Mesenchymal Stem Cell in the Intervertebral Disc

Long, Dan; Liang, Shaoyu; Liu, Haiyan; Wu, Xiuping; Zhongyang, Li; Wang, Haozhong; Huang, Shishu

doi:10.5772/intechopen.69296

Cited by 3 publications

(8 citation statements)

References 51 publications

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“… 82 Moreover, needle injection into the disc or epidural space may result in complications, including infection and discitis. 29 Furthermore, the short monitoring times of the experiments may be not sufficient to generate conclusions about treatment efficacy, and further studies are needed to demonstrate the safety of MSC treatment in human patients. MSC infusion may also have tumorigenic effects, given that MSCs can transform into malignant cells or promote tumor formation.…”

Section: Discussionmentioning

confidence: 99%

“… 26 – 28 A high ECM content is maintained within IVD cells, and the disc matrix has an elaborate structure to attract and hold water. 29 The integrity of the IVD partially depends on the balance between matrix synthesis and degradation, and failure of this balance may lead to disc degeneration. 30 …”

Section: Intervertebral Disc Degenerationmentioning

confidence: 99%

“… 29 MSCs have three kinds of regenerative properties: i) differentiation into target cell types; ii) activation of proliferation of resident cells; and iii) improving nutrient supply by paracrine effects. 29 …”

Section: Marrow-derived Stem Cellsmentioning

confidence: 99%

“…Their limited nutrient and oxygen supplies, as well as constant high mechanical stress, mean that IVDs may find it difficult to regenerate themselves following degeneration and injury. 29 It has been proposed that MSCs may be used to treat diseased or injured musculoskeletal tissue by selecting stem cells that are characteristically similar to the differentiated target tissue. 41 MSCs play a vital role in IVD regeneration, due to their immunomodulatory functions and capacity to differentiate into chondrocytes in suitable microenvironments, and have thus been regarded as an ideal cell source for IVD regeneration.…”

Section: Marrow-derived Stem Cellsmentioning

confidence: 99%

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Regenerative medicine for the treatment of chronic low back pain: a narrative review

2023

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Low back pain (LBP) is a common and important clinical problem. In addition to pain, patients are also affected by personal, social, and economic burdens. Intervertebral disc (IVD) degeneration is a common cause of LBP, further increasing the patient’s morbidity and medical costs. The limitations of current treatment strategies for long-term pain relief mean that increasing attention has been paid to regenerative medicine. We carried out a narrative review to explore the roles of four types of regenerative medicine for treating LBP: marrow-derived stem cells, growth factors, platelet-rich plasma, and prolotherapy. Marrow-derived stem cells are regarded as an ideal cell source for IVD regeneration. Growth factors may stimulate the synthesis of extracellular matrix and attenuate or reverse the degenerative process in IVD, while platelet-rich plasma, which contains multiple growth factors, is thought to be a promising alternative therapy for IVD degeneration. Prolotherapy can initiate the body’s inflammatory healing response to repair injured joints and connective tissues. This review summarizes the mechanisms, in vitro and in vivo studies, and clinical applications of these four types of regenerative medicine in patients with LBP.

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Section: Discussionmentioning

confidence: 99%

Section: Intervertebral Disc Degenerationmentioning

confidence: 99%

Section: Marrow-derived Stem Cellsmentioning

confidence: 99%

Section: Marrow-derived Stem Cellsmentioning

confidence: 99%

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Regenerative medicine for the treatment of chronic low back pain: a narrative review

2023

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“…These factors may contribute to the development of low back pain that is discogenic in etiology based on a combination of the mechanical and biochemical changes within the disc. Therapies with the potential to shift the balance to a healthier IVD environment may have the ability to decrease discogenic pain [7,9,10].…”

Section: Introductionmentioning

confidence: 99%

Injections of concentrated bone marrow aspirate as treatment for Discogenic pain: a retrospective analysis

Wolff

Shillington

Rathbone

et al. 2020

BMC Musculoskelet Disord

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Background: There are an overwhelming number of patients suffering from low back pain (LBP) resulting from disc pathology. Although several strategies are being developed pre-clinically, simple strategies to treat the large number of patients currently affected is still needed. One option is to use concentrated bone marrow aspirate (cBMA), which may be effective due to its intrinsic stem cells and growth factors. Methods: Thirty-three patients who received intradiscal injections of cBMA to relieve LBP were followed up based on Numeric Rating Scale (NRS), Oswestry Low Back Pain Disability Index (ODI), and Short Form-36 Health Survey (SF-36) scores. Patients were also subdivided into those with a pre-injection NRS > 5 and pre-injection NRS ≤ 5. The proportion of patients demonstrating at least 50% improvement (and 95% confidence intervals) from baseline at five follow-up visits for each outcome was evaluated. Results: At least 50% improvement in NRS was observed for 13.8, 45.8, 41.1, 23.5, and 38.9% of patients across five follow-up visits, out to 1 year. When stratified by high (> 5) versus low (≤ 5) baseline NRS scores, the values were 14.3, 45.5, 71.4, 22.2, and 44.4% among those with high baseline pain, and 13.3, 46.2, 20.0, 25.0, and 33.3% among those with low baseline pain. The 50% improvement rates across visits were 4.3, 28.6, 30.0, 22.2, and 30.8% for SF-36, and 4.2, 26.7, 36.4, 55.6, and 30.8% for ODI. Conclusions: Intradiscal cBMA injections may be effective to reduce pain and improve function. Patients with relatively higher initial pain may have potential for greatest improvement.

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Regulating the fate of stem cells for regenerating the intervertebral disc degeneration

Ekram¹,

Khalid²,

Salim³

et al. 2021

WJSC

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Lower back pain is a leading cause of disability and is one of the reasons for the substantial socioeconomic burden. The etiology of intervertebral disc (IVD) degeneration is complicated, and its mechanism is still not completely understood. Factors such as aging, systemic inflammation, biochemical mediators, toxic environmental factors, physical injuries, and genetic factors are involved in the progression of its pathophysiology. Currently, no therapy for restoring degenerated IVD is available except pain management, reduced physical activities, and surgical intervention. Therefore, it is imperative to establish regenerative medicine-based approaches to heal and repair the injured disc, repopulate the cell types to retain water content, synthesize extracellular matrix, and strengthen the disc to restore normal spine flexion. Cellular therapy has gained attention for IVD management as an alternative therapeutic option. In this review, we present an overview of the anatomical and molecular structure and the surrounding pathophysiology of the IVD. Modern therapeutic approaches, including proteins and growth factors, cellular and gene therapy, and cell fate regulators are reviewed. Similarly, small molecules that modulate the fate of stem cells for their differentiation into chondrocytes and notochordal cell types are highlighted.

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Mesenchymal Stem Cell in the Intervertebral Disc

Cited by 3 publications

References 51 publications

Regenerative medicine for the treatment of chronic low back pain: a narrative review

Regenerative medicine for the treatment of chronic low back pain: a narrative review

Injections of concentrated bone marrow aspirate as treatment for Discogenic pain: a retrospective analysis

Regulating the fate of stem cells for regenerating the intervertebral disc degeneration

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