Really interesting 6 minute video where speaker Kevin Stone an orthopedic surgeon talks about the bio-future of joint replacement, after briefly mentioning his development of an arthritic knee after a meniscus tear playing soccer in college, and then he tore his ACL. One of the ways in which this video was really interesting was in the way that he describes when looking at the differences between cancer and arthritis, although cancer may kill you when looking at the numbers "[A]rthritis ruins more lives", and there's a "50 % chance you'll develop arthritis". The video was still very interesting because rather than automatically pushing the idea of a biomechanial joint, he says that there may be a more natural way, and that it may be possible that all the replacement our bodies need already exist in nature, or possibly already exist within our own stem cells.
Dr. Kevin Stone starts describing the procedure that he does to help individuals with their arhtiritc ailments, and he describes how he uses donor grafts and describes that when fixing the damaged arthrits on the surface of the knee they do a stem cell paste graft - which allows the articular cartilage surface to regrow and eventually give that smooth surface that can decrease the amount of pain that individuals experience. He also says that although it is a good alternative and it works, biological tissue will not be the future route because there is not enough young healthy people donating tissue, and it is expensive. His alternative is animal tissue, because it is plentyful and cheap, but the problem here is immunlogical problems that can arise when putting animal tissue in patients. The immunological barrier is the epitope galactosyl or gal epitope.
He designed an enzyme wash to strip the galctosyl epitopes with a specific enzyme (called gal-stripping technique) by humanizing the tissue, and this lets them put it back into a patients knee. They've done it in 10 patients in an FDA approved trial, and even mentions that one of the patients was a skier who went on to be a Canadian Masters Downhill Champion.
So what's the next step? Well this talk was in 2010 and he mentions that there was a wider clinical trial pending, so i'm interested in the progression that has been made post 2 years. Their plan was to take articular cartilage from a young, healthy pig - strip it of its antigens - load it with the patients stem cells and put it back onto the arthritic surface in the knee, and once that surface heals viola you have created a new biologic surface for the knee!!
Really recommend checking out the video the link is below:
<iframe src="http://embed.ted.com/talks/kevin_stone_the_bio_future_of_joint_replacement.html" width="560" height="315" frameborder="0" scrolling="no" webkitAllowFullScreen mozallowfullscreen allowFullScreen></iframe>
http://www.ted.com/talks/kevin_stone_the_bio_future_of_joint_replacement.html
this is very interesting that they can transplant cartilages too, because I hear mostly transplants from pigs are for their organs like the heart, liver, etc. After these cartilages in humans, do they actually last as long or do they constantly need to repeat the procedure in adding more too it as it decays over time?
ReplyDeleteBrilliant. This video is quite the gem in 6 minutes. It hits on some very fundamental issues regarding inflammation, immunology and BME. Indeed, it doesn't go into great detail and I didn't really like the arthritis/cancer comparison but I suppose he must get the attention of his spectators somehow. All in all, this is quite a fascinating post. It simply goes to show how much further we as physiologists and future researchers and clinicians have to go. There is lots more out there to be discovered and it starts in the classroom.
ReplyDeleteNice post!
I think that's a good point! His comparison does catch listeners attention because everyone is aware of how detrimental cancer is and can be.
DeleteThis sounds like a pretty cool procedure that could potentially bring a great deal of health benefits to the general population. My first question is, what does it mean to humanize a piece of tissue? Is it more than just the removal of the galctosyl epitopes?
ReplyDeleteI'm also curious as to why human cartilage stem cells have to be added to the already healthy pig cartilage. Why can't they just place the pig cartilage as a graft in the human? Why wouldn't that be enough? Or does the human have a lower chance of having an immune reaction if some of their own stem cells are joined with the pigs?
So when I was looking for an answer for what humanizing a piece of tissue means, I believe that it is when the tissue graft that they are using contains human genes and cells. When trying to look for this answer I came across the term "humanized mouse" often. A "humanized mouse" is a mouse that is carrying functioning human genes, cells/organs. Studies will typically use immunodeficient humanized mice for medical research for human therapeutics. So I think that by humanizing the piece of tissue, researchers are integrating aspects into these tissues that make it a human model.
DeleteI'm not too sure why the human cartilage stem cells have to be added to already healthy pig cartilage. - I had trouble finding the answer for that.
Great info. In the clinic where I shadow a PA, we see at least one patient a day with total knee replacement, meniscus tear induced arthritis, ligament tears, and many more complex problems associated with joints. I don't know if any PAs or surgeons already know about this revolutionized procedure, but I am definitely going to tell them what's up!! Thank you for the great post.
ReplyDelete