Stem Cell Treatment for Degenerative Disc Disease

Stem Cell Treatment for Degenerative Disc Disease

Degeneration of the intervertebral disc, often called "degenerative disc disease" (DDD) of the spine, is a condition that can be painful and can greatly affect the quality of one's life.


While disc degeneration is a normal part of aging and for most people is not a problem, for certain individuals a degenerated disc can cause severe constant chronic pain. Often, degenerative disc disease can be successfully treated without surgery. One or a combination of treatments such as physical therapy, chiropractic manipulative therapy (CMT) and other chiropractic treatments, osteopathic manipulation, anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs, traction, or spinal injections often provide adequate relief of these troubling symptoms.

Degenerative discs typically show degenerative fibrocartilage and clusters of chondrocytes, suggestive of repair. Inflammation may or may not be present. Histologic examination of disc fragments resected for presumed DDD is routine to exclude malignancy.

Fibrocartilage replaces the gelatinous mucoid material of the nucleus pulposus as the disc changes with age. There may be splits in the annulus fibrosis, permitting herniation of elements of nucleus pulposus. There may also be shrinkage of the nucleus pulposus that produces prolapse of the annulus with secondary osteophyte formation at the margins of the adjacent vertebral body.

The pathologic findings in DDD include protrusion, spondylolysis, and/or subluxation of vertebrae (sponylolisthesis) and spinal stenosis.


Stem Cell Treatment and Degenerative Disc Disease NIH Streaming Database

Differential Response of Encapsulated Nucleus Pulposus Cells and Bone Marrow Derived MSCs in Isolation and Co-culture in Alginate and Chitosan Hydrogels. Tissue Eng Part A. 2014 Jul 24; Authors: Naqvi SM, Buckley CT Abstract Cell-based therapies may hold significant promise for the treatment of early stage degeneration of the intervertebral disc (IVD). Given their propensity to proliferate and ability to form multiple tissue types, mesenchymal stem cells (MSCs) have been proposed as a potential cell source to promote repair of the nucleus pulposus (NP). However, for any successful cell-based therapy a carrier biomaterial may be essential for targeted delivery providing key biophysical and biochemical cues to facilitate differentiation of MSCs. Two widely used biomaterials for NP regeneration are chitosan and alginate. The primary objective of this study was to assess the influence of alginate and chitosan hydrogels on bone marrow (BM) MSCs and NP cells in isolation or in co-culture. A secondary objective of this study was to investigate co-culture seeding density effects of BM and NP cells and simultaneously explore which cell type is responsible for matrix formation in a co-cultured environment. Porcine NP and BM cells were encapsulated in alginate and chitosan hydrogels separately at two seeding densities (4x10<sup>6</sup> and 8x10<sup>6</sup> cells/ml) or in co-culture (1:1, 8 x10<sup>6</sup> cells/ml). Constructs (diameter:5mm, height:3mm) were maintained under IVD-like conditions (low-glucose, low (5%) oxygen) with or without TGF-β3 supplementation for 21 days. Results demonstrated differential viability depending on hydrogel type. NP cells remained viable in both biomaterial types whereas BM viability was diminished in chitosan. Furthermore, hydrogel type was found to regulate sGAG and collagen accumulation. Specifically, alginate better supports sGAG accumulation and collagen type II deposition for both NP and BM cell types compared to chitosan. Having identified that alginate more readily supports cell viability and matrix accumulation we further explored additional effects of seeding density ratios (NP: BM - 1:1, 1:2) for co-culture studies. Interestingly, in co-culture conditions, the BM cell population declined in number while NP cells increased indicating that MSCs may in fact be signalling NP cells to proliferate rather than contributing to matrix formation. These findings provide exciting new insights on the potential of MSCs for NP tissue regeneration strategies. PMID: 25060596 [PubMed - as supplied by publisher]

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