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Knee pain doesn't have to hold you back from enjoying an active life.
Osteoarthritis (OA) is degenerative and characterized by a gradual loss of cartilaginous tissue, leading to stiffness, pain, and impaired movement of the affected joint. The disease affects the hips, knees, spine, feet, and hands. Its modifiable and nonmodifiable risk factors include obesity, genetic predisposition, lack of exercise, trauma, sex, and age. Dr. (Lt Col) Pawan K Gupta, President Medical & Regulatory Affairs, Stempeutics Research, shares that it is evident that osteoarthritis is caused not only by wear and tear but also by the involvement of various proinflammatory cytokines and mediators.
According to the World Health Organization, 18.0% of women and 9.6% of men above 60 years have symptomatic osteoarthritis worldwide. 80% have limitations in movement, and in 25%, quality of life is majorly affected. In the Indian population, knee OA is most prevalent, followed by hand OA. In India, around 23.46 million individuals had OA in 1990, which increased to 62.35 million in 2019.
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Current practices in the management of osteoarthritis include primary prevention (weight management, averting joint injury) and clinical management, which focuses on improving function and pain. Surgical interventions include osteotomy, unicondylar and total knee replacements. From a societal viewpoint, OA is costly, with high indirect costs through lost productivity of individuals and their caregivers.
Despite the enormous burden of OA, there are no disease-modifying drugs approved. This may be due to the heterogeneity of the disease process, as it makes it challenging to target different pathways for pharmacologic intervention. Due to this inconsistency in palliative treatment, the role of cell therapy, especially mesenchymal stromal cell therapy (MSC), has come to the forefront to provide a potential disease-modifying approach for regenerating the damaged articular cartilage. These cell-based therapies are presented as an alternative source to chondrocytes, which have the potential for cartilage regeneration in OA. The regenerative potential of MSCs is of interest in OA as no treatments have been shown to reverse or stop the loss of cartilage.
Immunomodulatory and anti-inflammatory properties of MSCs may be of value in osteoarthritic joints, regardless of their regenerative properties. In our published studies in peer-reviewed International scientific journals, we had shown that the intra-articular administration of cultured, pooled, allogeneic mesenchymal stromal cells was safe and showed a positive trend in improvement in pain, stiffness and physical function of the affected joint and prevented worsening of cartilage quality. Hence, these cell therapies, either autologous or allogeneic, hold promise in the management of this chronic progressive disorder.