This paper (Smith, Hayes & Melrose) is a very significant review...

This paper (Smith, Hayes & Melrose) is a very significant review and I have referred to it in a number of posts here before.

It’s of direct personal interest given its focus on the spine, and it gives a great overview of the anatomy and tissue structure in this complex joint. I found it very helpful in understanding my own condition.

it also gives a great overview of the structure and chemistry of pentosan and other polysaccharides, glycans and biopolymers. And it describes the mechanism and pathology of degradation.

It describes the various effects of pentosan but what really amazed me was the impact on stem cells. It activates stem cells within their niches. It promotes chondrogenesis, ie it causes mesenchymal stem cells to differentiate into chondrocytes and others in that lineage. In other words it turns stem cells into the kinds of cells you need for joint repair. That seems to be the case whether it’s your own population of stem cells, or if they’re grown in culture, or stem cells co-administered with pentosan.

It also appears to alter gene expression in chondrocytes and upregulate the expression of enzymes producing the various glucoseaminoglycans, hyaluronic acid, and other components of the ECM.

it’s quite remarkable the concerted activity on all these different pathways. The potential for stem cell and other therapies, specifically for disc repair but also for other joints is enormous. I hope Paradigm has some ip in these areas.