Spare parts: Healthy bone and cartilage
Dr. Shai Meretzki is the first in the world to create a technology for turning fat cells into living material for repairing tissue loss.
HUMAN BONE CREATED from human fat cells removed by liposuction, shown in the vials. Photo: Courtesy
Thanks to an astounding new Israeli advance in regenerative medicine, science
fiction is rapidly becoming reality. An Israeli company named Bonus BioGroup is
only a few short years away from producing customized human bones from fat
Researchers in other parts of the world have only published
theoretical journal articles on the subject, but it took local minds to actually
accomplish this feat.
The first to achieve the breakthrough, the Haifa
company will face huge demand for living, healthy bone – grown according to
patented technology – for surgical transplantation.
As that is
accomplished clinically, and the technology receives official approval from the
US Food and Drug Administration and other authorities, cartilage will be
produced by the same process for more exciting applications.
Biogroup has already proven the success of its concept by removing human fat
cells, isolating adult stem cells, inserting them into a three-dimensional
scaffold and growing them into tiny but fully formed bones, which were then
inserted into the legs of hairless mice.
Dr. Shai Meretzki, who earned
degrees in biology, biotechnology and chemical engineering at Haifa’s
Technion-Israel Institute of Technology and Rehovot’s Weizmann Institute of
Science, is the company’s founder and CEO. An officer in the Israel Defense
Forces’ armored corps, in civilian life he established a company named Pluristem
(2001), based on his doctoral work, to grow cells in three dimensions.
eventually became a $200 million public company traded on the stock
“There’s a big difference between a biologist and an engineer,
which I am. It’s more practical, and you learn how to make things,” he said. “It
will mean a world revolution in medical care,” he predicted.
made use of stem cell patents he had developed with his colleagues in Rehovot,
and the company was purchased by a local software company and changed its name
to Pluristem Life Systems and then to Pluristem Therapeutics Inc., whose shares
are traded on the NASDAQ exchange, the Tel Aviv Stock Exchange and the Frankfurt
The firm develops human placental cells for commercial
use in disease treatment; patients with bone marrow disease have already been
shown to improve significantly as a result of treatment. Meretzki later left the
company, which continues to exist.
He refocused from working with single
cells to whole tissues.
“At Bonus BioGroup, which I established in 2008,
I work now with mesenchymal stem cells (MSCs), which are multipotent stromal
cells that can differentiate into a variety of cell types. I took a monolayer of
cells and developed a way to grow them in multilayer tissue, so that
biologically and chemically, the cells are more like what happens in body,” he
told The Jerusalem Post in an interview.
HIS NEW company with the strange
name (based on “bone” and preferred by the stockholders) is a product-focused
biotechnology firm applying patented technology for supplying bone and cartilage
regeneration tissues. It is located just a few minutes’ drive from Meretzki’s
alma mater, the Technion, and a minutes’ walk from Pluristem. Bonus BioGroup has
a few dozen employees, most of them PhDs in biology, biotechnology and chemistry
and physicians with joint MD/PhD degrees.
Its technology, with a
multi-billion- dollar market, is sure to be pursued by patients around the world
who have suffered bone loss due to cancer, road accidents and other physical
trauma, osteoporosis, arthritis, hip fractures, knee injuries and
At present, doctors usually take autologous (“from self”) bone in
parts of the leg (people can walk without having both the tibia and the fibula).
Autologous bone grafting is the current gold standard in bone reconstitution
field accounting for most bone reconstructions performed.
procedure has severe major handicaps. In many cases, there is not enough bone
for the graft to be effective, in others, patients’ condition may decline.
Patients can suffer from serious pain and discomfort or have problems getting
about. In addition, the autologous bone grafts cannot be accurately shaped,
negatively impacting the healing process and leaving ugly holes in the treated
Thus “autologous grafts can be very difficult and painful,”
said Meretzki, who added that there’s also the much-rarer “harvesting” of dead
bone from cadavers. “This involves taking a supportive scaffold, not live
tissue. And if taken from someone else, the donated bone causes the immune
system to reject foreign tissue,” which requires medications to
Thus finding a way for healthy new bone to be produced from the
patient’s own fat cells creates a large supply and eliminates
The engineered bones create themselves, with interior channels
for the blood vessels.
FOR SEVERAL years, Meretzki has been working with
physicians at Assaf Harofeh Medical Center in Tzrifin and Emek Medical Center in
Afula, which will be the first to perform clinical trials, implanting the
engineered bones into patients.
Eventually, it will become available in
hospitals throughout the world, with six or seven Bonus BioGroup centers around
the world to provide bones for surgical procedures.
“It will be even
cheaper than surgery moving bone from one part of the body to another or
implanted donated bone,” Meretzki asserted.
“And surgeons will not have
to learn new operating techniques; the surgery is just using a new source of
bone or cartilage.”
With the development of computerized 3-D printing
machines to create new objects, the biodegradable scaffold into which the cells
are squeezed can be given the exact size and shape of a human bone; a few weeks
later, after a bio-reactor grows the bone, the patient will be invited to come
in and have his surgery and then be sent home. It will look like any other of
his bones, as the scaffold disintegrates as the new bone grows.
technology makes it possible to produce matched bone tissue in the precise,
This leads to bone transplant available on
demand, that fits like a tailored suit and is safer and less expensive,” Meretzi
“We are waiting for Helsinki Committee approval for human
Since it is autologous, it won’t be very difficult to get,
because the tissue comes from the patient’s own body. We will start with about
20 participants, who after the liposuction procedure carried out on an
outpatient basis to remove fat cells wouldn’t have to be hospitalized,” Meretzki
“After a year or two of human trials, I believe we will be able to
go ahead. The world bone-loss market is at least $3 billion. When we go on to
produce healthy cartilage from the same patient’s fat cells, just think how
we’ll be able to treat knees and other destroyed joints. The possibilities are
endless. It will be good not only for Israelis here for also for the country’s
medical tourism industry.”
He is also certain that many young physicians
who want to learn a specialty will be eager to study surgery to make a place for
themselves in a highly promising and exciting field.
PROF. NIMROD Rozen,
head of Emek Medical Center’s orthopedics department, told The Post that he has
been hugely impressed by Meretzki and his “brilliant” technology.
of our hospital departments will be able to repair damaged bones and replace
missing ones,” said Rozen, who was so certain about the efficacy of the
breakthrough that he became a shareholder of Bonus BioGroup.
Tzur, chief of oral and maxillofacial surgery department at the Tzrifin
hospital, envisions lessconventional uses for the plentiful bone.
could use it to build fingers destroyed in work accidents. Later, we could
create longer bones to make dwarves taller.”
Tzur added that oral and
maxillofacial surgeons – but not dentists – could create pieces to augment the
lower jaw by filling out the jawbone.
“This has been almost impossible
until now. If they didn’t have 10 mm or so of bone, tooth implants were closed
to them. There are patients with so little bone tissue in their jaw that they
couldn’t benefit from tooth implants. It could also be added after the removal
of cysts. There are also esthetic surgical applications, such as to adding bone
to eye sockets so people can look younger.
“But of course, treating
victims of cancer, road accidents, bullet wounds and even rock-throwing is more
important,” he stressed. A fractured bone around the eye can be fixed and have a
very pleasant result. Broken skulls with missing bone have for years been fixed
with pieces of plastic. Now they can have real bone to replace it, literally
leaving them without a hole in their heads.
Thus the Tzrifin surgeon is
keen on completing his team’s research.
A world short of human bone will
beat a path to Meretzki’s door.