Cartilage Disease & Regeneration. Genomics in Osteoarthritis. Genetics GENOMICS. Human Genome Project. Human Genome Project

Transcription

1 Cartilage Disease & Regeneration Darryl D. D Lima, MD, PhD Clifford W. Colwell Jr, MD Shiley Center for Orthopaedic Research & Education Donald P Shiley Visiting Lectureship February 11, 2009 Genomics in Osteoarthritis Shiley Center for Orthopaedic Research & Education Donald P Shiley Visiting Lectureship February 11, 2009 Genetics Single gene disorders Cystic fibrosis Huntington s Multifactorial Heart disease Diabetes OA GENOMICS Study of genes and how genetic variations affect function and disease Human Genome Project A GENOME the complete set of DNA for an organism Location of each gene on the chromosome (normal volunteers) Human Genome Project HUMAN GENOME ~ 3 billion pairs of nucleotides 23 pairs of chromosomes How many genes are there? 20,000-75,000 C. elegans GeneSweep Winner: 24,947 1

2 Genome Trivia Chromosome 1 has the most genes = 2968 Y (Male) chromosome has the fewest = 231 X (Female) chromosome = 2000 Human Genome Project Less than 2% of the genome codes for proteins The functions are unknown for over 50% of discovered genes Junk DNA = repeated sequences that do not code for proteins make up at least 50% of the human genome Is This JUNK? Human Genome Project O lny srmat poelpe can raed tihs. I cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoatnt tihng is taht the frist and lsat ltteer be in the rghit pclae. The rset can be a taotl mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Amzanig huh? yaeh adn I awlyas tghuhot slpeling was ipmorantt! 99.9% nucleotide bases are exactly the same in all people Single Nucleotide Polymorphism SNP Humans differ in genetic makeup by only 0.1% 1.4 million locations where single-base DNA differences (SNPs) occur in humans Success in Genomics Macular degeneration Rheumatoid arthritis Crohn s disease Bipolar disorder Breast cancer Hypertension Diabetes Osteoarthritis? 2

3 Femoral Condyles MRI 72 yr 52 yr Linkage Analysis Rare Mendelian Families Affected Sibling Pairs Candidate Gene Linkage Analysis COL2A1 Type II procollagen/chr 12 Single base mutation Knowlton RG, N Engl J Med 1990 Palotie A, Lancet 1989 Linkage Analysis Chr 2, 4, 16 No known genes Uncommon OA Review Loughlin J, Curr Opin Rheum 2001 First Large Twin OA Study 250 twins Monozygotic 64% concordance Dizygotic 39% concordance Spector TD, BMJ

4 Candidate Genes Matrix proteins Vit D Growth factors Linkage Analysis Rare Mendelian Families Affected Sibling Pairs Candidate Gene Whole Genome Approach Single Nucleotide Polymorphism SNP Humans differ in genetic makeup by only 0.1% 1.4 million locations where single-base DNA differences (SNPs) occur in humans Whole Genome Approach LRCH1 N = 335 (Females) Knee OA DNA pooling ~25,000 SNPs 13q14 Odds ratio = 1.4 Spector TD, Arth Rheum 2006 Study Design Primary Knee OA Total Knee Arthroplasty Exclusion Secondary OA Study Design N = cc blood Saliva DNA extraction SNP detection Statistical Treatment 4

5 Study Design Scripps Genomic Medicine Scripps Translational Science Institute Control 80 years No Major Disease Wellderly Eric Topol, MD Nick Schork, PhD Kelly Frazer, PhD Sarah Murray, PhD SCRDA Grant Award, CRS, Brian Issell, MD Validation NIH OAI Mayo Clinic Hospital for Special Surgery Trained Fellows Relevance Identify at-risk candidates Identify high-risk candidates Discover new treatments Tailor treatment specific to each patient Stem Cells in Osteoarthritis Shiley Center for Orthopaedic Research & Education Tissue Engineering Obtain cells Physiologic environment Cell proliferation Matrix production Phenotype Bovine Chondrocytes in Agarose Gel Day 5 Day 10 Day 20 5

6 Tissue Engineering Status in laboratory Obtain cells Physiologic environment Cell proliferation Matrix production Phenotype Tissue Engineering Clinical Status Obtain cells Physiologic environment Cell proliferation Matrix production Phenotype Stem Cells Rapid unlimited proliferation Differentiate into several types of cells Ready source Human Embryonic Stem Cells Cell Pellets Pellet Culture of Stem-Cell-Derived Cells Stem Cell Pellet in Human Cartilage Control TGFβ3 Transforming Growth Factor 3 weeks Cartilage Bone Empty Defect Cell Pellets 6

7 Stem Cell Pellet in Human Cartilage Stem Cell Pellet in Human Cartilage 10 X 40 X Stem Cell Pellet in Human Cartilage Cartilage Slice 6 mm 300 micron Cartilage Slice Embryonic Stem Cells Ethics Allogeneic 7

8 Induced Pluripotent Stem Cells Nuclear Transfer Cell Fusion Lowry WE & Plath K, Nature Biotech 2008 Induced Pluripotent Stem Cells Repair Regenerate Replace ipsc from Human Chondrocytes GENOMICS TISSUE ENGINEERING STEM CELLS Donald P. and Darlene V. Shiley Shiley Center for Orthopaedic Research & Education OSTEOARTHRITIS PREVENTION SURGICAL PROCEDURES DRUG THERAPY 8

9 Cartilage Disease & Regeneration Darryl D. D Lima, MD, PhD Clifford W. Colwell Jr, MD Shiley Center for Orthopaedic Research & Education Donald P Shiley Visiting Lectureship February 11,