Towards Cell Therapy for Osteoarthritis

Abstract

Osteoarthritis (OA) is a disabling joint disease affecting over 10% of individuals aged 60 years or older. In a study from 2007, prevalence of OA in the Netherlands was estimated to be around 650,000 patients. OA involves the entire joint and is characterized by inflammation and catabolic processes, leading to progressive cartilage damage. Current treatments include pain medication, lifestyle changes such as weight loss and regular exercise, and ultimately joint replacement. Pain medication and lifestyle changes are symptomatic treatments which are not able to cure the disease. Joint replacement is a good option for many OA patients, but unfortunately joint prostheses have a limited lifespan and as a result they do not provide a final solution for OA. Regenerative medicine therapies are promising approaches to modify the pathologic processes associated with OA and other musculoskeletal diseases. Regenerative medicine aims at replacing or regenerating human cells, tissues or organs to restore or establish normal function. This goal can be achieved by replacing damaged tissue or by stimulating the body’s own repair mechanisms to heal tissues or organs with poor self-repair capacity. Regarding regenerative medicine, a lot can be learned from other organisms. Probably the most striking example of musculoskeletal regeneration is the regrowth of an entire limb, after it has been traumatically amputated, in a salamander. This classic example unfortunately doesn’t apply to humans, but growth factors and stem cells are indispensable in physiological tissue homeostasis and regeneration after musculoskeletal tissue injury. In this thesis we studied the efficacy and working mechanisms of biological treatments for OA.