The medical research efforts of McGowan Institute for Regenerative Medicine
affiliated faculty member Constance Chu, MD (pictured), UPMC orthopedic surgeon, director of the Cartilage Restoration Program at the University of Pittsburgh School of Medicine's Department of Orthopaedic Surgery, associate professor at the University of Pittsburgh Departments of Orthopaedic Surgery and Bioengineering, and the Ferguson Endowed Chair in Orthopaedic Surgery at the University of Pittsburgh School of Medicine, are focused on detecting, treating, and reversing cartilage damage before it leads to osteoarthritis.
“The reason we want to classify early diagnosis [is] that's what's going to allow other treatments to be accurately evaluated whether they're going to work or not,” Dr. Chu said. “That's how we would take new developments to patients as new treatments.”
In the Cartilage Restoration Laboratory, Dr. Chu and her team are leading translational research (from the bench to the clinic) in three main areas: cartilage tissue engineering, novel cartilage imaging technologies, and chondroprotection. Their research focuses on improving cartilage repair potential and minimizing stress to healthy, degenerative, and aged cartilage. The laboratory seeks solutions to these problems from many angles--from the development of smart polymers for controlled in vivo release of growth factors, to assessing human stem cell potential, to the application of imaging technologies like optical coherence tomography (OCT).
As reported by Pohla Smith, Pittsburgh Post-Gazette, Dr. Chu estimates she could be no more than 2 years from a trial with people testing how reintroduction of enriched stem cells into wounded cartilage can spark regrowth of the bone-covering tissue damaged during a serious knee injury. Clinical studies show that about half of the people develop osteoarthritis after an anterior cruciate ligament (ACL) injury.
Dr. Chu currently has 10 open studies pointed at detecting and treating cartilage damage earlier than what is done now. Her research studies include, but are not limited to:
- Stem cell injections into the knees of horses which is showing promise in that new tissue is bonding to original cartilage several months after the procedure
- Gene therapy introduced into the knees of rats to stimulate stem cells to form new cartilage
- The use of OCT to detect damage even deeper beneath the surface of the cartilage in human patients
- Quantitative MRI which generates color maps of the cartilage and shows gaps in the layers of tissue where damage has occurred in human patients
- Looking for biomarkers in human patient blood and urine samples that may correspond with early cartilage injury and degeneration identified by OCT
- The role of exercise in the degeneration of cartilage and the development of arthritis in the knees of rats which has a major finding that the effects of exercise depend on the stability of the joint.
Dr. Chu recently published the conclusions of her work using OCT as a nondestructive imaging technology that can detect degenerative changes in articular cartilage with an intact surface. The study showed that OCT detects acute cartilage changes after impact injury at levels insufficient to cause visible damage to the articular surface but sufficient to cause chondrocyte death and microscopic matrix damage. The team’s finding supports the use of OCT to detect microstructural subsurface cartilage damage that is poorly visualized with conventional imaging.
Illustration: McGowan Institute for Regenerative Medicine.
Pittsburgh Post-Gazette (09/15/10)
The Cartilage Restoration Laboratory
Bio: Dr. Constance Chu
Abstract (Journal of Orthopaedic Trauma. 2010 Sep;24(9):577-82.)