By Don C. Reed
Toward the end of her life, Gloria tried to use our home stairs only twice a day: once coming down in the morning, once climbing back up at night. We would do the steps together, her arm across my shoulders.
It was slow and difficult: step, pause…step, pause… all the fourteen steps. We talked about getting her one of those built-in escalators, but they cost too much.
X-rays revealed the problem.
A healthy knee joint has an internal cushion of smooth white cartilage, like a pancake, only tough: Gloria’s knee cartilage was almost entirely gone, worn away. Her knee joint was bone on bone, grinding together. I could hear her pain, in the way she breathed.
The only relief she got was cortisone injections, a temporary cushion in the joint, so she could be normal for a few weeks. What joy that was, when her face relaxed and her normal grace and vitality returned! She was once a tremendous walker, who had to hold herself back when we walked together, so she would not leave me in a cloud of dust. But the cortisone effects only lasted for a couple of weeks, and she could only have the injections three times a year.
We used to walk beside the Fremont channel, and watch the snowy egrets fly; but now, no more. I went by myself, for exercise, and tried to tell her what I saw.
Arthritis affects as many as 52 million people in our country, at a cost, conservatively, of about $20 billion a year.
What about artificial knee joints? They do exist, metal/ porcelain contraptions, attempted replacements for a normal knee.
It takes surgery to put them in, of course. But people who have endured the process report a 6–12 week recovery period; for some it was so painful they would only have the one limb done, declining the second surgery. Also, there are no guarantees the surgery may not need to be repeated.
I went to a website where you can learn about clinical trials:
It is a valuable website. Just type your condition of interest in the search box, and it points you to a bunch of mostly FDA-approved clinical trials.
I looked for the magic word “recruiting”, which meant they were taking volunteers — but she was not a match for their criteria.
Of course, I visited the California stem cell program website: www.CIRM.CA.GOV. The website was a comfort; here were people fighting on our side.
I found 5 projects attacking arthritis, for a total of $23,881,185.00.
These were led by outstanding scientists: Peter Schultz of Scripps Research Institute, Dan Gazit of CedarsSinai Medical Center, Dennis Evseenko of UCLA, Kristen Johnson of Calibr — and Darryl D’Lima, director of orthopedic research at Scripps Clinic. Let’s focus on him this time.
In 2000, Dr. D’Lima won the Best Cartilage Basic Science Award from the International Cartilage Repair Society, and he has stood out ever since.
His coworkers were tops in their field: people like Clifford Colwell, who established the Shiley Center for Orthopedic Research and Education (SCORE) at Scripps Clinic in San Diego where both men work: Scripps orthopedic surgeons William Bugbee and Heinz Honecke, as well as veteran scientists Martin Lotz, Jeanne Loring, and Evan Snyder from SanfordBurnham plus Shawn Grogan, tissue engineer — like a “Who’s Who” in scientific excellence!
D’Lima’s project had the usual gigantic title: “chondroprogenitor cells to repair osteochondral defects” — scientists can’t say anything without big words! The key term is “chondro”, bone and joint. “chondroprogenitor cells” means the in-between cells that may be helpful to bones and joints.
The grant was for more than seven million ($7,660,210) the amount a good sign in itself: CIRM does not lightly give away large quantities of cash. The grants all come with conditions: milestones of progress that must be met in order to continue receiving funding, agreed on before the project begins. If you say you can do thus-and-so, you must do it, before you get another nickel.
Disease Focus: Arthritis, Bone or Cartilage Disease
What was Grant Number PCl08128 ’s approach?
A knee implant with a gel structure, (a scaffold, tough but biodegradable, so that it will break down and be disposed of by the body, when the need is done) seeded with cells…programmed to (change) into bone and cartilage cells…
The aim was “early osteoarthritis” for people under 55. This would not be helpful to people of Gloria’s or my age (we both saw 70 in the rear-view mirror), but the technique might be “tweakable”, later on.
Why choose the early form of the condition?
“For younger patients with severe arthritis or impending arthritis, there is no treatment that can prevent, cure, or even slow the progression of this disease.”
Bad enough for oldsters like my wife and me (I have it in hip, knee, shoulder and lower back) to have the condition — but for young people to suffer almost their whole lives? That would be terrible indeed.
Instead, they might end up with what feels and acts like a new knee…
Background? Dr. D’Lima’s previous CIRM experiment was successful enough to be carried out over three years (Grant TR0126) for $3,118,431.
How is the new project working?
“Major milestones for year 1 set by CIRM were met. A cell manufacturing and quality control process was established to generate cell banks that would be safe and suitable for clinical work. The cells passed all established laboratory criteria to measure potency in repairing tissue and treating arthritis…The first preclinical experiments were initiated…
“The funding provided by CIRM is essential to the development and support of the
research we are doing with regard to tissue regeneration…” said Dr. D’Lima.
If you want to follow Dr. D’Lima’s work, here is a good place to start.
Millions of families wish Darryl D’Lima and all CIRM’s scientists —
Remember, if you want to see the California stem cell program continue, there is only one way it is possible — vote YES! on Proposition 14: the California Stem Cell Research, Treatments and Cures Initiative of 2020.
If we win Prop 14, the funding for the Golden State’s stem cell program continues.
If not, not.
Don C. Reed is the author of “CALIFORNIA CURES”, from World Scientific Publishing, Inc., and other books about stem cell research.