Enhanced Soft Tissue-to-Bone Healing via Treatment with Novel Growth Factor NELL-1: Targeted Delivery and Biomimetic Scaffolds

通过新型生长因子 NELL-1 治疗增强软组织到骨的愈合：靶向递送和仿生支架

• 批准号: 10456093
• 负责人: THOMAS John KREMEN
• 金额: --
• 依托单位: VA GREATER LOS ANGELES HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10456093
• 关键词: 3D Print; Affect; Age; Animal Model; Architecture; Award; BMP2 gene; Back; Biological; Biology; Biomechanics; Biomimetics; Cartilage; Cellular Morphology; Characteristics; Clinical; Clinical Trials; Complex; Coupled; Data Analyses; Development; Environment; Exhibits; Exposure to; Extracellular Matrix; Failure; Financial Support; Fluorochrome; Funding; Generations; Goals; Grant; Growth Factor; Implant; Incidence; Inferior; Injury; Instruction; International; Laboratories; Ligaments; Link; Measures; Mechanics; Mentors; Mentorship; Mesenchymal Stem Cells; Military Personnel; Molecular Chaperones; Muscle; Musculoskeletal; Natural regeneration; Operative Surgical Procedures; Orthopedics; Osteoclasts; Outcome; Parents; Peptide Hydrolases; Persons; Physiologic Ossification; Population; Positioning Attribute; Procedures; Process; Property; Proteins; Research; Role; Rotator Cuff; Rupture; Savings; Schools; Scientist; Site; Skeleton; Societies; Soft Tissue Injuries; Specialist; Sports Medicine; Structure; Surgeon; Technology; Tendon structure; Time; Tissues; Training; Training Programs; Translational Research; United States; United States National Institutes of Health; Use Effectiveness; Work; anterior cruciate ligament injury; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; bisphosphonate; bone; bone cell; bone healing; career; career development; cathepsin K; clinical efficacy; comparative efficacy; compare effectiveness; design; drug discovery; healing; implantation; improved; in vivo; innovation; insight; medical specialties; musculoskeletal injury; novel; novel strategies; osteochondral tissue; pre-clinical assessment; reconstitution; reconstruction; repaired; scaffold; soft tissue; square foot; stem cells; targeted delivery; translational scientist

I am an Orthopaedic Sports Medicine specialist pursuing a career as a clinician-scientist focusing on the biology of soft tissue healing to bone. The comprehensive training plan described in this proposal will uniquely position me as a surgeon-scientist to i) investigate the biology of soft-tissue-to-bone healing, ii) characterize novel approaches for growth factor delivery and scaffold design, iii) perform preclinical assessments of potential therapies and, ultimately, iv) design and operate appropriately powered clinical trials aimed at improving the treatment of soft tissue musculoskeletal injuries. There are 32 million musculoskeletal injuries in the United States annually of which 45% involve tendons or ligaments. Complete tendon and ligament separation injuries do not heal back to their bony attachments without surgical intervention and, thus, are often treated with surgical procedures including rotator cuff tendon repairs and anterior cruciate ligament reconstructions. There are more than 5.7 million people with a rotator cuff tendon tear in the US alone and this number is increasing as our population ages. In addition, there are more than 200,000 ACL injuries in the US each year; the incidence of these injuries in the military population is ten times higher than that of the civilian population. Normal tendon and ligament insertions to bone are comprised of a complex tissue structure that effectively transmits the interactions between dynamic muscle tissues and the rigid skeleton. Unfortunately, surgically repaired tendon tears and ligament reconstruction procedures characteristically “heal” with an abnormal tissue architecture that results in inferior biomechanical properties resulting in high failure rates. In this proposal we aim to stimulate local progenitor cells to repair the enthesis via a novel approach by delivering bisphosphonate-targeted growth factors to the bony site of the ruptured enthesis coupled with the insertion of a uniquely-designed biomimetic scaffold embedded with those factors. The CDA award would provide me the opportunity to turn potential into results. In order to accomplish the aims of this proposal we have assembled an internationally-recognized mentoring team to provide me with the technical training required for this research. In parallel with my mentored technical training, instruction in career development, drug discovery, data analysis and translational aspects relevant to my research goals will be provided via the UCLA CTSA-sponsored Training Program in Translational Science modules and supplemental graduate school course work. With guaranteed protected time, institutional financial support from my Department and 500 square feet of independent laboratory space and with transdisciplinary, cross-specialty guidance provided by my mentorship committee, my scientific advisory panel and my team of collaborators to assist in my development into an independent translational scientist, The ultimate goal is to allow me to successfully i) compete for additional VA, NIH and DoD grant funding, ii) manage a laboratory and iii) concurrently navigate a career that flourishes at both the benchtop and the bedside.

我是一名骨科运动医学专家，正在追求临床医生-科学家的职业生涯 专注于软组织愈合到骨的生物学。全面的培训计划 这份提案中描述的内容将使我成为一名外科医生兼科学家，以研究 软组织到骨愈合的生物学，II)表征生长因子的新方法 交付和支架设计，三)对潜在疗法进行临床前评估， 最终，四)设计和操作适当的临床试验，旨在改善 软组织肌肉骨骼损伤的治疗。 美国每年有3200万起肌肉骨骼损伤，其中45%涉及 肌腱或韧带。完全的肌腱和韧带分离损伤不会愈合回 他们的骨附着不需要手术干预，因此通常需要手术治疗。 手术包括肩袖肌腱修复和前交叉韧带重建。 仅在美国就有超过570万人肩袖肌腱撕裂，而这 随着我们人口的老龄化，这一数字正在增加。此外，还有20多万个ACL 每年在美国受伤；这些伤害在军事人口中的发生率是十倍 比平民人口要高。正常的肌腱和韧带插入骨骼是 由一个复杂的组织结构组成，它有效地传递 有活力的肌肉组织和僵硬的骨骼。不幸的是，手术修复的肌腱撕裂 韧带重建手术的特点是用不正常的组织“愈合” 导致生物力学性能较差从而导致高故障率的架构。在这 我们的目标是通过一种新的方法刺激局部祖细胞修复牙槽骨 将双膦酸靶向生长因子转移到牙槽突破裂的骨性部位 再加上一个独特设计的仿生支架嵌入了这些 各种因素。 CDA奖将为我提供将潜力转化为结果的机会。为了 实现这项建议的目标我们已经组建了一个国际公认的 指导团队为我提供这项研究所需的技术培训。并行的 在我指导下的技术培训、职业发展指导、药物发现、数据 与我的研究目标相关的分析和翻译方面将通过加州大学洛杉矶分校提供 CTSA赞助的翻译科学模块和补充培训计划 研究生院课程作业。有保障的保护时间，机构资金支持 从我的部门和500平方英尺的独立实验室空间 由我的导师委员会、我的科学委员会提供的跨学科、跨专业的指导 顾问小组和我的合作者团队帮助我发展成为一个独立的 翻译科学家，最终的目标是让我成功i)争取更多 弗吉尼亚州、美国国立卫生研究院和国防部拨款资助，ii)管理实验室，iii)兼职 这一点在桌面和床边都很活跃。