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No.01 Autologous Cultured Cartilage

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Our Science Reporters with the Inside Scoop INNOVATION REPORT A completely new way to treat knee pain? The compelling story of cutting-edge regenerative medicine!

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Meet Our Reporters

  • photo:MIORI NAKAYAMA

    MIORI NAKAYAMA

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Our Technology

Autologous cultured cartilage is revolutionizing regenerative medicine.
Our Innovation reporters, Miyori Nakayama, welcomed Yuichi Itahara,Senior Manager of Sales & Marketing at J-TEC,
to the Frontier Core Technology Laboratories to learn more about this technology.

[Technology and Product Overview]Nakayama : Can you give us an overview of the autologous cultured cartilage technology and the product itself?

Itahara : Sure. The technology behind autologous cultured cartilage was originally developed by Dr. Mitsuo Ochi, president of and professor of orthopedic surgery at Hiroshima University, and we spent more than a decade working on the product’s commercialization. This is a new regenerative medicine product designed to provide a fundamental treatment for cartilage damage, which normally cannot naturally repair itself. The treatment consists of transplanting cultured cartilage made from a combination of atelocollagen and the patient’s own cells to the area where cartilage has been lost.

About Autologous Cultured Cartilage

Nakayama : Nakayama: What kind of patients can be treated with autologous cultured cartilage, and what are the advantages of this new method?

Itahara : Autologous cultured cartilage is used in patients with damage to a large area (more than 4 ㎠) of knee cartilage. So far, smaller loss of cartilage has been treated by taking the patient’s own cartilage and transplanting it to the affected area. In the case of major losses, where transplantation wasn’t possible, the only available treatment was to use artificial joints. The use of autologous cultured cartilage, however, is a completely new treatment method, and the advantages are expected to include a reduction in joint pain and the recovery of joint function.

Nakayama : Does that mean that by using the patient’s own cells, you avoid tissue rejection, making the treatment safer?

Itahara : That’s right. Conventional methods using artificial joints are, of course, quite safe, and have an extensive track record. For some individuals, however—those allergic to certain metals; those unable to withstand the stress of the major surgery required to implant the device or to replace it for maintenance purposes; as well as those who are concerned about becoming unable to walk with the cartilage they have left—regenerative medicine can be a godsend.

Nakayama : That’s very appealing, if you can walk on your own using your own cartilage instead of relying on metal or other materials!

Itahara : Yes. Since treatment involves repairing only the injured cartilage, the greatest advantage may be that it allows patients to continue walking using their own knees.

Nakayama : Can you show us a sample of the autologous cultured cartilage and the model of a knee joint you have prepared for us today?

Itahara : Certainly. This white substance is cultured cartilage. It’s about the size of a 500-yen coin, and it has the consistency of agar.

Nakayama : Agar! I didn’t realize cultured cartilage was so soft!

Itahara : People think of cartilage as something hard, but autologous cultured cartilage was designed from the beginning to be rather soft, making it easy for doctors to work with during transplantation to the affected area, and ensuring it adheres firmly and is more easily incorporated in the body. Through post-operative rehabilitation, it gradually becomes part of the body and the soft cartilage eventually hardens.

photo:a sample of the autologous cultured cartilage Itahara has prepared

Nakayama : That means that autologous cultured cartilage is completely made to order for each patient, doesn’t it? That must require very careful management.

Itahara : You’re correct. To ensure the autologous cultured cartilage prepared for each patient is delivered to that individual, we manage the process through a stringent traceability program we’ve set up. We coordinate scheduling with the hospitals so that the day of surgery falls exactly four weeks from the day we receive the patient’s own cartilage, and make sure that the patient’s autologous cultured cartilage is in the doctor’s hands on the day of surgery. Because temperature control is also important, we even developed a dedicated shipping container, which you see here, that maintains the cultured cartilage at a specific temperature during transport, part of our effort to deliver the finest product possible to each patient, in terms of both safety and quality.

Nakayama : So it’s not just cell culture—you rely on many other kinds of technology too!

About Fujifilm’s Core Technologies

Examples and Outlook

How autologous cultured cartilage contributes to the development of regenerative medicine.
Patient Stories and Future Prospects

Nakayama : Are there already many patients actually using autologous cultured cartilage?

Itahara : Yes. After undergoing clinical testing, our autologous cultured cartilage also passed safety and effectiveness screening by the Ministry of Health, Labour and Welfare, and in July of 2012, we obtained approval for its manufacture and sale. This is currently the third year in which we’ve made it available as a regenerative medicine product, and there are now over 300 cases in which it has been used in patients, including professional athletes.

Nakayama : Suppose I’d like to undergo an autologous cultured cartilage transplant myself—what is the process like? I also wonder about the cost.

Itahara : First, let’s talk about the process. Once a medical institution determines you are an appropriate candidate for the use of autologous cultured cartilage, they will start by checking to see if you’re allergic to atelocollagen, which is used in culture. If this is not a problem, they’ll verify the affected area in 3-D with an MRI scan, and then collect cartilage tissue for culture using an arthroscope, which allows for minimally invasive surgery. Four weeks later, you’ll undergo another procedure to return the cultured cartilage to your knee.
Regarding the cost, while you may have the impression the process is expensive, as of April 2013,the procedure is covered by the national health insurance, and by taking advantage of the government’s High-Cost Medical Expense Benefit System, we can assure patients that the cost is not significantly different than that incurred with the use of other kinds of artificial joints.

Nakayama : Japan today is an ultra-aging society, and with that I imagine demand for treatment of joint pain and other conditions will continue to increase. Can you tell us about the outlook for the procedure going forward?

Itahara : Yes, as healthy life expectancy grows, we believe—as you noted—that demand for the use of autologous cultured cartilage will expand even further. To put it simply, autologous cultured cartilage is currently only approved by the government for use with injuries resulting from external force, including traumatic cartilage injury and osteochondritis dissecans, which can cause fragments of bone and cartilage to hinder joint movement.
Still, most people think of “sore knees” as something that happens to the elderly as the cartilage gradually wears down, until eventually their knees hurt. This is what is known as osteoarthritis, and currently the autologous cultured cartilage has not been indicated for this condition.
This is because the government has determined that the pathology of such traumatic injuries differs from that of osteoarthritis of the knee. Today, research is underway into a variety of regenerative medical approaches to knee problems, and the hope is that in the future, we will be able to treat osteoarthritis of the knee as well.

Nakayama : It would be wonderful if our senior citizens could go without suffering from knee pain!

Itahara : Yes, and I think a huge number of patients are having to deal with knee pain. Roughly 70,000 people a year use artificial joints, mostly the result of osteoarthritis caused by cartilage damage due to aging. Regenerative medicine has the potential to contribute significantly to the reduction of such discomfort, and we continue to push forward with research and development aimed at finding solutions.

Nakayama : I imagine that new treatment methods must give those patients a lot of hope.

Itahara : Certainly, and the most attractive thing about autologous cultured cartilage is that it enables a patient to recover healthy functioning that was once lost, using the patients’ own cells rather than an artificial, external material.
Since regenerative medicine can provide fundamental treatment for illnesses, going forward we are focusing all of our efforts on delivering this kind of new medicine to as many people as possible, as we work to contribute to improving patient’s quality of life.

Nakayama・ : Thank you for your time today!

After the Interview

Miori Nakayama

This was all such a fresh new experience, getting to speak directly with someone in charge of a new technology, and visiting a corporate research lab. It reaffirmed for me that science is wonderful—never-ending, always moving forward, lighting up the future. This was a valuable, very stimulating experience!

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MIORI NAKAYAMA Age22 Scientific Specialization:Complex Chemistry

Hobbies include anime, movies and solo travel. Began studying rhythmic gymnastics at the age of four, gymnastics in junior high school, and ballet in college (she can even pop her shoulder joints!). Has never once dyed her hair. "My entire family's background is in science, so I was always good at science subjects. I'll be providing solid reporting on everything I learn about Fujifilm technologies."

photo:MIORI NAKAYAMA

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