Joe-Henry Schulte

Joe-Henry Schulte

Orthobiologics can be nature’s healing agents

Orthobiologics are biological agents that stimulate healing when standard therapies don’t work. Examples are osseous hollow fillers, extracellular matrix (ECM) substances, bone morphogenetic protein-2 (BMP-2), bone marrow aspirate (BMA), bone marrow aspirate concentrate (BMAC), mesenchymal stem cells (MSCs), and platelet-rich plasma (PRP) — platelets spun from a patient’s blood that promote cell repair—,that have shown potential for tissue regeneration.

“Cells and growth factors that act as healing agents are taken from a person’s own blood, manufactured, and given back to them. The American Orthopaedic Society for Sports Medicine reports that 66% of orthopedic surgeons are using platelet-rich plasma in their practice, and 70% of those physicians say they are increasing the use to complement standard care.”

Gold Induced Cytokines (GOLDIC®) is a is a novel technology involving the in vitro pre-conditioning of autologous patient whole blood with designed gold particles to induce autologous protein production. The development of this method to produce a conditioned serum rich in anti-inflammatory cytokines has proven to be very effective by enhancing the intrinsic regenerative capacity of the host plasma components. Gold compounds have been used for quite a long time in the treatment of different inflammatory disorders, especially in rheumatology. The specialized gold particles, derived from the gold compound aurothiomalate, have been shown to inhibit the production of nitric oxide (NO) from chondrocytes. Nitric oxide mediates the destructive effects of interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-a), which include reduced collagen and proteoglycan production, apoptosis of chondrocytes and stimulation of matrix metalloproteinases.

In vitro studies have shown that incubation with gold particles inhibits catabolic factors, increases anti-catabolic and anabolic factors, and increases the level of gelsolin (GSN), which is a key protein in cellular metabolism. The exact mode of action of this procedure is not well understood, but in vitro studies have shown a significant increase in plasma GSN levels in the autologous serum as well as increased GSN levels in synovial fluid after each serum injection. Both GSN and Granulocyte colony-stimulating factor (G-CSF) have been shown to promote tissue repair and regeneration.

The available data strongly support a crucial role for GSN in a variety of physiological and pathological processes including GSN involved as an actin-binding and depolymerizing protein, which exerts its effects in the form of intracellular cytoskeletal GSN and plasma GSN (pGSN). Of note, GSN is known to be a cytoplasmic regulator of actin organization, which regulates the viscoelasticity of the cell cytoskeleton and modulates important cell functions such as cell motility, phagocytosis, and apoptosis.

This correlation between pGSN and clinical conditions suggests the possibility for the therapeutic use of the gold induced cytokines aimed at producing serum rich in anti-inflammatory cytokines and GSN to alleviate the destructive cascades in these acute settings or in chronic inflammatory conditions.

Future randomized-controlled trials may fully validate the safety and efficacy of this GOLD Induced Cytokine therapy in different patient populations.

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