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

Wang, Fengfeng; Cheung, Chi Wai; Wong, Stanley Sau Ching

doi:10.1177/03000605231155777

Cited by 10 publications

(5 citation statements)

References 80 publications

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“…Acetaminophen and NSAIDs are the first medications used to treat LBP. NSAIDs are associated with a higher incidence of adverse effects, like stomach ulcers, cardiovascular and renal impairment, even though they have demonstrated greater efficacy than paracetamol [ 6 ]. Consequently, new biological therapies are being researched to treat LBP.…”

Section: Introductionmentioning

confidence: 99%

Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?

Jayasoorya,

Samal,

Pisulkar

et al. 2024

Cureus

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Autologous platelet-rich plasma (PRP) injections have emerged as a new biological intervention for many musculoskeletal conditions, such as low back pain (LBP), and have garnered significant attention in recent research endeavors. The recognition of PRP's use is progressively growing; nonetheless, comprehensive clinical validation is required to establish its uses and efficiency. This article offers a thorough evaluation regarding the assurance as well as the efficacy of PRP therapy in the management of low back pain. It specifically focuses on the analysis of clinical trials undertaken in this field.

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Section: Introductionmentioning

confidence: 99%

Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?

Jayasoorya,

Samal,

Pisulkar

et al. 2024

Cureus

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“…1,2 LBP is defined as pain (with or without pain in one or both legs) lasting at least one day, located posteriorly, ranging from the lower border of the 12th rib to the lower gluteal crease. [3][4][5] LBP symptoms can arise from various anatomical issues, including bones, nerve roots, fascial structures, joints, muscles, intervertebral discs, and abdominal organs. 6,7 Precisely defining the source of LBP is impossible for most patients.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Efficacy of Platelet-Rich Plasma Injection Therapy versus Different Control Groups for Chronic Low Back Pain: A Network Meta-Analysis of Randomized Controlled Trials

Zhang,

Guan

et al. 2024

JPR

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Objective Low back pain is one of the main causes of disability in the world. Although regenerative medicine may represent breakthroughs in the management of low back pain, its use remains controversial. Therefore, we conducted a meta-analysis to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection therapy versus different control groups for chronic low back pain during 4 weeks, 3 months, and 6 months. Methods Different electronic databases were searched for randomized controlled trials up to August 2023. Mean changes from baseline in pain and Oswestry Disability Index (ODI) scores at 4 weeks, 3 months, and 6 months and standard deviations of outcome were recorded. Results Four articles with 154 cases were finally included in this meta-analysis. After 4 weeks, corticosteroid (CS) was the optimal treatment option for chronic low back pain in terms of improvement in pain and disability index (surface under the cumulative ranking curve [SUCRA]=71.3%, SUCRA=57.8%, respectively). After 3 months, radiofrequency (RF) emerged as the best therapy in pain (SUCRA=100%) and disability index (SUCRA=98.5%), followed by PRP (SUCRA=62.3%, SUCRA=64.3%, respectively), CS (SUCRA=24.6%, SUCRA=25.9%, respectively) and lidocaine (SUCRA=13.1%, SUCRA=11.3%, respectively). At 6 months, RF was most likely to be the best treatment in pain (SUCRA=94.9%) and disability index (SUCRA=77.3%), followed by PRP (SUCRA=71.2%, SUCRA=79.6%, respectively). However, compared with the last follow-up, there was a slight downward trend in improvement pain and disability index with RF, while PRP was still an upward trend. Conclusion This study demonstrated better short-term improvement of chronic low back pain with CS after 4 weeks. PRP and RF improvement effects matched, but follow-up of at least 6 months showed that PRP seemed to be more advantageous in improvement in disability indices. Considering the limitations of this study, these conclusions still need to be verified by more comparative RCTs and a longer follow-up period.

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“…As such, degeneration of IVD-ECM directly impacts cell behavior, likely further promoting a catabolic state. Recently, research efforts have been exploring regenerative medicinal strategies to halt or even reverse IVD degeneration, showing rapid progression in the last decade [11,12]. Specifically, cellular therapeutics have garnered much attention, with multiple clinical trials reporting pain and disability alleviation following intradiscal injection of de novo cell populations [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Recombinant Laminin-511 Fragment (iMatrix-511) Coating Supports Maintenance of Human Nucleus Pulposus Progenitor Cells In Vitro

Soma,

Sakai,

Nakamura

et al. 2023

IJMS

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The angiopoietin-1 receptor (Tie2) marks specific nucleus pulposus (NP) progenitor cells, shows a rapid decline during aging and intervertebral disc degeneration, and has thus sparked interest in its utilization as a regenerative agent against disc degeneration. However, the challenge of maintaining and expanding these progenitor cells in vitro has been a significant hurdle. In this study, we investigated the potential of laminin-511 to sustain Tie2+ NP progenitor cells in vitro. We isolated cells from human NP tissue (n = 5) and cultured them for 6 days on either standard (Non-coat) or iMatrix-511 (laminin-511 product)-coated (Lami-coat) dishes. We assessed these cells for their proliferative capacity, activation of Erk1/2 and Akt pathways, as well as the expression of cell surface markers such as Tie2, GD2, and CD24. To gauge their regenerative potential, we examined their extracellular matrix (ECM) production capacity (intracellular type II collagen (Col2) and proteoglycans (PG)) and their ability to form spherical colonies within methylcellulose hydrogels. Lami-coat significantly enhanced cell proliferation rates and increased Tie2 expression, resulting in a 7.9-fold increase in Tie2-expressing cell yields. Moreover, the overall proportion of cells positive for Tie2 also increased 2.7-fold. Notably, the Col2 positivity rate was significantly higher on laminin-coated plates (Non-coat: 10.24% (±1.7%) versus Lami-coat: 26.2% (±7.5%), p = 0.010), and the ability to form spherical colonies also showed a significant improvement (Non-coat: 40.7 (±8.8)/1000 cells versus Lami-coat: 70.53 (±18.0)/1000 cells, p = 0.016). These findings demonstrate that Lami-coat enhances the potential of NP cells, as indicated by improved colony formation and proliferative characteristics. This highlights the potential of laminin-coating in maintaining the NP progenitor cell phenotype in culture, thereby supporting their translation into prospective clinical cell-transplantation products.

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

Cited by 10 publications

References 80 publications

Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?

Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?

The Clinical Efficacy of Platelet-Rich Plasma Injection Therapy versus Different Control Groups for Chronic Low Back Pain: A Network Meta-Analysis of Randomized Controlled Trials

Recombinant Laminin-511 Fragment (iMatrix-511) Coating Supports Maintenance of Human Nucleus Pulposus Progenitor Cells In Vitro

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