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A
cooperative research project between Calvin College and the Spectrum Health Flow
Cytometry Laboratory has confirmed the benefits of a drug used to treat osteoarthritis,
a degenerative disease that affects 90% of people over the age of 65.
Calvin biology
professor David DeHeer and 2001 Calvin graduate Kyle Sheehan have spent
the last three years researching the reasons why a substance called
hyaluronic acid helps relieve the pain of osteoarthritis in people who
are not helped by such typical anti-inflammatories as ibuprofen. Hyaluronic
acid is injected right into the joint, typically the knee joint, in
a physician's office and usually given once a week for five weeks. Its
benefits, reduced pain and inflamation, last anywhere from six to nine
months.
But
some physicians and researchers have doubted the worth of hyaluronic acid, which
has been used in Europe to treat osteoarthritis since 1987. It's been called "goo,"
in not all-together flattering terms by some researchers. And DeHeer himself admits:
"It's a long, simple, rather unexciting molecule. It's basically repeating
sugar units."
But, despite its
simplicity, what DeHeer and Sheehan discovered over the last three years
is that hyaluronic acid, a natural chemical found in the body in particularly
high amounts in joint tissue, is an incredibly effective anti-inflammatory
agent in and around the human knee joint (and non-human joints too as
evidenced by years of use on race horses).
This
summer they are reporting their findings in papers for three different medical
journals, including the Journal of Biological Chemistry and the Journal of Orthopaedic
Research. What
they'll describe in those papers is their conclusion and how they got to it. Their
conclusion is simple: hyaluronic acid works. But there's more to how it works
than meets the eye. The drug is injected into the synovial sac, which protects
the joint and also secretes the synovial fluid, which oils the joint. But the
half life of the acid is 24 hours, so after about a week the typical injection
of two millilitres has disappeared. Yet it continues to work. What DeHeer and
Sheehan hoped to figure out was how. What they discovered is that the acid, before
it disappears, interacts with a cell called a macrophage. Macrophages produce
inflammation. "Hyaluronic
acid," says Sheehan, "basically tells the macrophages to be quiet, calm
down, to die. Fewer macrophages means less inflammation." In fact Sheehan
and DeHeer found that hyaluronic acid will eliminate about 99% of the macrophage
cells. In patients this could contribute to a significant reduction in inflammation
and pain.
Their work was
done, says DeHeer, at a very basic scientific level. They grew macrophage
cell cultures. And they studied the impact of clinical preparations
of hyaluronic acid, which they purchased from the two major manufacturers,
on those cell cultures, using a sophisticated piece of equipment at
Spectrum Health called a flow cytometer. The results, they say, were
dramatic. Macrophage cell cultures treated with the acid were decimated.
Those not treated thrived.
"The
result," says DeHeer, "is that macrophage cells behave like they do
in a person without osteoarthritis. There are lots of big molecules of hyaluronic
acid, but hardly any macrophage cells. Thus a reduction in inflammation and a
reduction in pain. This 'unexciting' molecule has a very exciting role in the
knee joint." |