BASEL, Switzerland — A cure for osteoarthritis may literally be right on the tip of your nose. A new study reveals that nasal cartilage can relieve chronic inflammation in the knee, according to researchers from the University of Basel.
Doctors say the treatment could revolutionize therapies for a crippling condition that affects over 10 percent of Americans over age 60. The cells originate from embryonic brain and spinal cord tissue – known as the neuroectoderm.
“Unlike the cartilage tissue in the joints, these cartilage cells originate from precursor cells of the neuroectoderm and therefore have a distinct regenerative and adaptive capacity (plasticity). Tissue grown from nasal cartilage cells seems also to retain these special properties,” says co-lead author Professor Ivan Martin in a university release — calling the discovery “amazing.”
Correcting debilitating knee pain and bone problems
Unlike other tissues, cartilage that cushions the surface of joints has little capacity to grow back. Osteoarthritis – the most common form of arthritis – can lead to worsening joint damage and pain. Knee replacement surgery is often the only option.
Now, clinical studies have shown cartilage cells from the nasal septum – the partition that divides the nostrils – can combat the disease. Orthopedic and plastic surgeons took a tissue sample from the noses of two patients and cultivated them in a lab. They then used the tissue to grow a cartilage layer that doctors implanted into the knee joint.
The young volunteers had severe osteoarthritis due to a misalignment of their leg bones. They were in danger of needing a whole knee prosthesis. Following implantation of the engineered cartilage, both patients reported a reduction in pain and increased quality of life.
MRI scans showed the bones in the knee of one of the patients grew further apart than — reducing the bone-on-bone contact that causes many arthritis patients severe pain. This is an indication of the joint’s recovery. Study authors note the other volunteer could only be interviewed for a subjective assessment of their progress due to the pandemic.
Researchers add that the bones in both volunteers could be surgically corrected and the most likely cause of their osteoarthritis eliminated. They are confident patients will be able to manage without knee joint prostheses, at least for some time.
“Our results have enabled us to lay the biological foundation for a therapy, and we are cautiously optimistic,” Prof. Martin says.
Shutting down the pathway to knee pain
Unlike knee traumas caused by sports injuries and falls, an osteoarthritic knee suffers persistent inflammatory reactions.
“First we had to test whether the cartilage replacement was attacked and degenerated by the inflammatory factors,” Prof. Martin continues.
The international team initially tested human cartilage tissue in the presence of inflammatory factors. They carried out the experiments on mice and various other models of the disease.
They also tested the durability of the tissue under stress and inflammation in sheep. The team then took cartilage cells from the nose of the animals and transplanted into their osteoarthritic knee joints. The tissue proved to be extremely robust and also seemed to counteract the inflammatory reactions.
Further analysis suggested this effect was caused by a chemicals fueled by osteoarthritis, known as the WNT signaling pathway. The study, published in the journal Science Translational Medicine, discovered this pathway was dampened by the presence of the nasal cartilage cells.
Could nose tissue save millions from reversible knee problems?
In-depth clinical trials using the approach for the treatment of patellofemoral osteoarthritis are now in the planning phase. The researchers are also aiming to further develop the method for other types of osteoarthritis to treat a broader spectrum of patients.
They pioneered nose-to-knee cartilage transplants a decade ago in nine patients who had suffered sports injuries, falls, or other accidents. That process followed successful experiments in goats. This is the first time the surgery has been used for osteoarthritis.
Globally, the disease affects more than 300 million people. Osteoarthritis occurs when the protective cartilage that cushions the ends of the bones wears down over time. The condition can damage any joint, but usually affects the hands, knees, hips, and spine. Osteoarthritis symptoms can usually be managed, although the damage to joints can’t be reversed.
Staying active, maintaining a healthy weight, and receiving certain treatments might slow progression and improve pain and joint function.
South West News Service writer Mark Waghorn contributed to this report.