Dr. Marc Darrow

Stroma cells are connective tissue cells found in body organs and in bone marrow.Fibroblasts(cells that make collagen) andpericytes( facilitating new blood vessel formation to bring circulation to the area) are the most common stroma cells. In our practice we use bone marrow derived stem cells to regenerate damaged joints.

Doctors at the University of Iowa are experimenting with stroma cells. This is from the University: Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors.

Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

But a University of Iowa orthopedics research team is working on a solution with hopes it will result in a minimally invasive, practical, and inexpensive approach for repairing cartilage and preventing osteoarthritis.

We are creating an [injectable, bioactive] hydrogel that can repair cartilage damage, regenerate stronger cartilage, and hopefully delay or eliminate the development of osteoarthritis and eliminate the need for total knee replacement, says Yin Yu, a graduate student in the lab of James Martin, PhD, UI assistant professor of orthopedics and rehabilitation. Yu is first author of the study, which is featured on the cover of the May issue of the journalArthritis and Rheumatology.

Martins team had previously identified precursor cells within normal cartilage that can mature into new cartilage tissue. This was a surprising discovery because of the long-held assumption that cartilage is one of the few tissues in the body that cannot repair itself. (Note: Prolotgerapy doctors have often documented cartilage regrowth.)

The team also identified molecular signaling factors that attract these precursor cells, known as chondrogenic progenitor cells (CPC), out of the surrounding healthy tissue into the damaged area and cause them to develop into new, normal cartilage. One of the signals, called stromal cell-derived factor 1 (SDF1), acts like a homing beacon for the precursor cells.

In an experimental model of cartilage injury, Yu loaded the custom-made hydrogel with SDF1 and injected it into holes punched into the model cartilage. The precursor cells migrated toward the SDF1 signal and filled in the injury site. Subsequent application of a growth factor caused the cells to mature into normal cartilage that repaired the injury.

This process gives us a great result, Yu says. The new cartilage integrates seamlessly with the undamaged tissue, it has normal concentrations of proteoglycans, good structural properties, and looks like normal cartilage.

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