Everyone has thought about arthritis at some point. Older relatives are often living with arthritis. We worry about an injury leading to an arthritic joint prematurely. We Google “Will cracking my knuckles give me arthritis?”, because even though we’ve looked it up before, we wonder if something has changed, or if we remember the facts correctly.
Osteoarthritis is the most common form of arthritis, affecting more than 32.5 million people in the United States alone, according to the Centers for Disease Control(1). There are clinical trials seeking new treatments for any condition that affects so many people, so it’s no surprise that there are trials investigating the value of stem cells to treat osteoarthritis.
That’s likely no surprise, as professional athletes and celebrities have publicly proclaimed the benefits of experimental stem cell treatments for injuries and troublesome joints for several years now. As research continues, it looks increasingly likely that not only do stem cells have potential as a treatment for osteoarthritis, but that stem cells only available at birth also have greater potential than stem cells sourced at another time.
What is Osteoarthritis?
According to the Mayo Clinic, osteoarthritis “occurs when the protective cartilage that cushions the ends of your bones wears down over time.”(2) When you hear someone describe a join as “bone-on-bone”, that’s osteoarthritis.
There are a number of symptoms of the condition, which often develop slowly and worsen over time, including:
- Pain in affected joints, particularly during or after movement
- Stiffness in joints after a period of inactivity, such as sleep
- Tenderness and swelling of affected joints
- Loss of flexibility that might impede a full range of motion in the joint
- A grating sensation and bone spurs
Experiencing any of these symptoms persistently is cause to visit a doctor, and there are a number of ways to help manage osteoarthritis – however, there is no current treatment that can reverse this damage.
Stem Cell Trials
Stem cells’ ability to differentiate into other cell types, as well as the immunomodulatory properties of some types of stem cells, have led to scientific interest in their ability to treat conditions like osteoarthritis.
An American and an Australian clinical trial are two of the most prominent. The American trial(3) is utilizing a number of cells taken from a patient’s adipose tissue, including mesenchymal stem cells (MSCs), which are also found in umbilical cord and placental tissue. This trial is focusing on evaluating the safety and efficacy of using the cells for osteoarthritis of the knee, a common focus. Efficacy will be measured at 42 and 84 days post-treatment with the KOOS knee survey, which assesses “pain, symptoms, average daily living, sport/recreation, and quality of life” in an effort to measure practical improvement of a patient.
The Australian trial(4) is sponsored by the University of Sydney and will also utilize MSCs for patients with osteoarthritis of the knee. Professor David Hunter, the Principal Investigator for the trial, notes that current treatment options for osteoarthritis focus on alleviating pain, “rather than modifying the course of the underlying disease”. This trial will involve injecting the patients with MSCs three times over the course of a year and, while knee pain at 24 months post-treatment will be one of the primary assessments, cartilage loss from baseline to 24 months is also a primary outcome measure. In layperson’s terms, that means that the trial intends to examine the potential of stem cells to modify the course of osteoarthritis, not just relieve pain for the patient.
While these are two of the most notable active trials, there have been many others. An academic review of 18 studies of mesenchymal stem cell treatments for osteoarthritis of the knee, featuring a total of 1069 treated knees, suggests these treatments are effective. Patients experience statistically significant improvements on a number of measures of pain, knee function, and quality of life, including the KOOS knee survey.
A trial(5) published in The American Journal of Sports Medicine suggests there may be an increased benefit to utilizing specific sources of MSCs that are only available at birth. While mesenchymal stem cells can be obtained from adipose tissue, such as the American trial mentioned above, and bone marrow, they can also be found in umbilical cord tissue and the amniotic membrane of the placenta. This trial found that amniotic-membrane-derived MSCs “demonstrate a greater differentiation potential toward bone and cartilage” when compared to MSCs derived from adipose tissue.
The Takeaway for Expecting Families
The trials seeking new treatments for osteoarthritis are among the most exciting developments in stem cell medicine because of their promising results and the enormous number of people who could benefit from these findings.
The possibility that stem cells that can only be collected from the placenta may be even more effective than cells derived from other sources should also be exciting news for parents. We know that stem cells taken from the amniotic membrane of the placenta can be safely used not just for the mother and her baby, but also first and second-degree relatives of the baby. This means that siblings and grandparents could also potentially benefit from banking these valuable stem cells.