Growth Plate Regeneration By Robert Ballock Orthopaedic Surgeon

When I was in contact with Tyler from HeightQuest.Com he gave me two leads or ideas to look into so I could be better acquainted with what options and ideas are current available or in the process of being developed in our search for an increase in height. One of the ideas was the Joint Loading Modality done by Yokota which I wrote a very short review and analysis found HERE. The other idea he wanted me to do research on was the idea of “Growth Plate Regeneration” being developed by Robert Ballock from the Cleveland Clinic.

Let me do a little review and critical analysis on what I managed to find out about this method/technique. The first  thing I found from searching about the type of growth plate regeneration research done by Robert Ballock was either a paper submitted to the National Institute of Health (located HERE) or it was maybe a proposal for a grant or project.

However let’s get a summary of how Dr. Ballock describes his own research from his profile webpage found on the Cleveland Clinic website (located HERE) If you would like to contact him all his contact information is available on his profile webpage which you get get to again by clicking on the link above.

“”….I had the good fortune of being taken in by Drs. Michael Sporn and Anita Roberts in the Laboratory of Chemoprevention at the National Cancer Institute. Their laboratory had recently discovered TGF-beta and they were interested in exploring the role of this new peptide growth factor in regulating growth and differentiation in the skeleton.During these two years, I focused on the role of TGF-beta in the growth plate and developed the three-dimensional pellet culture model of growth plate chondrocyte differentiation that is now used by many laboratories throughout the world.This experience resulted in three publications, including first author papers in Developmental Biology and Journal of Cell Physiology….”

“”….I spent a third year in his laboratory at Johns Hopkins where I formulated the serum-free, chemically defined culture conditions for growth plate chondrocyte pellet cultures that are also now used by many laboratories world-wide.For example, Dr. Brian Johnstone and colleagues at CWRU used our pellet culture model and serum-free, chemically-defined conditions to demonstrate for the first time that mesenchymal stem cells could undergo chondrogenesis in vitro. This year at Johns Hopkins was marked by several other key observations, including the discovery that terminal differentiation of growth plate chondrocytes was a default pathway that could be accelerated by thyroid hormone, and that morphogenesis of columnar cartilage in the growth plate could be recapitulated in our serum-free three-dimensional pellet cultures by addition of thyroid hormone….”

“”….my research program began its focus on the molecular mechanisms of thyroid hormone action in the growth plate that continues to be the major thrust of our laboratory work today.We initially determined that the principal site of thyroid hormone action during skeletal maturation was regulation of the critical transition between cell proliferation and terminal hypertrophic differentiation in the growth plate.In addition to characterizing the expression of thyroid hormone receptors in this tissue, we also explored the interactions between thyroid hormone, vitamin D, and retinoic acid in regulating terminal differentiation of growth plate chondrocytes.Other work established an important link between thyroid hormone-induced terminal differentiation and upregulation of cell cycle proteins p21cip-1, waf-1 and p57 kip-1, indicating that growth arrest at the G1-S restriction point of the cell cycle is an obligatory step in the terminal differentiation process of growth plate chondrocytes….”

“”….we also began to investigate the role of obesity in the dysfunction of the growth plate that results in slipped capital femoral epiphysis, a potentially devastating hip condition in adolescents. These studies have demonstrated that peroxisome proliferator activated receptors (PPARs), which are upregulated in response to a high fat diet, are also expressed in growth plate chondrocytes and interfere with the normal transcriptional activation function of thyroid hormone receptors in these cells, eventually resulting in the inhibition of terminal differentiation and matrix mineralization that allows the subsequent mechanical failure of the growth plate to occur….”

“”….we initiated DNA microarray studies of growth plate chondrocytes in order to identify the direct downstream genetic targets of the thyroid hormone receptor in the growth plate.These studies resulted in the surprising identification of the gene encoding carboxypeptidase Z (CPZ) as a direct target of thyroid hormone action.CPZ is an enzyme that removes C-terminal amino acid residues, particularly arginines, from proteins, and has also been shown to modulate Wnt signaling.Further experiments in our laboratory have demonstrated that Wnt-4, which is the principal Wnt family member expressed in the mammalian growth plate, contains a C-terminal arginine, and that removal of this C-terminal arginine enhances the biological activity of Wnt-4 in inducing terminal differentiation of these cells….”

Me: As for what I can contribute to the effort or knowledge right now, there is little I can do that has not already been covered and researched by Tyler from HeightQuest.Com. He has already looked into the proposal ideas. And yes, it appears the first link was a grant proposal of some kind to get money to fund for a project. The project was supposed to have started in April of 2012 and end in March 2014. They appeared to have gotten some money, around $140,000 which in my opinion is really NOT a lot.  I’ll copy and paste the entire abstract right below here. I’ll highlight the areas which I feel are the most important and applicable to us height increase seekers. Again you can get to the paper submitted by clicking HERE.

Abstract Text:
DESCRIPTION (provided by applicant): The growth plate, also known as the epiphyseal plate or physis, is the area of growing tissue near the end of the long bones in children and adolescents that determines the future length and shape of the mature bone. Fractures through the cartilage growth plates of the long bones of children may result in growth arrest with subsequent leg length inequality and progressive deformity. This growth arrest is due to formation of a bony bar across the traumatic growth plate defect that acts as an tether to resist further longitudinal growth. If the bar is large or is located in the central portion of the growth plate, a complete growth arrest ensues. A bar located in the peripheral portion of the physis tethers growth asymmetrically, producing a progressive angular deformity of the limb. Once a physeal bar forms, surgical excision is technically difficult and resumption of further growth is quite variable. Previous studies of experimental growth plate injury have focused on the histological events in the growth plate defect leading to bar formation. However, our understanding of the factors that regulate the proliferation and differentiation of growth plate chondrocytes, as well as the principles of cartilage tissue engineering, have increased dramatically over the past decade. These advances now provide a unique opportunity to develop strategies for regeneration of normal physeal cartilage following serious growth plate injuries. Successful regeneration of growth plate cartilage architecture in vivo would have a transformational impact on the practice of pediatric orthopaedic surgery, providing for the first time not only the ability to replace growth plates irreversibly damaged by trauma, infection or irradiation, but also the possibility of restoring longitudinal growth in individuals beyond the age of skeletal maturity. Our hypothesis is that co-cultured chondrocytes and osteoblasts implanted into tibial bone defects in vivo will recapitulate the function of the normal growth plate and result in the reformation of columnar physeal architecture and resumption of longitudinal growth. This hypothesis will be tested by using a tissue engineering approach to determine the degree to which this optimized physeal construct replicates the function of the normal growth plate in vivofollowing implantation into a complete growth plate defect.PUBLIC HEALTH RELEVANCE: Our understanding of the factors that regulate the proliferation and differentiation of growth plate chondrocytes, as well as the principles of cartilage tissue engineering, have increased dramatically over the past decade. These advances now provide a unique opportunity to develop strategies for regeneration of normal physeal cartilage following growth plate injury. Successful regeneration of growth plate cartilage architecture in vivo would have a transformational impact on the practice of pediatric orthopaedic surgery, providing for the first time not only the ability to replace growth plates irreversibly damaged by trauma, infection or irradiation, but also the possibility of restoring longitudinal growth in individuals beyond the age of skeletal maturity.

Me: If you took the time to read the abstract, it might still be a little hard to understand what Dr. Ballock is talking about. The basic idea proposed is that for many children who are still growing, when they suffer an injury like a fracture on their growth plates, they can actually stunt their growth or growth irreuglarly afterwards because of how the growth plates cartilage form and heal themselves. To solve this problems, as well as give all height increase seekers around the world hope, is that they want to test this hypothesis and radical on implanting some cultured (made in the lab) chondrocytes (growth plate cells) and osteoblasts (bone cells) into the tibia fractures and defects and see if they can result in the growth plates in regrowing again and providing longitudinal growth (increase in bone length, thus increase in height). This technology is defenitely something every serious height increase seekers should stay up to date with. One might even be able to participate in the study and even get their height increase for free during the experimental trials and be paid some extra money for being a willing trial subject. Just something to think about. 

To be completely honest, it is actually really hard to find anymore information about Dr. Ballock or his research being done since professor doctors who do really advanced scientific research are not as easily found on the internet as a Kim Kardashian sex tape. To find the latest and most advanced innovations and scientific breakthroughs, you really have to dig through the science online databases like Pub Med. The problem is that I don’t have an account with PubMed and I am not sure I want to pay for something like a yearly fee to become some form of member. 

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