Department: Surgery, University of Toronto
The Division of Orthopaedics, led by Dr Nizar Mahomedhave recently initiated a research programme with a goal to cure arthritis. One of the key areas of investigation is the application of stem cells. There is potential for stem cells to have properties to reduce inflammation within the body and specifically within an osteoarthritic joint, while they may also have the ability to generate cartilage within a joint, when cartilage has degenerated as a result of the disease process. The early stages of this research programme are being accomplished through strong collaborations with the McEwen Centre for Regenerative Medicine at MaRS and led by Dr Gordon Keller, with support by Dr April Craft. This work has led to the growth of cartilage cells in vitro using embryonic pluripotential stem cells. While this research is critical to the understanding of the potential of ESS to be used for the treatment of osteoarthritis in the future, the use of autologous stem cells (Mesenchymal bone marrow derived) will provide excellent knowledge of the role of MSCs in potentially relieving symptoms related to inflammation of the joint. Since autologous MSCs have a lower potential for rejection and other adverse events, collaboration has been established with Dr Armand Keating, Director of the REMEDI core facility for Cell Expansion and Manipulation. This collaboration between clinicians and basic scientists will build on the existing knowledge of the safety of autologous Mesenchymal stem cells and the experience of the group working with Dr Keating to enable a clinical trial of bone marrow derived MSC to be planned within the next two years. Another aspect of the stem cell programme is a strong collaboration with Dr David Jaffray’s STTARR facility at MaRS. This group has excellent knowledge and technology available and, under the direction of a strong researcher with knowledge of tracking cells in the body, will apply innovative approaches to tracking MSC when introduced into a joint, in order to determine the fate and location of the introduced cells. The Academic Advisory Board for the Arthritis Program, which met for an inaugural meeting in September 2012 recommended the following programme for stem cell research in the Arthritis Program:
- phase II allogeneic stem cell studies
- phase I research should involve autologous mesenchymal stem cell studies,
- phase III pluripotent stem cell studies. These recommendations are based on existing opportunities to enter clinical studies.