By Don C. Reed
Dear Friend of Stem Cell Research:
As you know, the National Institutes of Health (NIH) is the most important source of medical research funding in the world. It deserves protection from politically motivated budget cuts: fighting arthritis is just one reason why.
When my late wife Gloria’s knees “went bad” with arthritis, she tried to limit her use of our home stairs to just twice a day: coming down in the morning, going back up at night.
What was the problem?
A healthy knee joint has an inner cushion of smooth white cartilage, the meniscus; Gloria’s was nearly worn away: when she walked, it was bone on bone.
The pain was intense, and relentless. The only relief was cortisone injections in the knees. For two to three weeks the shots would let her walk almost normally. But she could only have them three times a year, and they grew less effective over time.
No one should suffer like that — but millions do.
According to the Center for Disease Control and Prevention (CDC), an estimated 18.9% of adult Americans report arthritis — 53 million — almost one in five! (1)
What about artificial knee joints? They do exist, metal/ porcelain contraptions, designed to replace a normal knee. But it takes surgery to install them; also the pain of recovery can be severe, and long-lasting.
I take immense pride in the California stem cell program, formally known as the California Institute for Regenerative Medicine (CIRM). (2)
But CIRM has a total budget (from its beginning in 2004 to the present and beyond) of $8.5 billion; the NIH budgets roughly $47 billion for just one year.
Visiting the CIRM website, I found 5 major projects fighting arthritis, led by:
Peter Schultz of Scripps Research Institute;
Dan Gazit of Cedars Sinai Medical Center;
Dennis Evseenko of UCLA;
Kristen Johnson of Calibr — who has a clinical trial going on right now, congratulations to her!
— and Darryl D’Lima, director of orthopedic research at Scripps Health. Dr. D’Lima has been a leader in the field for twenty-five years , ever since he won the Kappa Delta award from the American Academy of Orthopaedic Surgeons in 2005.
A CIRM-funded project from D’Lima described possibilities of bone and joint repair in words not always easy for non-scientists like myself to understand; like auto mechanics, scientists speak a specialist language.
In phrases like “chondroprogenitor cells to repair osteochondral defects”, the key term is “chondro”, bone and joint. “Chondro¬progenitor cells” means cells that may regenerate bone and joint.
What was Dr, D’Lima’s approach?
A knee implant would have a gel structure that would break down and be disposed of by the body, when the need was done. This scaffold would be seeded with cells…programmed to become bone and cartilage.
The target was “early osteoarthritis” for people under 55. (3)
Why “early”? Two reasons:
First: “for younger patients with severe or impending arthritis, there is no treatment that can prevent, cure, or even slow the progression of this disease.”
Second, it’s bad enough for oldsters like myself to have the condition (I have it in right hip, both knees, left shoulder and middle/lower back) — but for young people to suffer almost their whole lives? That would be terrible indeed.
The ultimate goal is what feels and acts like a new knee.
How is the new project working?
“Major milestones set by CIRM… were met. A cell manufacturing and quality control process was established. 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 theresearch we are doing with regard to tissue regeneration…” said Dr. D’Lima.
Question: How much do we spend on federal research, compared to the costs of maintaining folks who suffer arthritis? Brace yourself.
“Federal spending on arthritis research in FY17 is estimated at $222 million”. Conservatively, this suggests a ratio of only one dollar spent on therapeutic research for every 600 dollars spent on care”. (4)
To paraphrase Shakespeare: care or cure, that is the question. America can either continue to pay the roughly $120 billion a year (5) which is the cost of maintaining patients with arthritis, or support ongoing research for cure.
1. https://www.cdc.gov/nchs/products/databriefs/db497.htm
2. www.CIRM.CA.GOV.
3. https://www.cirm.ca.gov/our-progress/people/darryl-d-dlima/
4. https://issuu.com/dam-dpha/docs/de-jph-chronicdisease-march2017_032
5. Stem Cell-Based Therapy for Cartilage Regeneration and Osteoarthritis — CIRM