517 replies to this topic

[aconita]

About collagen the source doesn't really matter (bovine, porcine, poultry, marine), at an hydrolyzed enough level collagen is totally tasteless and readily soluble, it would be very unlikely to perceive any taste at 1.5-2.5KDa (the ideal molecular weight).

 

As I already stated there is no way to tell the molecular weight but asking the seller....well...one might just guess that if a taste is perceived the molecular weight is greater than ideal.

[Nate-2004]

In that case, it sounds like Bulksupplements may not be low enough in weight, but then as you said there's such a thing as too low and I'm not sure what too low would be.  The taste isn't completely imperceptible so it must be slightly heavier than it needs to be.  I'll have to find another source I think.

Edited by Nate-2004, 30 September 2016 - 01:40 PM.

[aconita]

Peptan 2000 is great if you can find it, I use Peptan B 2000 (bovine).

 

Probably much below 2KDa is too small.

[Nate-2004]

Peptan 2000 is great if you can find it, I use Peptan B 2000 (bovine).

 

Probably much below 2KDa is too small.

 

Thanks, they responded to my question on Amazon (bulksupplements) with the response: "The most recent batch that we have has the molecular weight of 1030."

 

I'm not sure what that means, do they mean 1030 daltons or do they mean 1030KDa

[aribadabar]

Collagen sups? Herbal anti-inflammatories? A useless waste of money in my experience.

 

I couldn't disagree more. Also, Ibuprofen should be last, not first, resort action.

 

Herbal anti-inflammatories such as Olive leaf extract, boswellia serrata, curcumin, raw garlic are solid choices for virtually any inflammatory condition that have proven themselves to work over the centuries in many cultures. I suspect you ran into low-quality supps which clouded your experience.

 

I agree that the yogic exercises do help with flexibility/core strength.

 

 

 

 but I'm not a fan of yoga, especially given my embarrassing case of essential tremor and classes are expensive

 

No need to attend any (paid) classes. There are plenty of free online resources to follow from home.

[BioFreak]

Does Boron play any role in cartilage regeneration? I read some sites that suggested that it does, but I also read a site that said "Boron is an effective treatment for 95% or more in the relief of arthritis" and I'm pretty sure that's not backed up by any studies.

I'm interested to hear any info anyone has about this. Thanks!

edit - this page says 69mg of Boron daily "caused symptom remission in 90 percent of arthritis patients studied including people with osteoarthritis, rheumatoid arthritis and juvenile arthritis." 69mg!!! Isn't a normal dose 3mg?

http://www.chiro.org...oint_Pain.shtml

The cited study is this one:
5. Newnham RE. Arthritis or skeletal fluorosis and boron. Int Clin Nutr Rev 1991;11:68-70.

 

I'm actually looking into boron now because:

1. It seems like there is an inverse relationship between boron consumption and arthritis (by country)
2. It may increase FREE testosterone by 30% (dose 6-10mg/day)
3. 64% less likely to get prostate cancer (but also seems to have an positive effect on lung cancer and leukemia)
4. Reviews (yea I know not the most reliable source) tend to favor boron for arthritis.
5. Boron seems to increase higher brain frequencies, while a lack of it seems to increase lower brain frequencies.

 

Sources:

http://www.ganzimmun.../?get_file=3384

1

Gröber, U. (2011). Mikronährstoff e. 3. Aufl age, Wissenschaftliche Verlagsgesellschaft Stuttgart.

2

Ferando A. A., Green N.R., Barnes K.W., Woodward B. (1993). Microwave digestion preperation and ICP determination of boron in

human plasma. Biol. Trace Elem. Res., 37, 17-25.

3

Nielsen F. H. (1990). Studies on the relationship between boron and magnesium which possibly aff ects the formation and mainte-

nance of bones. Magnes Trace Elem, 9, 61-69.

4

Nielsen F. H., Hunt C. D., Mullen L. M. et al. (1987). Eff ect of diatary boron on mineral, estrogen, and testosterone metabolism in

post-menopausal women. FASEB J., 1, 394-397.

5

Hegsted M., Keenan M. J., Siver F. et al. (1991). Eff ect of boron on vitamin D defi cient rats. Biol. Trace Elem. Res., 28, 243-255.

6

Travers R. L., Rennie G. C., Newnham R. E. (1990). Boron and arthritis: the result of a double-blind pilot study. J. Nutr. Med., 1, 127-132.

7

Hall I. H., Starnes C. O., McPhail A. T. et al. (1980). Anti-infl ammatory activity of amine cyano-boranes, amine carboxyboranes, and

related compounds. J. Pharm. Sci., 69, 1025-1029.

8

Hunt C. D., Idso J. P. (1999). Dietary boron as a physiological regulator of the normal infl ammatory response: A review and current

research progress. J. Trace Elem. Med., 12, 221-233.

9

Newnham R. E. (1994). Essentiality of boron for healthy bones and joints. Environ. Health Perspect., 102, 83-85.

10

Robert Koch-Institut: Heft 36 Prostataerkrankungen – Gesundheitsberichterstattung des Bundes.

11

Zhang Z.-F., Winton M. I., Rainey C. et al. (2001). Boron is associated with decreased risk of human prostate cancer. FASEB J., 15,

A1089.

12

Gallardo-Williams M. T., Maronpot R. R., King P. E. et al. (2002). Eff ects of boron supplementation on the morphology, PSA levels,

and proliferative activity of LNCaP tumors in nude mice. Proc. Amer. Assoc. Cancer Res., 43, 77.

13

Ghosh P., Sur B., Bag S. P. et al. (1999). A new boron compound (guanidine biboric acid adduct) as an antitumor agent against

Ehrlich ascites carcinoma in mice. Tumour Biol., 20, 44-51.

14

Dibas A., Howard J., Anwar S. et al. (2000). Borato-1,2-diaminocyclohexane platinum (II), a novel anti-tumor drug. Biochem. Bio-

phys. Res. Commun., 270, 383-386.

15

Nielsen F. H., Penland J. G. (1999). Boron supplementation of perimenopausal women aff ects boron metabolism and indices asso-

ciated with macromineral metabolism, hormonal status and immune function. J. Trace Elem. Exp. Med., 12, 251-261.

16

Bakken N. A., Hunt C. D. (2003). Dietary boron decrease peak pancreatic in situ insulin release in chicks and plasma insulin concen-

trations in rats regardless of vitamin D or magnesium status. J. Nutr., 133, 3577-3583.

17

Penland J. G. (1994). Dietary boron, brain function, and cognitive perfomrmance. Environ. Health Perspect., 102, 65-72.

Edited by BioFreak, 05 October 2016 - 01:49 PM.

[Nate-2004]

I would not trust a chiropractor site to convey any kind of legitimate science. I would highly doubt it if boron regrew cartilage much less relieved most of arthritis pain. They're having much more success lately with 3D printing and stem cells. 

[Globespy]

I would rather trust a chiropractic site disseminating this info as opposed to any legitimate allopathic medicine doctor, who have all been wonderfully trained (literally crafted and moulded by the pharma funded medical schools which have fundamentally changed the educational institution to produce '10-minute-consult-symptom-to-drug-conversion-experts') by the western medicine establishment to dismiss anything that doesn't involve getting another government/pharma approved drug addict in the books! You will find no answers to medical ailments your seek to actually resolve with these hypocrites of the great Hippocrates to which they still swear an oath to.
PS - any chance you could translate the important parts of that document, my German is very rusty. Was it 2g daily of boron, which was taken (and facilitated uselessness) with magnesium, calcium and vitamin D?
Thanks.

[Nate-2004]

Sorry, chiropractic is not science based medicine. It's pure placebo. I don't trust anything that does not base its recommendations or treatment on discoveries made through the scientific method, and ultimately robust, replicated and controlled study - especially on humans. Call me "ill informed" but I consider myself well informed in this area.

[BioFreak]

I would rather trust a chiropractic site disseminating this info as opposed to any legitimate allopathic medicine doctor, who have all been wonderfully trained (literally crafted and moulded by the pharma funded medical schools which have fundamentally changed the educational institution to produce '10-minute-consult-symptom-to-drug-conversion-experts') by the western medicine establishment to dismiss anything that doesn't involve getting another government/pharma approved drug addict in the books! You will find no answers to medical ailments your seek to actually resolve with these hypocrites of the great Hippocrates to which they still swear an oath to.
PS - any chance you could translate the important parts of that document, my German is very rusty. Was it 2g daily of boron, which was taken (and facilitated uselessness) with magnesium, calcium and vitamin D?
Thanks.

 

 

You mean the pdf or any of the other sources (which one)? I'm pretty sure the dosage range is in mg(like 10mg), not g. The pdf I've linked contains no dosage recommendations as far as I can see, the numbers are about blood levels.

 

I would not trust a chiropractor site to convey any kind of legitimate science. I would highly doubt it if boron regrew cartilage much less relieved most of arthritis pain. They're having much more success lately with 3D printing and stem cells. 

 

Ganzimmun is not a chiropractor, its a lab doing blood etc tests. And its a pretty good one, too. Their publications normally are of pretty high quality, thats why I trust in them this time too. Judging by your hasty assumption about it being a chiropractor site, I guess the rest you assume about boron is probably hasty too.

 

I've some boron on my way. I'm not sure if it really regenerates cartilage (I will see, I'll combine it with hydrolized collagen, glucosamine, which I've been taking a long time now). I'll be taking between 6-9mg.

 

Judging by the reviews I've seen on boron supplements however, at least the pain seems to be significantly reduced. I am intrigued by the low incidence of arthritis in countries with a high boron intake however...

[Nate-2004]

Chiro.org is a chiropractic site. That is what I'm referring to.

[Globespy]

Sorry, chiropractic is not science based medicine. It's pure placebo. I don't trust anything that does not base its recommendations or treatment on discoveries made through the scientific method, and ultimately robust, replicated and controlled study - especially on humans. Call me "ill informed" but I consider myself well informed in this area.

If you are aware of how 'modern' medications are brought to market you should realize the dichotomy and humor in your statement if you understand anything about 'science based medicine' as you put it.... Often the biggest challenge is in fact the placebo effect with many drugs and medications seeking FDA approval because of often very close/statistically insignificant results regarding active participants and placebo. A drug can be approved if >55% of the active group report positive (which in itself is ambiguous in nature) experiences as that's 'significant'. Pharma companies often 'bury' 75-90% of clinical trial results, only presenting the ones that favor their approval - the ones where the placebo participants were less significant.
If you're curious I've had keen insight with GSK for over 15 years (I won't expand any further on that so don't bother asking). It's truly all about money, but isn't everything?
BTW, the so-called 'placebo effect' is perhaps one of the most intriguing aspects of the human being. It's portrayed as this fake, powerless side factor - a nuisance in the progress of your 'science based medicine'. I think (it's a fact) the power of the human mind is potentially far greater than the effects of any drug with focused clarity and attention. I suspect you won't buy into that either, because it's difficult for some character types to get their brains around matters that are yet not very well understood, but as an example check out a strange little Dutchman called Wim Hof. (https://youtu.be/VaMjhwFE1Zw)
You might find it hard to believe (and ultimately you just won't), but if you take the time to listen and learn you will find that your sacred 'science based' medical approach was applied here in carefully controlled clinical settings identical to those used approved governing agencies, and they can't dispute the very fact that when neurotoxins were injected intravenously into this man's body, he manipulated his immune response to nullify what 'science based medicine' would have categorically guaranteed would have made any human very sick. And to take it further, after training a dozen random people in his method/approach they were all able to do the exact same thing, dispelling any 'freak of nature' theory's the very accomplished science based doctors and professors had postulated.
Or you can continue to keep your head in the sand (just a term, nothing personal) and put all your faith in an institution that does so much more harm than good. If science based medicine was so good, then why does it account for killing on average 300% (and rising) more Americans annually than every death from every illegal drug combined? Think about that. Every illicit drug death combined is only a third of the deaths caused by prescribed drugs. Yes, yes, more people take prescribed drugs than those taking illegal drugs, but does that make it justifiable? If you can't see something wrong here then I'm at a total loss......
Good day.

[Nate-2004]

I'm no fan of the FDA and its protection racket like effect and the progress stifling nature of its regulations and control that favor only the big pharmaceuticals who can afford their reticulum. That's not the issue. Science based medicine is still valid even if it's not applied very well in the mainstream. Just because the FDA enables and provides incentives for pursuing profit over results doesn't mean the scientific method or science based medicine is invalid, nor does it mean that suddenly quackery and so called "alternative medicine" is valid. As Tim Minchin put it, alternative medicine that works is simply called "medicine".

 

All the problems you cite are rooted in protectionism and the FDA, not science.

 

This is getting way off topic though.

 

As I said, stem cells and 3D printing will do a lot more than boron for regrowing cartilage.

Edited by Nate-2004, 05 October 2016 - 06:09 PM.

[Globespy]

Yes, a little off topic. Such is the internet.
BTW there are tens of millions who 100% believe in the benefits of chiropractic and there's enough empirical data to suggest that it has tangible value for many.
Let's just focus on cause and effect. If something helps an ailment then it works regardless of what popular belief is.
Science is man made with certain man made guidelines and practices that have and will continue to be challenged and changed over the years. It's a moving target that's only static as much as it's current understandings. In many ways it's in itself it's own placebo as theory's are disproven and seemingly rigid opinions changed.
Enjoy the rest of your day.

[sthira]

As I've written repeatedly ad nauseum, it depends where the cartilage tear or insult occurs. If the insult is vascular, then indie compounds might speed the body's own healing. But, like duh, if the injury don't get no blood flow then how on earth would "boron" or any other magic wave its wand?

And speaking of "3D printed scaffolds" and "stem cells" they've been working on sheep forever, and there's still no straight horizon. Millions of injured people must wait and wait and wait until orthopedic advances figure out how to make more money out of suffering people than they already do with joint replacements.

[Nate-2004]

And speaking of "3D printed scaffolds" and "stem cells" they've been working on sheep forever, and there's still no straight horizon. Millions of injured people must wait and wait and wait until orthopedic advances figure out how to make more money out of suffering people than they already do with joint replacements.

 

Is that what's holding them back? I can't quite figure out what the holdup is on all this new tech over the past several years. I've mainly blamed the FDA and the outrageous over hesitation of so called "bioethicists", the expensive and inaccessible monopoly tort system overrun with lawyers and other protection rackets like the patent system and license rackets.

Edited by Nate-2004, 05 October 2016 - 06:58 PM.

[zorba990]

As I've written repeatedly ad nauseum, it depends where the cartilage tear or insult occurs. If the insult is vascular, then indie compounds might speed the body's own healing. But, like duh, if the injury don't get no blood flow then how on earth would "boron" or any other magic wave its wand?

And speaking of "3D printed scaffolds" and "stem cells" they've been working on sheep forever, and there's still no straight horizon. Millions of injured people must wait and wait and wait until orthopedic advances figure out how to make more money out of suffering people than they already do with joint replacements.

How can any tissue in the body survive with no blood or lymph flow? ART, Voodoo floss, RRT all seem to work by breaking up scar tissue and improving blood flow, but a tissue with no nutrient flow at all is going to be necrotic unless I don't understand something.

Edited by zorba990, 05 October 2016 - 08:31 PM.

[aconita]

Joint cartilages are not innervate and have no blood supply but that doesn't mean they don't get growth factors or nutrients or that their cells are not subjected to apoptosis and regeneration, it is just much slower than other tissues therefore, especially in case of injury, more tricky to resolve.

 

By the way lets distinguish between an injury caused tear of cartilage like what Sthira unfortunately suffered from osteoarthritis which is a metabolic disease involving a slower rate of cartilage regeneration compared to the wear out leading to a deficit, while the former is unlikely to be solved by boron supplementation alone the latter might.

 

Rebuilding a destroyed tissue is a different task than normalizing a metabolic unbalance, of course.

[BioFreak]

Chiro.org is a chiropractic site. That is what I'm referring to.

 

Woops, my mistake. I was just quoting an earlier post on boron, didn't care about the links in it. Actually, I'm you on this one. Chiropractic may have some uses, but not nearly as much as the chiropractors think...

 

Anyways, some pubmed info:

 

Essentiality of boron for healthy bones and joints.

 

Since 1963, evidence has accumulated that suggests boron is a safe and effective treatment for some forms of arthritis. The initial evidence was that boron supplementation alleviated arthritic pain and discomfort of the author. This was followed by findings from numerous other observations epidemiologic and controlled animal and human experiments. These findings included a) analytical evidence of lower boron concentrations in femur heads, bones, and synovial fluid from people with arthritis than from those without this disorder; b) observation evidence that bones of patients using boron supplements are much harder to cut than those of patients not using supplements; c) epidemiologic evidence that in areas of the world where boron intakes usually are 1.0 mg or less/day the estimated incidence of arthritis ranges from 20 to 70%, whereas in areas of the world where boron intakes are usually 3 to 10 mg, the estimated incidence of arthritis ranges from 0 to 10%; d) experimental evidence that rats with induced arthritis benefit from orally or intraperitoneally administered boron; e) experimental evidence from a double-blind placebo-boron supplementation trial with 20 subjects with osteoarthritis. A significant favorable response to a 6 mg boron/day supplement was obtained; 50% of subjects receiving the supplement improved compared to only 10% receiving the placebo. The preceding data indicate that boron is an essential nutrient for healthy bones and joints, and that further research into the use of boron for the treatment or prevention of arthritis is warranted.

[BioFreak]

 

As I said, stem cells and 3D printing will do a lot more than boron for regrowing cartilage.

 

Its largely irrelevant for many because the treatment is not widely available(yet) and many won't be able to afford it. Also, it seems like Boron decrases the chances of developing arthritis in the first place, which is better then just getting every joint 3D cartilage printed whenever there is new cartilage degeneration. I for one want to prevent arthritis in the first place, and I doubt 3D printing, even if available, will be an option if they develop arthritis in a lot of joints... Then there is the problem of the changing bone structure with arthritis, which also would have to be corrected surgically. Which means, with your approach, people greatly affected by arthritis will be hoping to get a flatrate on op tables. My mother and Grandmother both have arthritis in virtually every joint in the body, now you really think that surgery is an option for this? Only for the worst affected joints or the ones that affect daily life the most. This still leaves all other affected joints with no progress.

 

Preventing arthritis and maximizing regeneration is key when it comes to arthritis, with 3D printing being a tool only for those instances where this is not enough.

 

I for one will do everything necessary to make my body repair itself and to keep it in its current form, with surgery only being a last resort.

[BioFreak]

Joint cartilages are not innervate and have no blood supply but that doesn't mean they don't get growth factors or nutrients or that their cells are not subjected to apoptosis and regeneration, it is just much slower than other tissues therefore, especially in case of injury, more tricky to resolve.

 

By the way lets distinguish between an injury caused tear of cartilage like what Sthira unfortunately suffered from osteoarthritis which is a metabolic disease involving a slower rate of cartilage regeneration compared to the wear out leading to a deficit, while the former is unlikely to be solved by boron supplementation alone the latter might.

 

Rebuilding a destroyed tissue is a different task than normalizing a metabolic unbalance, of course.

 

One could argue, however, that the injury was partly a result of cartilage that simply was not as strong as it could be, which would make boron an option for prevention of future cartilage damage, or decreasing it, if there is a new accident.

 

3d cartilage printing would be the best option for cartilage damage from injury, however. Still waiting for having that option for my patellas...

[ironfistx]

What do you all think about hyaluronic acid having adverse effects?

 

http://www.longecity...s-people-state/

[Rocket]

I have successfully use nandrolone deconate to recover from shoulder and elbow issues.  Yes, it's a steroid.  Otherwise I would try BPC157 except my only known source (P.S.) of real BPC157 seems like they have temporarily shut their doors.

[zorba990]

Manganese may be important also. Probably in concert with a full mineral supplement.

From http://www.dcnutriti...RecordNumber=80

"Manganese is needed in the production and repair of connective tissue, which includes bones, ligaments, tendons, and fascia. Its specific role is in the manufacture of mucopolysaccharides, which are one of the main components of all connective tissue. Experimentally it has been found that manganese deficiency may produce structural deformities in animals. The slipped tendon and perosis syndrome in chickens -in which bone deformity and ligamentous laxity are involved -has for some time been used as a rationale for manganese supplementation in humans with ligamentous and osseous problems.

The thyroid gland also requires manganese in order to produce thyroxin. Consequently, correction of a manganese deficiency is necessary for proper thyroid function. This is important in relation to musculoskeletal problems because lowered thyroid function may result in muscle aches, spasms, and weakness; In the case of severe hypothyroidism, the general musculature becomes hypertrophied due to infiltration of mucopolysaccharides. This situation has obvious implications in the patient's ability to maintain structural corrections. "

[Nate-2004]

Manganese is rich in most foods, mainly brown rice, which I eat plenty of and have been eating for a long time. I guarantee you it's not regenerating collagen or cartilage to any significant degree.

[pamojja]

Manganese is rich in most foods, mainly brown rice, which I eat plenty of and have been eating for a long time. I guarantee you it's not regenerating collagen or cartilage to any significant degree.

 

I would think twice before coming to such premature conclusions. That it's one of the elements needed doesn't imply that it would be in any way regenerating, if other codependent elements are still needed. I get about 10 mg manganese from diet, about 1.4 mg from supplements. UL is at 11 mg/d. But testing HTMA's for 6 years its been consistently at the lowest end of normal range. Each of us has a biochemical individuality, therefore from intake alone one can't exclude deficiency.

 

The same with boron, it's been all the time at the lowest end of normal range, while supplementing in average 6 mg/d all these years (no idea how much I get from diet).

 

Edited by pamojja, 06 October 2016 - 06:53 PM.

[zorba990]

Mineral content of your food sources may not be what you think:
https://www.scientif...nutrition-loss/
If you are having no health issues then perhaps your mineralization may be adequate.

[pamojja]

If you are having no health issues then perhaps your mineralization may be adequate.

 

If you meant me, I have serious health issues since 8 years (PAD). That's why I tested regularly and try to adjust supplementation carefully. And though meanwhile have only a limited number of lab parameters under control, still most debilitating symptom has improved greatly (intermittent claudication).
 

[zorba990]

If you are having no health issues then perhaps your mineralization may be adequate.

If you meant me, I have serious health issues since 8 years (PAD). That's why I tested regularly and try to adjust supplementation carefully. And though meanwhile have only a limited number of lab parameters under control, still most debilitating symptom has improved greatly (intermittent claudication).

From my perspective, You are doing the correct thing in considering biochemical individuality, massive de-mineralization of the soil for decades, and poor diet choices (grains) for livestock. Successful vets know this. Even pigs get tributyrin to counteract a garbage corn diet.

[sthira]

Nose cells could help repair damaged knee cartilage

http://www.medicalne...cles/313631.php

21 Oct 2016

In a small trial of 10 patients with damaged knee joints, doctors harvested cells from their noses to engineer new cartilage tissue and transplant it into their damaged knees. In a paper published in The Lancet, the Swiss team describes how 2 years after transplant, most of the patients had developed new tissue similar to normal cartilage and reported improvements in knee function, pain, and quality of life.

Every year, approximately 2 million people in Europe and the United States are diagnosed with damage to knee joints arising from injuries or accidents.
However, the authors point out that while the results of their phase I study are promising and show the approach is feasible and safe, there is still a long way to go before such a procedure can be approved for routine use with patients.

They note that the observational study only involved a small number of patients, there was no control group, and the follow-up was quite short.

There now needs to be randomized trials - with longer follow-up - that compare the promising treatment with conventional alternatives.

Lead author Ivan Martin, professor of tissue engineering at the University of Basel and University Hospital Basel in Switzerland, adds:

"Moreover, in order to extend the potential use of this technique to older people or those with degenerative cartilage pathologies like osteoarthritis, a lot more fundamental and pre-clinical research work needs to be done."

Study unique for using nose cells to repair knee damage

About 2 million people in Europe and the United States are diagnosed with damage to knee joint cartilage every year, caused by injury or accident.

Joint or articular cartilage is the layer of smooth tissue at the ends of bones that eases movement, and protects and cushions the surfaces of the joint where the bones meet.

As this tissue has no blood supply, if it gets damaged it cannot regenerate. Eventually, as the cartilage wears away, the bones become exposed and inflamed from rubbing against each other, leading to painful joint conditions like osteoarthritis.

There are medical techniques - such as microfracture surgery - that can prevent or delay the onset of cartilage degeneration following injury or accident, but they do not regenerate healthy cartilage to protect the joints.

There have also been attempts to use cartilage cells or chondrocytes from the patients' own joints to make new cartilage in the joint, but these have not been very successful at creating the right structure and function of the cushioning tissue.

One of the unique features of the new study is that Prof. Martin and colleagues used chondrocytes harvested from a site far away from the damaged joint - from the patients' nasal septum. These cells have a unique ability to grow new cartilage tissue.

New tissue of similar composition to cartilage

For the study, the team enrolled 10 patients (age 18-55) with full-thickness cartilage damage to the knee and took a biopsy from their nasal septum under local anesthetic. They grew chondrocytes harvested from the biopsy tissue by stimulating them with growth factor for 2 weeks.

The team then took the cultured new cells and seeded them onto "scaffolding" made of collagen and grew them for another 2 weeks. The result was a 2-millimeter thick graft of new cartilage measuring about 30-40 millimeters.

Each patient then underwent surgery where the damaged knee cartilage was removed and replaced with their own cultured graft cut into the appropriate shape.

After 2 years, scans showed new tissue of similar composition to cartilage had grown at the affected sites.

Nine of the 10 patients - one was excluded because of sports injuries not related to the trial - also reported significant improvements in the use and function of their knee and reduction in pain, compared with pre-surgery.

The authors note there were no reports of adverse reactions to the surgery, although there were two reports of injuries not related to the procedure.

Patient age does not appear to affect success

In an accompanying comment article, Dr. Nicole Rotter, from Ulm University Medical Center, and Dr. Rolf Brenner, from the University of Ulm - both in Germany - say the trial "represents an important advance towards less invasive, cell-based repair technologies for articular cartilage defects."

The main reason they give is that the cells were not taken from healthy tissue near the site of injury but from a completely unaffected part of the body, which avoids the risk of harvesting affecting the damaged joint.

They also mention the promising result that patient age does not appear to affect the success of the procedure.

However, like the trial authors, they conclude that only longer-term randomized, controlled trials - that among other things test the quality of the repair tissue - will be needed before we can say whether this approach is likely to gain regulatory approval and reach clinical use.

"Our findings confirm the safety and feasibility of cartilage grafts engineered from nasal cells to repair damaged knee cartilage. But use of this procedure in everyday clinical practice is still a long way off as it requires rigorous assessment of efficacy in larger groups of patients and the development of manufacturing strategies to ensure cost effectiveness."

Prof. Ivan Martin

References

Nasal chondrocyte-based engineered autologous cartilage tissue for repair of articular cartilage defects: an observational first-in-human trial, Marcus Mumme et al., The Lancet, doi:10.1016/S0140-6736(16)31658-0, published online 21 October 2016, abstract.

Editorial: Cartilage repair across germ layer origins, Nicole Rotter and Rolf E Brenner, The Lancet, doi:10.1016/S0140-6736(16)31892-X, published online 21 October 2016, extract.