Kobe Bryant will hit Dusseldorf again this summer to get another (the 16th) evergreen season despite his knee threatening the aggressiveness of his game only a couple years ago.
Just like many other pros, Kobe was suffering knee pain probably due to an underlying process of osteoarthritis, a degenerative disease that affects joints common in the elderly but that annoys also younger highly competitive athletes, due to the great amount of strain and physicality of modern sports.
Overuse osteoarthritis in young individuals occur as a consequence of the relentless strain that is placed on the athlete’s body on daily basis, causing ‘wear and tear’ injuries that ultimately result in damage of the cartilage so the cushioning effect between bones at a joint level is compromised, causing pain and degeneration of the tissue.
Strict conventional medicine has not come to a final solution to the problem yet, with osteoarthritis being one of the biggest healthcare burdens, other than ruining sport careers.
One of the great ideas of recent medicine is ‘if we can’t fix, let’s see if we can make the body fix it for us’, maybe we just need to give it a kick start and the body repairing machine will turn on and do what we cannot. And so Biologic medicine was born, the main interest of which is understanding how the body’s own healing mechanisms could be triggered to repair a worn tissue.
Ligament and tendon ruptures are considered serious injuries because often the blood supply to these tissues is limited and their healing capacity is not as prompt as in muscles or other tissues.
Growth factors regulate the growth and healing of a tissue. Because systemic growth factors are delivered via the blood these organs have difficulty to undergo the repair process and are easily re-injured.
Biologic therapies have addressed these problems by a direct delivery of growth factors in the site of injury –platelet rich plasma (PRP) technique is one of them.
The evidence in favor of these treatments is controversial with mixed results in different trials, although in same cases anecdotes seem to blindly support the mean with pro athletes swearing to have witnessed the orthopedic miracle. Reality is that apparently these methods are subjective and they work on some, while for some they don’t, raising doubts on the placebo benefits affecting some minds.
Here is Kobe Bryant, one of the toughest and most respected sportsman of all time, going back for treatment 2 after an individually-speaking awesome season when he almost removed the crown of scoring champion from the 10 years younger rising star Kevin Durant, this at the verge of his 34th birthday.
Media are confused on the technicalities of the therapy Kobe undergone in Germany –PRP? autologus conditioned serum? Stem cells? Well, you can’t blame them because the patented therapy is called Regenokin and its secrets are reveled to few elects. I’m not one of them but I’ll try to pass you what I understood.
The therapy addresses the pain problem from different sides.
Tissue degeneration and the inflammatory process partly responsible for the pain are driven by cytokines like interleukin-1 that are also involved in healing processes. Limiting the action of IL-1 is therefore one of the strategies of the orthokin therapy. They do so by increasing the expression of IL-1 receptor antagonist (ra), creating a competitive inhibition of IL-1; reworded, it means that they increase the quantity of receptors in the cell that do NOT provoke inflammation, so that most IL-1 binds to these harmless receptors and not much is left free to produce the inflammatory effect that causes pain.
How they do so then? Apparently in many ways.
The patient’s whole blood is incubated with CRSO4-coated glass beads, technique which stimulates the production of IL-1ra and other anti-inflammatory cytokines that are then separated. This serum is then re-injected in the injured joint, in an auto logus procedure meaning that something is transplanted into the same individual it originally belonged to.
Alternatively, IL-1ra is delivered by gene transfer. Auto logus synovial fibroblasts (cells of the connective tissue extracted from the patient himself) are genetically modified with a retro virus to contain the DNA of human IL-1ra protein. When injected in the artrithic joint, a study showed that in some cases this process increases IL-1ra expression up to 4 weeks after the procedure and decreased joint pain and swelling.
Both methods are supported only by incomplete evidence, but Regenokin seems to include them both and possibly other unconfirmed beneficial tools, such as stem cells.
Science is not built on tales but more and more influential people have created a great hype that could probably increase the interest on this fascinating field even more and with it the number of experiments designed to understand whether to believe, or not.
Lastly, if these aids are proven not to work but their patients are happy anyway, should they really know?