Rocky S. Tuan, Ph.D. Receives Grant to Evaluate Bones in Space
Rocky S. Tuan, Ph.D., Cellular and Molecular Engineering Lab and Distinguished Professor in the Department of Orthopaedic Surgery at the University of Pittsburgh School of Medicine, has received a research grant from the Center for the Advancement of Science in Space (CASIS). This award will enable him to continue his work on a 3D microphysiological system (MPS) to be conducted on board the International Space Station (ISS) to evaluate the accelerated aging and degeneration process of bones that occurs in space.
Dr. Tuan is also Associate Director of Pitt’s McGowan Institute for Regenerative Medicine and Director of the Center for Military Medicine Research. Asked how he envisions this work unfolding, Dr. Tuan told OTW, “A critical requirement for effective modification or treatment of the well known microgravity-related bone loss during space travel is to understand the underlying cause. Note that the relationship between ‘gravity’ and ‘bone’ is not just a space travel phenomenon, in that long-term bed-rest leading to bone loss, for example, has been long been known. Whether the two events are mechanistically similar is however not known.”
“Further understanding of the mechanism clearly requires enough study subjects, something that the space travel environment simply cannot accommodate, as there can only a few astronauts on each space mission.”
“The International Space Station offers a tremendous opportunity, as it is now designated as a U.S. National Laboratory. What is needed is therefore a way of replicating human skeletal tissue as microphysiological systems that may be produced in large number of identical units and be maintained or cultured in space. In this manner, the scientists on board the ISS will be able to study the development of the disease and also test candidate therapeutic drugs to halt the bone loss. (Note: There are currently drugs for bone loss, for example for the treatment of osteoporosis; however, whether these drugs will be effective for microgravity bone loss is completely unknown.)”
“We have successfully produced, based on live cell 3D printing technology developed in our lab, micro-osteochondral tissues that resemble a biopsy sample from a joint, say the knee joint, containing a living piece of cartilage attached to bone, all developed from human adult stem cells. This engineered tissue functions similarly to the native human tissue. This is the system we will be developing and refining further to make it implementable for study on the ISS.”
“We believe that once implemented in the ISS, our micro tissue will develop ‘symptoms’ similar to the bone loss observed in humans during space travel. Our system will be built to allow a certain degree of live monitoring, which will provide key readouts relevant to the “disease condition.’ This capability will allow the scientists to start testing for the effectiveness of candidate drugs. Even more importantly, we believe the utility of the system goes beyond treating bone loss during space travel. As the bone loss develops rapidly in the micro tissue during exposure to microgravity, what we will have essentially is a large cohort of ‘micro-patients’ suffering from ‘osteoporosis-like’ symptoms, thus presenting a ‘patient base’ to do drug screening. The findings will therefore be directly relevant to drug development for humans on Earth, with significant relevance to medical research.”
The announcement of the award, which is part of the 3D Microphysical Systems for Organs-On-Chips Grand Challenge by CASIS, was recently made at the White House Organ Summit.
Study: Age, Sex Matters in Hip Impingement Outcomes
Research from Midwest Orthopaedics at Rush (MOR) has found that while both male and female patients fared well following arthroscopic surgery for hip impingement, the outcomes did vary depending on a patient’s age and sex.
Specifically, for patients under 45, femoroacetabular impingement (FAI), the results were better and there were fewer complications than in those cases where patients were over 45. Female patients older than 45 had lower outcome scores than their male counterparts.
The study, co-authored by Drs. Shane Nho and Charles Bush-Joseph, hip, shoulder and knee physicians at Midwest Orthopaedics at Rush, examined 150 male and female patients of varying ages who underwent hip arthroscopy to treat FAI, a condition in which the ball and socket of the hips are misshapen.
Dr. Nho told OTW, “Hip arthroscopy is a powerful tool to treat intra-articular hip labral tears and femoroacetabular impingement (FAI). We know that in the best patients that hip arthroscopy can eliminate pain, improve function, and allow many patients to return to sports and other recreational activities. We also know that hip arthroscopy may not be effective for everyone and choosing the right patient is important for a predictable outcome.”
“Over the past decade, we have observed that some patients do extremely well and others improve but may not as much as our best patients. We learned that younger patients regardless of sex do exceedingly well after hip arthroscopy. We also found that our older patients (> 45 yrs) did improve after surgery but not as much as the younger group. It is this group that we need to understand why their outcome is less predictable.”
“Patient selection is important as well as managing patient expectation on the level of pain relief and improvement in their overall function after surgery. My goal is to educate the patients about their disease and provide the best information so that the patients can be equipped to make an educated decision.”
“Hip arthroscopy is evolving very quickly and what is being performed today was not done a few years ago. As our techniques improve as well as our instrumentation, our outcomes have been better and more predictable. There are some orthopedic surgeons that believe that the procedure is only effective for young male athletes. Our study shows that females do equally as well as males especially in the patients under 45 years old. Also, our patients over 45 years still benefit from surgery, but they do not perform as well as our younger patients and likely related to early osteoarthritis or bone density.”
Mild Knee OA? Get Intensive in the Pool
Limping, aching with knee osteoarthritis (OA)? Well, if you are a postmenopausal woman with mild knee OA, a new study from Finland says to head to the pool.
The research, conducted at the Department of Health Sciences at the University of Jyväskylä, indicated that these women are good candidates for intensive aquatic resistance training. Authors Matti Munukka and Benjamin Waller told OTW, “We recruited 87 volunteer women from 60 to 68 years of age with mild knee OA, and randomly assigned them to either a training group or a control group. Those in the former group participated in one hour of intensive lower-limb aquatic resistance training three times a week for four months. The control group was told to maintain their status quo. Despite the intense nature of the training, with over 400 to 500 repetitions per session, we observed a high compliance rate.”
The authors told OTW, “Clinically useable and safe interventions that prevent the progression of knee OA, in terms of both maintaining physical functioning and reversing degeneration of articular cartilage is a vital. Our research indicates that aquatic exercise, in the form of high intensity aquatic resistance training, has a potential role in the management of early and mild knee OA. The health benefits, i.e., improved cardiovascular fitness, in combination with the significant improvements in the biochemical composition of cartilage, as measured with two innovative qMRI [quantitative parametric] techniques, suggest therapeutic possibilities. The high adherence and low harms are major factors in favor of aquatic resistance training over pharmaceutical or surgical options.”
