Cartilage is a flexible, connective tissue in our joints that is important for cushioning our bones against impacts. This cartilage deteriorates as we age due to normal wear and tear and in some instances excessive damage or a deteriorating disease. The deterioration of cartilage is also the primary cause of joint pain and arthritis, which affects more than 55 million Americans.

It was generally assumed that adult cartilage could not be regenerated after damage. Fortunately, a CIRM funded project by Dr. Charles K.F. Chan, Dr. Michael Longaker, and Dr. Matthew Murphy at Stanford University found a way to use chemical signals to steer skeletal stem cells, which are responsible for the production of bone and cartilage, to regrow cartilage in joints.

Damaged cartilage is currently treated with a technique known as microfracture. Tiny holes are drilled into the surface of a joint, which activates the body’s skeletal stem cells to create fibrocartilage in the joint. Unfortunately, this newly created tissue lacks the flexible properties and cushion of normal cartilage.

The team theorized that there might be a way to influence skeletal stem cells to produce normal cartilage after microfracture. In a mouse model, the researchers used a molecule called BMP2 to initiate bone formation after microfracture. Next, they stopped the bone formation process midway with another molecule called VEGF. The result of this process was the generation of cartilage that had the same important properties as natural cartilage.

In a Stanford press release, Dr. Chan elaborated on these findings.

“What we ended up with was cartilage that is made of the same sort of cells as natural cartilage with comparable mechanical properties, unlike the fibrocartilage that we usually get. It also restored mobility to osteoarthritic mice and significantly reduced their pain.”

To show that this process could work in humans, the team then transferred human tissue into special mice that wouldn’t reject the tissue. They showed that human skeletal stem cells could be steered toward bone development but stopped at the cartilage stage.

The next stage for this research is to conduct experiments in larger animals before eventually starting human clinical trials. The ultimate goal of this treatment would be to help prevent arthritis by rejuvenating cartilage in the joints before it is badly degraded.

In the same press release, Dr. Longaker discusses the advantages of using BMP2 and VEGF for this process.

“BMP2 has already been approved for helping bone heal, and VEGF inhibitors are already used as anti-cancer therapies. This would help speed the approval of any therapy we develop.”

The full results of this study were published in Nature.