However, there is reason for optimism, as an agency of the US Department of Health and Human Services has allocated millions of dollars to various initiatives investigating treatments for the disease. That agency is the Advanced Research Projects Agency for Health (ARPA-H), and the project that wants to eliminate osteoarthritis is called NITRO, or Novel Innovations for Tissue Regeneration in Osteoarthritis. The most advanced initiative in this area is being led by a multidisciplinary team at the University of Colorado Boulder, which has received a $33.5 million grant from NITRO to develop an experimental therapy with the potential to reverse joint damage in just a few weeks through a simple injection.
Osteoarthritis is characterized by the gradual destruction of cartilage, the tissue that softens the contact between bones. Over time, this deformity causes not only pain and swelling but also joint deformity and loss of mobility. It is the most common type of arthritis in the US and affects about 240 million people worldwide.
“At the moment, the options for many patients are either a major, expensive surgery or nothing at all. There is not much in between,” Evelina Berger, professor and chair of the department of orthopedics at CU Anschutz, said in a statement. “That’s why ARPA-H is so important.”
Against this backdrop, the Colorado team, led by biomedical engineer Stephanie Bryant, proposes a completely different approach: “Our goal is not just to treat pain and stop progression, but to end this disease.”
Joints that can heal on their own
This success is based on harnessing the body’s natural ability to regenerate itself. Instead of introducing artificial tissues or a prostheses, Colorado scientists have designed a system that “recruits” the body’s own cells to repair the damage.
One of the strategies involves a single injection that releases an already approved drug in a controlled manner, thanks to a particle system that acts as a vehicle. This system allows small doses to be delivered directly into the affected joint over months, speeding up the repair process.
The second strategy is designed for more advanced cases. It consists of a kit of biomaterials and proteins that can be applied through minimally invasive procedures. Once inside the body, this material solidifies and acts as a scaffold, attracting progenitor cells that fill in and regenerate damaged areas of cartilage or bone.
The very important thing that both approaches have in common is that they seek to transform the diseased joint into an environment conducive to natural regeneration.
rapid and positive progress
In animal studies, results have been encouraging. Treated joints return to a healthy state within four to eight weeks. Furthermore, in more severe injuries, researchers observed complete regeneration of damaged tissue.
“In two years, we went from having a great idea to develop these treatments to being able to demonstrate that they reverse osteoarthritis in animals,” Bryant said. Additional experiments with human cells obtained from patients undergoing joint replacement also showed clear regenerative effects, suggesting that this approach could be translated to humans.
However, it is important to emphasize that these results have not been validated in clinical trials. The researchers intend to publish their findings in an academic journal later this year. He has also founded a startup, Renovare Therapeutics, to begin the commercialization process.
Back in the lab, the next step will be to expand the animal studies and analyze key aspects such as toxicity and safety. If all goes according to plan, human clinical trials could begin in about 18 months.
This story originally appeared in WIRED en Español and is translated from Spanish.
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