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Dr. Tim Welting Head of Laboratory for Experimental Orthopaedics In patients with osteoarthritis, articular cartilage deteriorates and eventually disappears, causing a lot of pain. Our research focuses on this ‘diseased’ cartilage. We are trying to understand, at a molecular level, the exact processes that occur in cartilage cells when osteoarthritis develops. If we are able to delay the moment at which the fitting of a joint replacement prosthesis is the only remaining option, we will achieve a major breakthrough. Cartilage cells effectively become ‘ill’, resulting in the mineralisation and eventual destruction of cartilage. As a result of our research, we now know that a certain protein in our bodies plays a major role in the health of our cartilage. We have recreated a piece of that protein (a peptide). This peptide works very well on cartilage cells in our lab: it slows down the process of osteoarthritis. Currently, we are testing how this works in situations where we simulate osteoarthritis. A clinical trial in patients with osteoarthritis is the next step, but there is still a long way to go before any potential medicine will appear on the market. Intervening in molecular disease processes in cartilage offers a way to tackle osteoarthritis right at its source. This method differs from existing (experimental) treatment options that mainly fight symptoms, such as pain. That is why we are also studying other molecular routes that we might be able to influence through peptides. To researchers, peptides provide a great ‘toolbox’ that can be redesigned in any number of ways to find the most effective combination. Any eventual medicine we develop will not be the sole treatment for osteoarthritis; depending on the stage and type of the disorder, a combination of options will be required. For the time being, the prosthetic option continues to play a major role. Together with orthopaedic surgeons, we can close the circle. A relay race is probably the best comparison: they provide us with a major clinical problem that challenges us to develop a solution. Once we have reached the point where we are ready to test the effectiveness of a new substance in patients, the surgeons come back into play. A university medical centre is a type of ecosystem, in which everything eventually comes full circle. On the job


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