Dr Claudia Di Bella
|Funded by:|| Jointly funded by Eventide Homes Arthritis South Australia
Arthritis Australia – Suzette Gately donation for OA
|Recipient:||Dr Claudia Di Bella|
|Intended Department||Department of Orthopaedics-St Vincent’s Hospital – Melbourne|
|Project:||3D Bioprinting of Bio-adhesive scaffold for cartilage regeneration|
Musculoskeletal conditions – the suite of injuries and diseases of the bones, muscles, and connective tissue – account for 15.3% of the global burden of death and disability in Australia, second only to cancer (16.2%). For people who injure their articular cartilage, that all important tissue that cushions our joints and enables their smooth movement, a cascade of impacts results from the tears or other physical damage caused by mechanical stresses on the joint. Years of chronic pain, disability, distress, and a reduced ability to work or enjoy physical activity are common implications; trauma to joints causes 14.1% of all serious workplace claims– more than twice that of back injuries. Articular injuries also have severe long term consequences because they almost always lead to osteoarthritis, in itself a major load on the healthcare system, at a cost of $AUD2.2 billion/year, projected to grow exponentially unless something is done to mitigate the condition.
Current surgical options for joint injuries degrade and fail over time, and thus only delay the invasive procedure of a joint replacement, when patients are older and pain is severe enough.
The root problem is that once damage occurs, our bodies cannot regrow normal cartilage. Instead, injured joints normally produce scar like tissue, which neither lasts nor provides the important, movement enabling properties of healthy cartilage. But what if we could trigger the body to instead regenerate the right kind of tissue? To produce not a scar or defect, but normal cartilage, to replace that which was lost? Administered early, such an intervention could transform the outcome of this commonplace injury. Although in the laboratory we can already create tissues that mimic the cartilage present in our body, one of the main difficulties in transferring this to actual surgical implantation is the ability of this tissue to “stick” to native cartilage. Our cartilage is, by nature, very slippery, and nothing can really adhere onto it. Glues can be used,
But they damage the cells because they are toxic. The ones that are not toxic are not strong enough to adhere to cartilage.
In this project we have worked to find a special glue that not only allows good adhesion of our printed material to cartilage, but also allows cells to grow in it, so that the new tissue can survive after surgical implantation. We have chosen a glue used in the food industry (with thanks for the idea to Heston Blumenthal!). This material is called transglutaminase.
We have discovered that transglutaminase, when mixed in the right amount and for the right period of time to our gel producing a cartilage (all aspects that we had to understand, define and fine tune in our project), can make our gel sticky enough to the native human cartilage and still let the cells inside the printed gel do their work. These results are extremely important on the path of clinical translation. This approach can now be further optimised to finally be applied in our advanced printing machine that can be used by the surgeon, directly during the surgical procedure, to deliver a gel directly within the cartilage hole in the damaged knee
which needs to be repaired. This gel has all the requirements to become cartilage in time. Thanks to our new adhesive properties, this gel will not be washed out after surgery (as it would happen if it was not as sticky), and can remain in place, therefore allowing the cells time to create the new reparative tissue directly in the human body.
I would like to thank the funders of my grant including Eventide Homes, Arthritis South Australia, Arthritis Australia and Suzette Gately’s donation.
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