In 1976, Alan Grodzinsky ’71, ScD ’74, was feeling a little frustrated. 

He had spent two years teaching a basic course on semiconductor physics and circuits in MIT’s Department of Electrical Engineering and Computer Science, learning the material in the fast-moving field as he went along. That didn’t leave him any time for research. Then a golden opportunity arose.

With the help of the late Irving London, founder of the Harvard-MIT Program in Health Sciences and Technology, Grodzinsky won a sabbatical at Boston Children’s Hospital under the mentorship of the late Mel Glimcher, chief of orthopedic surgery and a pioneering researcher on the biology of human bones and collagen.

Glimcher wanted to start a research project on cartilage, the tough matrix of fibers that lines the joints, and on osteoarthritis, the chronic, painful disease that breaks that cartilage down.

It was a perfect fit for the 29-year-old Grodzinsky, who had earned his ScD studying the electrical properties of collagen, one of the constituents of cartilage. By year’s end, he was on the path he has followed ever since: trying to find effective treatments for osteoarthritis, the leading cause of chronic pain and disability around the world. It affects more than 30 million Americans, and hundreds of millions globally.

“It’s a huge financial burden and disability burden. And while it’s not fatal, it certainly contributes to loss of quality of life,” says Joseph Buckwalter, an orthopedic surgeon and osteoarthritis expert based in Iowa, who has known Grodzinsky for decades. “The costs of total joint replacements, mainly knees and hips, is one of our major health expenditures.”

No plan for pain

The US Food and Drug Administration has not approved any disease-modifying medications for osteoarthritis—drugs that treat the underlying condition rather than just the symptoms. The most sufferers can hope for, Grodzinsky says, are pain relievers like Motrin, occasional injections of steroids, and eventually joint replacement surgery. More than a million knee and hip replacements are done in the US each year, and the number is expected to soar as the population ages.

While older people are most susceptible to osteoarthritis, Grodzinsky has focused much of his research on younger people, particularly female athletes, who often develop the condition after knee injuries.

Tens of thousands of young women suffer injuries to the anterior cruciate ligaments of their knees each year. “When I teach my course at MIT related to biomechanics,” Grodzinsky says, “I ask about ACL injuries, and just as many hands go up today as in the past. I taught a Harvard Medical School course recently, and of the 20 students in the class, four women had suffered ACL tears, and one was on her third surgery.”

Doctors can fix these tears, he says, but both men and women who suffer joint injuries are still at high risk of developing osteoarthritis in subsequent years. And while knee replacements can counteract the effects of osteoarthritis, doctors are reluctant to perform such surgery on younger people because it will probably need to be repeated after the first artificial joint wears out.

A knee implant can last years, says Buckwalter, but “I would have nightmares doing it in someone under 40, because the odds are almost overwhelming that they’ll need another one.”

Nanoparticle Rx

Researchers have identified existing drugs that might alleviate the onset of osteoarthritis, but they are hampered by the fact that cartilage does not have a natural blood supply, Grodzinsky says. When doctors inject a steroid in the knee joint to reduce inflammation, the body clears most of the medication before it can get into the cartilage.

To tackle this problem, his lab has pioneered research involving nanoparticles, human cadaver knees, and even missions to the International Space Station.

Read More

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By: Mark Roth
Title: Looking to space to cure osteoarthritis
Sourced From: www.technologyreview.com/2021/10/26/1036739/looking-to-space-to-cure-osteoarthritis/
Published Date: Wed, 27 Oct 2021 00:00:00 +0000

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