Osteoarthritis is by far the most common arthritic condition in Australia, affecting over 1.8 million people. Both medical and allied health treatments for the disease are primarily focused on pain management and symptom control.
Despite their effectiveness, these treatments do not repair the damage caused by osteoarthritis or stop its progression. The Australian Rheumatology Association (ARA) states “there is currently no disease modifying therapy that has a credible evidence base for osteoarthritis, and this presents a major challenge”.
Whilst research into stem cells has delivered promising results, this research is still in its initial stages.
Stem Cells Australia explains “Stem cells from fat and bone marrow are being investigated as possible treatments for osteoarthritis. It remains too early to know which approach will be most suitable. We need evidence collected in clinical trials to determine if a proposed stem cell treatment is both effective and safe”.
Arthritis Queensland’s Health Education Team sat down with Queensland University of Technology (QUT) researchers Ms. Ena Music and Dr Kathryn Futrega to find out more.
Both are part of Dr. Mike Doran’s Stem Cell Therapies laboratory situated at the Translational Research Institute in Brisbane. Simply
put “Stem cells are 'un-special' cells that become 'special'.” says Dr Futrega, “They are like primary school students,
they have the potential to become many things. They advance to high school then on to university, slowly figuring out what they want to be,
and eventually become teachers or doctors, for example. ”
Similarly, stem cells are primitive cells. Over time, they change into the specialised cells found throughout our body, including those in our cartilage and bones. Largely due to their ability to differentiate into chondrocytes (cartilage cells), adult mesenchymal stem cells have long been acknowledged as possessing some potential for osteoarthritis.
“Initially it was thought restoring cartilage was going to be pretty easy. Cartilage is a seemingly simple tissue with only one type of cell. However, these cells (chondrocytes) represent only 2% of our total cartilage volume” explained Ms. Music. The rest of our cartilage is made up of a complex matrix of proteins.
Integrating stem cell therapies with this matrix is proving to be a challenge for researchers. “Cartilage is great at what it is designed to do, which is allowing for bones to smoothly glide over one another, so getting newly engineered cartilage to ‘stick’ to our own cartilage is tricky” says Ms. Music.
Ms. Music’s project is attempting to create cartilage constructs consisting of stem cells and other materials. These constructs are being designed to act like “cartilage bandages” that will attach to the bone underneath our cartilage, rather than directly to it. It is hoped these constructs will produce cartilage tissue that will assist in the repair of damaged cartilage.
There are a number of stem cell treatments currently available for osteoarthritis, however there is no credible evidence base for their use and they are often expensive.
Both Ms. Music and Dr Futrega stressed that people who are interested in stem cell treatments should involve themselves in a regulated clinical trial, as opposed to current treatments.
Whilst stem cell therapies are not yet at a stage to be effective in treating osteoarthritis, we are hopeful that in years to come, research will progress to the point that this becomes a possibility.
By James Bayliss
Health Promotions Officer, Arthritis Queensland
References: Australian Rheumatology Association. (2014). Position Statement on Stem Cell Therapies. Accessed from https://rheumatology.org.au