This is a story straight out of a science lab that was tried on a cute pet dog in Glasgow called Eva, to get her back on her feet after an accident and a likely amputation.
The two-year-old Munsterlander dog was hit by a car last summer resulting in a broken front leg. She received state-of-the-art treatment from the University of Glasgow Small Animal Hospital. All went well until infection set in. The persistent infection forced vets to remove bone tissue, leaving Eva with a 2cm gap at the top of her right foreleg. Eva was not in any real pain, but she was in discomfort and as each new attempt to treat her leg failed, amputation seemed inevitable.
At this juncture, William Marshall, Eva’s vet, who is a Clinician in Orthopaedic Surgery at the University of Glasgow School of Veterinary Medicine, found out by chance about a synthetic bone research project at his university being funded by football legend Sir Bobby Charlton’s landmine charity ‘Find A Better Way’.
Sir Bobby founded the charity in 2011 following a visit to Cambodian minefields three years previously.
Project leaders Prof Manuel Salmeron-Sanchez and Prof Matt Dalby had begun work in January to develop synthetically grown bone tissue for use by trauma surgeons when treating landmine blast survivors around the world. With thousands of civilians being injured by landmines and other explosive remnants of war every year, the project could transform the quality of life of landmine blast survivors in future.
The bone-growth research at the University of Glasgow was working on several technologies, but Marshall was interested in one in particular that encourages new bone tissue to grow where it would otherwise not naturally regenerate.
Trials on patients were not expected to start for a few more years, but Eva’s situation was desperate. If the new bone-growth treatment was not tried, the only other option was to amputate.
This treatment was a new way to deliver a naturally occurring protein called BMP-2. It had long been known that BMP-2 will cause bones to grow, but getting it to stick in the right place had always been a problem. In previous tests BMP-2 had spread around the body, causing bone tissue to grow in unwanted places.
Quite by chance, Prof Sanchez had discovered that an extremely common household ingredient found in paint and nail polish called polyethyl acrylate or PEA was perfect for holding the BMP-2 in place, and also for making it effective in extremely small doses.
As a last resort before amputation, Marshall took a mixture of bone chips and coated them with PEA and BMP-2 before placing the mixture in the 2cm gap in Eva’s front leg. It was the first time PEA and BMP-2 had ever been used to treat anyone – dog or man – so no one could be sure it would work.
Much to everyone’s delight, however, bone fully regrew just as was hoped – a -best-case scenario - and seven weeks later, Eva was on the road to a full recovery. Most importantly, Eva will not be living the rest of her life as a three-legged dog.
Although PEA is used in hundreds of everyday applications, it has never been approved for medical use in humans.
The Find A Better Way-funded project will be seeking this approval as part of their work, but this is expected to take up to five years to come through.
Having the chance to help save Eva’s leg has not only helped her, but it has also offered an enormous opportunity for Prof Sanchez and Prof Dalby to learn about the potential for their new treatment.
Getting bone tissue to grow using BMP-2 is just one of the technologies being developed by the Find A Better Way-funded project at the University of Glasgow.
The final result, which will be the one used to treat human landmine blast survivors, will be a 3D-printed scaffold made of medical-grade, biodegradable plastic and stem cells. The scaffolds will then be coated with a mixture of BMP-2 and polyethyl acrylate before being placed into a new device known as a Nanokick, which vibrates the scaffolds at 1,000Hz to accelerate the stem-cell growth into bone tissue.
The Nanokick technology was developed by the team with input from the University of the West of Scotland.
When placed in a body, the plastic element of the scaffold will slowly dissolve leaving healthy bone tissue in place. Unlike the treatment of Eva, where only a relatively small amount of bone tissue was needed, by using the scaffold and stem cells, synthetic bones of any size would be theoretically possible.
The first-in-man’ trial of the technology is expected to begin in 2020.
Following the results in Eva’s case, Marshall said that he was looking forward to developing the use of PEA and BMP-2 further in veterinary medicine. “Eva is an energetic and otherwise very healthy dog. Amputating her leg would have significantly affected the way that she walks and runs, but without the treatment provided by Manuel and his team there would really have been no other option,” he said.
Although initially designed to help treat landmine blast survivors, this technology has the potential to be used for anyone who needs new bone tissue.
Fiona Kirkland, Eva’s owner, who was absolutely thrilled with Eva’s recovery, commented: “When we heard about an experimental treatment that might help her, we had no idea it was connected to such an important project. It is amazing to think that the treatment used to heal Eva’s leg will help researchers one day repair the bones of landmine blast survivors. I’m very grateful to everyone at the University of Glasgow, the researchers and veterinary team, and to Sir Bobby Charlton and Find A Better Way.”
Sir Bobby said: “When I signed the funding agreement for this project just six months ago I was not expecting there to be any results from this technology for years. Eva is a beautiful dog and I’m delighted she will now have a normal life thanks to the work Find A Better Way has funded at the University of Glasgow. I’m even more thrilled to think about what promise this technique holds for landmine blast survivors, and the rest of humanity, in the future.”
N.P. Krishna Kumar is a writer based in Dubai.
