Regenerative medicine is a new buzzword in biomedical research and describes an emerging area of medicine, according to a leading Faculty investigator.
Professor Minghao Zheng, Director of Research in the School of Surgery’s Centre for Orthopaedic Research, said scientists were now able, by stimulating stem cells or progenitor cells, to regenerate organs and tissues that had deteriorated due to degenerative diseases. These included neurodegenerative disorders, arthritis, tendonopathy and other musculo-skeletal diseases.
His team has used patients’ own chondrocytes, which are considered the progenitor cells of cartilage, to regenerate the cartilage of patients with arthritis of the knee. The technique is known as matrix-induced autologous chondrocyte implantation.
“This technology has been used Australia-wide and worldwide in about 6000 patients,” Professor Zheng said.
The focus has now turned onto tendon regeneration. Tendon injury or tendonopathy is a chronic degenerative condition in which the tendon cells undergo apoptosis and autophagy and die.
Tendon injuries are particularly common in knee joints, shoulders, ankles and elbows, such as in tennis elbow. Almost 15,000 operations are carried out each year in Australia to repair tendon damage in the shoulder and about 8000 operations repair Achilles heel tendons.
“We have now introduced this new technology of taking patients’ own tendon progenitor cells and growing the cells in a culture,” Professor Zheng said.
After pre-clinical studies in animals over the past five years, the group started the first phase of clinical safety trials in patients with severe, intractable tennis elbow at the Gairdner Hospital in August. There will be up to 30 patients in the trial and some are still being recruited.
Each patient’s cells are harvested by a needle biopsy and then grown in the laboratory by the patented method that expands a significant population of cells. These are then injected into the diseased tendon to restore the pool of the cells depleted by the tendonopathy.
In October, the first two patients received an implantation of tendon cells grown from their own tendon progenitor cells taken from the patella. The patients will be monitored for up to two years for side effects and evidence of efficacy of the procedure. To date,
there have been no side effects caused by harvesting the progenitor cells.
“We still don’t know the final outcome,” Professor Zheng said.
“But the procedures are very minimally invasive.
“The reason we have chosen progenitor cells rather than stem cells is that progenitor cells have a more defined differentiation pathway toward tendon regeneration while stem cells have multiple pathways of cell differentiation.”
By using the patients’ own progenitor cells, when the cultured tendons or cartilage are transplanted the potential problem of transmission of viral diseases or rejection of the foreign tissue is avoided.