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Stem Cell Therapy for Fragile Bone Disease| Dr. David Greene Arizona

Osteogenesis imperfecta, often known as brittle bone disease, is a hereditary condition that manifests as weak, easily fractured bones before birth. It is caused by a genetic mutation in the genes coding for collagen produced by bone-forming cells (osteoblasts). Collagen is essential for the development of bones and skin; therefore, the presence of a mutation results in aberrant or inadequate collagen, which lowers bone mass and strength.

During development, unspecialized cells (stem cells) assist in the formation of the body. In response to stimuli from the microenvironment, stem cells migrate and differentiate into various cell types with varying functions, creating organs and tissues. Most of our organs still have a modest number of stem cells, which are utilized in later life to treat acute injury-related tissue damage and restore organ function. The building blocks of the body also include these cells. Researchers like Dr. David Greene Arizona have investigated using endogenous stem cells to treat various diseases, including genetic disorders where organ function is reduced due to a genetic mutation.

Stem cells as a  therapeutic treatment 

Human mesenchymal stem cells (MSCs) can be found in tissues with a mesenchymal/stromal origin, like bone marrow. At various stages of pregnancy, it has also been discovered that other organs can create stem cells that resemble bone marrow MSCs. Fetal MSCs, sometimes referred to as human fetal MSCs (hfMSCs), are more capable of tissue repair than adult MSCs and have several benefits, including quicker cell division. Additionally, MSCs from healthy donors can be isolated, multiplied in vitro, and frozen at very low temperatures. Using their ability to differentiate into multiple cell lineages, MSCs can be stored and used for clinical purposes in regenerative medicine.

It has been suggested that the implantation of healthy osteoblasts during a formative period for the bones (fetus or birth) might strengthen them. This is so because osteoblasts' inability to produce enough or the right kind of collagen results in osteogenesis imperfecta, which causes bone fragility. Dr. David Greene Orthopedic Surgeon study, however, has shown that stem cell transplantation is superior to osteoblast transplantation since, once formed, cells lose their ability to move out and engraft into multiple body parts. So it has been recommended to transplant hfMSC during infancy instead (pre-or post-natal). This has several advantages. First, the disease has not yet progressed to the point where injury to the bones indicates it has occurred, as the skeleton will continue to develop for several years following the injection of healthy cells. Second, fewer cells are required for transplantation when the recipient is smaller. Finally, transplantation can occur when the immune system is still growing and won't reject the given cells.

The future of personalized medicine 

Another advanced option for treating osteogenesis imperfecta is the ability to repair genetic mutations by cutting out specific sections of DNA with genetic scissors. Then, patients' somatic cells are extracted from their urine, rejuvenated in vitro to become pluripotent, genetically altered to eliminate the osteogenesis imperfecta mutation-causing gene, and differentiated into iMSCs before being transplanted. This makes it possible to produce individualized stem cell therapy. In addition, an approach like this demonstrates the advantages of standardized care.

Fewer donor MSCs engraft in bones than expected. According to studies on the mechanisms of action of donor MSCs by specialists like Dr. David Greene Arizona, these cells may develop into osteoblasts. Still, it is highly unlikely that this is the only thing they do to help produce the healthy bone extracellular matrix. Instead, the evidence suggests that donor MSCs enhance the skeleton's quality by changing the host osteoblasts' behavior. Even though the creation of aberrant collagen is the main consequence of the mutation causing osteogenesis imperfecta, osteoblasts develop malfunction and cannot differentiate into mature osteoblasts properly. Immature osteoblasts produce excessively high quantities of elements that further weaken the bone extracellular matrix by providing strength to the organic matrix consisting of collagen fibers. We have shown that the development of host osteoblasts by donor MSCs enhances the strength and quality of the bone extracellular matrix.

These techniques could deliver specific treatments to improve bone health for various skeletal dysplasias.

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