Cell-Based Therapies for Degenerative Disc Diseases

Abstract

Intervertebral discs (IVDs) degeneration are responsible for the majority of cases of low back pain, which affects millions of people worldwide. Current clinical therapies for degenerative disc diseases (DDD) involve medications or physiotherapy for mild to moderate degeneration, and surgeries for severe degeneration. However, current treatments aim to remove symptoms sometimes at the cost of mobility instead of restoring the biological function. Future therapy for disc repair is in development by biological strategies, including protein/growth factor injections, gene therapy or cell therapy approaches. Cell-based therapies provides the greatest hope, as it is a continuous source of cells and cytokine production, and the safety is superior compared to gene therapy. The choice of cell source include chondrocytes, disc cells, embryonic stem cells, hematopoietic stem cells and mesenchymal stem cells (MSCs). Results of several clinical trials suggest that MSCs is the best choice of cell source for IVD regeneration. The remaining concern is that the harsh environment of the degenerated disc may have impact on the engraftment and differentiation of implanted cells. The timing of cell implantation may also have effect on the degree of disc regeneration, which may require a earlier intervention at mild to moderate level of disc degeneration to achieve satisfactory surgical outcome.

Therapeutic potential of growth differentiation factors in the treatment of degenerative disc diseases

“…Anticatabolic factors include small molecule inhibitors of inflammatory signaling, including TNF‐α and IL‐1 receptor antagonists, which have been shown to attenuate the phenotypic changes in IVD cells associated with degeneration . Numerous growth factors have also been investigated, including transforming growth factor (TGF)β3, insulin growth factor (IGF)‐1, and epidermal growth factor‐1 . Most notably, however, a range of members of the bone morphogenetic protein (BMP) family have been investigated due to their roles in skeletal tissue development and repair.…”

The generation and functional characterization of induced pluripotent stem cells from human intervertebral disc nucleus pulposus cells

“…[3, 4]. Although autologous cells have the advantage of no immune response, the availability of autologous NPCs is extremely low in the adult.…”

“…Cell-based tissue regeneration including autologous chondrocytes, primary NPCs and stem cells has great impact for DDD. [ 3 , 4 ]. Although autologous cells have the advantage of no immune response, the availability of autologous NPCs is extremely low in the adult.…”