nanomedicine

Nanomedicine for regenerating joints

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Researchers from Inserm and the University of Strasbourg, within Unit 1260 "Regenerative Nanomedicine", have developed an implant which, applied as a dressing, enables cartilage to be regenerated in the event of major joint injuries or early osteoarthritis. Details of this innovation, validated in the preclinical phase, are published today in Nature communication.
 
L’Longer life expectancy and the increase in accidental trauma necessitate an increase in surgical interventions to replace a defective joint. Among chronic conditions, osteoarthritis, described as the destruction of cartilage affecting all joint structures including bone and synovial tissue lining the inside of joints, is a real public health problem. Depending on the medical diagnosis, several treatment options are available, ranging from micrografting to prosthetics. However, these procedures are all invasive and/or painful for the patient, with limited effectiveness and side effects.
 
Nowadays, apart from fitting prostheses, we are actually content to temporarily repair joint cartilage and alleviate pain. Treatments consist mainly of injecting anti-inflammatory drugs and hyaluronic acid to improve the viscosity of the joint. Stem cells can also be used, in particular because they secrete molecules capable of controlling inflammation.
 
In this context, and in order to regenerate this connective, supple and often elastic tissue that covers our joints and allows the bones to move and slide in relation to each other, a research team involving Inserm and the University of Strasbourg has just developed a dressing for cartilage - inspired by the new generation of dressings that form like a second skin on skin wounds. With the dressings developed by the researcher and her team, the therapeutic response is taking a new direction. We're no longer just talking about repair, we're really talking about regeneration of articular cartilage.
 
The team of researchers from Inserm and the University of Strasbourg 1260 under the direction of Mrs Benkirane-Jessel has indeed developed an innovative osteoarticular implant technique, capable of reconstituting a damaged joint and whose application can be compared to that of dressings. “The implant we have developed is intended for two cases in particular, large cartilage lesions and early osteoarthritis." explains the researcher.
In detail, these joint dressings are composed of two successive layers. The first, which acts as a support (conventional dressings), is a membrane composed of polymer nanofibres and equipped with small vesicles containing growth factors in quantities similar to those secreted by our cells themselves. The second is a layer of hydrogel loaded with hyaluronic acid and stem cells from the patient's own bone marrow, which, by differentiating into chondrocytes (cartilage-forming cells), will regenerate the cartilage of the joint.
 
Scientists see a promising future for their "cartilage dressing": in addition to the knee and shoulder joint, it could also be used for the temporomandibular joint, which is connected to the jaw. Quite disabling, this one can lead to pain, joint noises but especially to a decrease in the amplitude of the opening of the mouth.
 
An advanced therapy composite (ATMP) drug developed for osteoarticular regeneration (OAR) of focal cartilage lesions that combines a synthetic dressing and a live treatment consisting of autologous mesenchymal stem cells (MSC), coated in an alginate/hyaluronic acid hydrogel, which is aimed at regenerating articular cartilage.

 
The research team has already carried out cartilage lesion trials in small animals, mice and rats, as well as in large animals, sheep and goats, models that are highly suitable for the comparative study of cartilage with humans. The objective is to launch a human trial with a small cohort of 15 patients.
Source : Inserm, 14 May 2019
 
Header photo : Articular cartilage © Inserm/Chappard, Daniel
 

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