Can Torn Cartilage Be Healed?

Arthritis is one of the most common of all disease of the joints and a primary cause of chronic pain and disability worldwide. Associate Professor (PD) Dr. Eva Johanna Kubosch of the Freiburg University Medical Center has received the "Sabine von Kleist Award" for her postdoctoral thesis. "I investigated the influence inflammation has on the degeneration of cartilage and if stem cells harvested from the mucosa of the joints have a positive effect on the metabolic balance within the joint," explains Kubosch. The aim of Kubosch's work was to improve methods of regenerating cartilage. Since 2014, the Equal Opportunity Office of the Faculty of Medicine of the University of Freiburg has been presenting the 10 thousand-euro von Kleist award to junior women researchers. The award is named for Prof. Dr. Sabine von Kleist, who was Chair of Immunobiology at the University of Freiburg and from 1987 to 1989 was the first woman to hold the offices of assistant dean and dean of the Faculty of Medicine.

Kubosch assessed how successful a biologically-based operative procedure using stem cells was in rebuilding damaged ankle cartilage. Known as matrix-induced chondrogenesis, the procedure was found to be a safe and promising therapy for treating ankle injuries. "The clinical results and data from magnetic resonance tomography confirm this," says the Freiburg-based doctor. What is more, she added, it also proved to be effective in relieving pain. Kubosch went further to illuminate the influence inflammatory mediators – substances in the body that trigger or maintain inflammation within the joint – have on the degeneration of cartilage. To do this, she transferred the findings from an analysis of patients suffering from acute, bacterial inflammation to a three-dimensional tissue model for joint infections. "This made it possible to demonstrate that cartilage cells have an anti-inflammatory effect which is accompanied by an increased ability to resist infections and showed a higher proportion of vital stem cells in the joint mucosa," Kubosch elaborates. She continues, "When joints are inflamed, it frequently triggers a vicious cycle. The cartilage is damaged, the anti-inflammatory effect of the cartilage cells is reduced, and the destruction of the joint progresses.

These results produced the further question of whether "joint-like" stem cells could also play a decisive role in maintaining the metabolic balance within the joint. To find out, Kubosch examined stem cells of the joint mucosa and discovered that "these stem cells show great potential for cartilage formation and are possibly therefore better suited for cartilage regeneration than differentiated cells of human joint cartilage." "Further studies must now show how much of a positive effect stem cells can have on existing joint damage and to what degree they are suitable for cell-based regeneration of cartilage," says Kubosch.

PD Dr. Eva Johanna Kubosch studied medicine at the Universities of Göttingen and Freiburg. She received her doctorate from the University of Freiburg under the supervision of Prof. Dr. Norbert Südkamp and Prof. Dr. Philipp Niemeyer. Since 2010, Kubosch has been working in the Department of Orthopedics and Trauma Surgery, where she became a specialist in 2016. In October 2018, she qualified to teach orthopedics and trauma surgery at the university.

Original publication:
Kubosch, Eva Johanna (2018): "Der Einfluss proinflammatorischer Zytokine auf die Knorpeldegradation: Die Rolle von Synoviozyten für die Gelenkhomöostase und mögliche Ansätze für das Knorpel Tissue Engineering." ("The Influence of Pro-inflammatory Cytokines on the Cartilage Degradation: The Role of Synoviocytes in Joint Homeostasis and Possible Approaches for Cartilage Tissue Engineering") Freiburg.