The Application of Mesenchymal Stromal Cells and Their Homing Capabilities to Regenerate the Intervertebral Disc

Abstract

Chronic low back pain (LBP) remains a challenging condition to treat, and especially to cure. If conservative treatment approaches fail, the current “gold standard” for intervertebral disc degeneration (IDD)-provoked back pain is spinal fusion. However, due to its invasive and destructive nature, the focus of orthopedic research related to the intervertebral disc (IVD) has shifted more towards cell-based therapeutic approaches. They aim to reduce or even reverse the degenerative cascade by mimicking the human body’s physiological healing system. The implementation of progenitor and/or stem cells and, in particular, the delivery of mesenchymal stromal cells (MSCs) has revealed significant potential to cure the degenerated/injured IVD. Over the past decade, many research groups have invested efforts to find ways to utilize these cells as efficiently and sustainably as possible. This narrative literature review presents a summary of achievements made with the application of MSCs for the regeneration of the IVD in recent years, including their preclinical and clinical applications. Moreover, this review presents state-of-the-art strategies on how the homing capabilities of MSCs can be utilized to repair damaged or degenerated IVDs, as well as their current limitations and future perspectives.

Intervertebral Disc Stem/Progenitor Cells: A Promising “Seed” for Intervertebral Disc Regeneration

“…For example, Gianluca et al [ 89 ] reported that transplanted cells could form osteophyte and might migrate out of the IVD. The uncontrollable proliferation of transplanted cells also hampered the clinical utility of cell-based therapy because of tumorigenic potential [ 89 , 101 ]. What is more, the cell-based therapy for IVDD requires a large number of injected cells (usually ~10 [7]) [ 20 ].…”

What Molecular Recognition Systems Do Mesenchymal Stem Cells/Medicinal Signaling Cells (MSC) Use to Facilitate Cell-Cell and Cell Matrix Interactions? A Review of Evidence and Options

“…Recently. Such iPSC have been investigated for the potential treatment of heart diseases (discussed in [85]), neurodegenerative conditions (discussed in [86][87][88][89]), and musculoskeletal conditions such as intervertebral disc repair (reviewed in [90]).…”

Concepts of Regeneration for Spinal Diseases in 2021

“…Progenitor and/or stem cell transplantation has been a long-debated treatment strategy to regenerate intervertebral disc tissues. Croft AS et al [6] conducted a narrative literature review about the effectiveness of mesenchymal stromal cell (MSC)-based therapies for degenerative disc disease. Preclinical in vitro, ex vivo, and in vivo studies presented the development of MSCs with a disc cell-like phenotype and of hydrogels and scaffolds with embedded MSCs.…”