Osteoarthritis (OA) is one of the ten most disabling diseases in the developed world and is set to become more of a financial burden on health services as average life expectancy increases.
OA is the most common form of arthritis, affecting nearly 27 million Americans or 12.1% of the adult population of the United States, according to Laurence et al.¹ A 2001 study showed that the disease costs US health services about $89.1 billion,2 and indirect costs relating to wages and productivity losses and unplanned home care averaged $4603 per person.3
Aging and accumulated damage are expensive. If they didn't happen the total cost of health care would be a small fraction of what it is today.
Rejuvenation of the body's own repair systems is the best way to solve most aging problems. The most promising technique for joint repair involves extracting cells from cartilage, growing up the cells, and then reinjecting these cells so that they'll repair the joint.
In a review for F1000 Medicine Reports, Yves Henrotin and Jean-Emile Dubuc examine the range of therapies currently on offer for repairing cartilaginous tissue. They also consider how recent technological developments could affect the treatment of OA in elderly populations.
The most promising therapeutic technique is Autologous Chondrocyte Implantation (ACI), which involves non-invasively removing a small sample of cartilage from a healthy site, isolating and culturing cells, then re-implanting them into the damaged area.
A recent enhancement to this method is matrix-assisted ACI (MACI) - where the cultured cells are fixed within a biomaterial before being implanted to promote a smooth integration with the existing tissues. ACI and MACI have previously been reserved for younger patients who are not severely obese (i.e. with a BMI below 35), whose cartilage defect is relatively small and where other therapies have already been tried.
Reserved for younger patients: Of course. Cells in older people do not divide and do repairs as vigorously as cells in younger people. To make ACI and MACI useful for older people will probably require development of ways to either rejuvenate stem cells or to create local environments that stimulate the cells to grow. Irina Conboy is working that problem.
My worry: can the problem of tired stem cells be solved without raising the risk of cancer? Will we have to wait for non-toxic and effective ways to knock out cancer cells before we can safely turn up the activity of stem cells in aged bodies?
|Share |||Randall Parker, 2010 January 23 11:16 PM Biotech Repair Joints|