05.04.2024

At the University Hospital Wuerzburg, a promising new treatment for knee joint defects involves the use of nasal cartilage, and it's edging closer to approval with significant EU funding.

The new method is using autologous cartilage from the nasal septum, an approach that may seem as enchanting as the term "ENCANTO" implies. Funded with a substantial 2.3 million euros, the research team is on a path to revolutionize knee joint repair.

Image: Microscopic view of human skin tissue with the top layer of epidermal cells and underlying dermal layers stained in different colors for examination; Copyright: TERM/UKW

Histological staining (Safranin-O/Fast Green) of the finished cartilage construct N-TEC. The cartilage cells from the nasal septum were applied to a collagen membrane (green) and formed a distinct cartilage layer (red), in black the cell nuclei.

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The science behind nasal cartilage for knee repair

Dr. Sarah Nietzer and Associate Professor Dr. Oliver Pullig of the Tissue Engineering and Regenerative Medicine department spearhead projects focused on the generation of autologous cartilage tissue from the nose for knee regeneration. The process involves harvesting cartilage from the patient's nasal septum, cultivating it on a collagen matrix, and implanting it into the knee, aiming to regenerate damaged cartilage.

Proven efficacy and new horizons

This approach has previously demonstrated safety and efficacy in a study under the guidance of the University Hospital Basel, treating over 100 individuals with focal cartilage lesions. Now, the ENCANTO study – standing for ENgineered CArtilage from Nose for the Treatment of Osteoarthritis – is set to investigate its effectiveness against more advanced cartilage defects.

With 11.3 million euros allocated from the HORIZON-HLTH-2023-TOOL-05 program for healthy society tools and technologies, the University Hospital Wuerzburg's role is crucial, particularly in implant production under Oliver Pullig's leadership. Collaboration with the University Hospital Basel and other clinical centers in Europe signifies a united front in the advancement of this cartilage matrix.

Challenges of production and quality assurance

Producing these living cell implants is no small feat, given their classification as Advanced Therapy Medicinal Products (ATMPs) and the rigorous standards they must meet. The Wuerzburg team has been navigating these complexities, aiming to maintain quality throughout the production process, as Dr. Sarah Nietzer explains.

The journey from nose to knee

The intricate process involves taking a tiny piece of cartilage from the nasal septum, isolating cells to be cultured, and then embedding them onto a collagen membrane to form their own matrix. After four weeks, the resulting implant, N-TEC, is ready for surgical application to the affected knee area.

Future impact on osteoarthritis treatment

As osteoarthritis affects millions globally, with rising obesity rates and longer lifespans increasing prevalence, the potential for these implants to offer an alternative to prosthetic solutions is significant. This development could shift the focus from managing pain and joint replacement to actual cartilage regeneration.

The University Hospital Wuerzburg's innovative endeavors into nasal cartilage for knee treatment are forging a new path in regenerative medicine. With recruitment for patient trials on the horizon, the medical community eagerly awaits the potential benefits this treatment could unfold.

MEDICA-tradefair.com; Source: University Hospital Wuerzburg

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