How researchers in Vail are pursuing breakthroughs to help injuries heal faster and some day slow down the way … – The Denver Post
By JoanneRUSSELL25
VAIL Hallways at the world-famous Steadman Clinic are lined with framed, autographed jerseys of star athletes who have had surgery here, including John Elway, Mario Lemieux and Alex Rodriguez.
The clinic and its associated Steadman Philippon Research Institute (SPRI) attract world-class talent from all fields including U2 drummer Larry Mullen Jr., who joined the institutes board after he was a patient here but perhaps its top recruit was a renowned scientist researching ways to help injuries heal faster and slow down the way our bodies age.
Were trying to develop the iPhone 9 of medicine, said Dr. Johnny Huard, chief scientific officer and director of the institutes Center for Regenerative Sports Medicine. Your iPhone 6 and 7 are great, its doing everything you want, but youre looking on the web at what the iPhone 8s going to do. We want to have surgeons here doing surgery on our best football, hockey, basketball players, and instead of losing a year to heal, can we heal them in six months? Three months? Would that be great?
Joe Amon, The Denver Post
The field is called biologics, and its transforming orthopedics by using cells that heal produced in the patients body in concentrated injections that can hasten tissue repair directly at the site of the injury. Huard is leading cutting-edge research into stem cells and platelet-rich plasma (PRP) therapy that he believes will some day delay age-related diseases and cut the recovery time from serious injuries, such as to the knee, in half.
Stem cells are undifferentiated cells that can become specialized cells muscle, bone, cartilage to help repair tissue. Platelets carry proteins that help in the healing process. The breakthroughs Huard and his colleagues are pursuing hold exciting promise for weekend warriors as well as for star athletes.
I dont think we can reverse aging, but I think we can age better and recover from injury better, said Dr. Marc Philippon, managing partner of the Steadman Clinic and co-chairman of the research institute. As a surgeon my biggest challenge is, if I cut on you theres always that healing phase. We want to recover faster. But the most important thing is prevention of injury. If your cells are aging better, youll have less injury. The way I look at it, thats going to put us out of business, but thats OK. Its a good way to go out of business.
A world-class scientist, Huard discovered muscle-derived stem cells in 1998. Before joining SPRI two years ago he was the director of the Stem Cell Research Center at the University of Pittsburgh.Researchers here believe injections of stem cells and PRP can help delay or prevent the need for joint replacements, and at the adjacent clinic they can test their theories in clinical trials. They have shown in animal studies that young stem cells can rejuvenate old stem cells.
To that end Huard advocates passionately that when a child is born, stem cells from the umbilical cord should be harvested and frozen at minus-80 degrees Fahrenheit. As bodies age, stem cells diminish in number and vitality, but they can be preserved in suspended animation while frozen. Those cells later can be thawed and reintroduced into the body as younger and more robust stem cells than the ones that have aged in the patient, performing like a fountain of youth.
Thats the best gift you can give to that baby, said Huard, a French Canadian with a playful wit. Its the best gift you can give to that mother, too, because that (umbilical cord) is part of her, too. Its not only part of the baby. Can you believe the impact of that?
Stem cells, aging and exercise
Because stem cells can develop into every cell type in the body, researchers believe they can be used to hasten repair of nerves, bone and muscle. Bone marrow transplants are the most common form of stem cell therapy currently in use, but stem cells may be useful in fighting neurodegenerative diseases and other conditions.
We can use them to repair bone, cartilage, the heart, the bladder, Huard said. We have clinical trials now ongoing for bladder and the heart.
Imagine a Broncos running back blowing out his anterior cruciate ligament in training camp but being able to return to the field during the regular season. Huardforesees that day, as well as a time when patients whose stem cells were harvested and stored at birth will be able to have them injected into their knees decades later after ACL repair, for example, which theoretically could allow the person to recover much faster.
If I harvest stem cells from your muscle today, lets say I find 100 stem cells, but if I do the same thing 30 years ago I may have gotten 10,000, Huard said. Not only that, but the 100 stem cells you have are tired. They have been dividing and trying to repair your muscle.
When one of Huards children was born 17 years ago and it came time for Huard to cut the umbilical cord, he asked the nurse what they were going to do with it.
My wife said, Can you stop being a scientist and be my husband for a minute here? Huard tells the story with amusement, but he is passionate that umbilical cord stem cells should be saved.
I tell people, No more flowers, just freeze the stem cells from that newborn, Huard said. Thats the best gift you can give to that kid.
In the meantime, Huard believes exercise remains the best anti-aging mitigation we have. Beyond the benefits already well known, he is convinced exercise increases the production of stem cells and delays the aging process.Researchers found that mice that run on treadmills heal significantly faster than sedentary mice. Mice who exercised also had a better survival rate after being injected with cancer cells than those that were sedentary.
Huardbelieves exercise helps the brain as well as the heart in ways that might not be fully understood but might have implications for the prevention or delay of dementia and Alzheimers.
Stem cells come from blood vessels, Huard said. What can we do to increase the number of blood vessels? If we can do that, then we can probably improve tissue repair. If you exercise, you increase the number of blood vessels in your tissues.
Platelet-rich plasma therapy
PRP therapy is already in widespread use, not just in elite athletes but in recreational athletes as well. Sometimes it works well, and sometimes it doesnt work at all. Huard is trying to find out why.
Platelets in the blood carry proteins called growth factors that help the body repair injured tissue. In PRP therapy, a patients blood is removed and spun in an centrifuge or filtered to separate platelets. Then the platelet-rich plasma is injected into the site of an injury with hopes of speeding the healing process.
When you injure something, you bleed, Philippon said in his office with a view of Vails ski trails. Some of the first elements going there are your platelets, and theres a reason for that. Platelets have the growth factors, also what we call the chemotactic factors, to attract whats needed (to heal).
Philippon has used PRP to hasten healing of hip tendons in football players, for example.
What we found was that those I injected with PRP early recovered faster, Philippon said. We have that data here. We know, for a tendon injury, PRP is a great therapy.
Huard had elbow surgery last year after snapping a tendon off the bone in a ski accident I like to go fast, he said with a grin and Steadman surgeon Peter Millett asked Huard if he wanted a PRP injection in hopes of hastening recovery.
I said, Of course! You know what? I never wore a sling, Huard said. The week after, I was running. Three weeks after, I was back skiing.
But did the PRP help?
I dont know, Huard said.
So Huard is studying the success rate of PRP therapy in patients who receive it after surgery at the Steadman Clinic. When Philippon uses PRP on a patient, for example, he will set aside a fraction of that PRP and give it to Huard to analyze in the lab. Huard will catalog the different growth factors in each sample and then wait to see how the patients respond.
After this Im going to go back to Marc and say: Which patient worked? Which one was your best patient? Huard said. If he tells me patient No. 24 and 32 and 48, Im going to go back and try to see what those three patients PRP had in common in terms of growth factors.
Then Huard will be able to better advise surgeons before using PRP.
Lets say we find when IGF1 (insulin growth factor one) is high in your blood, PRP always works, Huard said. You know what Im going to give to those surgeons? Im going to say, Before you give PRP, take a blood draw, we go in the lab, test for IGF1, and if IGF1 is high, 95 percent chance PRP is going to help. But another patient, if IGF1 is not high, Based on our tests, I dont think PRP is going to help.
Another thing we found in PRP, it is a mixed bag. You have good things in PRP but you have bad things, too. So were doing science where Im going to take PRP, Im going to take out the bad guys.
As with stem cells, Huard foresees a day when a young patients PRP can be frozen and used decades later to delay aging, administered in conjunction with stem cell injections to work in synergy.
I think the two can be combined somehow, Huard said. They are different, but the stem-cell therapy and the PRP somehow can be together. If I have your PRP from 20 years ago and I have your stem cells from 20 years ago, I can make a very nice mixture, inject this into you. Sometimes adding one thing to another, biologically, it equals not two but three.
Having his laboratory in the same building as the Steadman Clinic, which has eight surgeons on staff, is a boon for Huard in his research. He takes ideas to them and vice versa.
I dont do science just to do science, he said. I do science to improve quality of life, and I think I can make a major contribution in the field. If you delay aging by 10 years, you delay all those age-related disorders by 10 years. The implications for health care is amazing.
Biologics: Using tools produced by a patients body such as stem cells and platelet-rich plasma (PRP) to help the patient heal faster and better.
Regenerative medicine: This and tissue engineering are promising treatment approaches that can enhance or promote musculoskeletal tissue healing and regeneration following surgery or injection therapy. Biological treatments such as growth factor supplementation, PRP and bone marrow concentrate have been shown to improve patient function and quality of life.
Platelet-rich plasma: A biologic treatment that is produced by concentrating the patients own blood to yield a high platelet count. Platelets are important blood components that secrete hundreds to thousands of biological factors that initiate musculoskeletal tissue healing and regeneration.
Stem cells: Stem cells have the ability to transform into specific musculoskeletal tissue cells. These types of cells also secrete biological factors that initiate musculoskeletal tissue healing and regeneration. There are several forms of stem cells, such as muscle-derived stem cells, bone marrow-derived stem cells, adipose-derived stem cells and others.
John Meyer, The Denver Post
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