The California Institute for Regenerative Medicine (CIRM) awarded Scripps Health a $2.7 million research grant to support research into using stem cells to engineer rotator cuff tendons in the laboratory and repair common shoulder injuries.
The rotator cuff consists of four muscles and their attached tendons. Together, they hold the upper arm in the shoulder socket.
The rotator cuff connects the humerus to the shoulder blade. It also helps lift and rotate the arm.
Most rotator cuff tears result from natural tendon degeneration over time.
These tears often cause pain and limit arm movement.
As the condition worsens, the shoulder can become weaker, more painful, and less functional.
Pluripotent stem cells
Using pluripotent stem cells to grow tendon tissue in the laboratory could help older patients with severe, age-related rotator cuff tears.
“Conventional repair surgery fails in about 40% of these patients,” said Dr. Darryl D’Lima, the initiative’s lead investigator.
D’Lima directs orthopedic research at the Shiley Center for Orthopaedic Research and Education at Scripps Clinic.
“This common injury affects many people, and our aging population needs new treatment options,” he said.
More than 100,000 Californians suffer tendon injuries each year. Most require surgery.
Shoulder rotator cuff repairs fail in 20% to 90% of cases.
When repairs fail, patients can develop osteoarthritis earlier. Total joint replacement remains the only effective treatment for advanced cases.
Preventing disability could provide significant economic benefits. It could also substantially reduce healthcare costs.
The funding from CIRM will support the initiative’s three-year discovery phase at Shiley Center for Orthopedic Research and Education (SCORE) on Torrey Pines Mesa. Researchers plan to develop a series of lab tests, called assays, to assess and measure the makeup of tendon cells and develop tendon material in the lab.
SCORE researchers intend to explore the possibility of transforming pluripotent stem cells into tendon-like cells, which would be embedded into a scaffold structure of “electrospun” fibers and grown into tendon tissue using bioreactors.
The lab-engineered tendon tissue would also be stretched to help stimulate the cells to produce more tissue and to help align the electrospun fibers so they mimic the intricate alignment of fibers in native tissue. Lining up the tendon fibers in the same direction that stretching occurs is needed to resist tensile force, or the stretching force experienced during motion.
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The rotator cuff consists of four muscles. These are the subscapular is, the supraspinatus, the infraspinatus and the teres minor muscles. These muscles end in short, flat, broad tendons which fuse intimately with the fibrous capsule to form the musculatendinoes cuff.
Stem cell therapy is an effective therapeutic treatment to treat rotator cuff injury. Pluripotent stem cell technology require to develop pluripotent stem cells into four different types of tendon-like cells which would be embedded into scaffold structure of electrospun fiber and grown into tendon tissues using bioreactor.
To note that, stem cells require growth factors for growth and differentiations. The growth factors have important roles to induce maturation and gene expression of adhesion molecules on progenitors. As the formation of rotator cuff requires four different muscles organized in correct conformation. Hence, the organization of four differentiated tendon cells is dependent on cell-suface interaction both with molecules on the surface of other cells and the extracellular matrix. Localization of cells can thus in principle be driven by the interplay between interaction with surface and matrix molecules that regulate adherence, and chemoatractant gradients that direct cell migration. These principle operate throughout the biology of multicellular organisms.