Stem Cell Clinic

UB-led study presents critical step forward in understanding Parkinson’s disease and how to treat it – University at Buffalo

BUFFALO, N.Y. A new study led by a researcher in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo has important implications for developing future treatments for Parkinsons disease (PD), a progressive nervous system disorder that affects movement and often includes tremors.

In this study, we find a method to differentiate human induced pluripotent stem cells (iPSCs) to A9 dopamine neurons (A9 DA), which are lost in Parkinsons disease, says Jian Feng, PhD, professor of physiology and biophysics in the Jacobs School and the senior author on the paper published May 24 in Molecular Psychiatry.

These neurons are pacemakers that continuously fire action potentials regardless of excitatory inputs from other neurons, he adds. Their pacemaking property is very important to their function and underlies their vulnerability in Parkinsons disease.

This exciting breakthrough is a critical step forward in efforts to better understand Parkinsons disease and how to treat it, says Allison Brashear, MD, UBs vice president for health sciences and dean of the Jacobs School. Jian Feng and his team are to be commended for their innovation and resolve.

Feng explains there are many different types of dopamine neurons in the human brain, and each type is responsible for different brain functions.

Nigral dopamine neurons, also known as the A9 DA neurons, are responsible for controlling voluntary movements. The loss of these neurons causes the movement symptoms of Parkinsons disease, he says.

Scientists have been trying hard to generate these neurons from human pluripotent stem cells to study Parkinsons disease and develop better therapies, Feng says. We have succeeded in making A9 dopamine neurons from human induced pluripotent stem cells. It means that we can now generate these neurons from any PD patients to study their disease.

Feng notes that A9 DA neurons are probably the largest cells in the human body. Their volume is about four times the volume of a mature human egg.

Over 99 percent of the volume is contributed by their extremely extensive axon branches. The total length of axon branches of a single A9 DA neuron is about 4.5 meters, he says. The cell is like the water supply system in a city, with a relatively small plant and hundreds of miles of water pipes going to each building.

In addition to their unique morphology, the A9 DA neurons are pacemakers they fire action potentials continuously regardless of synaptic input.

They depend on Ca2+ channels to maintain the pacemaking activities. Thus, the cells need to deal with a lot of stress from handling Ca2+ and dopamine, Feng says. These unique features of A9 DA neurons make them vulnerable. Lots of efforts are being directed at understanding these vulnerabilities, with the hope of finding a way to arrest or prevent their loss in Parkinsons disease.

Pacemaking is an important feature and vulnerability of A9 DA neurons. Now that we can generate A9 DA pacemakers from any patient, it is possible to use these neurons to screen for compounds that may protect their loss in PD, Feng notes. It is also possible to test whether these cells are a better candidate for transplantation therapy of PD.

To differentiate human iPSCs to A9 DA neurons, the researchers tried to mimic what happens in embryonic development, in which the cells secrete proteins called morphogens to signal to each other their correct position and destiny in the embryo.

Feng notes the A9 DA neurons are in the ventral part of the midbrain in development.

Thus, we differentiate the human iPSCs in three stages, each with different chemicals to mimic the developmental process, he says. The challenge is to identify the correct concentration, duration, and treatment window of each chemical.

The combination of this painstaking work, which is based on previous work by many others in the field, makes it possible for us to generate A9 DA neurons, Feng adds.

Feng points out there are a number of roadblocks to studying Parkinsons disease, but that significant progress is being made.

There is no objective diagnostic test of Parkinsons disease, and when PD is diagnosed by clinical symptoms, it is already too late. The loss of nigral DA neurons has already been going on for at least a decade, he says.

There was previously no way to make human dopamine neurons from a PD patient so we could study these neurons to find out what goes wrong.

Scientists have been using animal models and human cell lines to study Parkinsons disease, but these systems are inadequate in their ability to reflect the situation in human nigral DA neurons, Feng says.

Just within the past 15 years, PD research has been transformed by the ability to make patient-specific dopamine neurons that are increasingly similar to their counterparts in the brain of a PD patient.

Houbo Jiang, PhD, research scientist in the Department of Physiology and Biophysics, and Hong Li, PhD, a former postdoctoral associate in the Department of Physiology and Biophysics, are co first-authors on the paper.

Other co-authors on the study are: Hanqin Li, PhD, a graduate of the doctoral program in neuroscience and currently a postdoctoral fellow at University of California, Berkeley; Li Li, a trainee in UBs doctoral program in neuroscience; and Zhen Yan, PhD, SUNY Distinguished Professor of physiology and biophysics.

The study was funded by the Department of Veterans Affairs, National Institutes of Health and by New York State Stem Cell Science (NYSTEM).

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UB-led study presents critical step forward in understanding Parkinson's disease and how to treat it - University at Buffalo

Protein discovery reinvigorates promising new therapeutic – EurekAlert

image:A look at the structure of the SCF-based therapeutic. view more

Credit: The University of Texas at Austin / Cockrell School of Engineering

Several years ago, a promising therapeutic using stem cell factor (SCF) emerged that could potentially treat a variety of ailments, such as ischemia, heart attack, stroke and radiation exposure. However, during clinical trials, numerous patients suffered severe allergic reactions and development of SCF-based therapeutics stopped.

A research team led by engineers at The University of Texas at Austin has developed a related therapeutic that they say avoids these major allergic reactions while maintaining its therapeutic activity. The keys to the discovery, published recently inNature Communications, were the use of a similar, membrane-bound version of SCF delivered in engineered lipid nanocarriers.

"We envision this as something you can inject where you have lack of blood flow and it could induce blood vessels to grow in that area," said Aaron Baker, a professor in the Cockrell School of Engineering's Department of Biomedical Engineering, and one of the leaders on the project.

Stem cell factor is a cytokine, a type of soluble protein that can stimulate regeneration in the body and growth of stem cells. Its ability to help stem cells grow, especially in critical places like bone marrow, makes it very promising for many therapeutic applications. But when delivered to the body in clinical trials related to strokes, it caused mast cell growth, which activated the immune systems defenses and led to the allergic reactions.

The new therapeutic uses transmembrane stem cell factor, a version of the cytokine that tethered to a cell membrane. In the body, the transmembrane form can be cleaved off into to the soluble form, which travels around the body.

"We found this transmembrane stem cell factor has all the necessary therapeutic properties and without activating the immune system and causing allergic reaction," said Eri Takematsu, a former member of Bakers lab who is now a postdoctoral researcher at Stanford and was the first author on the paper.

The big problem with the transmembrane SCF is that, because its not soluble, it tends to just clump together in solution. So, the team developed lipid nanocarriers to help it say in solution and to tailor its activity towards different cell type. They looked specifically at using a liposomes (lipid bubbles) and lipid nanodiscs as carriers for transmembrane SCF.

"This type of nanodisc is something people haven't explored very much developing therapeutics before," Baker said. "It makes a little island of lipid around the transmembrane SCand holds it together with a ring of proteins, kind of like a lariat."

The researchers have patented their method, and the next step would be clinical trials. In order to do that, however, they need approval from the U.S. Food and Drug Administration to classify the therapeutic as aninvestigational new drug. In addition, they are continuing to fine-tune important details like correct dosage for patients.

Other team members on the project include Miles Massidda, Jeff Auster, Po-Chih Chen, ByungGee Im, Sanjana Srinath, Sophia Canga, Aditya Singh, Marjan Majid and Andrew Dunn from the Department of Biomedical Engineering; Michael Sherman from the Department of Biochemistry & Molecular Biology, University of Texas Medical Branch, Galveston; and Annette Graham and Patricia Martin of the Department of Biological and Biomedical Sciences at Glasgow Caledonian University in Scotland. The research was funded through grants from the American Heart Association, National Institutes of Health and the U.S. Department of Defense's Congressionally Directed Medical Research Programs.

Nature Communications

Transmembrane stem cell factor protein therapeutics enhance revascularization in ischemia without mast cell activation

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Protein discovery reinvigorates promising new therapeutic - EurekAlert

Senti Bio Debuts as Publicly Traded Company Focused on Developing Next-Generation Cell and Gene Therapies Engineered with Gene Circuits – BioSpace

- Business combination with Dynamics Special Purpose Corp. completed today; gross proceeds from transaction to Senti Bio expected to total approximately $156.5 million -

- Combined company Senti Bio will be listed on the Nasdaq Global Market under ticker symbol "SNTI" -

- IND filings for preclinical oncology candidates SENTI-202 and SENTI-301 anticipated in 2023 -

SOUTH SAN FRANCISCO, Calif., June 09, 2022 (GLOBE NEWSWIRE) -- Senti Biosciences, Inc. (Senti Bio), a biotechnology company developing next-generation cell and gene therapies using its proprietary gene circuit platform, today announced the completion of its business combination with Dynamics Special Purpose Corp. (DYNS; Nasdaq: DYNS), a special purpose acquisition company. Senti Biosciences, Inc., the resulting combined company, will commence trading on the Nasdaq Global Market under the symbol SNTI on June 9, 2022.

Over the last year, we have made significant pipeline progress in optimizing our gene circuit technology and generating promising data across our lead programs, SENTI-202 and SENTI-301, which we plan to advance toward IND filings in 2023, said Timothy Lu, MD, PhD, Chief Executive Officer and Co-Founder of Senti Bio. We believe that with the funding from this successful transaction, we are well positioned to maximize this unique opportunity to develop the next generation of gene circuit-enabled cell and gene therapies for patients in need.

Senti Bio is developing next-generation cell and gene therapies engineered with gene circuits, which are designed to reprogram cells with biological logic to sense inputs, compute decisions and respond to their respective cellular environments. Senti Bio's oncology pipeline uses healthy adult donor-derived, natural killer (NK) cells engineered with chimeric antigen receptor (CAR) gene circuits that are cryopreserved and dosed off-the-shelf. Senti Bios oncology pipeline is primarily focused on three preclinical-stage programs: SENTI-202, a Logic Gated (OR+NOT) off-the-shelf CAR-NK cell therapy designed to target and eliminate acute myeloid leukemia (AML) cells while sparing the healthy bone marrow; SENTI-301, a regulatable Multi-Armed off-the-shelf CAR-NK cell therapy designed for the treatment of hepatocellular carcinoma (HCC); and SENTI-401, a Logic Gated (NOT) off-the-shelf CAR-NK cell therapy designed to target and eliminate colorectal cancer (CRC) cells while sparing healthy cells elsewhere in the body. In addition, the company is collaborating with Spark Therapeutics (a member of the Roche Group) and BlueRock Therapeutics (a wholly-owned and independently operated subsidiary of Bayer AG) on applications of its gene circuit technology outside of oncology.

Omid Farokhzad, MD, Executive Chair of the DYNS Board of Directors, said, We believe in the powerful potential of engineering gene circuits with programmable computer-like logic in cell and gene therapies. We look forward to continued progress from the Senti Bio team including advancing product candidates towards and into clinical trials, solidifying its clinical-scale cGMP manufacturing capabilities, and expanding its gene circuit offerings across multiple diseases and modalities via partnering opportunities.

Mostafa Ronaghi, PhD, CEO of DYNS added, We have been very impressed with Sentis approach and platform, which has the potential to define the future of cell and gene therapy. Sentis scientific founders and management are pioneers in the field of mammalian synthetic biology and have assembled a highly qualified team to use this platform to improve the lives of patients in oncology and many other disease categories.

Senti Bio received gross proceeds of approximately $140.3 million of the expected $156.5 million in connection with the business combination, which included funds held in DYNS's trust account of $84.5 million (net of redemptions), $50.6 million of the expected $66.8 million in proceeds from a private investment in public equity (PIPE) financing that closed concurrently with the consummation of the business combination, and a recent $5.2 million investment by Leaps by Bayer, the impact investment arm of Bayer AG, through the purchase of a convertible note that was exchanged (at $10.00 per share, with accrued interest canceled) at the closing of the business combination for common equity with the same rights as the PIPE shares. Senti Bio expects the proceeds from this transaction, combined with cash on hand, to fund operations into 2024.

Investors in DYNS include funds managed by ARK Investment Management LLC, funds and accounts managed by Counterpoint Global (Morgan Stanley Investment Management), Invus, and funds and accounts advised by T. Rowe Price Associates, Inc., among others.

Investors participating in the PIPE financing as of the closing of the business combination included 8VC, Amgen Ventures, funds and accounts managed by Counterpoint Global (Morgan Stanley Investment Management), Invus, NEA, Parker Institute for Cancer Immunotherapy, and T. Rowe Price funds, among others. Of the $66.8 million in subscriptions for the PIPE financing, $16.2 million has yet to be funded as one investor, who entered into a subscription agreement concurrently with Senti Bio and DYNSs execution of the business combination agreement in December 2021, has not funded its commitment. Senti Bio intends to enforce such one investor's legal obligations under its subscription agreement. Solely for purposes of consummating the business combination on June 8, 2022, Senti Bio agreed to waive the $150 million available cash closing condition under the business combination agreement previously entered into with DYNS (as a result of such one investor failing to timely fund its $16.2 million commitment).

DYNSs board members, Dr. Omid Farokhzad and David Epstein, have joined the Senti Bio Board of Directors. The other Senti Bio board members are Susan Berland, Dr. James Collins, Dr. Brenda Cooperstone, Dr. Timothy Lu and Edward Mathers.

Uses of Proceeds and Planned Milestones Proceeds from the transaction are expected to provide Senti Bio with capital to further develop its gene circuit technologies and therapeutic pipeline, including:

Summary of Progress to Date

Advisors J.P. Morgan acted as lead capital markets advisor to DYNS and as co-placement agent to DYNS on the PIPE. Morgan Stanley & Co. LLC acted as financial advisor to DYNS and as co-placement agent to DYNS on the PIPE. BofA Securities acted as exclusive financial advisor to Senti Bio and as co-placement agent to DYNS on the PIPE. Davis Polk & Wardwell LLP acted as legal advisor to DYNS. Goodwin Procter LLP acted as legal advisor to Senti Bio. Latham & Watkins LLP acted as legal advisor to J.P. Morgan, Morgan Stanley & Co. LLC and BofA Securities in their roles as placement agents for the PIPE.

About Senti Bio Our mission is to create a new generation of smarter medicines that outmaneuver complex diseases using novel and unprecedented approaches. To accomplish this, we are building a synthetic biology platform that may enable us to program next-generation cell and gene therapies with what we refer to as Gene Circuits. These Gene Circuits, which are created from novel and proprietary combinations of DNA sequences, are designed to reprogram cells with biological logic to sense inputs, compute decisions and respond to their cellular environments. We aim to design Gene Circuits to improve the intelligence of cell and gene therapies in order to enhance their therapeutic effectiveness, precision and durability against a broad range of diseases that conventional medicines do not readily address. Our synthetic biology platform utilizes off-the-shelf chimeric antigen receptor natural killer (CAR-NK) cells, outfitted with these Gene Circuit technologies, to target particularly challenging liquid and solid tumor oncology indications. Our lead programs include SENTI-202 and SENTI-301. SENTI-202 is a Logic Gated OR+NOT off-the-shelf CAR-NK cell therapy designed to target and eliminate acute myeloid leukemia (AML) cells while sparing the healthy bone marrow. SENTI-301 is a Multi-Armed off-the-shelf CAR-NK cell therapy designed for the treatment of hepatocellular carcinoma (HCC). We anticipate filing Investigational New Drug (IND) applications in 2023 for both candidates. Over the past several months, Senti Bio scientists have presented preclinical proof-of-concept data across various programs including at the annual meetings of the American Society of Gene and Cell Therapy (ASGCT), the American Association for Cancer Research (AACR), and the American Society of Hematology (ASH). We have also demonstrated the breadth of our Gene Circuits in other modalities and diseases outside of oncology and have executed partnerships with Spark Therapeutics and BlueRock Therapeutics to advance these capabilities. For more information, please visit the Senti Bio website at https://www.sentibio.com.

About Dynamics Special Purpose Corp. DYNS was formed in May 2021 for the purpose of effecting a merger, capital stock exchange, asset acquisition, stock purchase, reorganization, or similar business combination with one or more businesses. It focused its search in healthcare and the life sciences, including development platforms that enable applications in prevention, diagnosis, treatment, or advanced biomaterials and, within that context, life-sciences tools, enabling software, synthetic biology and novel drug discovery.

Forward-Looking Statements This press release contains certain forward-looking statements within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995 with respect to DYNS and Senti Bio. These forward-looking statements generally are identified by the words believe, could, predict, continue, ongoing, project, expect, anticipate, estimate, intend, strategy, future, opportunity, plan, may, should, will, would, will be, will continue, will likely result, forecast, seek, target and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. Forward-looking statements are predictions, projections and other statements about future events that are based on current expectations of Senti Bios and DYNSs management and assumptions, whether or not identified in this document, and, as a result, are subject to risks and uncertainties. Forward-looking statements include, but are not limited to, statements regarding estimates and forecasts of financial and performance metrics, projections of market opportunity and market share, expectations and timing related to preclinical, clinical and regulatory milestones, potential benefits of the business combination and the potential success of Senti Bio's business strategy, the initial market capitalization and cash runway of the combined company, the benefits of the business combination, as well as statements about the potential attributes and benefits of Senti Bios product candidates and the progress and timing of Senti Bios product development activities, IND filings and clinical trials and expectations related to the effects of the business combination and the PIPE financing, including the unfunded portion thereof. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by any investor as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of Senti Bio and DYNS. Many factors could cause actual future events to differ materially from the forward-looking statements in this document, including but not limited to: (i) changes in domestic and foreign business, market, financial, political and legal conditions, (ii) risks that the transaction disrupts current plans and operations of Senti Bio and potential difficulties in Senti Bio employee retention as a result of the transaction, (iii) the outcome of any legal proceedings that may be instituted against Senti Bio or DYNS related to the Business Combination Agreement or the transaction, or any governmental or regulatory proceedings, investigations or inquiries, (iv) volatility in the price of Senti Bios securities, which may arise due to a variety of factors, including changes in the competitive and highly regulated industries in which Senti Bio currently operates and plans to operate, variations in operating performance across competitors, changes in laws and regulations affecting DYNSs or Senti Bios business and changes in the capital structure of the combined company, (v) the ability to implement business plans, forecasts and other expectations after the completion of the transaction, to realize the anticipated benefits of the transaction, and to identify and realize additional opportunities, (vi) the risk of downturns and a changing regulatory landscape in Senti Bios highly competitive industry, (vii) risks relating to the uncertainty of any projected financial information with respect to Senti Bio, (viii) risks related to uncertainty in the timing or results of Senti Bios preclinical studies and any future clinical trials, product acceptance and/or receipt of regulatory approvals for Senti Bios product candidates, (ix) the ability of the combined company to compete effectively and its ability to manage growth, (x) risks related to delays and other impacts from the COVID 19 pandemic, (xi) the ability of the combined company to issue equity or equity-linked securities in the future, and (xii) the success of any future research, development and commercialization efforts by the combined company.

Readers are cautioned not to put undue reliance on forward-looking statements, and Senti Bio assumes no obligation and does not intend to update or revise these forward-looking statements, whether as a result of new information, future events, or otherwise. Senti Bio gives no assurance that Senti Bio will achieve its expectations. The inclusion of any statement in this communication does not constitute an admission by Senti Bio or any other person that the events or circumstances described in such statement are material.

Non-Solicitation This press release does not constitute (i) a solicitation of a proxy, consent or authorization with respect to any securities or in respect of the Business Combination or (ii) an offer to sell, a solicitation of an offer to buy, or a recommendation to purchase any security of Senti Bio, or any of its respective affiliates. No such offering or securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the Securities Act of 1933, as amended.

Additional Information About the Business Combination and Where To Find It DYNS filed a registration statement on Form S-4 (the Registration Statement) with the SEC, which was declared effective on May 13, 2022. The Registration Statement includes a proxy statement/prospectus. The proxy statement/prospectus contains important information about DYNS, Senti Bio and the business combination. Senti Bios stockholders may access a copy of the Registration Statement, as well as other documents filed with the SEC by DYNS, without charge at the SEC's website located at http://www.sec.gov.

INVESTMENT IN ANY SECURITIES DESCRIBED HEREIN HAS NOT BEEN APPROVED OR DISAPPROVED BY THE SEC OR ANY OTHER REGULATORY AUTHORITY NOR HAS ANY AUTHORITY PASSED UPON OR ENDORSED THE MERITS OF THE BUSINESS COMBINATION OR THE ACCURACY OR ADEQUACY OF THE INFORMATION CONTAINED HEREIN. ANY REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE.

Find more information atsentibio.com Follow us on Linkedin:Senti Biosciences Follow us on Twitter:@SentiBio

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Senti Bio Debuts as Publicly Traded Company Focused on Developing Next-Generation Cell and Gene Therapies Engineered with Gene Circuits - BioSpace

CMC Joint Arthroplasty at Bone and Joint Institute of Tennessee Successfully Treats Advanced Thumb Joint Arthritis When Other Treatments Fail -…

The development of an opposable thumb in mankind is what has moved us beyond other animals, allowing us to make tools, eat more meat, and evolve a bigger brain. About seven million years ago, we grew a long thumb and shorter fingers allowing us to touch our thumbs to our other fingers. This is why our ancestors were able to throw a spear to kill wild game and hold a writing implement to record our history. However, because we use the thumb joint so much, thumb carpometacarpal (CMC) osteoarthritis is quite common. It affects up to 11% of men and 33% of women in their 50s and 60s. However, in the mid-1980s a successful surgical procedure was developed to return movement to the joint and relieve pain.

Todd Wurth, M.D. performs more than 100 of these surgeries every year, and has been recognized by the Nashville Business Journal many times as one of Nashvilles Best Hand Surgeons. He is a board-certified orthopaedic surgeon specializing in treatment of the shoulder, elbow, hand and wrist. He earned his medical degree in 1998 from the University of Louisville School of Medicine, completed his residency in orthopaedic surgery at the Indiana University Medical Center, then completed fellowship training at Allegheny General Hospital in Pittsburgh in the areas of hand, wrist, elbow, shoulder and microvascular surgery. He is a fellow in the American Academy of Orthopaedic Surgeons and a member of the American Society for Surgery of the Hand with a certificate of added qualifications in surgery of the hand.

Williamson Source: You do a lot of thumb carpometacarpal (CMC) arthroplasties every year. Tell us a little about the surgery?

Dr. Todd Wurth: CMC arthroplasty is a procedure that removes the damaged, arthritic trapezium bone at the base of the thumb and utilizes a tendon that is transferred from the forearm to stabilize the thumb in the absence of the trapezium. This is an exceptionally important joint, one that allows us to have an opposable thumb. The pain and dysfunction resulting from arthritis in the thumb CMC joint can have a huge impact on peoples lives.

There are many ways to complete this operation. A number of companies have developed implants to take the place of the damaged bone, but I prefer the use of my patients own tendon to stabilize the thumb and act as a soft tissue interposition rather than relying on manufactured implants that often only address one side of the arthritic joint and present a whole host of potential complications that are avoidable. I have seen the new technology in this area fail. The original description of this surgery was proposed in 1985 and has undergone some modifications since, but the original premise remains the same and is time tested. I value the idea of surgical procedures that use biologic rather than non-biologic materials to treat a condition when feasible. The biologic options typically outlast those of non-biologics and have lower rates of long-term complications.

After removing the damaged trapezium bone, I transfer a forearm tendon to create a sling that stabilizes the thumb in the absence of the removed trapezium. This transferred tendon actually reconstructs a ligament whose sole purpose is to stabilize the thumb. It is laxity within this original ligament that actually results in the arthritis to begin with. I then use the rest of the tendon to act as a soft tissue interposition to occupy the space of the removed trapezium.

The key to this surgery is stability of the thumb. Some surgeons simply remove the trapezium, which provides relief of the arthritic joint, but fails to stabilize the thumb. Studies have demonstrated similar outcomes to simple bone removal without tendon transfer to those of bone removal with tendon transfer at 1-3 years. Beyond three years, thumbs stabilized with tendon transfer outperformed and outlasted those without tendon transfer. My goal as a surgeon is to provide my patients with the best opportunity for long-lasting success.

WS: What is recovery time? What happens during recovery?

Dr. Wurth: Immediately after surgery the patient is put into a splint that immobilizes the thumb, wrist, and mid-forearm for five days. It is non-removable and must remain dry. After five days, the original splint is removed and replaced with a custom, removable splint that, like the original splint, goes up to the mid-forearm. This is worn day and night for about three weeks, removing it for bathing and wrist range of motion exercises. The fingers are not incorporated and we recommend aggressive finger range of motion from the start. We have patients refrain from heavy lifting and pinching activities, and because of this they may require assistance around the house for a period of time following surgery.

After three weeks in this splint, we cut the splint down to the hand only. This splint only immobilizes the thumb and leaves the wrist free when wearing. This splint is removed several times daily to work on the thumb range of motion including opposing to the other fingers. This splint is worn for approximately two weeks.

Finally, the splint is replaced with a neoprene sleeve. I encourage my patients to refrain from heavy gripping and pinching activities for a period of three months after surgery. At three months, I cut them loose to increase their activities as tolerated and return to all activities. Full return to certain activities can take up to six months.

WS: I know surgery is always a last resort, so what are non-surgical treatments?

Dr. Wurth: There are oral and topical anti-inflammatory medications that help relieve the pain. Over-the-counter versions would be things like Aleve, Motrin, Voltaren Gel or Icy Hot, but there are also prescription strength medications. Splinting is another option which works by adding additional stability to the thumb. Cortisone injections are also an option for temporary relief, but should be used judiciously. More than two a year may actually exacerbate the arthritic process.

WS: Is there any new technology being used to relieve the pain and damage of CMC arthritis?

Dr. Wurth: Work is being done on stem cell injections, but I would suggest holding off on this treatment until more research has been implemented. True stem cell lines are currently limited to research facilities. Facilities offering stem cell treatment in the community typically lack the quality and quantity of stem cell lineage to offer meaningful results. I have expectations that someday we may be able to use stem cell treatment to regenerate cartilage, but we are not there yet.

WS: As we age, we all get aches and pains? When will a patient know it is time to see you about the pain in their thumb?

Dr. Wurth: My recommendation to patients has always been that when their ailments, in this case basilar thumb pain, begin to affect what they need to do or what they want to do on a daily basis, then its time to come see me to discuss options for alleviating their symptoms.

If a patient has had a previous CMC surgery that is no longer relieving their pain, like those done with implants, they can be re-evaluated for revision surgery.

WS: Can anything be done to prevent thumb arthritis?

Dr. Wurth: Thumb arthritis is typically caused by a lack of stability in the CMC joint. Genetics plays a big role and women are more prone to it than men by a ratio of 7:1.

While some jobs are harder on the thumb joint than others, supporting the joint with a splint and changing thumb usage to minimize the strain that exacerbates laxity are ways to lessen the chance of developing arthritis or slowing its progress.

If you are suffering from arthritic pain and want more information, contact Dr. Wurth at Bone and Joint Institute of Tennessee.

To learn more about dealing with CMC arthritis joint pain, contact Dr. Wurths office at (615) 791-2630. Or schedule an appointment online.

Have a question for the Bone and Joint Institute? Fill out the form below:

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CMC Joint Arthroplasty at Bone and Joint Institute of Tennessee Successfully Treats Advanced Thumb Joint Arthritis When Other Treatments Fail -...