE:


    http://med.stanford.edu/news/all-ne...MR5DABr2x9rDtj-UwgeA52xFCYA0oMjgheKh7jpbz3-u4


    There is no current natural cure for cataracts. However, there is ongoing research into using nonsurgical treatments for the condition.

    Animal research into using NACA and oxysterol eye drops has both produced positive results. However, more research is necessary to determine whether these less-invasive treatments will be effective treatments for cataracts in humans.

    Surgery is a very effective treatment for cataracts, and most surgeries are successful. If a person does not undergo surgery to treat their cataracts, they can worsen, leading to vision loss.

    Last medically reviewed on December 6, 2022

    source:
    https://www.medicalnewstoday.com/articles/how-to-dissolve-cataracts-naturally#summary

    --MORE--

    N-acetylcysteine amide (NACA) is an antioxidant that has shown promise in reversing the formation of cataracts. In a 2017 study, researchers induced cataracts in rats and treated them with NACA eye drops. The results demonstrated that NACA could reverse the cataract grade, potentially improving vision and reducing cataract-related vision loss1. However, further research is needed to determine its effectiveness in humans.

    Another potential treatment is oxysterol, an oxygenated derivative of cholesterol. In a 2022 study, researchers used oxysterol to alter the levels of specific proteins (alpha-crystallin B and alpha-crystallin A) in the lenses of mice. Oxysterol improved lens opacity in 61% of cases, suggesting it might be an effective nonsurgical treatment for cataracts1.

    As for side effects of eye drops in general:

    Redness or irritation may occur due to excessive use of certain eye drops.
    Some eye drops can cause temporary blurriness after application, affecting visual clarity for a short period.
    Steroid eye drops may lead to glaucoma or posterior subcapsular cataracts if used excessively or after cataract surgery234.
    If you experience any unusual symptoms while using eye drops, such as eye redness, discharge, blurred vision, or eye pain, consult your healthcare provider promptly5.

    SOURCE

    https://www.medicalnewstoday.com/articles/how-to-dissolve-cataracts-naturally


    --MORE--

    Conclusions
    The data suggest that NACA has the potential to significantly improve vision and decrease the burden of cataract-related loss of function. Prevention and reversal of cataract formation could have a global impact. Development of pharmacological agents like NACA may eventually prevent cataract formation in high-risk populations and may prevent progression of early-stage cataracts. This brings a paradigm shift from expensive surgical treatment of cataracts to relatively inexpensive prevention of vision loss.

    Keywords: Cataract, N-acetylcysteine amide (NACA), Glutathione, Calpain, Crystallin, Lens, Sodium selenite

    SOURCE:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405552/

    --MORE--

    https://www.ncbi.nlm.nih.gov/pmc/?term=nac drops for cataracts

    --MORE---

    An approach to revolutionize cataract treatment by enhancing drug probingthrough intraocular cell line

    SOURCE:
    https://www.researchgate.net/public...ng_drug_probing_through_intraocular_cell_line

    --MORE--

    An approach to revolutionize cataract treatment by enhancing drug probing through intraocular cell line



    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070994/
     
  2. gorski

    gorski MDL Guru

    Oct 21, 2009
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    Beautiful!!!! Thanx! WIsh it was operational for all, already... My mum would certainly be in much less pain and have a much better quality of life...
     
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  3. 55Percent

    55Percent MDL Junior Member

    Mar 12, 2023
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    A few months ago I finished a particularly brutal year-long chemotherapy program and after MRIs it has been determined I might actually get a few more years of life, which is obviously kind of cool --- I think. So what that then allowed us (myself and the medical professionals helping me) --- allowed us to take a new look at my bone troubles, especially my backbone. Now we all know very well that a big part of my problem is the TaeKwonDo I engaged in for so many years of my life and then the fast pitch softball I engaged in until my fifties, both the Japanese fast pitch and the International League fast pitch, which use very different style balls. In other words, my spine trouble is a lot my own fault.

    But then the chemotherapy came along and the first round includes a lot of steroids and that really does further damage to an already not great spine. Then came two more rounds of chemotherapy and we weren't sure trying to fix my spine was worth the trouble and we dropped that until very recently, when it was looking like that extra work would be a benefit worth the extra effort and expense.

    So that department at the hospital put me on this medicine called Alendronate and these are 35mg tabs that are supposed to increase bone density and I think that specifically it is the bone marrow that is the target. And it is a once a week tab, so obviously a fair bit strong. They also had a system where I could inject the stuff, but I am not very good about sticking needles in me, so I went for the tabs.

    What I am trying to state here is this bone density stuff seems to be pretty important stuff and they already seem to have this medicine, but I don't know if maybe in the U.S. this particular medicine is not allowed.

    And I noticed that there was some points made by the OP that arthritis is some nasty business for a lot of folks as they get into this aging thing. My case is very odd. When I was into the TaeKwonDo professionally while on active duty our team doctor told us we were going to suffer in our later years from severe arthritis because of the hardcore way we were going about the TaeKwonDo every day --- we were teaching and monitoring teachers, as well as engaging in tournaments about every other week.

    Now this is what I view as really strange --- I have never had any arthritis trouble. And many years ago one of our VFW members was a retired medical professional and he admitted that my not having arthritis trouble was indeed very, very unusual. In fact, he isn't/wasn't the only retired medical professional I've discussed it with and that has stated they just couldn't figure that one out. But I sure am a lucky human on that one. Especially considering that I stayed pretty hardcore athletic into my mid fifties. And not because any team manager felt sort of sorry for me. It was because I could still perform. I could still do my job on the team. But that was about fifteen years ago and now I'm in my 70s and I am still getting through life without arthritis trouble.

    Now, gorski, .I am wondering if your mother may be in any way a bit like my mindset about pain --- I try very hard to not take my pain medicine (which certainly can be helpful) until my pain situation gets way beyond "normal" levels of pain. But my pain isn't caused by arthritis. My pain can get out-of-control due to spine and that related to the spine areas. But does your mother try not to take medicine? And something that you and her might want to check into, if it is possible in the U.S. and that is "Toaraset Combination 'Me'". It is acetaminophen and what one doc said was a kind of morphine type mix. Let me find a page in English.

    https://www.rad-ar.or.jp/siori/english/search/result?n=40999

    The thing is, that stuff works really good and if it is legal there and y'all don't know about it, then maybe I'm doing a good thing and doing a helpful post here to help her ease some of that pain.

    I'm looking at a package and it reads 325mg acetaminophen and 37.5mg of tramadol per pill.

    Truth is, I have pretty much lived with some sort of pain in various muscles over the years due to sports activities and a few times due to other medical problems associated with non-sports troubles. In your mother's situation, it could be this is her first true trouble with pain, which makes things different.
     
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  4. gorski

    gorski MDL Guru

    Oct 21, 2009
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    Much obliged, m8! I shall read and learn and see what I can do - IF my mum wants it... :)

    BRB...

    P.S. I have many sport injuries myself, aye, I share some of your troubles...
     
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