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Stem cells and low back pain

James Melrose
The intervertebral disc (IVD) is a major weight bearing structure that undergoes degenerative changes with aging limiting its ability to dissipate axial spinal loading in an efficient manner resulting in the generation of low back pain. Low back pain is a number one global musculoskeletal disorder with massive socioeconomic impact. The WHO has nominated development of mesenchymal stem cells and bioscaffolds to promote IVD repair as primary research objectives. There is a clear imperative for the development of strategies to effectively treat IVD defects...
October 2016: Regenerative Medicine
Christian Elabd, Christopher J Centeno, John R Schultz, Gregory Lutz, Thomas Ichim, Francisco J Silva
BACKGROUND: Chronic low back pain due to disc degeneration represents a major social and economic burden worldwide. The current standard of care is limited to symptomatic relief and no current approved therapy promotes disc regeneration. Bone marrow-derived mesenchymal stem cells (MSCs) are easily accessible and well characterized. These MSCs are multipotent and exhibit great tissue regenerative potential including bone, cartilage, and fibrous tissue regeneration. The use of this cell-based biologic for treating protruding disc herniation and/or intervertebral disc degeneration is a promising therapeutic strategy, due to their known regenerative, immuno-modulatory and anti-inflammatory properties...
2016: Journal of Translational Medicine
Christopher Fernandez, Alan Marionneaux, Sanjitpal Gill, Jeremy Mercuri
Intervertebral disc (IVD) degeneration (IDD) and herniation (IDH) can result in low back pain and impart significant socioeconomic burden. These pathologies involve detrimental alteration to the nucleus pulposus (NP) either via biochemical degradation or extrusion from the IVD, respectively. Thus, engineering living NP tissue utilizing biomaterial scaffolds that recapitulate native NP microarchitecture, biochemistry, mechanical properties and which support cell viability represents an approach to aiding patients with IDD and IDH...
August 10, 2016: Journal of Biomedical Materials Research. Part A
Jin Shang, Honggang Wang, Xin Fan, Lei Shangguan, Huan Liu
Low back pain is a prevalent disease, which leads to suffering and disabilities in a vast number of individuals. Degenerative disc diseases are usually the underlying causes of low back pain. However, the pathogenesis of degenerative disc diseases is highly complex and difficult to determine. Current therapies for degenerative disc diseases are various. In particular, cell-based therapies have proven to be effective and promising. Our research group has previously isolated and identified the cartilage endplate‑derived stem cells...
August 2016: Molecular Medicine Reports
Yaohong Wu, Zhiwei Jia, Longgang Liu, Yachao Zhao, Hao Li, Chaofeng Wang, Hui Tao, Yong Tang, Qing He, Dike Ruan
Low back pain (LBP) is mainly caused by intervertebral disc degeneration (IDD). Recent studies have demonstrated that the transplantation of mesenchymal stem cells (MSCs) can regenerate regions that have undergone degeneration, and the regenerative effect can be enhanced by using a hydrogel carrier. This article describes an injectable functional hydrogel system manufactured by combining RADA16-I and RADA-KPSS (RADA-KPSS was manufactured by conjugating a bioactive motif derived from BMP-7 [KPSS] onto the C terminal of RADA16-I) at a volume ratio of 1:1...
June 2016: Artificial Organs
Kee D Kim
Numerous health care resources are utilized to treat low back pain (LBP) resulting from degenerative disc disease (DDD). Most patients with disc degeneration remain asymptomatic, and the degree of disc degeneration does not correlate with pain severity, making diagnosis and effective treatment challenging.
April 2016: Spine
A A Thorpe, V L Boyes, C Sammon, C L Le Maitre
There is an urgent need for new therapeutic options for low back pain, which target degeneration of the intervertebral disc (IVD). Here, we investigated a pNIPAM hydrogel system, which is liquid at 39°C ex vivo, where following injection into the IVD, body temperature triggers gelation. The combined effects of hypoxia (5% O2) and the structural environment of the hydrogel delivery system on the differentiation of human mesenchymal stem cells (hMSCs), towards an NP cell phenotype was investigated. hMSCs were incorporated into the liquid hydrogel, the mixture solidified and cultured for up to 6weeks under 21% O2 or 5% O2 where viability was maintained...
May 2016: Acta Biomaterialia
Tao Wu, Hai-Xin Song, Yan Dong, Jian-Hua Li
STUDY DESIGN: A systematic review and single arm meta-analysis of clinical trials. OBJECTIVE: To assess the efficacy of mesenchymal stem cells (MSC) or chondrocyte in patients with discogenic low back pain. SUMMARY OF BACKGROUND DATA: There is no previous review evaluated the efficacy of MSC or chondrocyte therapy in adults with discogenic low back pain. METHODS: A comprehensive literature search was conducted from database on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO and Web of Science from database inception through on September 10, 2015...
March 4, 2016: Spine
Jeffrey Zeckser, Michael Wolff, Jason Tucker, Josh Goodwin
Low back pain with resultant loss of function, decreased productivity, and high economic costs is burdensome for both the individual and the society. Evidence suggests that intervertebral disc pathology is a major contributor to spine-related pain and degeneration. When commonly used conservative therapies fail, traditional percutaneous or surgical options may be beneficial for pain relief but are suboptimal because of their inability to alter disc microenvironment catabolism, restore disc tissue, and/or preserve native spine biomechanics...
2016: Stem Cells International
Jen-Chung Liao
Degenerative discs can cause low back pain. Cell-based transplantation or growth factors therapy have been suggested as a strategy to stimulate disc regeneration. Bone marrow-derived mesenchymal stem cells (BMDMSC) containing bone morphogenetic protein-7 (BMP-7) gene were constructed. We evaluated the effectiveness of these BMP-7 overexpressing cells on degenerative discs in rat tails. In vitro and in vivo studies were designed. In the first stage, the rats were divided into two group according to discs punctured by different needle gauges (18 gauge and 22 gauge)...
2016: International Journal of Molecular Sciences
Jin Shang, Xin Fan, Lei Shangguan, Huan Liu, Yue Zhou
Low back pain (LBP) is a very prevalent disease and degenerative disc diseases (DDDs) usually account for the LBP. However, the pathogenesis of DDDs is complicated and difficult to elucidate. Alternative splicing is a sophisticated regulatory process which greatly increases cellular complexity and phenotypic diversity of eukaryotic organisms. In addition, the cartilage endplate-derived stem cells have been discovered and identified by our research group. In this paper, we continue to investigate gene expression profiling and alternative splicing events during chondrogenic differentiation of cartilage endplate-derived stem cells...
2015: BioMed Research International
Manitha B Nair, Gaurav Baranwal, Prajuna Vijayan, Kripa S Keyan, R Jayakumar
Intervertebral disc degeneration, occurring mainly in nucleus pulposus (NP), is a leading cause of low back pain. In seeking to mitigate this condition, investigators in the field of NP tissue engineering have increasingly studied the use of hydrogels. However, these hydrogels should possess appropriate mechanical strength and swelling pressure, and concurrently support the proliferation of chondrocyte-like cells. The objective of this study was to develop and validate a composite hydrogel for NP tissue engineering, made of chitosan-poly(hydroxybutyrate-co-valerate) (CP) with chondroitin sulfate (CS) nanoparticles, without using a cross linker...
December 1, 2015: Colloids and Surfaces. B, Biointerfaces
P Priyadarshani, Y Li, L Yao
OBJECTIVE: The intervertebral disc (IVD) is composed of the external annulus fibrosus (AF) and the inner gel-like center, the nucleus pulposus (NP). The elastic NP can function to relieve stress and maintain IVD function by distributing hydraulic pressure evenly to annulus and endplate. Degeneration of the NP, which leads to increased death of NP cells, the loss of proteoglycan (PG), and aberrant gene expression, may result in an overall alteration of the biomechanics of the spinal column and cause low back pain...
February 2016: Osteoarthritis and Cartilage
Feng Wang, Rui Shi, Feng Cai, Yun-Tao Wang, Xiao-Tao Wu
Intervertebral disc (IVD) degeneration results in segmental instability and irritates neural compressive symptoms, such as low back pain and motor deficiency. The transplanting of stem cell into degenerative discs has attracted increasing clinical attention, as a new and proven approach to alleviating disc degeneration and to relieving discogenic pains. Aside from supplementation with stem cells, the IVD itself already contains a pool of stem and progenitor cells. Since the resident disc stem cells are incapable of reversing the pathologic changes that occur during aging and disc degeneration, it has been debated as to whether transplanted stem cells are capable of providing an efficient and durable therapeutic effect, even though there have been positive outcomes in both animal models and in clinical trials...
November 1, 2015: Stem Cells and Development
Kenneth Pettine, Richard Suzuki, Theodore Sand, Matthew Murphy
PURPOSE: The purpose of this study is to assess safety and feasibility of intradiscal bone marrow concentrate (BMC) injections to treat discogenic pain as an alternative to surgery. METHODS: A total of 26 patients (11 male, 15 female, aged 18-61 years, 13 single level, 13 two level) that met inclusion criteria of chronic (> 6 months) discogenic low back pain, degenerative disc pathology assessed by magnetic resonance imaging (MRI) with modified Pfirrmann grade of IV-VII at one or two levels, candidate for surgical intervention (failed conservative treatment and radiologic findings) and a visual analogue scale (VAS) pain score of 40 mm or more at initial visit...
January 2016: International Orthopaedics
Xingyu Miao, Xiaoying Wu, Wei Shi
We investigated the intrathecally administrated unbilical cord mesenchymal stem cells (UC-MSCs) by lumbar puncture and assessed the technical difficulties and effects in various neurological conditions. One hundred patients underwent subarachnoid placement of UC-MSCs between December 2006 and May 2010 in the Affiliated Hospital of Medicine. Technical difficulties in patients in the form of localization of subarachnoid space, number of attempts, and post-procedural complications were evaluated. Functional evaluation was done using Hauser Ambulation Index (HAI) by the stem cell transplant team on a regular basis...
April 2015: Indian Journal of Biochemistry & Biophysics
David Oehme, Tony Goldschlager, Peter Ghosh, Jeffrey V Rosenfeld, Graham Jenkin
Low back pain and degenerative disc disease are a significant cause of pain and disability worldwide. Advances in regenerative medicine and cell-based therapies, particularly the transplantation of mesenchymal stem cells and intervertebral disc chondrocytes, have led to the publication of numerous studies and clinical trials utilising these biological therapies to treat degenerative spinal conditions, often reporting favourable outcomes. Stem cell mediated disc regeneration may bridge the gap between the two current alternatives for patients with low back pain, often inadequate pain management at one end and invasive surgery at the other...
2015: Stem Cells International
Keran Song, Tao Gu, Feng Shuang, Jiaguang Tang, Dongfeng Ren, Jiang Qin, Shuxun Hou
Patients with degenerative disc disease (DDD) experience serious clinical symptoms, including chronic low back pain. A series of therapies have been developed to treat DDD, including physical therapy and surgical treatment. However, the therapeutic effect of such treatments has remained insufficient. Recently, stem cell‑based therapy, in which stem cells are injected into the nucleus pulposus in degenerated intervertebral disc tissue, has appeared to be effective in the treatment of DDD. In the present study, the effect of adipose‑derived stem cells on degenerated nucleus pulposus cells was investigated using a co‑culture system to evaluate the biological activity of degenerated nucleus pulposus cells...
September 2015: Molecular Medicine Reports
Guangyou Xie, Furong Lu, Haitao Yang
Low back pain caused by intervertebral disc degeneration is a common clinical chronic disease. The regenerative ability of intervertebral disc tissue is extremely poor. Meanwhile, current treating methods can not fundamentally solve such problems. With the increasing awareness of the mechanism of disc degeneration and the rapid development of the fields of cellular and molecular biology, gene and materials engineering, using stem cells and tissue engineering technology to slow down or reverse the progress of disc degeneration may become possible...
December 2014: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
Roman Tsaryk, Antonio Gloria, Teresa Russo, Laura Anspach, Roberto De Santis, Shahram Ghanaati, Ronald E Unger, Luigi Ambrosio, C James Kirkpatrick
Intervertebral disc (IVD) degeneration is one of the main causes of low back pain. Current surgical treatments are complex and generally do not fully restore spine mobility. Development of injectable extracellular matrix-based hydrogels offers an opportunity for minimally invasive treatment of IVD degeneration. Here we analyze a specific formulation of collagen-low molecular weight hyaluronic acid (LMW HA) semi-interpenetrating network (semi-IPN) loaded with gelatin microspheres as a potential material for tissue engineering of the inner part of the IVD, the nucleus pulposus (NP)...
July 2015: Acta Biomaterialia
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